Exam 3; Anemais and Hematinic Agents Flashcards
True or False
Anemia is the most common blood disorder
True
A stem cells need erythropoietin to become what
proerythroblast
A pro erythroblast needs Fe into the hemoglobin to become what
reticulocyte
The reticulocyte looses its cell nucleus
erythrocyte
This speeds up RBC synthesis
erythropoietin
This is also know as microcytic anemia
nutritional anemias
What is the cause of microcytic anemais
relative lack of iron; RBCs are small and contain less hemoglobin (pale in color)
True or False
there is no mechanism for eliminating iron from the body
True
Ingested iron is solubilized by what
HCl
What is iron absorbed as
Fe++ (ferrous)
Iron is carried as what throughout the body
Fe3+
ferric iron
What transforms ferrous into ferric iron
transferrin
Does transferring increase or decrease during times of anemia
increase
If there in an excess of iron, it is bound to and stored as what, primarily in the liver
ferritin
What are two probably causes of iron deficiency
decreased iron uptake; not enough iron in the diet
decreased absorption; GI dysfunction
What three conditions have an increased iron requirement
pregnancy
during period of rapid growth
patients with renal disease
When can you excessively lose iron
chronic blood loss
heavy menstruation
What is the drug of choice for microcytic anemia
iron; FeSO4; ferrous sulfate
What are the two methods to administer iron
orally
parenterlly; if there is an issue with oral or severe deficiency
What is a side effect of taking iron orally
GI upset; slow release will help
What is a side effect of parenteral iron dosage
iron dextran (IM) given subdural could leave a stain
What is a extreme toxicity of oral iron
lethal dose is only around 10 tablets (or 3 grams)
sometimes the pills look like candies
What are some symptoms of acute iron toxicity
nausea severe abdominal pain mucosal damage drowsiness cardiovascular collapse convulsions
What is the treatment for iron toxicity
achelate agent; deferoxamine
If there is chronically too much iron stored, what is the treatment
phlebotomy; bleeding
What are the characteristics of microcytic anemias
large RBC precursors
multinucleate nuclei due ti inhibition of DNA synthesis
get bigger without dividing
This is necessary for DNA replication; if you are deficient, you don’t make enough thiamine
folic acid
A folic acid deficiency can also leads to this deficiency
methionine
What is a symptom of folic acid deficiency
macrycytic RBC precursor
This most likely is not the case of the cause of a folic acid deficiency
dietary intake (unless alcoholics) folic acid is found primarily in green vegetables
What is the absorption rate of folic acid
rapid; GI dysfunction could stall it
What are three systemic requirements of folic acid
infection
pregnancy
Folic acid deficiency in pregnancy can lead to what
neural tube defects; flour companies add it now
What is the treatment for a folic acid deficiency
oral therapy is sufficient; parental if there is abnormal absorption
no contraindications or toxicities
This is essential for DNA synthesis and methionine
B12
What type of anemia can result from a B12 deficiency
megaloblastic anemia
B12 can cause a lack of methionine synthesis which can lead to what
decreased myelin synthesis = neuronal damage
What are symptoms of the neuronal damage brought upon by B12 deficiency
weakness
ataxia
spasticity
irreversible spinal cord damage
True or False
One of the main causes of B12 deficiency is insufficient intake
False; thats very rare
What is the main cause of B12 deficiency
decreased absorption
Parietal cells in the stomach make this
intrinsic factor (GIF)
B12 requires this for absorption
GIF
If a patient lacks that ability to make GIF, what occurs
b12 deficiency, then leads to pernicious anemia, which is fatal if not treated
If the b12 deficiency is not due to a lack of GIF, which type of administration is okay
oral
If there is pernicious anemia, B12 must be given how
by injection
What is shot gun therapy
loading them up with iron, folic acid, B12, etc.
What are three drugs used to treat anemias caused by chronic renal failure or chemotherapy
epoietin alfa
darbepoietin
peginesatide
What are three toxicities of epoietin alfa, darbepoietin, peginesatide
increased BP
increased clotting
MI
stroke
Hemolytic anemias are the result of what
abnormal lysis of RBCs; genetic or acquired
This treatment may be useful for treating hemolytic anemias
erythropoietin
This drug is used to treat sickle cell anemia
hyroxyurea
What is the mechanism of hyroxyurea
increases the formation of fetal hemoglobin which doesn’t sickle
What are two side effects of hyroxyurea
mutagenic
preg. category X
