Ch. 451 - Anemia of Chronic Disease Flashcards Preview

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Flashcards in Ch. 451 - Anemia of Chronic Disease Deck (26)
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1

Anemia of chronic disease is also referred to as

Anemia of inflammation

2

Characteristics of ACD

Mild to moderate, normo normo, hypoproliferative, low serum iron and transferrin; modest micro hypo may be seen

3

Mechanisms contributing to ACD

1) Decreased red cell life span 2) Impaired erythropoiesis 3) Increased uptake of iron in the RES

4

Low serum iron in ACD is coupled with accumulation of serum iron in

RES macrophages

5

Alterations in iron metab in ACD have been attributed to inflamm-associated excess synthesis of

Hepcidin

6

A key regulatory protein that controls intestinal iron absorption and tissue distribution

Hepcidin

7

Hepcidin is mainly synthesized by

Hepatocytes

8

Hepcidin exerts its function by

Binding to and initiating degradation of the iron exporter ferroportin

9

Hgb concentrations in ACD is generally at a range of

6-9 g/dL

10

Absolute retic count in ACD

Normal or low

11

T/F Leukocytosis is common in ACD

T

12

IDA and ACD are similar in that there is low seurm iron but differ in terms of

Serum transferrin (iron-binding protein); High in IDA, low in ACD

13

Best approach to ACD

Treatment of the underlying disorder

14

Erythropoietin stimulating agents (ESAs) may be used in treatment of ACD

True; usually necessarily given with iron supplementation for optimal effect

15

In children with CKD, Hgb levels decline as the GFT decreases below ___

43 ml/min/BSA

16

Decreased Hgb values are linked to increased incidence of what cardiomyopathy

LVH

17

T/F Higher hepcidin levels have also been implicated in the anemia of CKD

T; It is filtered by the glomerulus and excreted by the normal kidney

18

Anemia of CKD, characteristics

Normo, normo, hypoproliferative; micro hypo may be seen in cases of concomitant IDA or vitamin deificiency

19

Absolute retic count in anemia of CKD

Low

20

White cell and platelet count in anemia of CKD

Normal

21

T/F Oral iron therapy is recommended for all pediatric patients with CKD

T

22

Oral iron dose recommendation for patients with anemia of CKD

3-6mg elemental iron/kg of target dry weight OD x 3 months

23

Mainstay of therapy for anemia of CKD

ESAs

24

It is suggested to start ESA in all children with CKD when Hgb concentrations are at ___g/dL

9

25

Goal Hgb level for children with CKD

11-12 g/dL

26

In the setting of ESA hyporesponsiveness, this treatment modality may be employed

IV iron therapy