Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
38 Cards in this Set
- Front
- Back
Normal Hemoglobin Level for Men
|
14 to 18 g/dL
|
|
Normal Hemoglobin Level for Women
|
12 to 15 g/dL
|
|
Level of Hemoglobin in Life-Threatening Anemia
|
< 6.5 g/dL
|
|
7 Consequences of Anemia
|
Pallor, Fatigue, SOB, Worsening of Cardiac Disease, Cardiac Arrest, Shock, Death
|
|
Cardiovascular Effects from Anemia
|
Tachycardia, Hypotension, Mild Cardiac Enlargement, Functional Systolic Mumurs (diastolic murmur uncommon), High Output Failure, Worsening of HF or other CV disease
|
|
Pulmonary Effects of Anemia
|
Exertional Dyspnea, Orthopnea, Tachypnea
|
|
The Three Steps of Managing Anemia
|
1) Determine Acuity, 2) Determine Etiology, & 3) Initiate Therapy
|
|
How is life-threatening anemia treated. What are the benefits? The risks? Outline the Process.
|
Blood Transfusion. Benefit: Immediate increase of 1 g/dL Hg per unit infused. Risks: Infection &/or Transfusion Rxns. Process: Informed Consent, Type & Cross, Premed w/ APAP and Diphenhydramine, and Infuse 1 Unit over 4 hrs.
|
|
Define Microcytic, Normocytic, & Macrocytic w/ respect to MCV.
|
Microcytic: MCV < 80; Normocytic: MCV 80 to 100; Macrocytic MCV > 100
|
|
99% of the time, microcytic anemia is due to what?
|
Iron Deficiency
|
|
What does a negative Coomb's Test suggest as the source of hemolytic anemia?
|
A negative Coomb's test is likely to be drug-induced.
|
|
What does a positive Coomb's Test indicate as the source of hemolytic anemia?
|
A positive Coomb's test is indicative of autoimmune hemolytic anemia.
|
|
What are the three categories of people most prone to suffer B12 deficiency?
|
People who have a poor diet, alcoholics, and elderly patients.
|
|
What are 5 factors that may lead to folic acid deficiency?
|
1) Poor dietary intake, 2) decreased absorption, 3) hyperutilization (e.g. pregnancy), 4) inadequate utilization (rare), & 5) drugs (methotrexate, etc.)
|
|
What does a normal Schilling's Test indicate?
|
A normal Schilling's Test indicates that a B12 Deficient patient can be effectively treated w/ oral B12 supplementation.
|
|
What does an abnormal Schilling's Test indicate?
|
An abnormal Schilling's Test indicated that a B12 deficient patient must be treated with IM B12 supplementation (oral supplements will not be absorbed).
|
|
What does a Schilling Test measure?
|
It measures intrinsic factor. Intrinsic factor is in your stomach and you need intrinsic factor to absorb B12.
|
|
% Elemental Iron in Ferrous Sulfate?
|
20%
|
|
% Elemental Iron in Ferrous Sulfate Exsiccated?
|
30%
|
|
% Elemental Iron in Ferrous Gluconate?
|
12%
|
|
% Elemental Iron in Ferrous Fumarate?
|
33%
|
|
% Elemental Iron in Ferric Pyrophosphate?
|
12%
|
|
% Elemental Iron in Ferrous Carbonate?
|
43%
|
|
Approximately what percentage of iron is absorbed upon oral intake?
|
10%
|
|
Why should you never recommend sustained release iron products?
|
They release their iron in a place where iron cannot be absorbed.
|
|
Approximately how fast will HgB increase w/ iron supplement therapy?
|
HgB will increase ~ 1 g/dL per wk
|
|
For how long will someone who has iron deficiency anemia have to take iron supplements?
|
3 to 6 months
|
|
How soon will reticulocytosis occur following iron supplementation in patient who have iron deficiency anemia?
|
7 to 10 days
|
|
What are the common ADRs of iron supplementation?
|
Discoloration of feces, nausea, and constipation (in most people) or diarrhea (in some people)
|
|
What is the problem with use of Iron Dextran for IM or IV supplementation of iron?
|
It can cause anaphalaxis.
|
|
What are the two, newer IV iron products?
|
Ferrlecit and Venofer
|
|
What is the difference between Ferrlecit and Venofer?
|
Ferrlecit is a sodium ferric gluconate complex in sucrose (62.5 mg elemental iron in 5 mL sucrose). Venofer is iron sucrose (100 mg elemental iron in 5 mL water).
|
|
What are the main ADRs of Ferrlicet?
|
Hypotension, rash, flushing, GI upset in 10 to 20% of patients
|
|
What are the main ADRs of Venofer?
|
Very well tolerated. ADRs include diarrhea, GI upset, and minty taste in less than 5% of patients.
|
|
Treatment for B12 Deficiency
|
IM 800 to 1000 mcg/day for 1 to 2 wks, then 100 to 1000 mcg/wk until normal HgB, and then 100 to 1000 mcg/month thereafter.
|
|
What is the treatment for folic acid deficiency?
|
1 mg po qd x 4 months
|
|
Name the drugs most associated w/ hemolytic anemia.
|
Dapsone, methyldopa, penicillins, and sulfonamides (such as the sulfamethoxazole in Bactrim)
|
|
What is the two step treatment for drug-induced hemolytic anemia?
|
1) Stop the drug, & 2) Steroids, such as prednisone (to shut down the immune system, in severe cases)
|