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My own Naplex > Anemia > Flashcards

Anemia Flashcards

1
Q

What is anemia defined as

A

a decrease in hemoglobin and hematocrit

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2
Q

What is the purpose of Hgb

A

to carry oxygen

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3
Q

What are immature RBCs called

A

reticulocytes

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4
Q

What are three things that cau cause anemia?

A

1) nutritional deficiencies - iron, folate, b12
2) complication of another medical disorder like CKD
3) due to a malignancy

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5
Q

What are symptoms of anemia

A

fatigue, headache, exercise intolerance, diziness, anorexia, pallor

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6
Q

glossitis

A

inflamed sore tongue

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7
Q

kolionycias

A

thin, conave spoon shaped nails

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8
Q

pica

A

craving non foods such as chalk or clay

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9
Q

cobalmin

A

b12

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10
Q

b12 deficiency presentation

A

peripheral neuropathies

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11
Q

What does MCV tell you?

A

size of RBC

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12
Q

MCV <80

A

microcytic

likely due to iron deficiency

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13
Q

MCV 80-100

A

Normocytic

likely cause: acute blood loss, malignancy, CKD, bone marrow failure (aplastic anemia, hemolysis

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14
Q

MCV >100

A

macrocytic

likely cause either B12 or folate deficiency

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15
Q

Causes of iron deficiency anemia

A

1) iron poor diets (vegetarian)
2) Blood loss
3) Decreased iron absorption
4) Increased iron requirements - pregnancy, lactation

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16
Q

Reticulatocyte cell is low in untreated anemia and with bone marrow supression because

A

in order to form they take up hgb and iron in the bone marrow

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17
Q

Ferrous sulfate dosing and percent elemental iron

A

325 mg PO daily to TID, 65mg elemental iron which is 20%

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18
Q

what form of iron is used in dialysis

A

parenteral

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19
Q

desferal

A

deferoxamine which is the antidode for iron overdose

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20
Q

side effects of oral iron

A

constipation, dark tarry stoools - may give docusate

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21
Q

Administration of oral iron

A

food decreases absorption so take on empty stomach **, acidic environment increases absorption so avoid any meds that supress acid, sustained release causes less gi irritation

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22
Q

What classes of meds should iron be separated from by 2 hours before and 4 hours after

A

antacids/h2ras/ppi

levothyroxine (seperate by 2-4 hours after)

quinalone/tetracycline antibiotics

23
Q

What should you give iron with to increase absorption

A

vitamin c

24
Q

How to administer iron with bisphosphonates (alendronate/risedronate, oral ibandronate)

A

alendronate/risendronate - 30 minutes

ibandronate - 60 min

25
Q

What is the concern with IV iron?

A

serious and fatal anaphylactic reactions,

26
Q

what are the indications for getting IV iron?

A

CKD on hemodialysis or receiving ESA, unable to tolerate oral iron

27
Q

triferic indication

A

only for people in hemodialysis

28
Q

which iron requires test dose due to risk of anaphylaxis

A

iron dextran

29
Q

what is the most common cause of b12 deficiency

A

pernicious anemia aka lack of intrinsic factor for b12 absorption

30
Q

what can diagnose pernicious anemia

A

shilling test

31
Q

how to treat pernicious anemia

A

lifelong b12

32
Q

folic acid deficiency can cause

A

ulcerations of the tongue

33
Q

b12 name

A

cyanocobalmin

34
Q

b9

A

folic acid

35
Q

b1

A

thiamine

36
Q

b6

A

pyroxidine

37
Q

b3

A

niacin

38
Q

nasocobal

A

nasal b12 sprayed once weekly

39
Q

1st line tx for b12 deficiency

A

injections either IM or deep SC

40
Q

what is the purpose of giving an ESA

A

to maintain HGB levels and reduce need for blood transfusions

41
Q

ESA is ineffective if what is depleated

A

iron stores

42
Q

epo is what

A

a hormone produced by the kidney that stimulates the bone marrow to produce RBCS

43
Q

at what hgb level should epogen be initiated

A

<10, decrease when it exceeds 11 (CKD on HD)

44
Q

what is the boxed warning for esas

A

increased risk of death, MI, stroke, VTE, thombosis

45
Q

what are the side effects of EPOS

A

arthralgia, hypertension

46
Q

how to store EPO

A

in refrigerator, do not shake

47
Q

half life of epoetin vs darbepoetin

A

darbepoetin half life 3x longer than epoetin

48
Q

epogen

A

epoetin alfa (1/2)

49
Q

Procrit

A

epoetin alfa (1/2)

50
Q

aranesp

A

darbepoetin

51
Q

use of esas in cancer

A

not indicated when outcome is cure since can shorten survival

52
Q

types of hemolytic anemia

A

drug induced (usually by drugs that bind to RBC surface) or inherited (sickle cell, g6pD)

53
Q

Antibiotics that can cause hemolytic anemia (both drug induced/coombs test and inherited)

A

bactrim (coombs test, g6pd/inherited), nutrofurantoin (g6pd/inherited), isoniozid, rifampin, penicillnsm cephalosporins

My own Naplex (39 decks)

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