OMED - Iron Deficiency Anemia

Question 1

T/F: Patients with MILD iron deficiency anemia are usually asymptomatic

Answer 1

True

Question 2

Patients with more severe iron deficiency anemia may present with:

Fatigue, weakness
Skin and conjunctival _______
Irritability, decreased concentration
Shortness of breath
Brittle, fragile fingernails and ___________
Headache (frontal)
Decreased ___________ (especially in children)
Pica
______________ syndrome

Answer 2

pallor; koilonychia; appetite; Plummer-Vinson

Question 3

Dysphagia, iron-deficiency anemia, and weakness are the most common symptoms of what?

Answer 3

Plummer-Vinson syndrome (PVS)

Question 4

Dysphagia symptoms of PVS are caused by a ___________ structure that originates on the posterior wall of the cervical ___________ between the hypopharynx and 1 to 2 cm below the cricopharyngeal region

Answer 4

weblike; esophagus

Question 5

What condition develops over months to years, manifests in the 4th-5th decades of life, and is more common in Scandinavian countries than in the US?

Answer 5

PVS

Question 6

Because PVS is a risk factor for developing squamous cell carcinoma of the esophagus and hypopharynx, it is considered a _____________ condition

Answer 6

premalignant

Question 7

Oral findings of iron deficiency anemia may include:

Angular cheilitis
Atrophic _________ (often accompanied by tenderness or a burning sensation [glossodynia])
Generalized _________ atrophy

Answer 7

glossitis; mucosal

Question 8

T/F: GI referral for evaluation of GI malignancy is recommended in all patients with iron deficiency and suspected GI blood loss

Answer 8

True

Question 9

Patients should be instructed to consume foods that contain large amounts of iron, such as liver, red meat, and __________

Answer 9

legumes

Question 10

Pharmacologic treatment consists of oral _________ __________, 325 mg (1x, 2x or 3x / day)

Answer 10

ferrous sulfate

Question 11

Patients should be instructed to continue their iron supplements for at least __________ or longer to correct depleted body iron stores

Answer 11

6 months

Question 12

GI side effects from oral iron therapy are common and include nausea, abdominal pain /cramping, and _____________

Answer 12

constipation

Question 13

_______________ iron therapy is used for patients with poor tolerance or noncompliance with oral preparations, malabsorption, post gastrectomy or duodenal bypass and so forth

Answer 13

Parenteral (intravenous)

Question 14

____________ of packed RBCs is indicated in patients with severe symptomatic anemia

Answer 14

Transfusion

Question 15

What 5 laboratory studies are important in the evaluation of iron deficiency anemia?

Answer 15

RBC count and indices
serum iron
serum ferritin
serum transferrin
total iron-binding capacity (TIBC)

Question 16

The first detectable abnormality due to iron deficiency will be an abnormal decrease in ____________

Answer 16

serum ferritin

Question 17

What are the next 4 detectable abnormalities due to iron deficiency?

Answer 17

Decreased serum iron
Decreased serum transferrin
Increased transferrin
Increased total iron-binding capacity

Question 18

Laboratory abnormalities consistent with iron deficiency anemia include:

_____ serum ferritin level
_________ RBC distribution width (with values generally >15)
_____ mean corpuscular volume
_____ mean corpuscular hemoglobin
_________ total iron binding capacity (TIBC)
_____ serum iron

Answer 18

decreased; increased; decreased; decreased; increased; decreased

Question 19

___________, microcytic anemia is present with significant iron deficiency

Answer 19

Hypochromic

Question 20

Peripheral blood smear in patients with iron deficiency generally reveals microcytic, hypochromic red blood cells with a wide area of _________ _________ that exceed half the diameter of the cells

Answer 20

central pallor

Question 21

What 2 things may occur when anemia is severe?

Answer 21

Anisocytosis (variation in size)
Poikilocytosis (variation in shape)

Question 22

For patients with iron deficiency, pernicious or similar anemia:

If hemoglobin (Hgb) levels is ≥ 11 g/dL and are asymptomatic, then __________ with routine dental care

Answer 22

proceed

Question 23

Routine care should be ___________ in those patients whose Hgb is < 11 g/dL AND manifest signs and symptoms secondary to anemia such as:

Shortness of breath
Tachycardia
Oxygen saturation (SaO2) < _____% (as determined by pulse oximetry)

Answer 23

deferred; 91%

Question 24

__________ analgesics with strong respiratory depressant properties should be avoided with ____________ anemia

Answer 24

Narcotic; symptomatic

Question 25

Dentists should be aware that anemia places a patient at increased risk for what disease?

Answer 25

Ischemic heart disease

Question 26

For dental patients with extremely low ___________ levels, physician consultation prior to surgical treatment is recommended

Answer 26

hemoglobin