NAPLEX > Anemia & Sickle Cell > Flashcards

Anemia & Sickle Cell Flashcards

(85 cards)

Study These Flashcards
1
Q

a decrease in RBCs, Hgb, and/or Hct

A

anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

____ are immature RBCs that develop into ___ which are mature RBCs

A

reticulocytes - immature
erythrocytes - mature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

protein in RBCs that carries oxygen

A

Hgb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

nutritional deficiencies that can cause impaired RBC or Hgb production

A

B12, folate, iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

2 main processes of anemia

A

impaired RBC or Hgb production
RBC destruction - hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

2 medical disorders that can cause anemia

A

CKD, cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

symptoms of anemia due to reduced oxygen delivery

A

fatigue, weakness, SOB, exercise intolerance, HA, dizziness, and/or palor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

classifications of anemia based on MCV

A

microcytic - low MCV <80
macrocytic- high MCV >100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

common causes of microcytic anemia

A

iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

common causes of macrocytic anemia

A

b12 or folate deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

common causes of normocytic anemia

A

acute blood loss, malignancy, CKD, bone marrow failure, hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

measure of RBC production

A

reticulocyte count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

causes of iron deficiency

A

vegan diet, chronic blood loss (heavy menses, PUD), dec iron absorption (high gastric pH), GI disorders (gastric bypass), inc iron requirements (pregnancy, lactation, infants)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

most common nutritional deficiency in the US

A

iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

lab findings in iron deficiency anemia

A

decrease Hgb, MCV, reticulocyte count, serum iron, ferritin, and TSAT
increase TIBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

treatment, dosing, and how to take for iron deficiency anemia

A

oral iron 1 tablet daily or every other day on an empty stomach for best absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

SR and EC formulations of PO iron cause less ___ but are NOT recommended due to ____

A

GI irritation
poor absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

goal of PO iron therapy and duration

A

inc Hgb after 1-2 weeks, continue treatment for 3-6 months or until iron stores are normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the dose and elemental iron of oral ferrous sulfate

A

325 mg - 65mg elemental iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

BBW oral iron products

A

accidental overdose can cause fatal poisoning in children - go to ED or call poison control even if asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

AEs of oral iron

A

constipation (dose related), dark/tarry stools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

antidote for oral iron overdose

A

deferoxamine (Desferal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

DDIs of oral iron

A

antacids, H2RAs, and PPIs decrease absorption by inc gastric pH
vitamin C may inc iron absorption
polyvalent cation- separate from quinolones, tetracycline, bisphosphonates, levothyroxine, INSTIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

IV iron is typically restricted WHY?

