Exam 5 - Anemia

Question 1

Microcytic anemia:

Answer 1

deficiency of Fe (Iron Deficiency Anemia)

Question 2

Normocytic anemia:

Answer 2

deficiency of Erythropoietin

Question 3

Macrocytic anemia:

Answer 3

deficiency of folic acid and B12

Question 4

Most common cause of chronic anemia:

Answer 4

Iron Deficiency

Question 5

How is iron transported?

Answer 5

Transferrin (transports 2 Fe2+ molecules)

Question 6

Where is iron stored?

Answer 6

Intestinal mucosa, liver, spleen bone

Question 7

Iron deficiency management – PO requirements, options:

Answer 7

200 mg/day; low GI absorption

Ferrous Sulfate (65 mg) > Gluconate (36 mg) > Fumarate (33 mg)

Question 8

PO iron AE:

Answer 8

GI distress (take with or after meals); black stool may obscure recognition of GI bleeding

Question 9

Iron deficiency management – IV:

Answer 9

Iron dextran requires test dose, sodium ferric gluconate (Ferrlecit), iron sucrose (Venofer)

Question 10

How long does it take to see improvement in iron deficiency anemia therapy?

Answer 10

3 to 8 weeks

Question 11

Hemochromatosis:

Answer 11

An inherited disorder with excessive iron is absorption and deposition in in liver, heart, pancreas, and other organs

Question 12

Hemochromatosis treatment:

Answer 12

Iron chelation

Question 13

Deferoxamine aka desferrioxamine (Deferral) routes:

Answer 13

IV, SC, IM

Question 14

Deferasirox (Exjade) route, t1/2, AE:

Answer 14

PO, 12-16 hours, N/V/D, ↑ SCr, renal failure, hepatic failure, gastrointestinal hemorrhage

Question 15

Deferiprone (Ferriprox) route, t1/2:

Answer 15

PO, 3-4 hours

Question 16

Vit B12 Deficiency Anemia:

Answer 16

lack of intrinsic factor or disturbance of the specific transport system in distal ileum

Question 17

Vit B12 Deficiency effects:

Answer 17

Megaloblastic/macrocytic anemia

GI problems

Peripheral neuropathy

Neurological complications

Question 18

Macrocytic anemia treatment:

Answer 18

Folic Acid Will not correct peripheral neuropathy

Question 19

Neuropathy treatment:

Answer 19

Vit B12 must be used

Question 20

Vit B12 Basic Pharmacology:

Answer 20

Deoxyadenosylcobalamin, methylcobalamin – active forms

Question 21

Vit B12 therapeutic options:

Answer 21

Cyanocobalamin, hydroxycobalamin –> converted to active forms

Question 22

Vit B12 neuropathy cause:

Answer 22

methylmalonyl-CoA goes on to form abnormal fatty acids and causes subacute degeneration of the nerves.

Question 23

Folate Deficiency Anemia:

Answer 23

Folate deficiency during pregnancy –> NTDs (neural tube defects)