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Pharmacology 3 > Hematinics > Flashcards

Hematinics Flashcards

1
Q

What is the main regulator of erythropoiesis?

A

Tissue oxygenation

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2
Q

Erythropoietin dependent immature RBC:

A

Burst-forming unit (BFU-E)
Colony-forming unit (CFU-E)
Erythroblast

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3
Q

Iron dependent immature RBC:

A

Erythroblasts
Reticulocytes
Erythrocytes

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4
Q

Factors that decrease oxygenation:

A

Anemia
Poor blood flow/blood volume
Low hemoglobin
Pulmonary disease

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5
Q

Important nutrients/components of erythropoiesis:

A 
Hematopoietic growth factors
Erythropoietin
Iron
Cobalamin
Folic acid
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6
Q

Growth factors stimulating granulocyte and stem cell formation:

A

Granulocyte-Colony stimulating factor (G-CSF)

Granulocyte-Monocyte Colony stimulating factor (GM-CSF)

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7
Q

Endogenous regulators of platelet production:

A

Thrombopoietin

IL-11

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8
Q

Combine to form heme:

A

Protoporphyrin

Ferrous iron

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9
Q

Most common hemoglobin form in humans:

A

Hemoglobin A

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10
Q

Types of anemia:

A

Hypoproliferative anemia
Megoblastic anemia
Hemolytic anemia

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11
Q

Types of hypoproliferative anemia:

A 
Iron deficiency anemia
Chronic inflammation anemia
Metabolic defect
Renal disease
Infiltrative fibrosis/aplasia
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12
Q

Morphology of IDA:

A

Microcytic hypochromic

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13
Q

Causes of IDA:

A

Increased demand for iron/hematopoiesis
Increased iron loss
Decreased intake/absorption

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14
Q

1 mL RBC requires __ mg elemental Fe:

A

1

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15
Q

Amount of iron needed daily and percentage absorbed:

A

16-20 mg/day; 10-15% absorbed

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16
Q

Iron absorption needed in males, females and children:

A

Male: 1mg
Female: 1.4mg (x2 pregnancy)
Children: 1.5 mg

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17
Q

Stages of iron deficiency:

A

Negative iron balance
Iron deficient erythropoiesis
Iron deficiency anemia

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18
Q

First iron marker to decrease during negative iron balance stage:

A

Serum ferritin (20)

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19
Q

Iron marker profile during iron deficient erythropoiesis stage:

A 
15 serum ferritin (no iron stores)
380 TIBC
50 SI
20% saturation
10 marrow sideroblasts
100 RBC protoporphyrin
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20
Q

By definition, marrow iron stores are absent when ____ level is below ___ g/L:

A

serum ferritin; 15

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21
Q

When serum iron falls below ___ mcg/dL, ___ begins to be affected:

A

50; hemoglobin synthesis

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22
Q

Normal iron markers:

A 
1-3 marrow stores
50-200 serum ferritin
300-360 TIBC
50-150 SI
30-50% saturation
40-60 marrow sideroblasts
30-50 RBC protoporphyrin
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23
Q

Hemoglobin level where bone marrow remains hypoproliferative:

A

10-13 g/dL

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24
Q

In inflammation anemia TIBC is ___, Ferritin is ___ and serum iron is ___:

A

decreased; increased; decreased

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25
Q

Inflammation anemia is due to inhibition of ___ function in macrophages:

A

ferriportin

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26
Q

Protein stimulated by inflammation that inhibits ferriportin:

A

hepcidin

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27
Q

Iron is not affected in thalassemia, although ___ and ___ may be increased:

A

serum iron; serum ferritin

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28
Q

Type of anemia where the dysfunction is inability to utilize iron:

A

Sideroblastic anemia (iron not affected)

29
Q

Iron is absorbed in which part of the small intestine:

A

Duodenum

Proximal jejunum

30
Q

Causes increased absorption of iron:

A

ascorbic acid

31
Q

Causes decreased absorption of iron:

A

tea, dairy, fish

32
Q

Oral iron therapy gives ___ mg elemental iron/day:

A

300

33
Q

When to use parenteral iron therapy:

A

Pt cannot tolerate oral iron
Condition is chronic
Pt has advanced chronic renal disease
Pt needs continuous iron

34
Q

Administer iron with ___ to prevent neural tube defect:

A

folic acid

35
Q

Type of iron toxicity exclusively in young children:

A

Acute

36
Q

Drug and administration route used in acute iron toxicity:

A

Deferoxamine; parenteral

37
Q

Chronic iron toxicity occurs when:

A

Excess iron deposits in hear, liver, pancreas, etc. (hemochromatosis)

38
Q

Drug and administration route used in chronic iron toxicity:

A

Deferasirox; oral

39
Q

Erythropoietin is increased when:

A

Decreased red cell mass
Impaired O2 loading
High Hgb O2 affinity
Impaired renal blood flow

40
Q

Drug extends half life of EPO to 24-36hr:

A

Darbepoietin alfa

41
Q

Normal EPO level:

A

10-25 U/L

42
Q

EPO is increased when Hgb falls below:

A

10-12 g/dL

43
Q

Indications for epoietin alpha:

A

Chronic renal failure
AIDS
Cancer

44
Q

Megaloblastic anemia is due to a deficiency of:

A

Cobalamin (Vit B12)

Folic acid

45
Q

Deficiency of Vit. B12 causes:

A

Anemia with neutropenia
Thrombocytopenia
GI symptoms
Neurologic abnormalities

46
Q

Ultimate source of Vit B12:

A

Microbial synthesis

47
Q

Needed for absorption of Vit. B12:

A

Intrinsic factor

48
Q

Vit. B12 stores last for ___:

A

5 years

49
Q

Preferred drug in megaloblastic anemia:

A

Hydroxycobalamin (more protein bound)

50
Q

Main storage pool of Vit. B12 is located in:

A

Liver (3000-5000 ug)

51
Q

B12 deficiency is mainly related to dysfunction in:

A

Malabsorption (pernicious anemia)

52
Q

Megaloblastic anemia appears ___ after stopping folic acid:

A

1-6 months

53
Q

Daily requirement of folic acid:

A

100 ug

54
Q

GM-CSF is effective in treating neutropenia associated with:

A

Congenital neutropenia
Cyclic neutropenia
Myelodysplasia
Aplastic anemia

55
Q

Better tolerated G-CSFs:

A

Filgrastim

Pegfilgrastim

56
Q

GM-CSFs associated with more side effects:

A

Molgramostim

Sargramostim

57
Q

Most severe adverse effect of G-CSF:

A

Splenic rupture

58
Q

GM-CSF is associated with maturation of:

A

Monocytes

Macrophages

59
Q

G-CSF is associated with maturation of:

A

Neutrophils

60
Q

Recombinant myeloid GFs:

A

Sargramostim (GM-CSF)

Filgrastim (G-CSF)

61
Q

Advantage of pegfilgrastim over filgrastim:

A

Longer acting (long serum half-life)

62
Q

Recombinant thrombopoeitins:

A

Romiplostim

Eltrombopag (better tolerated)

63
Q

Recombinant thrombopoetins are used in:

A

idiopathic thrombocytopenic purpura

64
Q

Clotting factors dependent on Vitamin K:

A

II, VII, IX, X

65
Q

vWF disease is treated by ____, a Factor ___ concentrate:

A

Humate P; VIII

66
Q

Classic hemophilia is a deficiency in Factor ___:

A

VIII

67
Q

Christmas or hemophilia B is a deficiency in Factor ___:

A

IX

68
Q

Inhibits plasminogen activation:

A

Aminocaproic acid (EACA)

69
Q

Orally administered analog of EACA:

A

Tranexamic acid

Pharmacology 3 (5 decks)

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