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Flashcards in Geriatric Anemia Deck (22):
1

WHO definition of anemia

men: HgB

2

Highest and lowest rates of anemia (race)

nonhispanic blacks - highest
non hispanic whites - lowest

3

Commonly reported symptoms of anemia in elderly

fatigue, weakness, dyspnea
can worsen symptoms of other comorbid conditions (dyspnea from CHF)

4

What physical exam sign is a reliable sign of anemia in the elderly and noted in patients with Hgb

conjuntival pallor

5

glossitis, decreased vibratory sense, ataxia, paresthesia, confusion, dementia, pearly gray hair

vitamin b12 deficiency

6

Difference between vitamin b12 and folate deficiency

both present similarly but folate deficiency doesn't have neurologic deficits...folate usually seen in alcoholics

7

koilomychias (spoon nails), glossitis, dysphagia

severe iron deficiency

8

anemia with jaundice

hemolysis

9

anemia with splenomegaly

thalassemia/neoplasm?

10

What is the initial workup for suspected anemia?

CBC with measurement of RBC indices, peripheral smear, and reticulocyte count

11

Most common cause of anemia with low MCV

iron deficiency

in elderly this is due to chronic GI blood loss, poor nutrition, or bleeding disorder

12

What lab results would you expect to see in iron deficiency?

low serum iron, low ferritin, high TIBC

13

Iron deficiency can be initial presentation of what kind of malignancy

GI (so get those upper and lower GI endoscopies done!)

14

Anemias with high MCV

folate or vitb12 deficiency (most common)
drug effects, liver dx, or hypothyroidism (less common)

15

What labs indicate vitb12 and folate deficiency

vitb12 - elevated MMA (methylmalonic acid)
folate - elevated homocysteine

16

Most common cause of normocytic anemia in elderly

anemia of chronic inflammation (aka chronic disease)

17

How to differentiate between iron deficiency and anemia of chronic inflammation

iron deficiency - high TIBC, low ferritin
chronic disease- low TIBC, normal/high ferritin

can also use bone marrow iron store

18

Threshold for RBC transfusion

Hgb

19

treatment for iron deficiency anemia

oral iron (ferrous sulfate TID) plus correction of any source of blood loss...may need up to 6-8 weeks for treatment,

may need to give parental administration in patients with malabsorption, malignancy, or CKD and heart failure

20

how to treat vitb12 deficiency or folate

IM b12 or folate...duh

21

treatment for anemia of chronic inflammation

treat underlyin condition
if anemia severe enough...RBC transufsion or erythropoesis stimulating agents
goal in CKD patients - between 10-12 hgb

22

Most common cause of vitb12 deficiency

pernicious anemia (lack of intrinsic factor)