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APEA - Pre predictor > Heme CE 2 > Flashcards

Heme CE 2 Flashcards

1
Q

common microcytic anemias
2

A

IDA
thalassemia

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2
Q

IDA =

A

microcytic, hypochromic anemia

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3
Q

thalassemia =

A

microcytic hypochromic anemia

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4
Q

less common causes of microcytic anemia
3

A
  1. anemic of chronic disease
  2. sideroblastic anemia
  3. lead toxicity
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5
Q

IDA - what, why, where

A

what - microcytic, hypochromic
why - blood loss
where - most commonly GI or Gyn related

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6
Q

IDA presentation in young and middle-aged adults
5

A
  1. fatigue
  2. weakness
  3. headache
  4. irritability
  5. exercise intolerance
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7
Q

IDA presentation in older adults

A

exacerbation of comorbidities - angina, HF, dementia

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8
Q

MCV low, MCH low =

A

classic IDA

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9
Q

good sources of iron for IDA
7 - foods

A
  1. liver
  2. lentil soup
  3. spinach
  4. clams
  5. red beans
  6. rice
  7. oysters
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10
Q

IDA - iron replacement usually occurs over how long and with what mg

A

4-6 months, 150-200 mg of elemental iron

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11
Q

difference between ferrous fumarate and sulfate

A

fumarate is not well tolerated although it has 106 mg of elemental iron as compared to sulfate 65 mg. So sulfate is most often prescribed and usually taken TID

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12
Q

which lab indicates iron supplements can be stopped

A

normal serum ferritin levels

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13
Q

blood counts when you start on an iron supplement

A

the bone marrow starts making more reticulocytes which rises (takes 3 days to convert to mature RBCs) H/H but the iron stores are what need to become normal

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14
Q

can iron studies (serum iron, ferritin, TIBC) be normal in IDA and why

A

no - if microcytic, hypochromic with normal iron studies think thalassemia

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15
Q

inherited anemia

A

thalassemia

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16
Q

thalassemia RBCs keep their what

A

nucleus, look like target cells

17
Q

iron def anemia lab values
hgb, hct
MCV, MCH
RDW
serum iron
TIBC
serum ferritin

A

hgb/hct - low
MCV, MCH - low
RDW - elevated
serum iron - low
TIBC - elevated
ferritin - low

18
Q

hgb/hct - low
MCV, MCH - low
RDW - elevated
serum iron - low
TIBC - elevated
ferritin - low

A

IDA

19
Q

thalassemia lab values -
hgb, hct
MCV, MCH
RDW
serum iron
TIBC
serum ferritin

A

hgb/hct - low
MCV, MCH - low
RDW - normal
serum iron - normal
TIBC - normal
serum ferritin - normal

20
Q

hgb/hct - low
MCV, MCH - low
RDW - normal
serum iron - normal
TIBC - normal
serum ferritin - normal

A

thalassemia

21
Q

thalassemia - what, why, types, dx test, tx

A

what - microcytic, hypochromic
why - inherited
types - alpha, beta, others
dx test - hgb electrophoresis
tx - consider reproductive counseling

22
Q

what stores excess iron

A

liver

23
Q

thalassemia pts and excess iron

A

if thalassemia pt gets too much iron, they can store this in their liver which can cause hepatotoxicity

24
Q

anemia of chronic disease

A

normocytic, normochromic most common; microcytic, hypochromic (uncommon)

25
Q

anemia of chronic disease - why

A

RBC life span is shortened from the normal 100-120 days to 60-90

26
Q

RBC life span is shortened from the normal 100-120 days to 60-90

A

anemia of chronic disease

27
Q

anemia of chronic disease tx

A

better control of underlying chronic disease, tx of malignancy, tx of underlying cause

28
Q

common macrocytic anemias
2

A

b12 def/cobalamin def
folate def

29
Q

classic b12/folate def - what, presentation

A

what - macrocytic anemia
presentation - asymptomatic pt OR unexplained neuro symptoms, cognitive changes, burning tongue

30
Q

classic b12/folate def - who
5

A

older adults
alcoholics
malnourished
bariatric/gastric surgery pts
strict vegans/vegetarians

31
Q

classic b12/folate def - tx

A

b12 and/or folate supplementation

32
Q

why can older adults develop b12/folate def

A

pH stomach rises as you get older which makes it become less acidic which decreases absorption

33
Q

causes of b12 def
8

A
  1. pernicious anemia (autoimmune condition)
  2. inadequate dietary intake
  3. gastrectomy, bari surgery
  4. PPIs
  5. metformin
  6. colchicine
  7. methotrexate
  8. h. pylori
34
Q

causes of folate def
3

A
  1. inadequate dietary intake
  2. increased requirements such as pregnancy
  3. intestinal malabsorption
35
Q

b12/folate def mgmt - asymptomatic

A

can treat both orally - b12 1000-2000 mcg/day, folate 1 mg/day

36
Q

b12/folate def mgmt - symptomatic

A

consider treating both IV - b12 lifelong treatment needed if cause if not reversible like PA; folate 1-4 months or until hematologic recovery

37
Q

neuro deficits of b12 def are usually what

A

reversible - improved in 5-10 days

APEA - Pre predictor (38 decks)

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