Haematinics

Question 1

microcytic anaemia

Answer 1

MCV<80fL
iron deficiency 
anaemia of chronic disease 
copper deficiency 
acquired sideroblastic anaemia 
lead poisoning

Question 2

normocytic anaemia

Answer 2

MCV 80-100fL
acute haemorrhage or haemolysis
renal failure 
anaemia of chronic disease 
combined nutritional deficiencies 
marrow disorders 
malignancy

Question 3

microcytic anaemia

Answer 3

MCV>100fL
hypothyroidism 
B12/folate deficiency 
liver disease 
ETOH
compensated haemolysis/haemorrhage 
marrow disorder 
pregnancy 
drugs

Question 4

treatment for iron deficiency

Answer 4

iron, oral or parenteral

Question 5

treatment for renal failure

Answer 5

erythropoetin

Question 6

B12/folate deficiency treatment

Answer 6

B12, folate

Question 7

iron form more well absorbed

Answer 7

Fe2+ not Fe3+

Question 8

acidic pH of stomach

Answer 8

reductive, maintains Fe2+

Question 9

Fe in many foods is not absorbable because

Answer 9

it is complexed with phytates or phosphates

Question 10

Fe replacement

Answer 10

oral

Question 11

antacids

Answer 11

cause oxifation to Fe3+ making it not absorbable

Question 12

iron preparations are best taken

Answer 12

on an empty stomach

Question 13

antibiotics that complex with iron

Answer 13

tetracycline, and fluoquinolones

Question 14

adverse effects of Fe

Answer 14

gastrointestinal intolerance

hypersensitivity

Question 15

overdose of iron

Answer 15

serious, early GI irritation, later multi system failure and death

Question 16

megaloblastic anaemias

Answer 16

folic acid deficiency (usually dietary)

vit B12 deficiency (usually malabsorption, EG pernicious anaemia)

Question 17

dihydropholate reductase

Answer 17

turns folic and into dihydrofolic acid and then into tertahydrofolate

Question 18

C1 metabolism

Answer 18

picks up singe carbon groups from tetrahydrofolate

Question 19

single carbon groups are important for

Answer 19

making purines and thymidines

Question 20

replacing folic acid

Answer 20

oral folic acid daily
no adverse effects
especially important in pregnancy

Question 21

methotrexate

Answer 21

close analog of folic acid
dihydrofolic reductase works on it as well
rapidly dividing cells can’t work because methotrexate toxicity stops production of single carbon groups

Question 22

vit B12 is needed for

Answer 22

turning 5-methyltetrahydrofolate into tetrahydrofolate

Question 23

vit B12 deficiency is bad because

Answer 23

there’s too much 5-methyltatrahydrofolate ‘blocked hydrofolate’

Question 24

replacing vit B12

Answer 24

hydroxocobalamine
intramuscular injection
weekly x4 to replenish stores
no adverse effects

Question 25

Epo

Answer 25

encourages erythroid progenitor cells into red blood cells

Question 26

agent encouraging production of platelets from megakaryocytic

Answer 26

Tpo

Question 27

agent responsible for encouraging neutrophil progenitor cell into neutrophils

Answer 27

G-CSF

Question 28

EPO comes from

Answer 28

kidney | EPO is deficient in chronic renal failure

Question 29

times when recombinant G-CSF might be needed

Answer 29

- suppressed myeloid cell growth during cancer chemotherapy | - rebuilding leukocyte populations after bone marrow transplant

Question 30

thombopoetin-mimetic

Answer 30

romiplostim | binds and activates thrombopoeitin receptor of megakaryocyte

Question 31

clinical uses of thombopoetin mimetics

Answer 31

idiopathic thrombocytopaenic pursuer rebuilding platelet population after bone marrow transplant some other conditions where bone marrow fails to produce enough platelets