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ACR 2: Fatigue > Anemia > Flashcards

Flashcards in Anemia Deck (13)
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1

What are the 3 common causes of anemia?

↑Blood loss
↑RBC destruction
↓RBC production

2

What are common etiologies of anemia?

Common in pregnant women : 2-3x ↑risk for low birth wt, preterm delivery, perinatal mortality

Women taking OCP, have IUDs, are menstruating

Chronic Kidney dz (give EPO)

3

DDX of iron deficiency anemia, which is most common?

Occult bleeding (most common)
Dietary deficiency
CKD
Pregnancy
low testosterone
lead poisoning

4

S/S of Anemia

Constitutional: fatigue, weakness, HA, irritability

CV: palpitations, tachy, orthostatic hypotension, dizziness, syncope

Pulm: SOB

Skin: pallor, purpura, petechiae, jaundice

Abdomen: occult blood, ascites

5

S/S of iron deficiency anemia

Pagophagia (craving ice)
Pica
Angular cheilitis (glossitis)
Koilonychia (nail spooning)

6

what labs are needed in the w/u for anemia?

CBC w/ RBC indices + iron study
Pregnancy test (postmenopausal women only)

**don't forget about the labs in w/u of fatigue (they are usually included)

7

what labs can you use to differentiate B12 vs Iron def.

Homocysteine and Methylmalonic acid

8

what is the Tx for iron deficiency anemia?

How long is tx required?

1: tx the cause of the anemia, then work to normalize labs.

2. 120 mg/day iron required for tx, ↑1b/dL hemoglobin after 1 month is proof of adequate response
- tx is required for 3 months after anemia is corrected to replenish iron stores

3. refer to a specialist when needed

9

What are some pt education tips you may give to your pt with anemia?

Take Rx as prescribed

If new sx present, dark tarry stools, sx worsen = come back

May take a few weeks before sx improve

f/u in 4 weeks to check tx adequacy, then check periodically

10

What will happen with the following labs if a pt has iron deficiency anemia
Serum iron?
Serum transferrin (total iron binding cap.) ?
transferring saturation?
Serum ferritin?
Soluble serum transferring receptor?

Serum iron : ↓
Serum transferrin (total iron binding cap.): ↑
transferring saturation: ↓
Serum ferritin: ↓
Soluble serum transferring receptor: ↑

11

What will happen with the following labs if a pt has anemia of chronic dz
Serum iron?
Serum transferrin (total iron binding cap.) ?
transferring saturation?
Serum ferritin?
Soluble serum transferring receptor?

Serum iron: ↓
Serum transferrin (total iron binding cap.): ↓
transferring saturation: ↓
Serum ferritin : normal
Soluble serum transferring receptor: normal

12

what are common causes of iron deficiency anemia?

Inadequate intake
↓ Absorption (recent GI surgery, Celiac dz)
↑ Iron loss

13

who should be screened for iron deficiency anemia?

Symptomatic adults
Pregnant women
Children at 1 yr old