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PHARMA > BLOOD_GOUT > Flashcards

BLOOD_GOUT Flashcards

1
Q

Vitamin B12

A

Cobalamin

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2
Q

Results from either folate or vitamin B12 deficiency anemia

A

Megaloblastic anemia

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3
Q

A deficiency in serum hemoglobin and erythrocytes in which the erythrocytes are abnormally small. Often caused by iron deficiency

A

Microcytic anemia

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4
Q

The most common cause of erythrocyte deficiency, or anemia, is ____ substances required for normal production of erythrocytes.

A

insufficient supply of iron, vitamin B12, or folic acid

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5
Q

Caused by iron deficiency. Most common type of anemia.

A

Microcytic hypochromic anemia

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6
Q

The most common type of vitamin B12 deficiency anemia. Caused by a defect in the synthesis of intrinsic factor, a protein required for efficient absorption of dietary vitamin B12, or by surgical removal of that part of the stomach that secretes intrinsic factor.

A

Pernicious anemia

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7
Q

Role of Iron
• transport protein:
• a storage protein

A
  • Transferrin

- Ferritin

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8
Q

Pregnancy Daily Requirements
• Iron:
• Folic Acid:

A
  • Iron: 30-60 mg

* Folic Acid: 400 µg (0.4 mg)

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9
Q

is most common in children includes necrotizing gastroenteritis, shock, metabolic
acidosis, coma, and death may result

A

Acute iron intoxication

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10
Q

known as hemochromatosis, damages the organs that store excess iron (heart, liver, pancreas).

A

Chronic iron overload

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11
Q

Removal of unabsorbed tablets from the gut, correction of acid-base and electrolyte abnormalities, and parenteral administration of deferoxamine, which chelates circulating iron.

A

Treatment of acute iron intoxication

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12
Q

Treatment of chronic iron toxicity

A
  • Treatment of the genetic form of hemochromatosis is usually by phlebotomy.
  • Hemochromatosis that is due to frequent transfusions is treated with parenteral deferoxamine or with the newer oral iron chelator deferasirox.
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13
Q

Produced only by bacteria
• Intrinsic factor: a product of the parietal cells of the stomach.
• Plasma transport → transcobalamin II

A

Vitamin B12 (cobalamin)

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14
Q

Where is Vitamin B12 (cobalamin) stored?

2 forms of Vitamin B12 (cobalamin)

A
  • liver

- cyanocobalamin and hydroxocobalamin

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15
Q

Administration of folic acid to patients with vitamin B12deficiency helps refill the ___ and partially or fully corrects the anemia.

A

tetrahydrofolate pool

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16
Q

The major application of Vitamin B12 is in the treatment of naturally occurring

A
  • pernicious anemia

- anemia caused by gastric resection

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17
Q

Like vitamin B12, folic acid is required for normal DNA synthesis, and its deficiency usually presents as
.

A

megaloblastic anemia

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18
Q

Deficiency of folic acid during pregnancy increases the risk of

A

neural tube defects in the fetus

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19
Q

Because maternal folic acid deficiency is associated with increased risk of neural tube defects in the fetus, folic acid supplementation is recommended ____ and ___ pregnancy.

A

before, during

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20
Q

is produced by the kidney; reduction in its synthesis underlies the anemia of renal failure.

A

Erythropoietin

21
Q

Routinely used for the anemia associated with renal failure
• Sometimes effective for patients with other forms of anemia
– eg, primary bone marrow disorders or anemias secondary to cancer chemotherapy or HIV treatment, bone marrow transplantation, AIDS, or cancer

A

ERYTHROPOIESIS-STIMULATING AGENTS (ESAS)

22
Q

a glycosylated form of erythropoietin, has a much longer half-life.

A

Darbepoetin alfa

23
Q

The most common complications of ESA therapy are

A

hypertension and thrombosis

24
Q

The serum hemoglobin concentration of patients treated with an ESA should not exceed ____ because hemoglobin concentrations above this target have been
linked to an increased rate of mortality and cardiovascular events.

A

12 g/dL

25
Q

stimulate the production and function of neutrophils

A
  • Filgrastim (granulocyte colony-stimulating factor; G-CSF)

- sargramostim (granulocyte-macrophage colony-stimulating factor; GM-CSF)

26
Q
  • also stimulates the production of other myeloid and megakaryocyte progenitors.
  • Together with, to a lesser degree of GM-CSF mobilize hematopoietic stem cells (ie, increase their concentration in peripheral blood).
A
  • GM-CSF

- G-CSF

27
Q

The toxicity of G-CSF

A

sometimes causes bone pain

28
Q

The toxicity of GM-CSF

A

fever, arthralgias, and capillary damage with edema

29
Q

• stimulates the growth of primitive megakaryocytic progenitors and increases the
number of peripheral platelets.
• is used for the treatment of patients who have had a prior episode of thrombocytopenia after a cycle of cancer chemotherapy.

