MNT for Anemia Flashcards
Anemia is a deficiency in the ____ or ____ of RBC or decreased amounts of hemoglobin.
Size or number
Microcytic anemia
Small RBC size
Macrocytic anemia
Large RBC size
Normocytic
Normal RBC size
Hyperchromic
High amounts of hemoglobin
Hypochromic
Low amounts of hemoglobin
Normochromic
Normal amounts of hemoglobin
Nutrients required for RBC synthesis
B12 and folate for DNA synthesis
Iron to produce heme
Iron deficiency anemia
Microcytic and hypochromic
Small RBC with decreased hemoglobin content
The last stage of iron deficiency
Iron deficiency anemia - Causes
Inadequate intake: vegans, vegetarians
Inadequate absorption: calcium, tannins, decreased stomach acidity
Increased requirement: pregnancy, adolescents
Increased excretion: menstruation
Increased destruction
GI _____ is the most common cause of iron loss in men.
Bleed
Iron deficiency anemia - Symptoms
Fatigue
Impaired muscle function
Impaired growth
Impaired immunity
Pale skin
Thin/flat/spoon-shaped nails
Iron deficiency anemia - Diagnosis
Serum ferritin (storage iron): low
Serum iron: low but fluctuates
Transferrin: high
Total iron binding capacity: high
% Transferrin saturation: low
Hemoglobin and hematocrit: low
MCV: low
MCH: low
Serum ferritin will be high if ______ is present, making it a bad indicator of storage iron when diagnosing iron deficiency anemia
Inflammation
Transferrin is the protein that ____ to iron and transports it around the body.
Binds
Transferrin is ____ during iron deficiency anemia because there is less iron to bind, increasing transferrin.
High
Total iron binding capacity will be ____ in iron deficiency anemia
High
% transferrin saturation will be ___ in iron deficiency anemia because there is a low amount of iron saturated with transferrin.
Low
Both hemoglobin and hematocrit will be ____ in iron deficiency anemia.
Low
MCV is the average blood volume of each RBC and will be ___ in iron deficiency anemia since the RBCs are small.
Low
MCH will be ___ in iron deficiency anemia.
Low
________ is the best indicator of early iron deficiency anemia at stage 1 and stage 2.
Ferritin (usually missed because not included in routine panels)
In stage 4 of iron deficiency anemia, we start to see drops of __________ and __________.
Hemoglobin
Hematocrit
Iron deficiency anemia- Treatment
High iron diet
Heme iron: MFP
Combine non-heme iron with vitamin C to enhance iron absorption
Avoid consuming with tannins/phenols
Iron supplements are best absorbed on an _____ stomach due to stomach acidity.
Empty
T/F: It is best to take iron with coffee, tea, or dairy
False, it reduces the bioavailability
___________ is a common side effect of iron supplements, encourage fiber and fluids.
Constipation
__________ iron is the most common supplemental form.
Ferrous
_________ forms of iron are better absorbed than ferrous forms as they are less vulnerable to binding agents in the body.
Chelated
Combine nonheme iron with _______ to boost bioavailability.
Vitamin C
Megaloblastic anemia is due to _____ DNA synthesis and may be caused by ____ or B12 deficiency.
Altered, Folate
Pernicious anemia, a type of megaloblastic anemia is ONLY due to ____ deficiency.
B12, (vegans at risk)
B12 deficiency, (the cause of pernicious anemia) can be due to age, ____ blocking medication, ilial resection, and loss of _______ factor (autoimmune disease or gastric bypass)
Acid, intrinsic
Pernicious anemia is concerning because it affects the _____ system, causing memory loss, confusion, and irreversible neurological symptoms.
Nervous
_______ infections decrease stomach acidity, which can cause B12 deficiency and loss of intrinsic factors, leading to pernicious anemia.
H Pylori
Hemoglobin and hematocrit are _____ with megaloblastic anemia.
Low
MCH and MCV are _____ with megaloblastic anemia.
High
Diagnosis for megaloblastic anemia
Hemoglobin
Hematocrit
MCV
MCH
Serum folate
B12
RBC folate
Intrinsic factor antibody test
Treatment for megaloblastic anemia
Folic acid supplementation
Foods high in folate include:
Oranges
Dark leafy greens
Legumes/Beans
T/F: B12 supplements are still greatly absorbed in low acidity in the stomach.
True
T/F: Anemia of chronic disease is due to nutritional deficiency
False, due to a decrease in RBC production
Anemia of chronic disease causes:
Inflammation
Infection
Malignancy/Cancer
Anemia of chronic disease characteristics include:
Low hemoglobin/hematocrit
Normal or high ferritin (inflammation)
Normal MCV and MCH
Anemia of chronic disease treatment
Erythropoietin (EPO)- stimulates RBC production
If you see low hemoglobin and hematocrit, check ____ and ____, if normal, no further intervention is needed because it is considered anemia of chronic disease
MCH and MCV
If you see low hemoglobin and hematocrit, check MCV and MCH, if low, check ______ _______, transferrin, or % transferrin saturation, which may be iron deficiency anemia.
Serum ferritin - may also be high or normal due to inflammation so check other labs too (transferrin, or % transferrin saturation)
If you see low hemoglobin and hematocrit, check MCV and MCH, if high, check ______ and _______ levels, which may be megaloblastic anemia.
Folate, B12
The type of anemia experienced by people who lack intrinsic factors is:
Megaloblastic macrocytic anemia
Macrocytic anemia may be caused by deficiencies of
Folate, Vitamin B12, or both
The type of anemia caused by iron deficiency:
Microcytic hypochromic anemia
The form of iron that is absorbed best is ____ iron.
Heme
We want to consume non-heme iron in the _____ form with vitamin C to boost absorption.
Ferrous
______ _____ supplements can mask a B12 deficiency.
Folic acid
T/F: Folic acid deficiency causes pernicious anemia
False, only B12 causes pernicious anemia. Folic acid deficiency can cause megaloblastic anemia.
In megaloblastic anemia, the RBCs are large, _____, and abnormal RBC.
immature
T/F: Pernicious anemia is more so a result of inadequate B12 absorption (Crohn’s, celiacs), rather than B12 intake (vegans).
True
T/F: Pernicious anemia can cause irreversible neurological damage.
True
T/F: Hemoglobin and hematocrit levels will be low with ANY type of anemia.
True
The form of folic acid most commonly found in food is _____, which is not the best absorbable form but still recommended before supplements.
Folate
