anemia and blood growth factors- wolffe

Question 1

adverse effect of filgrastim, sagramostim, and erythropoietin makes sense given site of their effects

Answer 1

bone pain

Question 2

example of oral iron pill

Answer 2

ferrous sulfate

Question 3

folate deficiency may cause this, but it is not associated with the neurological problems caused by vitamin B12 deficiency

Answer 3

depression

Question 4

infection that can cause pernicious anemia in the absence of autoantibodies

Answer 4

h. pylori

Question 5

while alcohol is the most common cause of sideroblastic anemia, this environmental toxin can also block heme synthesis to cause it

Answer 5

lead

Question 6

consequence of peripheral vasodilation due to oxygen-poor blood and reduced viscosity during anemia

Answer 6

low pressure

Question 7

transports ~98.5% of the oxygen in the blood

Answer 7

hemoglobin

Question 8

iron chelator administered as therapy for potentially lethal iron poisoning

Answer 8

deferoxamine

Question 9

___ is the same as vitamin b-12

Answer 9

cobalamin

Question 10

nanoparticle used to treat iron deficiency, can infuse faster than colloidal iron

Answer 10

ferumoxytol

Question 11

glycoprotein secreted by parietal cells, complexes with cobalamin to facilitate its uptake via cubulin receptors in the ileum

Answer 11

intrinsic factor

Question 12

use of this for analgesia during surgery can cause rapid onset of vitamin B12 deficiency symptoms

Answer 12

nitrous oxide

Question 13

common in anemia due to decreased oxygen carrying capacity of blood causing elevated heart rate

Answer 13

angina

Question 14

sign of anemia that can be evident from a distance

Answer 14

pallor

Question 15

common symptom of anemia

Answer 15

fatigue

Question 16

cause nausea an vomiting diarrhea or constipation, anorexia, heart burn, and dark spots

Answer 16

iron tablets

Question 17

this for macrocytic anemia is aided by measuring plasma levels of folate, vitamin B12, homocysteine, and methyl-malonic acid

Answer 17

diagnosis

Question 18

AKA c-kit, has potent synergistic actions on early progenitor cells, but cannot be used since this stimulatory effect extends to mast cells and gives rise to severe allergic reactions

Answer 18

stem cell factor

Question 19

contributes to the reason that 2 of the 4 heme moieties of hemoglobin have a bound O2 molecule at 26.8 torr

Answer 19

positive cooperativity

Question 20

this and sustained release formulations drastically reduces the bio availability of orally administered iron

Answer 20

enteric coating

Question 21

frequently heard in anemia because of teh thinner blood leaks through the closed valves

Answer 21

murmur

Question 22

recombinant granulocyte-colony stimulating factor, it increases growth and proliferation of neutrophil progenitor cells and also facilitate actions of mature neutrophils (i.e. phagocytosis, respiratory burst)

Answer 22

filgrastim

Question 23

visible GI tract consequences of folate deficiency

Answer 23

mouth ulcers

Question 24

approximately half-saturated with oxygen at 2 torr, reason oxygen can be stripped from hemoglobin and stored in muscles

Answer 24

myoglobin

Question 25

indication from romiplostim or eltrombopag, after failure of first choice

Answer 25

ITP - immune thrombocytopenia purpura

Question 26

although filgrastim can speed the recovery from severe neutropenia, there is less evidence of impact on this for this expensive drug

Answer 26

clinical outcomes

Question 27

life-threatening complication of chemo; hypotension, COPD, dehydration and age >60 years are among the risk factors for underlying gram -, gram + and/or fungal

Answer 27

neutropenic fever

Question 28

symmetric form of this +/- alterations in gait and cognition are common neuropsychiatric symptoms of vitamin B12 deficiency

Answer 28

parasthesia

Question 29

in combination with poor dietary intake, is a common cause of folate deficiency

Answer 29

alocoholism

Question 30

among the choices for IV administration of iron due to malabsorption or intolerance of oral forms, administration bypasses hepcidin regulation

Answer 30

iron dextran

Question 31

can be severe with oral iron administration

Answer 31

GI irritation

Question 32

can cause the elastin-rich eye to turn yellow

Answer 32

hemolysis

Question 33

whether black and tarry, magneta or bright red, blood loss here can be significant

Answer 33

stool

Question 34

appropriate route administration for vitamin b12 in pernicious anemia provided dose is ~500X the daily requirement

Answer 34

oral

Question 35

refers to anemia associated with loss of intrinsic factor

Answer 35

pernicious

Question 36

releases erythropoietin in response to hypoxia; failure of this organ causes a normochromic normocytic anemia

Answer 36

kidney

Question 37

name means that polyethylene glycol was attached to filgrastim to prolong its half-life

Answer 37

pegfilgrastim

Question 38

type of anemia caused by cancer chemotherapeutics, chloramphenicol and benzene

Answer 38

aplastic

Question 39

production is decreased by thalassemic disorders

Answer 39

globins

Question 40

anemia in which erythroblasts double protein but were unable to synthesize new DNA; extrusion of nucleus now leaves a large RBC

Answer 40

macrocytic

Question 41

forms when Fe2+ has occupies its place in protoporphyrin IX=

Answer 41

heme

Question 42

atypical form of this is an indication of eculizumab

Answer 42

HUS

Question 43

only actively regulated pharmacokinetic process to control the amount of iron in the body

Answer 43

absorption

Question 44

prevents formation of complement membrane attack complex, treat paroxysmal nocturnal hemoglobinuria cuased by insufficiency GPI-lniked CD59 and CD55 on the RBC cell surface that otherwise protects from this type of attack

