Neoplasia/Hematology - Pharmacology - Antianemia Agents; Hemostatic Agents Flashcards
Name the most relevant vitamins, minerals, or stimulating factors inducing proper erythropoeisis.
Vitamins B12 and B9
Fe2+
Erythropoeitin
What medication(s) can be given to stimulate platelet production?
Oprelvekin
(IL-11)
What medication(s) can be given to stimulate granulocyte production?
Filgrastim (G-CSF);
sargramostim (GM-CSF)
Vitamins B12 and B9 are necessary for synthesis of what in red blood cells?
dTMP
(due to proper activity of dihydrofolate reductase)
G-CSF stimulates production of what?
Neutrophils
GM-CSF stimulates production of what?
Granulocytes + other myeloid cells
What is the most common type of anemia?
Microcytic, hypochromic anemia
(due to iron deficiency)
Although most of the iron in the body is bound in hemoglobin, a significant portion is bound to ________, a transport protein, and ________, a storage protein.
Although most of the iron in the body is bound in hemoglobin, a significant portion is bound to transferrin, a transport protein, and ferritin, a storage protein.
What transporter in the duodenum allows for iron uptake?
DMT1
In what clinical scenarios should iron be given to a patient with hemolytic anemia?
It should not!
(Iron stores are elevated in hemolytic anemia)
What dietary forms of iron can be administered to a patient with iron deficiency anemia?
Ferrous sulfate;
ferrous gluconate;
ferrous fumarate
What parenteral forms of iron can be administered to a patient with iron deficiency anemia?
Iron dextran;
sodium ferric gluconate;
iron sucrose
Hemochromatosis occurs most often in patients with an __________ disorder of iron __________ and in patients receiving frequent __________ for treatment hemolytic anemia.
Hemochromatosis occurs most often in patients with an inherited disorder of iron absorption and in patients receiving frequent transfusions for treatment of hemolytic anemia.
How can acquired hemochromatosis be treated?
Chelation therapy (deferasirox or deferoxamine)
How can inherited hemochromatosis be treated?
Phlebotomy
True/False.
Folate (B9) is involved in the metabolism of both the following: methylmalonyl-CoA, homocysteine.
False.
Cobalamin (B12) is involved in the metabolism of both the following: methylmalonyl-CoA, homocysteine.
A deficiency of cobalamin leads to elevated serum levels of what?
A deficiency of folate leads to elevated serum levels of what?
Methylmalonic acid, homocysteine;
homocysteine
What is the typical scenario in which iron poisoning occurs?
A child finding/ingesting supplements
What are the signs/symptoms of iron poisoning?
Necrotizing gastroenteritis;
shock;
metabolic acidosis
The iron stored in intestinal mucosal cells is complexed to / stored in what?
Ferritin
(forming apoferritin)
What is the most common type of vitamin B12 deficiency anemia?
Pernicious anemia
Anticoagulants are generally used to prevent what?
Venous clots
Antiplatelet medications are generally used to prevent what?
Arterial clots
What medication class is used to prevent venous clots?
Anticoagulants
What medication class is used to prevent arterial clots?
Antiplatelets agents
The hemophilias are disorders of __________ hemostasis.
von Willebrand is a disorder of __________ hemostasis.
The hemophilias are disorders of secondary hemostasis.
von Willebrand is a disorder of primary hemostasis.
Primary hemostasis mostly involves what?
Platelet adhesion
_________ hemostasis mostly involves inactive circulating proteins primarily made in the ________.
Secondary hemostasis mostly involves inactive circulating proteins primarily made in the liver.
What glycoprotein binds platelets to exposed von Willebrand factor?
gp Ib
What glycoprotein binds platelets to each other via fibrinogen?
gp IIb/IIIa
Arterial clots are mainly composed of what?
Platelets
Venous clots are mainly composed of what?
Fibrin
What is the main trigger for arterial clots?
Atherosclerosis
What is the main trigger for venous clots?
Stasis
Venous clots can bypass the lungs and become arterial if what if present?
A patent foramen ovale
True/False.
DVTs and PEs typically result due to atherosclerosis and are clots composed mainly of fibrin.
False.
DVTs and PEs typically result due to stasis and are clots composed mainly of fibrin.
True/False.
MIs and strokes typically result due to atherosclerosis and are clots composed mainly of fibrin.
False.
MIs and strokes typically result due to atherosclerosis and are clots composed mainly of platelets.
Bleeding time is a measure of the time it takes for an incision to stop bleeding.
This is a measure of what process?
Primary hemostasis
How long is the average bleeding time?
1 to 9 minutes
An abnormal bleeding time indicates defects in either:
__________ or _________.
An abnormal bleeding time indicates defects in either:
platelets or vWF.
True/False.
Elevated bleeding times are seen in patients with pure clotting factor deficiencies.
False.
Normal bleeding times are seen in patients with pure clotting factor deficiencies.
(Bleeding time measures platelet function in primary hemostasis)
In pure clotting factor deficiencies, there is ________ bleeding time.
In pure clotting factor deficiencies, there is normal bleeding time.
What do PFAs measure?
Platelet function