Module 12 - Anemia Flashcards
- Classifications
Size
1. Macrocytic Anemia (large)
2. Normocytic Anemia (normal)
3. Microcytic Anemia (small)
Hemoglobin Content
1. Normochromic (normal amount)
2. Hypochromic (decreased amount)
Physical Manifestations:
1. Folic Acid Deficiency
2. Riboflavin Deficiency
3. Chelosis
- Folic Acid Deficiency
- shiny, smooth, red tongue - Riboflavin Deficiency
- chronic etoh, sore swollen magenta tongue - Chelosis
- vertical fissuring and ulceration of lips
- Iron Replacement
100-200 mg of elemental iron/day
- Ferrous gluconate 324mg TID
- Ferrous sulfate 200mg BID
- Ferrous fumarate 150mg BID
- Give with Vitamin C
- Stools can be black
- Stool softeners may be needed
- Start low go slow
- HCT increases in 2 weeks
- Fe stores take 4-6 mo to correct
- Iron Replacement Side Effects
S/E
- nausea
- constipation
- heart burn
- upper GI discomfort
- black stools
- sometimes diarrhea
Instructions:
- Take 30 minutes before meal with ascorbic acid (OJ)
* Increases iron absorption by 10%
* If taken with meals, reduces absorption by 40-50%
- Macrocytic Normochromic Anemia
- Termed megaloblastic anemia
- DNA synthesis is defective
- due to deficiencies in vitamin B12 or folate
- Vitamin B12 Deficiency
macrocytic normochromic deficiency
Causes:
- gastrectomy/lb loss surgery that bypass stomach
-VEGETARIAN
- long term PPI use !!!!!!!!!
- Pernicious Anemia
Autoantibodies against intrinsic factor = pernicious anemia
- lacks intrinsic factor from gastric parietal cells that is required for B12 absorption
Clinical Manifestations:
- weakness, fatigue
- paresthesia of feet and fingers
* difficulty walking
- loss of appetite, abdominal pain, weight loss
- sore tongue: smooth, beefy red, secondary to atrophic glossitis
- lemon yellow (sallow) skin color as a result of combo of pallor and icterus
- Neurologic symptoms from nerve demyelination
-Not reversible, even with treatment if present for longer than 3 months - Is often unrecognizable in older adults because of its subtle, slow onset and presentation.
- Evaluation of megaloblastic anemia
Causes: B12 and Folate
also called macro normochromic
- Iron Deficiency Anemia
micro hypo
GI BLEED/MENSTRUATION
Clinical manifestations
* Classic Symptoms plus:
* Brittle, thin, coarsely ridged, and spoon-shaped (concaveor koilonychia) nails
* Red, sore, painful tongue - glossitis
* Angular stomatitis: Dryness and soreness in the corners ofthe mouth
* Become symptomatic: When hemoglobin (Hgb) 7.5g/d
- Iron Rich Foods
Heme: Meats
Non Heme: Veggies
- Know differences between B12 and pernicious anemia
B12 is a lack of diet in B12 and pernicious is lack of intrinsic factors that allow you absorb B12 vitamins
Sources of B12
- Meats – especially fish
- Fortified cereals
- Others
- Folic Acid Anemia
ALCOHOLIC
- Clinical manifestations
- Severe cheilosis: Scales and fissures of the lips and corners of the mouth
- Stomatitis: Mouth inflammation
- Painful ulcerations of the buccal mucosa and tongue
- Neurologic symptoms: Usually not seen
- Treatment
- Oral dose of folate is administered daily until normal blood levels are obtained.
- Life-long treatment is not necessary
- Folic Acid Replacement
Need 1 mg/d
- Green leafy vegetables
- Broccoli
- Asparagus
- Beans and Legumes
- Citrus
Thalassemia Anemia
Mediterranean