Answer 44

eculizumab

Question 45

among the causes of iron loss

Answer 45

sloughing of cells

Question 46

adverse consequences of free heme or iron in the body

Answer 46

oxidative stress

Question 47

peptide produced by the liver that regulates iron hemostasis, increased levels reduce blood levels

Answer 47

hepcidin

Question 48

partial agonist at CXCR4 receptors important for homing hematopoietic stem cells, an expensive orphan drug administered when G-CSF or GM-CSF alone cannot mobilize enough stem cells of autologous transplant

Answer 48

plerixafor

Question 49

cancer chemo agent approved for the treatment of sickle cells anemia because it somehow boosts the levels of (normal) fetal hemoglobin, thereby blocking aggregation of abnormal adult hemoglobin

Answer 49

hydroxyurea

Question 50

reason to administer filgrastim +/- plerixafor to mobilize hematopoietic progenitor cells

Answer 50

leukapheresis

Question 51

often expected within a few days after initiating appropriate therapy for microcytic or macrocytic anemia; increases in hematocrit and hemoglobin follow shortly thereafter

Answer 51

reticulocytosis

Question 52

most common cause of drug induced immune thrombocytopenia

Answer 52

heparin

Question 53

can, for example, block intrinsic factor cobalamin interaction or the receptor for it in the ileum, or target receptor for it in the ileum, or target H-ATPase or parietal cells

Answer 53

autoantibody

Question 54

heme containing proteins

Answer 54

cytochrome p450

Question 55

increases in part due to increased viscosity of blood caused by epoetin alfa

Answer 55

blood pressure

Question 56

among good dietary sources of iron

Answer 56

meat

Question 57

symptoms that, when present with macrocytic anemia, justify parenteral b12

Answer 57

neurological

Question 58

potentially especially vulnerable to cognitive decline cause by vitamin b12 deficiency hat has been masked by the consumption of folate fortified foods

Answer 58

elderly

Question 59

plasma levels of this micronutrient fall within 3 weeks inadequate intake from animal products and leafy vegetables

Answer 59

folate

Question 60

blood doping with recombinant forms of this is banned by the olympics

Answer 60

erythropoietin

Question 61

stimulates platelet production in vivo, but recombinant forms for treating thrombocytopenia were withdrawn from the market due to frequent autoantibody production leading to profound thrombocytopenia

Answer 61

thrombopoietin

Question 62

considered severe if absolute count <500/microliter; low grade fever, sore mouth, severe pain from swallowing, upper and lower airway inflammation and perianal pain and irritation are among its sxs

Answer 62

neutropenia

Question 63

can readily meet their daily needs of vitamin b12 by rating fortified breakfast cerals

Answer 63

vegetarians

Question 64

orally active non-peptide thrombopoietin agonist approved for treatment of idiopathic thrombocytopenic purpura and the thrombocytopenia seen with hepatitis C

Answer 64

eltrombopag

Question 65

vitamin b12 deficiency is suggested when this is red/inflamed and smooth

Answer 65

tongue

Question 66

this use of filgrastim is considered warranted if calculated risk of getting neutropenic fever >220% or if its use permits timely administration of potentially curative chemo

Answer 66

prophylaxis

Question 67

potential characteristic of neurological pathology due to vitamin b12 deficiency

Answer 67

irreversible

Question 68

increased incidence of this is a predictable consequence of eculizumab therapy, and overwheming amount can also cause neutropenia

Answer 68

infection

Question 69

recombinant erythropoiesis stimulating glycoprotein with AA sequence identical to erythropoietin administered to treat anemia secondary to chronic kidney disease or chemotherapy to reduce the need for allogenic RBC transfusions

Answer 69

epoetinalfa

Question 70

needed to generate methionine from homocysteine and tetrahydrofolate from 5-methyltetrahydrofolate

Answer 70

vitamin b12

Question 71

recombinant IL-11, early agent that increases platelet levels via unknown mechanism, no longer has a major clinical use

Answer 71

oprelvekin

Question 72

has been one of the leading causes of death by toxilogical agents in children < 6 years old

Answer 72

iron poisoning

Question 73

type of anemia frequently caused by cephalosporins and some penicillins

Answer 73

hemolytic

Question 74

for sagramostim, this includes fluid retention, dyspnea due to sequestration of granulocytes in pulmonary circulation, fatal "gasping syndrome" in premature infants

Answer 74

adverse effects

Question 75

antiarrhythmic drug, a classic cause of drug induced non immune thrombocytopenia

Answer 75

quinidine

Question 76

recombinant GM-CSF, acts in the bone marrow to increase production of neutrophils, eosinophils, and monocyte/macrophages (i.e. after a transplant)

Answer 76

sargramostim

Question 77

a "peptibody" has to igG constant regions linked by a peptide; has no homology to thrombopoietin but nevertheless stimulates the thrombopoietin receptor to promote platelet production

Answer 77

romiplostim

Question 78

hypersegmented in macrocytic anemia

Answer 78

neutrophils

Question 79

well known reason for folate intake to be increased

Answer 79

pregnancy

Question 80

anemia in which teh MCV<80 fl; iron deficiency is the most common cause (i.e. due to heavy menstrual bleeding)

Answer 80

microcytic

Question 81

period of time required to develop vitamin b12 deficiency, a reflection of daily need (micrograms) vs body stores (milligrams)

Answer 81

years