A

Oprelvekin (interleukin-11 [IL-11])

30
Q

A 23-year-old pregnant woman is referred by her obstetrician for evaluation of anemia. She is in her fourth month of pregnancy and has no history of anemia; her grandfather
had pernicious anemia. Her hemoglobin is 10 g/dL(normal, 12–16 g/dL).

If this woman has macrocytic anemia, an increased serum concentration of transferrin, and a normal serum concentration of vitamin B12, the most likely cause of her anemia is deficiency of?

A

Folic acid

31
Q

If the patient in question 1 had the deficiency identified, her infant would have a higher than normal risk of which of the following?

(A) Cardiac abnormality
(B) Congenital neutropenia
(C) Kidney damage
(D) Limb deformity
(E) Neural tube defect
A

Neural tube defect

32
Q

The laboratory data for your pregnant patient indicate that she does not have macrocytic anemia but rather microcytic anemia. Optimal treatment of normocytic or mild microcytic anemia associated with pregnancy uses which of the following?

(A) A high-fiber diet
(B) Erythropoietin injections
(C) Ferrous sulfate tablets
(D) Folic acid supplements
(E) Hydroxocobalamin injections
A

Ferrous sulfate tablets

33
Q

If this patient has a young child at home and is taking iron-containing prenatal supplements, she should be warned that they are a common source of accidental poisoning in young children and advised to make a special effort to keep these pills out of her child’s reach. Toxicity associated with acute iron poisoning usually includes which of the following?

(A) Dizziness, hypertension, and cerebral hemorrhage
(B) Hyperthermia, delirium, and coma
(C) Hypotension, cardiac arrhythmias, and seizures
(D) Necrotizing gastroenteritis, shock, and metabolic acidosis
(E) Severe hepatic injury, encephalitis, and coma

A

Necrotizing gastroenteritis, shock, and metabolic acidosis

34
Q

An endogenous anticlotting protein that irreversibly inactivates thrombin and factor Xa. Its enzymatic action is markedly accelerated by the heparins.

A

Antithrombin III

35
Q
  • Fractionated preparations of heparin of molecular weight

- Unfractionated heparin has a molecular weight range of

A
  • 2000—6000

- 5000—30,000

36
Q
  • treatment of both venous and arterial thrombosis

- used primarily for treatment of arterial disease

A
    • Anticoagulant and thrombolytic drugs

- Antiplatelet drugs

37
Q

3 major types of anticoagulants are available:

A 
1. Heparin and related products
– must be used parenterally
2. Direct thrombin and factor X inhibitors
– used parenterally or orally
3. Coumarin derivatives (eg, warfarin)
– oral
38
Q

Heparin is given intravenously or subcutaneously to avoid the risk of ___ associated with intramuscular injection.

A

hematoma

39
Q

is a small synthetic drug that contains the biologically active pentasaccharide present in unfractionated and LMW heparins. It is administered subcutaneously once daily.

A

Fondaparinux

40
Q

Unfractionated heparin binds to endogenous ____ via a key pentasaccharide sequence.

A

antithrombin III (ATIII)

41
Q

The action of heparin is monitored with the activated ___ laboratory test.

A

partial thromboplastin time (aPTT)

42
Q

the short-chain heparin–ATIII and fondaparinux– ATIII complexes provide a more selective action because they fail to affect ___.

A

thrombin

43
Q

When to use heparin?

A

Because of its rapid effect, heparin is used when anticoagulation is needed immediately (eg, when starting therapy).

44
Q

Common of heparin uses include treatment of:

A

– DVT
– Pulmonary embolism
– Acute myocardial infarction

45
Q

Heparin is used in combination with thrombolytics for ___ and in combination with glycoprotein IIb/IIIa inhibitors during angioplasty and placement of coronary stents.

A

revascularization

46
Q

is the most common adverse effect of heparin and related molecules

A

Increased bleeding

47
Q

can lessen the risk of serious bleeding that can result from excessive unfractionated heparin. Only PARTIALLY reverses the effects of LMW heparins and DOES NOT AFFECT the action of fondaparinux.

A

Protamine

48
Q

causes moderate transient thrombocytopenia in many patients and severe
thrombocytopenia and thrombosis (heparin-induced thrombocytopenia or HIT) in a small percentage of patients who produce an ANTIBODY that binds to a complex of heparin and platelet factor 4.

A

Unfractionated heparin

49
Q

Prolonged use of unfractionated heparin is associated with

A

osteoporosis

PHARMA (26 decks)

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