Micro & Normocytic Anemias

Question 1

microcytic MVC

Answer 1

<80 fl

Question 2

most common cause of microcytic anemia

Answer 2

iron def

Question 3

other causes of microcytic anemia

Answer 3

hemoglobinopathies (thalassemia). lead poisoning. copper, vit C, vit B6 def

Question 4

causes of Fe def anemia

Answer 4

inadequate iron intake/absorption, gastric prob, meds

Question 5

meds that cause Fe def anemia

Answer 5

chronic antacid, PPI, or H2 blocker use

Question 6

PPI meds

Answer 6

*esomeprazole (Nexium)
lansoprazole (Prevacid)
omeprazole (Prilosec, Zegarid)
pantoprazole (Protonix)
rabeprozole (Aciphex)
dexlansoprazole(Dexilant)

Question 7

antacid meds

Answer 7

Maalox, Mylanta, aluminum carbonate or hydroxide (Alu-Tab, AlternaGEL), calcium carbonate (tums, caltrate, oscal)

Question 8

H2 blocker meds

Answer 8

ranitidine (Zantac)

*nizatidine (Axid)

famotidine (Pepcid)

cimetidine (Tagamet)

Question 9

meds/foods that cause Fe def anemia

Answer 9

reduced iron absorption thru tannins, phytates, PAS (antibiotic), neomycin (antibiotic), cholestyramine (antihyperlipidemic)

Question 10

high Fe output

Answer 10

blood loss d/t hemorrhage and hematemesis

Question 11

cause of Fe def anemia: occult blood loss

Answer 11

in stool from GI bleeding like PUD, NSAID (aspirin) use, other meds

Question 12

HD & iron loss

Answer 12

4-11 mg iron lost w/each dialysis session

Question 13

higher need for Fe

Answer 13

pg, rapid growth

Question 14

biochemical indicators of Fe def anemia: LOW

Answer 14

RBC,
MVC=microcytic,
MCHC=hypochromic,
Hbg & Hct (low in any anemia),
reticulocyte Hb content (CHr),
serum iron& ferritin,
% transferrin saturation

Question 15

biochemical indicators of Fe def anemia: HIGH

Answer 15

RBC distribution width,
erythrocyte protoporphyrin,
TIBC/transferrin

Question 16

false high serum ferritin in

Answer 16

infection, inflammation, some cancers (leukemia, Hodgkin’s), liver disease, inflamm bowel diseases, RA, recent blood transfusion, menstruation, meds

Question 17

Fe def anemia: s/s

Answer 17

weakness, lassitude, dyspnea, numbness, tingling, sore month, glossitis, smooth pale tongue, anorexia, heartburn, pica, murmus or angina, ankle edema, renal perfusion, tachycardia, CHF, koilonychias, pallor

Question 18

pica associated w/

Answer 18

iron def or lead poisoning

Question 19

types of pica

Answer 19

geophagia = dirt/clay
pagophagia = ice/freezer frost
coprophagia = feces
others

Question 20

Fe def anemia: mgmt

Answer 20

mostly oral Fe sup, IV and IM iron sucrose.

Question 21

Fe def anemia in pts w/inflammatory disorders

Answer 21

serum ferritin will be elevated and Fe is stored not mobilized so many pts will not have improved % sat and poor response to Tx. IV iron use increases toxicity

Question 22

oral Fe sups

Answer 22

ferrous fumarate - femiron
ferrous gluconate - fergon
ferrous sulfate - feosol

Question 23

oral Fe sup dose

Answer 23

150-300 mg/day, divided 2-4 times/day. chewable/time release tablets. Vit C slightly increases Fe absorption

Question 24

side effects of PI iron

Answer 24

nausea, diarrhea, constipation, dark stools, pain

Question 25

IM & IV Fe sups

Answer 25

Iron dextran - Imferon, Infed, DexFerrum

Question 26

IM & IV Fe sup dose

Answer 26

up to 100 mg/day

Question 27

IM & IV Fe sup side effects

Answer 27

anaphylaxis, fever, headache, syncope, hypotension, taste disorder, urticaria, dizziness

Question 28

IM & IV Fe multiple doses of

Answer 28

iron sucrose (venofer) or ferric gluconate (ferrlecit) can treat Fe def - less adverse rxns

Question 29

Thalassemia: type of anemia

Answer 29

microcytic, hypochromic

Question 30

thalassemia populations

Answer 30

Mediterranean, near and middle eastern, southeast asia

Question 31

thalassemia minor MCV

Answer 31

< 75 but RBC ct is lower in