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Oncology Exam 3 > Chronic Anemia > Flashcards

Chronic Anemia Flashcards

(50 cards)

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1
Q

Anemia is generally shown when the Hgb levels are

A

<11 g/dL

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2
Q

What patient population experiences anemia more commonly?

A

Women during reproductive years

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3
Q

Anemia is very common in patients with what 2 comorbid conditions?

A
  1. Cancer
  2. Chronic Kidney disease
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4
Q

What is the process stimulated by?

A

Erythropoietin

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5
Q

What do reticulocytes mature into?

A

Erythrocytes

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6
Q

What are 6 symptoms of anemia?

A
  1. Fatigue
  2. Lethargy
  3. SOB
  4. Headache
  5. Edema
  6. Tachycardia
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7
Q

True or False: Anemia is seen as a cause of disease rather than a marker

A

False

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8
Q

What are the 3 main causes of anemia?

A
  1. Decreased RBC production
  2. Increased RBC destruction
  3. Blood loss
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9
Q

What 3 things can cause a decrease in RBC production?

A
  1. Hypoproliferative bone marrow
  2. Decreased production of EPO or decreased response to EPO
  3. Nutritional deficiencies
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10
Q

What 2 things can cause hypoproliferative bone marrow?

A
  1. Cancer
  2. Chemotherapy
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11
Q

What 2 things can cause a decrease in EPO or decreased response to EPO?

A
  1. CKD
  2. Other inflammatory conditions
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12
Q

What are 3 nutritional deficiencies that can cause anemia?

A
  1. Iron
  2. Vitamin b12
  3. Folic acid
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13
Q

What does chemotherapy decrease the production of?

A

Mature erythrocytes

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14
Q

When are blood transfusions the most useful?

A

In severe anemia and life threatening anemia

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15
Q

What Hgb level is considered severe anemia?

A

<8

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16
Q

What Hgb level is considered life threatening anemia?

A

<6.6

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17
Q

Blood transfusions are most useful in cases of ______

A

Active bleeding

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18
Q

What are 2 medications that can increase the production of RBCs?

A
  1. Epoetin Alfa
  2. Darbepoeitin
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19
Q

When are the ESAs used?

A

To prevent and treat anemia associated with cancer and chemotherapy

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20
Q

True or False: both ESA agents are considered equivalent

A

True

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21
Q

What are 4 ADRs of the ESAs?

Study These Flashcards
A
  1. Venous thromboembolism
  2. Hypertension
  3. Cardiovascular events
  4. Stroke
22
Q

ESAs are not indicated in patients who are receiving chemotherapy and the anticipated outcome is _______

23
Q

ESAs should not be used to treat anemia associated with cancer if the patient is not what?

Study These Flashcards
A

Receiving myelosuppressive chemotherapy

24
Q

ESAs are not generally recommended in patients with _________

Study These Flashcards
A

Hematologic malignancies

25
ESA therapy should not begin until the Hgb level is
<10 g/dL
26
Hgb should be increased to the ______ concentration needed to avoid what?
Lowest; blood transfusion
27
What are all ESAs apart of?
REMS program
28
Evaluation of anemia should be initiated in patients with what stage of CKD?
Stage 3 or higher
29
What is the target hemoglobin for anemia caused by CKD?
10-12 g/dL
30
What brand of ESA is only used for CKD?
Epogen
31
Epoetin Alfa
PROCRIT
32
Darbepoeitin Alfa
ARANESP
33
Adverse effects from ESAs are more common in patients with CKD with what Hgb level?
>13 g/dL
34
What are 2 chronic autoimmune diseases where anemia is common?
1. RA 2. SLE
35
What is the most common cause of anemia worldwide?
Iron deficiency anemia
36
What patients is iron deficiency anemia most common in?
Young children and women of childbearing age
37
What is iron stored as?
Ferritin
38
What are 3 functions of iron in the body?
1. Oxygen transport 2. Electron exchange 3. Control of toxic free radicals
39
What are 4 unique symptoms associated with iron deficiency anemia?
1. Hair loss 2. Pica 3. Kolionychia 4. Inflammation of the angles of the mouth
40
Diet supplementation alone is usually _____
Inadequate
41
What is the goal for elemental iron per day?
200 mg
42
When is absorption best for iron?
One hour before meals
43
What are 4 most common ADRs when taking iron?
1. Constipation 2. Discoloration of feces 3. Nausea and vomiting 4. Heartburn
44
What is the goal for iron replacement?
1000 mg per treatment course
45
What 5 ADRs can be caused by IV iron replacement?
1. Anaphylaxis 2. Infusion related reactions 3. Cramps 4. Diarrhea 5. Hypotension
46
What 4 things can cause vitamin b12 deficiency?
1. Poor intake 2. Malabsorption 3. Inadequate utilization 4. Medications
47
How would you treat a vitamin b12 deficiency?
1. Treat underlying problem 2. Replacement
48
What 3 things can cause a folate deficiency?
1. Inadequate intake 2. Malabsorption 3. Increased requirement
49
How do you treat folic acid?
Replacement
50
What can an increase in destruction of RBCs be caused by?
Steroids

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