Hematinics & Coagulants

Question 1

Which type of iron is absorbed readily in the duodenum?

Answer 1

Heme iron

Question 2

How can ferric iron be absorbed?

Answer 2

Reduction to ferrous iron.

Question 3

Transporter for ferrous iron?

Answer 3

DMT1

Question 4

Iron enters circulation attached to

Answer 4

Transferrin

Question 5

Iron is stored as

Answer 5

Ferritin

Question 6

Elevated transferrin levels could indicate:

Answer 6

DECREASED Fe levels

Question 7

Elevated ferritin levels could mean

Answer 7

INCREASED Fe levels

Question 8

Peptide that reduces iron absorption in enterocytes and increases iron accumulation by macrophages

Answer 8

Hepcidin (hormone produced by liver)

Question 9

Lifespan of RBC

Answer 9

120 days

Question 10

1 mL RBC contains how much elemental iron

Answer 10

1 mg

Question 11

Three foods that may impair iron absorption

Answer 11

tea, dairy, fish

Question 12

What increases iron absorption?

Answer 12

Ascorbic acid

Question 13

ADR of iron:

Answer 13

abdominal pain
nausea and vomiting
constipation

Question 14

How many mg/day of elemental iron in iron replacement therapy?

Answer 14

300 mg/day

Question 15

In oral iron replacement therapy, the goal for iron stores to reach how many g?

Answer 15

0.5-1g

Question 16

Indications of parenteral iron therapy?

Answer 16

1) Patient cannot tolerate oral iron
2) Condition is acute
3) There is a continuous need for iron

Question 17

Which parenteral iron preparation has the risk of anaphylaxis?

Answer 17

Iron dextran

Question 18

Parenteral iron therapy is used to augment the response of

Answer 18

Recombinant EPO in patients undergoing dialysis

Question 19

Excess iron depositions in chronic iron toxicity can be found in which organs?

Answer 19

Heart, liver, pancreas, other

Question 20

IDA patients are prone to what toxicity?

Answer 20

Lead toxicity.

Lead absorption can be increased in patients with low dietary calcium, IDA, and ingestion on empty stomach.

Question 21

Cobalamin (B12) or folate (B9) deficiency can cause what kind of anemia?

Answer 21

Megaloblastic (macrocytic type)

Question 22

What kind of anemia can cause B12 deficiency?

Answer 22

Pernicious anemia (loss of gastric parietal cells –> decreased intrinsic factor –> impaired B12 absorption)

Question 23

Why should folate not be used in B12 deficiency?

Answer 23

Folic acid may elleviate the anemia but allow the neurologic deficits from B12 deficiency to continue. Vit B12 deficiency impairs reutilization of folate, so effects of folate deficiency can manifest. Supplementing with folate can mask the B12 deficiency.

Question 24

Indications of Epoetin alfa?

Answer 24

Also known as recombinant human erythropoietin.
Anemia in chronic kidney disease.
AIDS
Cancer chemotherapy and surgery.
Prematurity.
Chronic inflammation

Question 25

Modified form of EPO is also called

Answer 25

Darbepoetin alfa

Question 26

Difference between G-CSF and GM-CSF potential?

Answer 26

GM-CSF has broader biologic actions. Multipotential hematopoeitic growth factor (granulocyte, megakaryocyte, erythroid).

Question 27

Exogenous forms of GM-CSF/G-CSF?

Answer 27

Sargramostim Filgrastim Pegfilgrastim

Question 28

Sargramostim is extracted from: It is a form of :

Answer 28

yeast recombinant human GM-CSF

Question 29

Filgrastim is extracted from: It is a form of:

Answer 29

E. coli recombinant human G-CSF

Question 30

``` Thrombocytopenia drug(s) with the following ADR: tachycardia palpitation edema shortness of breath ```

Answer 30

Oprelvekin

Question 31

Thrombocytopenia drug(s) that is/are recombinant thrombopoietin

Answer 31

Romiplostim & Eltrombopag

Question 32

Thrombocytopenia drug(s) that is/are recombinant IL-11

Answer 32

Oprelvekin

Question 33

Vit K-dependent factors:

Answer 33

Factors II, VII, IX, X

Question 34

Which Vit K form is synthesized by intestinal bacteria?

Answer 34

K2 (menaquinone) This is why dietary requirement is low

Question 35

Which Vit K form is a water soluble salt and should never be used therapeutically?

Answer 35

K3 (menadione)

Question 36

Which Vit K form is found in food?

Answer 36

K1 (phytonadione)

Question 37

Which Vit K form is found in human tissues?

Answer 37

K2 (menaquinone)

Question 38

FDA-approved treatment for vWF bleeding:

Answer 38

Humate-P

Question 39

Treatment for uncomplicated hemorrhage into a joint:

Answer 39

Factor VIII or Factor IX replacement

Question 40

Initial loading dose for FVIII

Answer 40

50 units/kg daily in 2 divided doses

Question 41

Fibrinolytic inhibitor similar to lysine

Answer 41

Aminocaproic acid (EACA)

Question 42

Fibrinolytic inhibitor similar to EACA

Answer 42

Tranexamic acid