Studydroid is shutting down on January 1st, 2019

by tbruno


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Decrease in Red blood cells could be caused by
Decreased absorption of iron and B12

Decreased produciton of hemoglobin or RBCs

Hemolysis

Hemorrhage
Acute Anemia symptoms
Mor dangerous

Cardio respiratory symptoms, tachycardia, lightheadedness and SOB
Chronic Anemia Symptoms
Fatigue
Headache
vertigo
faintness
cold intolerance
pallor
mental status changes
Microtic anemia causes
Iron deficency
Sickle cell anemia
thalassemieas (not common)
Macrotcytic anemia causes
Megaloblastic
-pernicious anemia, B12 deficency anemia
-Folate deficiency

Nonmegaloblastic-alcoholism

Normocytic
-Recent blood loss
-Anemia of inflamation
-chronic disease, criticl illness
CKD
Hemolysis
Hgb
Male 14-18

Female 12-16
Hct
Male 39%-49%

Female 33%-43%
MCV
76-100
WBC
3.2-9.8 x 103
Plt
130-400 x 103
Iron Deficency Anemia (IDA) Causes
Vegetarian diet

Decreased absorption of iron
-Calcium
-High fiber

Increaed iron utilization
-Children and pregnancy

Physiologic iron loss
-Menstration, pregnancy

Pathologic iron loss
-GI bleeding
-other hemorrhage
Serum Iron
Normal Value 50-160, 40-150 mcg/dL
Total Iron Binding Concentration (TIBC) and %Satruation
TIBC
-Normal value 250-400 mcg/dl
-Indirect measure of capacity of transferrin to bind iron

Saturation
Normal 20%-50%
IDA
Serum Ferritin
Normal Value 15-200/12-150

Protien that stores iron in body

One of the first indicatiors to decrease IDA

Any inflammatory disorder can raise the farritin level
Miscellaneous
Symptoms of IDA may include
Pica (eating inorganic substances)
Pagophagia (Compulsie ice eating)
Treatment of IDA basics
Dieat
Iron replacemnt
parenteral iron replacement
Transfusion

Vitamin C may increase absorption

Calcim and higher fiber decrease absorption
Iron Drug interactions decrease absorption
Decrease Fe absorption
Antacids
Tetracyclins/Doxycycline
PPIs/Antihistamines
Cholestyramine
Iron Drug interactions decrease absorption off
Fe Decreases absorption of

Levodopa

Levothyroxine

Fluoroquinolines/tetra and doxyclcyin
Oral Iron therapy
Start with ferrous suulfate 325mg PO daily
-incease to bid or tid if needed

Monitor CBC and ferrtin
-2-5g/dL and reticulytosis in 3 weeks imrovement symptoms in 2-4 weeks
Iron ADRs
GI upset
Constipation
diarrhea
darkened stools

Take on empty stomick if tolerated

Stool softener if constipation
Macrocytic anemia
Megaloblastic (problems with DNA synthesis)
B12 and/or folate deficency

Nonmegoloblastic
-Liver Disease
-Hypothyrodisim
-Hymolytic anemia
-Alcohol
B12
Nomral level 100-900 pg/mL
Treat if
Folic Acid
Normal 1.8-1.6 ng/mL

Poor diet

Pregnancy

Drugs
-methotrexate, trimethoprim, tiamterene, anticonvulsants
Chronic Diease Anemia
EPO

Give only if hgb is
Hemolytica Anemia
Many reason
Drug induced
-Cephalosporins
-Levodopa
-Methyldopa
-Penicillin and it derivitives
-Quinidine
-NSAIDS

Defective membrane
Altered Hgb solubiltiy
G6PD deficency
Hemolytic Anemia treatment
Treat underlying cause

Immunosuppresive therapy

Splenectomy
Sickle Cell Animia (SCA)
Painful vaso-occlusive crises
Infarctions (speen, liver, kidney, brain, lungs, bone marrow)
Gallstones
Priaprism
Lower extremity ulcers
SCD even prevention
Hydration
Nosmokeing or execive EtOH
Flu shot
Penicil prophlaxis till 5yo
Folic acid 1mg QD
Hyroxyurea
Chroic transfusion theropy
Allogenic hematopetic stem cell transplant (Potentially curative)
SCD acute therapy
Transfusion
Treat inffections
Treat and/or provide supportice care for strokes, acute hest syndrom, priapisim

Pain managment 1-10 scale
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