Exam 3; Anemais and Hematinic Agents

Question 1

True or False

Anemia is the most common blood disorder

Answer 1

True

Question 2

A stem cells need erythropoietin to become what

Answer 2

proerythroblast

Question 3

A pro erythroblast needs Fe into the hemoglobin to become what

Answer 3

reticulocyte

Question 4

The reticulocyte looses its cell nucleus

Answer 4

erythrocyte

Question 5

This speeds up RBC synthesis

Answer 5

erythropoietin

Question 6

This is also know as microcytic anemia

Answer 6

nutritional anemias

Question 7

What is the cause of microcytic anemais

Answer 7

relative lack of iron; RBCs are small and contain less hemoglobin (pale in color)

Question 8

True or False

there is no mechanism for eliminating iron from the body

Answer 8

True

Question 9

Ingested iron is solubilized by what

Answer 9

HCl

Question 10

What is iron absorbed as

Answer 10

Fe++ (ferrous)

Question 11

Iron is carried as what throughout the body

Answer 11

Fe3+

ferric iron

Question 12

What transforms ferrous into ferric iron

Answer 12

transferrin

Question 13

Does transferring increase or decrease during times of anemia

Answer 13

increase

Question 14

If there in an excess of iron, it is bound to and stored as what, primarily in the liver

Answer 14

ferritin

Question 15

What are two probably causes of iron deficiency

Answer 15

decreased iron uptake; not enough iron in the diet

decreased absorption; GI dysfunction

Question 16

What three conditions have an increased iron requirement

Answer 16

pregnancy
during period of rapid growth
patients with renal disease

Question 17

When can you excessively lose iron

Answer 17

chronic blood loss

heavy menstruation

Question 18

What is the drug of choice for microcytic anemia

Answer 18

iron; FeSO4; ferrous sulfate

Question 19

What are the two methods to administer iron

Answer 19

orally

parenterlly; if there is an issue with oral or severe deficiency

Question 20

What is a side effect of taking iron orally

Answer 20

GI upset; slow release will help

Question 21

What is a side effect of parenteral iron dosage

Answer 21

iron dextran (IM)
given subdural could leave a stain

Question 22

What is a extreme toxicity of oral iron

Answer 22

lethal dose is only around 10 tablets (or 3 grams)

sometimes the pills look like candies

Question 23

What are some symptoms of acute iron toxicity

Answer 23

nausea
severe abdominal pain
mucosal damage
drowsiness
cardiovascular collapse
convulsions

Question 24

What is the treatment for iron toxicity

Answer 24

achelate agent; deferoxamine

Question 25

If there is chronically too much iron stored, what is the treatment

Answer 25

phlebotomy; bleeding

Question 26

What are the characteristics of microcytic anemias

Answer 26

large RBC precursors multinucleate nuclei due ti inhibition of DNA synthesis get bigger without dividing

Question 27

This is necessary for DNA replication; if you are deficient, you don't make enough thiamine

Answer 27

folic acid

Question 28

A folic acid deficiency can also leads to this deficiency

Answer 28

methionine

Question 29

What is a symptom of folic acid deficiency

Answer 29

macrycytic RBC precursor

Question 30

This most likely is not the case of the cause of a folic acid deficiency

Answer 30

``` dietary intake (unless alcoholics) folic acid is found primarily in green vegetables ```

Question 31

What is the absorption rate of folic acid

Answer 31

rapid; GI dysfunction could stall it

Question 32

What are three systemic requirements of folic acid

Answer 32

infection | pregnancy

Question 33

Folic acid deficiency in pregnancy can lead to what

Answer 33

neural tube defects; flour companies add it now

Question 34

What is the treatment for a folic acid deficiency

Answer 34

oral therapy is sufficient; parental if there is abnormal absorption no contraindications or toxicities

Question 35

This is essential for DNA synthesis and methionine

Answer 35

B12

Question 36

What type of anemia can result from a B12 deficiency

Answer 36

megaloblastic anemia

Question 37

B12 can cause a lack of methionine synthesis which can lead to what

Answer 37

decreased myelin synthesis = neuronal damage

Question 38

What are symptoms of the neuronal damage brought upon by B12 deficiency

Answer 38

weakness ataxia spasticity irreversible spinal cord damage

Question 39

True or False | One of the main causes of B12 deficiency is insufficient intake

Answer 39

False; thats very rare

Question 40

What is the main cause of B12 deficiency

Answer 40

decreased absorption

Question 41

Parietal cells in the stomach make this

Answer 41

intrinsic factor (GIF)

Question 42

B12 requires this for absorption

Answer 42

GIF

Question 43

If a patient lacks that ability to make GIF, what occurs

Answer 43

b12 deficiency, then leads to pernicious anemia, which is fatal if not treated

Question 44

If the b12 deficiency is not due to a lack of GIF, which type of administration is okay

Answer 44

oral

Question 45

If there is pernicious anemia, B12 must be given how

Answer 45

by injection

Question 46

What is shot gun therapy

Answer 46

loading them up with iron, folic acid, B12, etc.

Question 47

What are three drugs used to treat anemias caused by chronic renal failure or chemotherapy

Answer 47

epoietin alfa darbepoietin peginesatide

Question 48

What are three toxicities of epoietin alfa, darbepoietin, peginesatide

Answer 48

increased BP increased clotting MI stroke

Question 49

Hemolytic anemias are the result of what

Answer 49

abnormal lysis of RBCs; genetic or acquired

Question 50

This treatment may be useful for treating hemolytic anemias

Answer 50

erythropoietin

Question 51

This drug is used to treat sickle cell anemia

Answer 51

hyroxyurea

Question 52

What is the mechanism of hyroxyurea

Answer 52

increases the formation of fetal hemoglobin which doesn't sickle

Question 53

What are two side effects of hyroxyurea

Answer 53

mutagenic | preg. category X