PHRM 825: Anemia Flashcards
What is anemia?
Decrease in RBC or Hgb
How to truly diagnose anemia
bloodwork
Normal RBC
- 5-5.5X10^6 cell/uL (male)
4. 1-4.9X10^6 cells/uL (female)
Normal Hgb
13.5-18 g/dL (male)
12-16 g/dL (female)
Normal Hct
38-50% (male)
36-46% (female)
Normal MCV
80-100 mm^3
Normal MCH
26-34 pg/cell
Normal MCHC
31-37 g/dL
Normal RDW
11.5-14.5%
Causes of anemia
- Decreased RBC production
- Increased RBC destruction
- Increased RBC loss
3 classifications of anemia
- Microcytic
- Normocytic
- Macrocytic
Microcytic anemia MCV and causes
MCV <80
Iron deficiency, sickle cell, thalassemia
Normocytic anemia MCV and causes
MCV 80-100
Anemia of chronic disease, blood loss, hemolysis
Macrocytic anemia MCV and causes
MCV >100
Folic acid and or B12 deficiency
Normal ferritin
15-200 ng/mL
*Iron deficiency is still likely for ferritin <50 ng/mL
Normal iron
40-160 mcg/dL
Normal transferrin
200-360 mg/dL
Normal TIBC
250-400 mcg/dL
Normal TSAT
20-50%
How much oral iron per day is recommended for anemic patients?
120-200 mg
How long does it take to replete iron stores in an anemic patient?
3-6 months
Normal B12
> or = 200 pg/mL
What is another term used for vitamin B12
Cobalamin
Normal folic acid
> or = 5 ng/mL
How much vitamin B12 per day is recommended for deficient patients?
1000-2000 mcg/day
B12 is water soluble so it doesn’t matter how much we give the patient
How much folic acid per day is recommended for deficient patients?
1-5 mg until Hgb normalizes
What is erythropoietin and what does it to?
Hormone produced in the kidney that stimulates production of RBCs
What is the most common type of anemia?
Iron deficiency anemia
What is the second most common type of anemia?
Anemia of CKD
In what patients should ESA not be used?
Patients with HF
How much iron is in each unit of PRBC?
250 mg
What is the normal lifespan for RBCs?
120 days
What are the types of hemolytic anemia?
Intertied and acquired
What does RBC represent
Count of Red Blood Cells
Estimate of oxygen carrying capacity
What does Hgb represent
Hemoglobin
Oxygen carrying capacity
What does Hct represent
Hematocrit
Volume of RBC’s per unit of blood (changes with number or size of RBC)
What does MCV represent
Mean corpuscuar volume
Average volume of RBCs
What does MCH represent
Mean Corpuscular Hemoglobin
Percent (volume) of RBC that is Hgb
What does MCHC represent
Mean Corpuscular Hemoglobin Concentration
Weight of Hgb per volume of RBC’s
What does RDW represent
RBC Distribution Width
Variation in size of RBCs
What does the ferritin level mean
Iron stores in body
*acute phase reactant-elevated in acute inflammation or chronic disease
What does the iron level mean
Concentration of iron bound to transferrin
What does the transferrin level mean
Protein that delivers iron throughout the body
What does the TIBC level mean
Concentration of iron if all transferrin was bound to iron (usuallly only ~30%)
What does TIBC stand for
Total iron binding capacity
What does TSAT stand for
Transferrin saturation
What toes the TSAT level mean?
Amount of iron ready for erythropoiesis
What part of the GI tract has the maximal iron absorption
duodenum
What drugs cause iron deficiency
Drug causes are unlikely
What drugs cause B12 deficiency
PPI’s and metformin
What drugs cause folic acid deficiency
- Methotrexate
- Phenytoin
- Sulfasalazine
- Sulfamethoxazole/trimethoprim
The FDA mandated wheat flour be fortified with what?
Folic acid