medications for anemia

Question 1

what is MHCH and what does it mean when it is less

Answer 1

it stands for mean corpuscular hemoglobin content and when it is less it means that the hemoglobin content is less and thus there is anemia

Question 2

what are the different causes for anemia

Answer 2

the different causes for anemia is 1) hypo-proliferation

2)abnormal maturation and 3) hemolysis

Question 3

tell an eg of anemia caused due to abnormal maturation

Answer 3

and eg of anemia caused due to abnomal maturation is deficiency of folate or vit b12 or iron deficiency sideroblastic anemia , sickle cell and thalassemia

Question 4

mention drugs which causes aplastic anemia, hemolytic anemia and megaloblastic

Answer 4

aplastic anemia, by chloramphinicol (antbiotic)
megaloblastic : methotrexate (used for cancer as well as RA)
hemolytic : penicillin and its derivatives

Question 5

how will the rbc look like in iron deficiency anemia

Answer 5

microcytic hypochromic

Question 6

treatment plans for patient with iron deficiency anemia and severe iron deficiency anemia

Answer 6

iron deficiency give iron suppliment and in case of severe iron deficicency then give rbc transfusion

Question 7

a 61 year old patient is suffering from chronic kidney failure, he has been complaining of fatigue and tiredness for the past one week blood test show microcytic hypochromic blood cells what is you treatment option?

Answer 7

since this patient is suffering from iron deficiency anemia and also having chronic kidney failure we really should replenish his iron storage as fast as possible and for it will give him iron through IV

Question 8

so does the absorption increase or decrease with increased doses

Answer 8

the absorption decreases with the increase in the dosage so its better to split the dose up and when you add up the amount that you get its gonna be higher

Question 9

does the absorbed dose differ or is it same all the time

Answer 9

if the iron storage is low then the absorption is high and viseversa

Question 10

the fe3+ is changed to fe2+ by which enzyme

Answer 10

ascorbate

Question 11

the fe2+ is transported inside the cell via

Answer 11

divalent metal transporter

Question 12

the transporter which takes the ferric form cell to blood

Answer 12

ferroportin

Question 13

how long will it take for the oral treatment to work

Answer 13

it will take 3-6 months

Question 14

when do we opt to give parental administration of iron

Answer 14

inflammatory bowel diseases
small bowel resection
gastrectomy
hereditary absorption defects

Question 15

so when you use the iron dextran what happens

Answer 15

so when you use iron dextran the macrophages engulf it and then relase the iron slowly

Question 16

what happens when you take iron sucrose

Answer 16

the iron is transfered to transferrin through mechanism of trnasporting

Question 17

so if a patient has gastric distress what will we do we to replenish his iron storage

Answer 17

we give him iv (iron dextran ,iron sucrose) if the need is urgent
or we give him small doses of tabet or delayed release tablet

Question 18

what is the fatal overdose of iron in children? and what is the treatment therapy

Answer 18

1-10 g

deferoxamine

Question 19

what are the stimulus’s for the kidney to release erythropoitin

Answer 19

hypoxia, increased demand for o2, decrese rbc

Question 20

how does teh kidney sense that there is hypoxia

Answer 20

teh peritubular cells in teh kidney senses hypoxia

Question 21

incase if a pateint had a liver failure and now he needs epo supppliment name some supplemnet and also write its route of administration along with the other supplies

Answer 21

ok so teh suppliemnts are epoetin-alfa and darbepoetin (wich has more half life than epoetin) and both of thenm are administered iv and we should also give iron supplemnt if teh patient is suffering from iron deficiency

Question 22

adverse effect sof erythropoietin

Answer 22

Hypertension
Seizures
headache probably caused by rapid expansion of blood volume.
Thromboembolemic events

Question 23

to whom all do we prescribe epo

Answer 23

chronic renal failure
hiv infected pateints
as they are taking zidovudine and thus it is a myelosuppresor
and cancer patients they take methotrexate and it is also a myelosuppresor

Question 24

sideroblastic anemia is seen in who all

Answer 24

it is seen in patients who are alcoholic, those who take tb medication ie isoniazid and pyrazinamide autoimmune problems and it can be inherited as x linked trait

Question 25

treatment option for sideroblastic anemia

Answer 25

give vitamin b6 pyridoxine (oral or parentaral)

Question 26

megaloblastic anemia is due to

Answer 26

b12 na dfolic acid deficiency

Question 27

where is the iron absorbed from in the intestine and where is the b12 absorbed from

Answer 27

iron in teh dueodenum and b12 in the distal ilium

Question 28

what is the vehicle of iron in blood an db12 in blood

Answer 28

the vehicle of iron is transferiin and

vehicle of b12 is transcobalamin

Question 29

vitamin b12 is stored in

Answer 29

hepatocytes

Question 30

dietray folate become s

Answer 30

methyl tetrahydrofolate

Question 31

methyl tetrahydrofolate becomes _________and that becomes___

Answer 31

methylene tetrahydrofolate and that becomes dihydrofolate

Question 32

folic acid should be reduced into ________by _______

Answer 32

methyltetrahydrofolate by dihydrofolate reductase

Question 33

what is the main function of the folic acid

Answer 33

the main function is to act as a cofactor for the production of pyramidines and purines

Question 34

megaloblastic anemia should be treated via

Answer 34

parentaral administration fo vit b12 and teh main reason is due to malabsorption

Question 35

what is the active form of the folic acid

Answer 35

methylenetetrahydrofolate