CV-anemia

Question 1

What are normal causes of Anemia?

Answer 1

Dec iron, B12, or folic acid- INC HGB

Question 2

What gives detail of color of RBC and info of anemia?

Answer 2

Mean corpouscular[Hgb]. N- 33.-35

Question 3

What if MCHC ranges is <33, what is color?

Answer 3

Hypochromic-DEC Hgb lighter. Hyperchromic darker, rare >35

Question 4

What is needed to make Hgb?

Answer 4

Iron, VB12, VB9, Erythropoietin-RBC

Question 5

Mrs. White cc fatigue, tachycardia, angina. PE-orthostasis, syncope, SOB? What is DDX

Answer 5

Anemia sypmtoms

Question 6

Mrs. White Hgb is 8.5 g/d? What is this DX?

Answer 6

Moderate Anemia . MILD 10-12, SEVERE <8

Question 7

Lead poisoning, Thalessemia, Anemia all show a MCV of?

Answer 7

MCV < 80, MICROCYTIC

Question 8

VIT B12 DFX, folate dfx, Liver Dz, Alcholism, HypothyRoid, Chemo, HIV all have a MCV of?

Answer 8

MCV > 96, MACROCYTIC

Question 9

What condtions have normal MCV

Answer 9

CKI, Sudden blood loss, Hemolytic anemia

Question 10

What are 2/2 labs to order if anemia is suspected?

Answer 10

hihg due to HIGH 1st pass, IV 5m x 3

Question 11

How do you treat a Pt w/ significant blood loss, with normocytic anemia?

Answer 11

Transfuse Blood, Hemopoietic growth factors

Question 12

What is microcytic hypochromic anemia?

Answer 12

Low vol of RBC and low HgB, light color. TX- IRON

Question 13

How do you treat macrocytic anemia?

Answer 13

Large vol of RBC.. TX- Vit B12, Folate

Question 14

Pt has PMH of GI bleeding. What is considered to improve in their diet?

Answer 14

IRON replacement 1. LIVER, oysters, cereals, soybeans, tofu, Lentils

Question 15

What increases iron absorption when treating iron deficiency anemia?

Answer 15

Vit C

Question 16

Pt is pregnant what are some ADR to consider in iron replacement?

Answer 16

Black stools- upper GI tract bleeds, darken b/c old. OTHER- GI upset

Question 17

How long should you recheck values?

Answer 17

1. reticulocytes by 1wk , H/H 2-4wks. 1-2mo. 4. SX of SOB, HA better w/in 3w 5. TREAT for 3-6mo

Question 18

What is ideal strength and iron % to recc to pts?

Answer 18

PO-#1. Ferrous fumarate 33% iron 2. Ferrous sulfate 20-30 %iron 200-325 mg strength

Question 19

What are major risk with iron?

Answer 19

Child who ingest NO mech. for reversal of OD. SX 1. necrotizing gasteris 2. shock 3. lethargy 4. SOB 5. Metabolic acidosis 6. death coma

Question 20

How do you treat iron OD?

Answer 20

1. Sedate and pump 2. Acid base correct 3. Parenteral deferoxamine 4. Charcoal does not absorb iron in gut

Question 21

Pt has issue with PO iron, not absorbing well? What med can be used?

Answer 21

1. Parenteral iron Ferumoxytoal- NO MRI 2. Iron: Sucrose, dextran, ferric gluconate

Question 22

Pt has PMH of CKD what meds can be given for anemia?

Answer 22

iron sucrose & gluconate. Slow IV or Inj. ADR- HYPOTENSION and CRAMPS

Question 23

Mr. heme has anemia and had a reaction to iron via IV. What drug is causing this?

Answer 23

Iron DEXTRAN ADR- BBW ANAPHYLAXIS. Slow and low. Test dose

Question 24

Which parenteral iron agent is ideal for peds?

Answer 24

Iron gluconate

Question 25

What is common factor in people with neurologic d/o?

Answer 25

B12 deficiency

Question 26

Proton pump, Metformin, ETOH lead to ?

Answer 26

B12 deficiency

Question 27

Which group of people need more monitoring for B12?

Answer 27

DM and vegans, biartric, Chrons/Celiac, ETOH

Question 28

Where is folate in foods?

Answer 28

yeast, liver, Kidney, leafy green

Question 29

How long should follow up be for B12 and folic dfx anemia?

Answer 29

PO, IV- reticulocytes 3-4d, 1-2mo

Question 30

Where is folate and B12 stored?

Answer 30

Liver

Question 31

What is requried by proximal jejunm to store folic acid?

Answer 31

Requires B12

Question 32

What tx for this condition can mask B12 dfx, thus L/t neuolgoic irreverislble d/o, neural tube defect?

Answer 32

megalblastic anemia w/ folate TX

Question 33

ETOH, pregnant, vegans, malabsorbers, CA, Renal dfx are depleted of which compound?

Answer 33

Folic acid

Question 34

Which drug dec absorbtion of Folate?

Answer 34

Phenytoin (epilepsy), isoniazide (TB), OCP. Methortroate, Trim/Sulfa,

Question 35

Why cant hematopoeitc growth factors be given PO?

Answer 35

Proteins large. Stomach will digest them

Question 36

Erythropoetin is given to treat?

Answer 36

CKD, HIV, Chemo. JWs

Question 37

Where is EPO made?

Answer 37

Kidney hormone released to inc RBC

Question 38

When giving EPO, what should be monitored?

Answer 38

H/H will inc. rapidly d-wks. Thrombosis. Seizures, Tumor progress, CVA, MI, HTN encephalapathy

Question 39

What should be checked b4 giving EPO?

Answer 39

H/H bc if HIGH or Normal, no EPO is needed- induce DEATH

Question 40

What is advantage of Darbepoetin?

Answer 40

IV/SQ. Longer 1/2 life- pegalated oligosacc. Given 1x/wk vs 3x/wk EPO

Question 41

Filgrastime, Pegfilgrastim, Sagramostin all are what?

Answer 41

Myeoloid growth factors- stimulate neutrophils production in bone marrow

Question 42

The grastim can be used for which d/o?

Answer 42

Myelosupressive chemo. Bone marrow transplant. Neutropenia (severe Figrastime), Acute myeloid (Saramostin)

Question 43

Which myeloid growth facotor causes spleen rupture, ARDs?

Answer 43

Filgrastim, Pegfilgrastim

Question 44

Sargramostim ADR to some people is?

Answer 44

**ARF and arrythmia-N/V/D rash-