Haematinics Flashcards

1
Q

microcytic anaemia

A
MCV<80fL
iron deficiency 
anaemia of chronic disease 
copper deficiency 
acquired sideroblastic anaemia 
lead poisoning
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2
Q

normocytic anaemia

A
MCV 80-100fL
acute haemorrhage or haemolysis
renal failure 
anaemia of chronic disease 
combined nutritional deficiencies 
marrow disorders 
malignancy
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3
Q

microcytic anaemia

A
MCV>100fL
hypothyroidism 
B12/folate deficiency 
liver disease 
ETOH
compensated haemolysis/haemorrhage 
marrow disorder 
pregnancy 
drugs
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4
Q

treatment for iron deficiency

A

iron, oral or parenteral

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5
Q

treatment for renal failure

A

erythropoetin

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6
Q

B12/folate deficiency treatment

A

B12, folate

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7
Q

iron form more well absorbed

A

Fe2+ not Fe3+

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8
Q

acidic pH of stomach

A

reductive, maintains Fe2+

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9
Q

Fe in many foods is not absorbable because

A

it is complexed with phytates or phosphates

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10
Q

Fe replacement

A

oral

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11
Q

antacids

A

cause oxifation to Fe3+ making it not absorbable

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12
Q

iron preparations are best taken

A

on an empty stomach

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13
Q

antibiotics that complex with iron

A

tetracycline, and fluoquinolones

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14
Q

adverse effects of Fe

A

gastrointestinal intolerance

hypersensitivity

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15
Q

overdose of iron

A

serious, early GI irritation, later multi system failure and death

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16
Q

megaloblastic anaemias

A

folic acid deficiency (usually dietary)

vit B12 deficiency (usually malabsorption, EG pernicious anaemia)

17
Q

dihydropholate reductase

A

turns folic and into dihydrofolic acid and then into tertahydrofolate

18
Q

C1 metabolism

A

picks up singe carbon groups from tetrahydrofolate

19
Q

single carbon groups are important for

A

making purines and thymidines

20
Q

replacing folic acid

A

oral folic acid daily
no adverse effects
especially important in pregnancy

21
Q

methotrexate

A

close analog of folic acid
dihydrofolic reductase works on it as well
rapidly dividing cells can’t work because methotrexate toxicity stops production of single carbon groups

22
Q

vit B12 is needed for

A

turning 5-methyltetrahydrofolate into tetrahydrofolate

23
Q

vit B12 deficiency is bad because

A

there’s too much 5-methyltatrahydrofolate ‘blocked hydrofolate’

24
Q

replacing vit B12

A

hydroxocobalamine
intramuscular injection
weekly x4 to replenish stores
no adverse effects

25
Q

Epo

A

encourages erythroid progenitor cells into red blood cells

26
Q

agent encouraging production of platelets from megakaryocytic

A

Tpo

27
Q

agent responsible for encouraging neutrophil progenitor cell into neutrophils

A

G-CSF

28
Q

EPO comes from

A

kidney

EPO is deficient in chronic renal failure

29
Q

times when recombinant G-CSF might be needed

A
  • suppressed myeloid cell growth during cancer chemotherapy

- rebuilding leukocyte populations after bone marrow transplant

30
Q

thombopoetin-mimetic

A

romiplostim

binds and activates thrombopoeitin receptor of megakaryocyte

31
Q

clinical uses of thombopoetin mimetics

A

idiopathic thrombocytopaenic pursuer
rebuilding platelet population after bone marrow transplant
some other conditions where bone marrow fails to produce enough platelets