MNT for Anemia

Question 1

Anemia is a deficiency in the ____ or ____ of RBC or decreased amounts of hemoglobin.

Answer 1

Size or number

Question 2

Microcytic anemia

Answer 2

Small RBC size

Question 3

Macrocytic anemia

Answer 3

Large RBC size

Question 4

Normocytic

Answer 4

Normal RBC size

Question 5

Hyperchromic

Answer 5

High amounts of hemoglobin

Question 6

Hypochromic

Answer 6

Low amounts of hemoglobin

Question 7

Normochromic

Answer 7

Normal amounts of hemoglobin

Question 8

Nutrients required for RBC synthesis

Answer 8

B12 and folate for DNA synthesis
Iron to produce heme

Question 9

Iron deficiency anemia

Answer 9

Microcytic and hypochromic
Small RBC with decreased hemoglobin content
The last stage of iron deficiency

Question 9

Iron deficiency anemia - Causes

Answer 9

Inadequate intake: vegans, vegetarians
Inadequate absorption: calcium, tannins, decreased stomach acidity
Increased requirement: pregnancy, adolescents
Increased excretion: menstruation
Increased destruction

Question 10

GI _____ is the most common cause of iron loss in men.

Answer 10

Bleed

Question 11

Iron deficiency anemia - Symptoms

Answer 11

Fatigue
Impaired muscle function
Impaired growth
Impaired immunity
Pale skin
Thin/flat/spoon-shaped nails

Question 12

Iron deficiency anemia - Diagnosis

Answer 12

Serum ferritin (storage iron): low
Serum iron: low but fluctuates
Transferrin: high
Total iron binding capacity: high
% Transferrin saturation: low
Hemoglobin and hematocrit: low
MCV: low
MCH: low

Question 13

Serum ferritin will be high if ______ is present, making it a bad indicator of storage iron when diagnosing iron deficiency anemia

Answer 13

Inflammation

Question 14

Transferrin is the protein that ____ to iron and transports it around the body.

Answer 14

Binds

Question 15

Transferrin is ____ during iron deficiency anemia because there is less iron to bind, increasing transferrin.

Answer 15

High

Question 16

Total iron binding capacity will be ____ in iron deficiency anemia

Answer 16

High

Question 17

% transferrin saturation will be ___ in iron deficiency anemia because there is a low amount of iron saturated with transferrin.

Answer 17

Low

Question 18

Both hemoglobin and hematocrit will be ____ in iron deficiency anemia.

Answer 18

Low

Question 19

MCV is the average blood volume of each RBC and will be ___ in iron deficiency anemia since the RBCs are small.

Answer 19

Low

Question 20

MCH will be ___ in iron deficiency anemia.

Answer 20

Low

Question 21

________ is the best indicator of early iron deficiency anemia at stage 1 and stage 2.

Answer 21

Ferritin (usually missed because not included in routine panels)

Question 22

In stage 4 of iron deficiency anemia, we start to see drops of __________ and __________.

Answer 22

Hemoglobin
Hematocrit

Question 23

Iron deficiency anemia- Treatment

Answer 23

High iron diet
Heme iron: MFP
Combine non-heme iron with vitamin C to enhance iron absorption
Avoid consuming with tannins/phenols

Question 24

Iron supplements are best absorbed on an _____ stomach due to stomach acidity.

Answer 24

Empty

Question 25

T/F: It is best to take iron with coffee, tea, or dairy

Answer 25

False, it reduces the bioavailability

Question 26

___________ is a common side effect of iron supplements, encourage fiber and fluids.

Answer 26

Constipation

Question 27

__________ iron is the most common supplemental form.

Answer 27

Ferrous

Question 28

_________ forms of iron are better absorbed than ferrous forms as they are less vulnerable to binding agents in the body.

Answer 28

Chelated

Question 29

Combine nonheme iron with _______ to boost bioavailability.

Answer 29

Vitamin C

Question 30

Megaloblastic anemia is due to _____ DNA synthesis and may be caused by ____ or B12 deficiency.

Answer 30

Altered, Folate

Question 31

Pernicious anemia, a type of megaloblastic anemia is ONLY due to ____ deficiency.

Answer 31

B12, (vegans at risk)

Question 32

B12 deficiency, (the cause of pernicious anemia) can be due to age, ____ blocking medication, ilial resection, and loss of _______ factor (autoimmune disease or gastric bypass)

Answer 32

Acid, intrinsic

Question 33

Pernicious anemia is concerning because it affects the _____ system, causing memory loss, confusion, and irreversible neurological symptoms.

Answer 33

Nervous

Question 34

_______ infections decrease stomach acidity, which can cause B12 deficiency and loss of intrinsic factors, leading to pernicious anemia.

Answer 34

H Pylori

Question 35

Hemoglobin and hematocrit are _____ with megaloblastic anemia.

Answer 35

Low

Question 36

MCH and MCV are _____ with megaloblastic anemia.

Answer 36

High

Question 37

Diagnosis for megaloblastic anemia

Answer 37

Hemoglobin Hematocrit MCV MCH Serum folate B12 RBC folate Intrinsic factor antibody test

Question 38

Treatment for megaloblastic anemia

Answer 38

Folic acid supplementation

Question 39

Foods high in folate include:

Answer 39

Oranges Dark leafy greens Legumes/Beans

Question 40

T/F: B12 supplements are still greatly absorbed in low acidity in the stomach.

Answer 40

True

Question 41

T/F: Anemia of chronic disease is due to nutritional deficiency

Answer 41

False, due to a decrease in RBC production

Question 42

Anemia of chronic disease causes:

Answer 42

Inflammation Infection Malignancy/Cancer

Question 43

Anemia of chronic disease characteristics include:

Answer 43

Low hemoglobin/hematocrit Normal or high ferritin (inflammation) Normal MCV and MCH

Question 44

Anemia of chronic disease treatment

Answer 44

Erythropoietin (EPO)- stimulates RBC production

Question 45

If you see low hemoglobin and hematocrit, check ____ and ____, if normal, no further intervention is needed because it is considered anemia of chronic disease

Answer 45

MCH and MCV

Question 46

If you see low hemoglobin and hematocrit, check MCV and MCH, if low, check ______ _______, transferrin, or % transferrin saturation, which may be iron deficiency anemia.

Answer 46

Serum ferritin - may also be high or normal due to inflammation so check other labs too (transferrin, or % transferrin saturation)

Question 47

If you see low hemoglobin and hematocrit, check MCV and MCH, if high, check ______ and _______ levels, which may be megaloblastic anemia.

Answer 47

Folate, B12

Question 48

The type of anemia experienced by people who lack intrinsic factors is:

Answer 48

Megaloblastic macrocytic anemia

Question 49

Macrocytic anemia may be caused by deficiencies of

Answer 49

Folate, Vitamin B12, or both

Question 50

The type of anemia caused by iron deficiency:

Answer 50

Microcytic hypochromic anemia

Question 51

The form of iron that is absorbed best is ____ iron.

Answer 51

Heme

Question 52

We want to consume non-heme iron in the _____ form with vitamin C to boost absorption.

Answer 52

Ferrous

Question 53

______ _____ supplements can mask a B12 deficiency.

Answer 53

Folic acid

Question 54

T/F: Folic acid deficiency causes pernicious anemia

Answer 54

False, only B12 causes pernicious anemia. Folic acid deficiency can cause megaloblastic anemia.

Question 55

In megaloblastic anemia, the RBCs are large, _____, and abnormal RBC.

Answer 55

immature

Question 56

T/F: Pernicious anemia is more so a result of inadequate B12 absorption (Crohn's, celiacs), rather than B12 intake (vegans).

Answer 56

True

Question 57

T/F: Pernicious anemia can cause irreversible neurological damage.

Answer 57

True

Question 58

T/F: Hemoglobin and hematocrit levels will be low with ANY type of anemia.

Answer 58

True

Question 59

The form of folic acid most commonly found in food is _____, which is not the best absorbable form but still recommended before supplements.

Answer 59

Folate