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anemia and blood growth factors- wolffe Flashcards

1
Q

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

A

bone pain

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2
Q

example of oral iron pill

A

ferrous sulfate

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3
Q

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

A

depression

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4
Q

infection that can cause pernicious anemia in the absence of autoantibodies

A

h. pylori

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5
Q

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

A

lead

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6
Q

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

A

low pressure

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7
Q

transports ~98.5% of the oxygen in the blood

A

hemoglobin

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8
Q

iron chelator administered as therapy for potentially lethal iron poisoning

A

deferoxamine

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9
Q

___ is the same as vitamin b-12

A

cobalamin

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10
Q

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

A

ferumoxytol

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11
Q

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

A

intrinsic factor

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12
Q

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

A

nitrous oxide

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13
Q

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

A

angina

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14
Q

sign of anemia that can be evident from a distance

A

pallor

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15
Q

common symptom of anemia

A

fatigue

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16
Q

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

A

iron tablets

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17
Q

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

A

diagnosis

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18
Q

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

A

stem cell factor

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19
Q

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

A

positive cooperativity

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20
Q

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

A

enteric coating

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21
Q

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

A

murmur

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22
Q

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)

A

filgrastim

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23
Q

visible GI tract consequences of folate deficiency

A

mouth ulcers

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24
Q

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

A

myoglobin

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25
Q

indication from romiplostim or eltrombopag, after failure of first choice

A

ITP - immune thrombocytopenia purpura

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26
Q

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

A

clinical outcomes

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27
Q

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

A

neutropenic fever

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28
Q

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

A

parasthesia

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29
Q

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

A

alocoholism

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30
Q

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

A

iron dextran

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31
Q

can be severe with oral iron administration

A

GI irritation

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32
Q

can cause the elastin-rich eye to turn yellow

A

hemolysis

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33
Q

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

A

stool

34
Q

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

A

oral

35
Q

refers to anemia associated with loss of intrinsic factor

A

pernicious

36
Q

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

A

kidney

37
Q

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

A

pegfilgrastim

38
Q

type of anemia caused by cancer chemotherapeutics, chloramphenicol and benzene

A

aplastic

39
Q

production is decreased by thalassemic disorders

A

globins

40
Q

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

A

macrocytic

41
Q

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

A

heme

42
Q

atypical form of this is an indication of eculizumab

A

HUS

43
Q

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

A

absorption

44
Q

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

A

eculizumab

45
Q

among the causes of iron loss

A

sloughing of cells

46
Q

adverse consequences of free heme or iron in the body

A

oxidative stress

47
Q

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

A

hepcidin

48
Q

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

A

plerixafor

49
Q

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

A

hydroxyurea

50
Q

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

A

leukapheresis

51
Q

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

A

reticulocytosis

52
Q

most common cause of drug induced immune thrombocytopenia

A

heparin

53
Q

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

A

autoantibody

54
Q

heme containing proteins

A

cytochrome p450

55
Q

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

A

blood pressure

56
Q

among good dietary sources of iron

A

meat

57
Q

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

A

neurological

58
Q

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

A

elderly

59
Q

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

A

folate

60
Q

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

A

erythropoietin

61
Q

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

A

thrombopoietin

62
Q

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

A

neutropenia

63
Q

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

A

vegetarians

64
Q

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

A

eltrombopag

65
Q

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

A

tongue

66
Q

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

A

prophylaxis

67
Q

potential characteristic of neurological pathology due to vitamin b12 deficiency

A

irreversible

68
Q

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

A

infection

69
Q

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

A

epoetinalfa

70
Q

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

A

vitamin b12

71
Q

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

A

oprelvekin

72
Q

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

A

iron poisoning

73
Q

type of anemia frequently caused by cephalosporins and some penicillins

A

hemolytic

74
Q

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

A

adverse effects

75
Q

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

A

quinidine

76
Q

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

A

sargramostim

77
Q

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

A

romiplostim

78
Q

hypersegmented in macrocytic anemia

A

neutrophils

79
Q

well known reason for folate intake to be increased

A

pregnancy

80
Q

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

A

microcytic

81
Q

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

A

years

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