A

adverse reactions and cost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
IV iron is restricted to what patients
CKS on hemodialysis and/or received ESAs unable to tolerate PO iron
26
brand name of IV iron sucrose
Venofer
27
brand name of IV ferumoxytol
Feraheme
28
BBW for iron dextran
serious fatal anaphylactic reactions, get a test dose
29
BBW for iron ferumoxytol
serious fatal anaphylactic reactions
30
warning for all IV iron
hypersensitivity
31
an autoimmune condition cause by antibodies to intrinsic factor, commonly causing B12 deficiency
pernicious anemia
32
pernicious anemia often requires lifelong
parenteral B12 replacement
33
causes of macrocytic anemia
pernicious anemia AUD, low intake, dec GI absorption, long term use of metformin/H2RA/PPIs
34
labs in macrocytic anemia
low Hgb and reticulocyte count high MCV
35
symptoms of B12 deficiency
neurologic dysfunction - cognitive impairment, peripheral neuropathy (can become irreversible)
36
symptoms of folate deficiency
ulcerations of the oral mucosa
37
first line for severe B12 deficiency
b12 injections
38
alternative non PO or injectable option of B12 and its brand name & admin
nasal Nascobal - one nostril once weekly
39
admin of injectable B12
IM or deep SC
40
treatment of folate deficiency
oral folic acid
41
hormone produced by the kidneys that stimulates the bone marrow to produce RBCs
erythropoietin (EPO)
42
deficiency in EPO causes
anemia of chronic disease
43
treatments for anemia of chronic disease
iron and ESAs
44
KDIGO recommendations for iron in CKD? when are ESAs used?
IV iron preferred ESAs if causes of anemia are addressed and Hgb stays <10
45
when are ESAs started? when are doses decreased or interrupted?
start when Hgb <10 stop/dec if Hgb approaches or exceeds 11
46
adequate ___ is needed for ESAs to be effective
iron stores
47
brand names of epoetin alfa
Epogen, Procrit
48
brand name of darbepoetin alfa
Aranesp
49
frequent of epo alfa in CKD
3x week
50
BBW for ESAs
inc risk death, MI, stroke, VTE, thrombosis use lowest effective dose inc risk death in CKD when Hgb >11 not indicated in certain cancers if anticipated outcome is cure
51
warning and AE with ESAs
warning- hypotension AE- arthralgia
52
monitoring for ESAs
H&H, TSAT, serum ferritin, BP
53
is IV or SC recommended for ESAs in dialysis
IV
54
which ESA has longer half life? frequency or admin?
darb alfa 3x longer = given weekly
55
store ESAs ___. Do not___.
fridge, do not shake
56
2 main mechanisms of drug induced hemolytic anemia
immune mediated - positive direct Coombs in setting of G6PD deficiency (must avoid high risk meds)
57
drugs that cause immune mediated + Coombs hemolytic anemia
penicllins, cephalosporins, isoniazid, levodopa, methyldopa, rifampin, quinine, quinidine, sulfonamides
58
drugs that cause hemolytic anemia in G6PD deficiency
dapsone, methylene blue, nitrofurantoin, pegloticase, rasburicase, primaquine, quinidine, quinine, sulfonamides
59
ESA injection sites
outer arm, sides above hip, abdomen, top of thigh
60
RBCs have a lifespan of
~120 days
61
group of inherited RBC disorders from a genetic mutation in genes encoding hemoglobin and causing RBCs to have abnormal Hgb (HgbS)
sickle cell disease
62
sickle cell most commonly affects
african americans
63
RBCs in sickle cell have a ___ shape and hemolyze after ___ days causing ____
concave (sickle) shape 10-20 days anemia
64
sickle cell complication due to vascular occlusion
vaso-occlusive crisis or acute pain crisis
65
acute pain crisis in the chest with evidence of pulmonary infection
acute chest syndrome
66
3 bacteria of concern in sickle cell due to asplenia and what they may cause
s. pneumoniae, h. influenzae, n. meningitidis sepsis, meningitis
67
patients with sickle cell have a shrunken spleen also called
functional asplenia - absent spleen function
68
asplenia increases risk for
serious infections - immunizations and prophylactic abx needed
69
non drug treatment options for sickle cell
blood transfusions bone marrow transplant
70
goal Hgb in blood transfusion for sickle cell
<= 10
71
one of the risks of blood transfusion in sickle cell is
iron overload
72
infants who are positive for sickle cell should be initiated on what therapy and admin and for how long?
prophylactic oral penicillin BID until age 5
73
important routine childhood vaccines in asplenia
Hib, pneumo
74
important additional vaccines in asplenia
meningococcal conjugate and group B, pneumo if not gotten as a child
75
treatment to remove excess iron due to iron overload from blood transfusions in sickle cell
PO chelation therapy with deferasirox or deferiprone
76
patients with severe pain in sickle cell will require
IV opioids or patient controlled analgesia
77
sickle cell disease modifying drug that stimulates production of HgbF indicated in adults with >= 1 mod-sev pain crisis
hydroxyurea
78
rounds doses of hydroxyurea to the nearest
capsule size
79
BBW hydroxyurea
myelosuppression
80
warnings hydroxyurea
fetal toxicity, avoid live vaccines
81
monitoring with hydroxyurea
CBC with diff ANC
82
what supplementation is recommended with hydroxyurea therapy
folic acid
83
hydroxyurea is a ___ drug, Wear ____ and do what?
hazardous wear gloves, wash hands
84
what is required during hydroxyurea treatment and after
contraception
85
DDI hydroxyurea
additive risk of myelosuppression with other immunosuppressants
NAPLEX
flashcards
Decks in class (54)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions