Lecture 163

Question 2

What levels are typically increased in direct proportion to the severity of the anemia?

Answer 2

Erythropoietin

Question 3

What type of anemia often results from an insufficient supply of iron?

Answer 3

Microcytic anemia

Question 4

What type of anemia is often the result of a vitamin B12 or folic acid deficiency?

Answer 4

Megaloblastic anemias

Question 5

What type of anemia is caused by a defect in the synthesis of intrinsic factor?

Answer 5

Pernicious anemia

Question 6

What formulation is used as an oral iron replacement?

Answer 6

Ferrous sulfate

Question 7

How often is ferrous sulfate taken for treating anemia?

Answer 7

2-4 times daily

Question 8

What are common side effects of ferrous sulfate?

Answer 8

GI irritation

Question 9

What pharmaceutical is used to treat anemia with IV administration?

Answer 9

Iron dextran

Question 10

What must be done before initiating therapeutic IV iron dextran therapy?

Answer 10

A test dose due to risk of anaphylaxis

Question 11

How is IV iron dextran processed?

Answer 11

By macrophages

Question 12

What are common side effects of IV iron dextran?

Answer 12

Headache, fever, generalized lymphadenopathy

Question 13

Where is vitamin B12 stored?

Answer 13

In the liver

Question 14

B12 is a cofactor for ____

Answer 14

Methionine synthase

Question 15

In the absence of adequate B12, MTHF cannot be converted to ____

Answer 15

Tetrahydrofolate (THF)

Question 16

Vitamin B12 is vital for maintaining the integrity of ____

Answer 16

Myelin sheath

Question 17

How is vitamin B12 deficiency treated orally?

Answer 17

Cyanocobalamin

Question 18

What administration method is typically used to treat vitamin B12 deficiency?

Answer 18

IM injection

Question 19

What glycoprotein delivers B12 to various cells?

Answer 19

Transcobalamin

Question 20

What treatment for vitamin B12 deficiency can also be used as an antidote for cyanide poisoning?

Answer 20

Hydroxocobalamin

Question 21

How is folic acid typically administered?

Answer 21

Orally

Question 22

How long does it take Hgb and Hct levels to normalize after initiating folic acid therapy?

Answer 22

4 to 8 weeks

Question 23

What supplement should not be administered as a monotherapy in patients with vitamin B12 deficiency?

Answer 23

Folic acid

Question 24

What hormone is produced mainly by peritubular interstitial cells in the kidney?

Answer 24

Erythropoietin

Question 25

What is the abbreviation for recombinant human EPO?

Answer 25

rHuEPO

Question 26

What therapeutic is used to treat symptomatic anemia that is not responding to therapy directed at underlying cause of the disease?

Answer 26

Epoetin alfa

Question 27

How is epoetin alfa administered and dosed?

Answer 27

SubQ or IV, 3x week

Question 28

What is the onset of action of epoetin alfa?

Answer 28

2-6 weeks after initiation of treatment

Question 29

What labs should be monitored in patients receiving epoetin alfa therapy?

Answer 29

Hemoglobin once weekly until dosing is established

Question 30

What is the most common adverse effect of epoetin alfa?

Answer 30

Hypertension

Question 31

What is a rare condition where RBC production in the bone marrow stops?

Answer 31

Pure red cell aplasia (PRCA)

Question 32

What treatment for anemia can induce pure red cell aplasia?

Answer 32

Epoetin alfa

Question 33

What is the black box warning of epoetin alfa?

Answer 33

Risk of death, MI, stroke, VTE, and thrombosis

Question 34

What hemoglobin level should not be surpassed in CKD patients receiving ESA therapy?

Answer 34

10-11 g/dL

Question 35

What is the antimetabolite that selectively inhibits the enzyme ribonucleoside diphosphate reductase (RNR)?

Answer 35

Hydroxyurea

Question 36

Hydroxyurea increases the production of ____?

Answer 36

Fetal hemoglobin (HbF)

Question 37

Induction of HbF typically occurs within ____ of starting hydroxyurea therapy

Answer 37

4-12 weeks

Question 38

What is the most significant side effect of hydroxyurea therapy?

Answer 38

Myelosuppression

Question 39

What labs should be monitored during therapy with hydroxyurea?

Answer 39

CBC