Np Review

Front 1

decreased numbers of red blood cells or hemoglobin content caused by blood loss, deficient erythropoiesis, excessive hemolysis, or a combination of these changes.

Back 1

anemia

Front 2

only occurs when the insult is severe enough to disturb normal homeostatic mechanisms and exceed reserves

Back 2

anemia

Front 3

Where is 90% of erythopoietin formed
and other 10% is:

Back 3

renal system 90%
Hepatic 10%

Front 4

At what GFR level is Erythopoietin supply diminished

Back 4

<49

Front 5

DNA synthesis is impaired by presence of:

Back 5

Chronic inflammation
such as found in:
Systemic Lupus,
Rheumatoid Arthritis, Chronic infection
REVERSABLE when inflammation treated

Front 6

Iron containing oxygen transport protein found in red blood cells

Back 6

hemoglobin

Front 7

What do you need to make hemoglobin

Back 7

iron
b vitamins
Vitamin C
protein

Front 8

what are reticulocytes

Back 8

young blood cells that contain some residual RNA

Front 9

What % of RBC count are Reticulocytes

Back 9

1-2%

Front 10

-osis means

Back 10

increase in

Front 11

reticulocytes increase or decrease in response to anemia?

Back 11

increase

Front 12

-penia

Back 12

too few cells

Front 13

Common causes of anemia

Back 13

1. blood loss (uncommon in primary care) must be 1L or more loss although chronic is far more common (erosive gastritis)
2. reduced RBC production
3. premature destruction

Front 14

most likely cause of sudden dangerous drop in Hct and Hgb

Back 14

hemorrhage

Front 15

Reduced RBC production results from:

Back 15

1. nutritional deficiency (B12, folic acid, iron)
2. anemia of chronic disease
3. Bone marrow suppression

Front 16

anemia from Hemolysis is

Back 16

shortened RBC lifespan <90 days

Front 17

what is normal hemoglobin to hematocrit ratio

Back 17

1:3

Front 18

which? hemoglobin or hematocrit may be effected by dehydration

Back 18

hematocrit

Front 19

MCV (mean corpuscle volume)

Back 19

red blood cell volume

Front 20

microcytic

Back 20

MCV <80 small

Front 21

Normocytic

Back 21

MCV 80-96 (normal)

Front 22

Macrocytic

Back 22

MCV >96 (abnormally large

Front 23

Red blood cell hemoglobin content

Back 23

MCH - mean cell hemoglobin
MCHC - mean cell hemoglobin concentration

Front 24

Source of the RBC's color

Back 24

hemoglobin
(chromic)

Front 25

Hemoglobin comprises what % of RBC volume

Back 25

90%

Front 26

Normochromic

Back 26

normal color
MCHC 31-37

Front 27

Hypochromic

Back 27

pale color
MCHC <31

Front 28

RDW

Back 28

RBC distribution width

Front 29

What is an abnormal value for RDW

Back 29

greater than 15%

Front 30

What is one of the earliest laboratory indicators of an evolving microcytic or macrocytic anemia?

Back 30

Abnormal RDW

Front 31

What is the normal RDW?

Back 31

11.5-15%

Front 32

What is the normal reticulocyte percentage?

Back 32

1-2%

Front 33

Normal response to anemia is for reticulocytes to increase by ?? %

Back 33

>2%

Front 34

Most common etiology Normocytic Anemia
(2)

Back 34

Acute blood loss
Anemia of chronic disease (most common in primary care)

Front 35

MCV of 80-96

Back 35

normocytic anemia

Front 36

What is it:
Hgb - 10.1 Hct 32%
RBC 3.2 million MCV 82
MCHC 34.8
RDW 12.1%

Back 36

Normocytic Anemia

Front 37

MCV <80

Back 37

Microcytic

Front 38

Most common etiology of microcytic, hypochroic anemia with elevated RDW

Back 38

Iron Deficiency anemia

Front 39

Small RBC are always:

Back 39

PALE

Front 40

What is it:
Hgb 10.1 Hct 32%
RBC 3.2 million MCV 72
MCHC 26.8
RDW 18.1%

Back 40

Microcytic
hypochromic

IRON DEFICIENCY ANEMIA

Front 41

What etiology presents with anemia that is microcytic hypo chromic with normal RDW

Back 41

Alpha and beta Thal minor

Front 42

What ethnic group is at risk for alpha thalassemia

Back 42

Asian
African
A, A, A

Front 43

What ethnic group is at risk for Beta thalassemia

Back 43

African
Mediterranean
Middle Eastern
B, A, M, ME

Front 44

What is it:
Hgb 11.6 Hct 36.7%
RBC 6.38 mil MCV 69.6
MCH 22 RDW 13.8%

Back 44

Beta Thal Minor
(small pale cells - but lots of them)

Front 45

Etiology of Macrocytic, Normochromic anemia

Back 45

1. Dietary induced vit B12 deficiency (uncommon if omnivore)
2. Pernicious anemia (most common)
3. Folate deficiency anemia

Front 46

What is it:
Hgb 8.2 Hct 25%
RBC 2.7 million MCV 125.5
MCH 31 RDW 18.8%

Back 46

Pernicious anemia

*marked macrocytosis

Front 47

Drug induced macrocytoisis without anemia caused by which meds:

Back 47

carbamazepine,
zidovudine,
valproic acid,
phenytoin,
alcohol

Front 48

What is it:
Taking phenytoin
Hgb 12 Hct 37%
RBC 4.2 mil MCV 105.5
MCH 31 RDW 12.8%

Back 48

Drug induced macrocytoisis
Do NOT treat... Leave pt alone

Front 49

Anemia treatment:

Back 49

Treat underlying cause
consider multiple causes

Front 50

What medication is helpful in severe anemia, particularly in the presence of advancing renal failure:

Back 50

Epoetin alfa (procrit)

Front 51

most common type of anemia in childhood

Back 51

iron deficiency anemia

Front 52

most common type of anemia in pregnancy

Back 52

Iron deficiency

Front 53

most common type of anemia in women during reproductive years

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iron deficiency anemia

Front 54

most common type of anemia in the elderly

Back 54

anemia of chronic disease

Front 55

Most important source of the body's iron supply

Back 55

recycled iron content from aged red blood cells (85%)

Front 56

You advise a person who is a vegan to supplement the diet with:

Back 56

Vitamin B12

Front 57

In evaluating a person with microcytic anemia, the next step in laboratory assessment includes obtaining a serum:

Back 57

Ferritin
(iron deficiency status)

Front 58

In providing information about the best way to take oral iron therapy to maximize the drugs absorption you advise the patient to take the medication:

Back 58

on an empty stomach

Front 59

A 68 /o woman presents with a 6 month hx of increasing severe peripheral numbness and oral irritation. Pale conjunctiva, 2/6 systolic murmur, beefy red tongue - What is it:
Hgb 6.2, Hct 20%, RBC 2.1 mil, MCV 132, MCHC 32.4, RDW 19%

Back 59

Vitamin B12 Deficiency
(causes neurologic dysfunction)

Front 60

Per each unit of blood HCt increases by how many points

Back 60

3

Front 61

Murmur heard in patients with severe dehydration, high fever, profound anemia, thyroid toxicosis:

Back 61

hemic murmur

Front 62

Iron deficiency anemia presents:

Back 62

Microcytic, hypochromic, elevated RDW

Front 63

Folate deficiency anemia presents:

Back 63

Macrocytic, normochromic, elevated RDW

Front 64

Alpha Thalassemia anemia presents with:

Back 64

Microcytic, hypocromic, normal RDW

Front 65

Anemia of Chronic disease presents with:

Back 65

Normocytic, normochromic, reticulocytopenia

Front 66

Primary care of the person with alpha thalassemia minor should include:

Back 66

offering genetic counseling prior to pregnancy