Card Set Information
Anemia PHPR523 Test3
What is the etiology of Iron-deficiency anemia?
Inadequate iron absorption
What is the pathophysiology of Iron-deficiency anemia?
: iron stores are reduced but serum levels remain normal; Hb normal
: iron stores depleted; Hb declines, but stays above lower limit
: Hb drops below lower limit
What are the sx of Iron-deficiency anemia?
glossitis (inflammation of the tongue)hair loss
koilonychia (spoon nails)
pica (compulsive eating of non-food items)
stomatitis (inflammation of the mouth)
decreased mental acuity
What are the lab values for Iron-deficiency anemia?
What is the tx for Iron-deficiency anemia?
Polysaccharide iron complex
What is the dose and duration of tx for Iron-deficiency anemia?
Ferrous Sulfate 325mg PO TID
Elemental Fe 200mg PO BID-TID
Dexferrum/INFeD 50mg/mL IM
What are the SE of iron supplementation?
separate from cations, FQs, TCNs, thyroid by 2hrs
What should be monitored for Iron-deficiency anemia?
Reticulocytes should increase in 5-7d
Hb should increase 2-4g/dL q 3wks
What are the characteristics of parenteral iron (Dexferrum/INFeD)?
use Z-track technique
: brown staining, hypotension, anaphylaxis (do a 0.5mL test dose)
What is the etiology of Vitamin B12 deficiency anemia?
What is the pathophysiology of B12 deficiency anemia?
impairs DNA and RNA nucleic acid synthesis in the immature RBC which impairs mitotic cell division and maturation producing large immature RBCs
What are the sx of B12 deficiency anemia?
: numbness, paresthesias, peripheral neuropathy, ataxia, diminished vebratory sense, decreased proprioception, imbalance, possible vision changes
: irritability, personality changes, memory impairment, dementia, depression, psychosis (rare)
What are the lab findings of B12 deficiency anemia?
Methylmalonic acid test is elevated (v. diagnostic for B12 deficiency)
Anti-intrinsic factor antibody test
Anti-parietal cell antibody test
What is the tx for B12 deficiency anemia?
1000mcg PO QD
1000mcg IM QD or QOD
: Nascobal or CaloMist intranasal
What are the SE of B12 supplementation?
What is monitored during B12 supplementation?
What is the etiology of Folic Acid deficiency anemia?
What are the sx of Folic Acid deficiency anemia?
similar to B12 deficiency minus neurologic sx and psych sx
What are the lab findings for Folic Acid deficiency anemia?
What is the tx for Folic Acid deficiency anemia?
Folic acid 1mg PO QD
Why must B12 deficiency be ruled out before treating Folic Acid deficiency?
so you don't ignore neurologic sx if they also have B12 deficiency
What is the etiology of Anemia of Chronic Disease?
alcoholic liver disease
ischemic heart disease
What is the pathophysiology of Anemia of Chronic disease?
immune activation causes inflammatory cytokine production which reduces iron availability, impaired erythrocyte proliferation, impaired erythropoietin production, and shortened RBC lifespan
What are the Sx of Anemia of Chronic Disease?
often overshadowed by the sx of the underlying disorder
What are the lab findings for Anemia of Chronic Disease?
What is the tx for Anemia of Chronic Disease?
correct underlying disease (not usually)
RBC transfusion if < 8
Iron supplementation (if Fe deficient)
What are the SE of the erythropoietic drugs?
pure red cell aplasia