PHRM 825: Anemia

Question 1

What is anemia?

Answer 1

Decrease in RBC or Hgb

Question 2

How to truly diagnose anemia

Answer 2

bloodwork

Question 3

Normal RBC

Answer 3

4. 5-5.5X10^6 cell/uL (male)

4. 1-4.9X10^6 cells/uL (female)

Question 4

Normal Hgb

Answer 4

13.5-18 g/dL (male)

12-16 g/dL (female)

Question 5

Normal Hct

Answer 5

38-50% (male)

36-46% (female)

Question 6

Normal MCV

Answer 6

80-100 mm^3

Question 7

Normal MCH

Answer 7

26-34 pg/cell

Question 8

Normal MCHC

Answer 8

31-37 g/dL

Question 9

Normal RDW

Answer 9

11.5-14.5%

Question 10

Causes of anemia

Answer 10

• Decreased RBC production
• Increased RBC destruction
• Increased RBC loss

Question 11

3 classifications of anemia

Answer 11

• Microcytic
• Normocytic
• Macrocytic

Question 12

Microcytic anemia MCV and causes

Answer 12

MCV <80

Iron deficiency, sickle cell, thalassemia

Question 13

Normocytic anemia MCV and causes

Answer 13

MCV 80-100

Anemia of chronic disease, blood loss, hemolysis

Question 14

Macrocytic anemia MCV and causes

Answer 14

MCV >100

Folic acid and or B12 deficiency

Question 15

Normal ferritin

Answer 15

15-200 ng/mL

*Iron deficiency is still likely for ferritin <50 ng/mL

Question 16

Normal iron

Answer 16

40-160 mcg/dL

Question 17

Normal transferrin

Answer 17

200-360 mg/dL

Question 18

Normal TIBC

Answer 18

250-400 mcg/dL

Question 19

Normal TSAT

Answer 19

20-50%

Question 20

How much oral iron per day is recommended for anemic patients?

Answer 20

120-200 mg

Question 21

How long does it take to replete iron stores in an anemic patient?

Answer 21

3-6 months

Question 22

Normal B12

Answer 22

> or = 200 pg/mL

Question 23

What is another term used for vitamin B12

Answer 23

Cobalamin

Question 24

Normal folic acid

Answer 24

> or = 5 ng/mL

Question 25

How much vitamin B12 per day is recommended for deficient patients?

Answer 25

1000-2000 mcg/day | B12 is water soluble so it doesn't matter how much we give the patient

Question 26

How much folic acid per day is recommended for deficient patients?

Answer 26

1-5 mg until Hgb normalizes

Question 27

What is erythropoietin and what does it to?

Answer 27

Hormone produced in the kidney that stimulates production of RBCs

Question 28

What is the most common type of anemia?

Answer 28

Iron deficiency anemia

Question 29

What is the second most common type of anemia?

Answer 29

Anemia of CKD

Question 30

In what patients should ESA not be used?

Answer 30

Patients with HF

Question 31

How much iron is in each unit of PRBC?

Answer 31

250 mg

Question 32

What is the normal lifespan for RBCs?

Answer 32

120 days

Question 33

What are the types of hemolytic anemia?

Answer 33

Intertied and acquired

Question 34

What does RBC represent

Answer 34

Count of Red Blood Cells | Estimate of oxygen carrying capacity

Question 35

What does Hgb represent

Answer 35

Hemoglobin | Oxygen carrying capacity

Question 36

What does Hct represent

Answer 36

Hematocrit | Volume of RBC's per unit of blood (changes with number or size of RBC)

Question 37

What does MCV represent

Answer 37

Mean corpuscuar volume | Average volume of RBCs

Question 38

What does MCH represent

Answer 38

Mean Corpuscular Hemoglobin | Percent (volume) of RBC that is Hgb

Question 39

What does MCHC represent

Answer 39

Mean Corpuscular Hemoglobin Concentration | Weight of Hgb per volume of RBC's

Question 40

What does RDW represent

Answer 40

RBC Distribution Width | Variation in size of RBCs

Question 41

What does the ferritin level mean

Answer 41

Iron stores in body | *acute phase reactant-elevated in acute inflammation or chronic disease

Question 42

What does the iron level mean

Answer 42

Concentration of iron bound to transferrin

Question 43

What does the transferrin level mean

Answer 43

Protein that delivers iron throughout the body

Question 44

What does the TIBC level mean

Answer 44

Concentration of iron if all transferrin was bound to iron (usuallly only ~30%)

Question 45

What does TIBC stand for

Answer 45

Total iron binding capacity

Question 46

What does TSAT stand for

Answer 46

Transferrin saturation

Question 47

What toes the TSAT level mean?

Answer 47

Amount of iron ready for erythropoiesis

Question 48

What part of the GI tract has the maximal iron absorption

Answer 48

duodenum

Question 49

What drugs cause iron deficiency

Answer 49

Drug causes are unlikely

Question 50

What drugs cause B12 deficiency

Answer 50

PPI's and metformin

Question 51

What drugs cause folic acid deficiency

Answer 51

- Methotrexate - Phenytoin - Sulfasalazine - Sulfamethoxazole/trimethoprim

Question 52

The FDA mandated wheat flour be fortified with what?

Answer 52

Folic acid