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21 Cards in this Set
- Front
- Back
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What is the definition of anemia?
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less than normal amount of red blood cells
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What does hypochromic mean?
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low on color; found in iron deficient patients
since less hemaglobin then blood is not as red |
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microcytic vs macrocytic
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small cell vs large cell
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What is transferrin?
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protein in blood stream to help transport Fe
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What is Ferritin?
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soluble storage form of iron; parrallels amount of iron in body
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What is the Coombs test?
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Immune vs non-immune hemolytic anemia
Bilirubin Indirect/unconjugated is elevated in hemolysis vs. direct in cholestasis or obstruction of liver if direct is elevated look at liver if indirect is elevated more consistent with hemolytic anemia |
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How is anemia presented?
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Weakness, fatigue, shortness of breath, pallor (paleness associated with decreased oxyhemaglobin to skin/mucous membranes)
Folate vs. B12: neuropathy & CNS Dementia, memory, paresthesias Iron: spooning of nails (concave) Hemolysis: cholelithiasis, jaundice Hemoglobinopathies: pain crisis (sickle cell) |
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Who usually experiences iron deficiency?
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infants,young women pregnancy, elderly
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Whats the best way to go about iron replacement?
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200mg/day elemental irong for 6 months; or 325 mg TID FeSO4 (20% elemental iron)
sustained release poor absorption liquid stains teeth absorbed better w/out food |
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What drugs interact with Fe?
foods? |
tetracyclines, acid blockers, quinolones
tea, coffee, fiber, milk, formula: all decrease absorption |
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What should you do if giving Fe by IV?
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give single dose and watch out for anaphylaxis
fewer allergic rxns with smaller doses |
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What can Megaloblastic folte/B12 cause?
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MCV increased
cause pancytopenia B12 deficiency can cause nerve damage to myelin sheath |
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best way to go about B12 replacement?
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SC or IM B12 1mg/day x 1-2 weeks, then q 1-3 monts for life
PO: 1-2 mg/day x 2 wks, then 1 mg/day Nasal gel 500 mcg weekly for maintenance (after 1-2 wks repletion) |
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what are some drug interactions with B12 replacement?
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PPIs, H2RAs, ascorbic acid
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What foods are good for B12?
Folate? |
B12 - needs acid, intrinsic factor, and terminal ileum for absorption - (liver stores 3-5 years worth)
meat, liver, fish, eggs, milk Folate - monoglutamated form is absorbed (body stores atleast 3-4 months worth) leafy green vegetables, fortified bread, and cereal |
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What drugs decrease absorption or utilizatin of folate?
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ETOH, phenytoin, phenobarb, carbamazepine, sulfasalazine, OC, PPI, H2RA, methotrexate, TMP-SMZ
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Best way for folate doseing is?
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1mg daily x 2-3 wks
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What are some diseases that give rise to anemia? (anemia of chronic disease)
what is this caused by? |
chronic infections, inflammation, malignancies
caused by increased hepcidin which blocks ferroportin and reduces use of iron from iron stores looks like Fe deficiency but TIBC and ferritin normal IRON replacement not helpful |
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What causes anemia in renal disease?
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deficiency of erythropoietin from kidney
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how to treat anemia from reanal disease?
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Erythropoietin 40,000U weekly SC
Darbopoietin 200mcg q 2 wks possibly Fe replacement |
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What % of cancer pts respond to erythropoietin
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50%
FDA, do not use if: currative intent metastatic beast or head/neck cancer ALWAYS USE CONSENT FORMS |
