Anemia MNT exam 1

Anemia is defined as a deficiency in the ____ or ____ of red blood cells (RBCs), or the amount of ____ they contain.

size; number; hemoglobin

Anemia limits the exchange of ____ and ____ between the blood and tissue cells.

oxygen; carbon dioxide

Anemias are classified based on cell ____ and hemoglobin ____.

size; content

Macrocytic anemia refers to ____ cells.

large

Normocytic anemia refers to ____ cells.

normal

Microcytic anemia refers to ____ cells.

small

Hypochromic anemia refers to cells with ____ color.

pale

Normochromic anemia refers to cells with ____ color.

normal

Most anemias are caused by lack of nutrients required for normal ____ synthesis.

erythrocyte

The three principal nutrients involved in anemia are ____, ____, and ____.

iron; vitamin B12; folate

Nutritional anemias result from inadequate intake of ___, ___, ____ (B12, folate, pyridoxine; ascorbic acid), copper, and heavy metals.

iron, protein, vitamins

Macrocytic anemia numbers

MCV>94, MCHC>31

Vitamin B12 deficiency and folate deficiency are ___ anemias

megaloblastic

Megaloblastic and nonmegaloblastic anemias fall into the ___ category

macrocytic

Hypochromic microcytic anemias numbers

MCV<80, MCHC<31

Hypochromimc microcytic anemias include…

iron deficiency, recent blood loss, chronic disease

Iron deficiency anemia is characterized by production of ____ erythrocytes and low circulating ____.

microcytic; hemoglobin

Microcytic anemia is the ____ stage of iron deficiency, representing the end point of a long period of…

last, iron deprivation

Poor diet without supplementation causes inadequate ____ intake.

iron

Celiac disease, atrophic gastritis, and gastrectomy cause inadequate iron ____.

absorption

Chronic GI disturbances cause inadequate iron ____.

utilization

Infancy, adolescence, pregnancy, and lactation increase iron ____.

requirement

Excessive menstrual blood or bleeding ulcers increase iron ____.

excretion

Chronic inflammation causes defective iron ____ from stores.

release

Iron deficiency causes inadequate muscle function leading to decreased ____ performance and ____ tolerance.

work; exercise

Neurologic involvement of iron deficiency anemia includes fatigue, anorexia, and pica, especially ____ (ice eating).

pagophagia

Iron deficiency may cause abnormal ____ development.

cognitive

Iron deficiency reduces ____ competence.

immune

Restless leg syndrome may result from lack of iron in the ____ affecting dopamine.

brain

Iron deficiency causes ____ skin.

pale

Iron deficiency anemia causes inside of lower eyelid to become ____ instead of red.

light pink

Glossitis from ____ causes a tongue that is smooth, ____, and glistening.

iron deficiency anemia, waxy

Iron deficincy anemia _____ causes irritation and fissures at the corners of the ____.

Angular stomatitis, lips

Koilonychia refers to ____ shaped ____.

spoon, fingernails

Iron deficiency anemia can cause ____, which can lead to ____ (lack of stomach acid).

gastritis, achlorhydria

Definitive diagnosis of iron-deficiency anemia requires more tahn one method of iron evaluation: ____ are the most useful

ferritin, iron, and transferrin

Hemoglobin alone is not suitable because it is affected ____ in the disease, cannot distinguish iron deficiency from ____, and hemoglobin values in normal individuals ___ and are lower in ____

late, other anemias, vary widely, women

Iron is transported in blood by plasma ____ after absorptiion

transferrin

Transferrin saturation measures amount of ___ bound to ___. It is a gauge of iron supply to the ___

iron, transferrin, tissues

TIBC (total iron-binding capacity) refers to the ____ of transferrin to take on or become saturated with ___.

capacity, iron

High transferrin usually indicates ____ iron.

low

Iron supplements are best absorbed when the stomach is ____.

empty

What form of iron should be used for iron oral supplementation?

inorganic iron in the ferrous form

Elemental iron dosage for adults is – mg per day.

50-200

Chelated iron is more ____ than non-chelated.

bioavailable

Phytates, oxalates, calcium, and tannins act as iron absorption ____.

inhibitors

Iron dextran is administered ____ when oral therapy fails.

parenterally

People with iron deficiency absorb ___% of dietary iron.

20-30

Those without iron deficiency absorb only ___% of dietary iron.

5-10

Heme iron is found in ____ and is about ____% absorbable.

meat/fish/poultry; 15

Nonheme iron is found in _____ and is only ___% absorbable.

MFP, eggs, grains, veggies and fruits; 3-8

Vitamin ____ improves iron absorption.

C

Megaloblastic anemias are characterized by ____ immature, ____ RBCs.

large, abnormal

95% of megaloblastic anemias are due to ____ or ____ deficiency.

folate; vitamin B12

Normal body folate stores are depleted within ___ months.

2-4

Vitamin B12 stores last for several ____.

years

Folic acid can ____ vitamin B12 deficiency.

mask

Low serum folate is defined as less than ____ mg/ml.

3

Low RBC folate is below ____ ng/ml.

140-160

Folate deficiency results in a ____ and ____ anemia.

macrocytic; megaloblastic

Folate supplementation dosage is ___ mg daily for ___ weeks to replenish stores

1-5, 2-3 weeks

Folate is easily destroyed by ____.

heat

RDA for folate in adults is ____ mcg/day.

400

After folic acid deficiency anemia is corrected, patient should be instructed to eat at least one ____, or drink a glass of ____

fresh, uncooked fruit or veggie, fruit juice daily

Pregnancy/childbearing age folate recommendation is ____ mcg/day.

600

Intrinsic factor is required for vitamin B12 ____.

absorption

Vitamin B12 is absorbed in the ____.

ileum

Lack of intrinsic factor causes ____ anemia, which is a ____ anemia most commonly caused by a lack of ___

pernicious, megaloblastic macrocytic, IF

Pernicious anemia affects blood, GI tract, and ____ systems.

nervous

B12 deficiency causes paresthesia (____ and ____), dimunution of senses of ___, ____, poor muscular coordination, poor ___, and ____

numbness; tingling; stomach, vibration, memory, hallucinations

Untreated B12 deficiency can cause ____ nerve damage.

irreversible

What test is used to see if a person has vitamin B12 deficiency by assessing how well the body absorbs it?

Schilling test

B12 injections of ____ mcg or more are given ____ or ____ for treatment of B12 deficiency once per ___

100, IM; subcutaneous, week

Maintenance dose for vitamin B12 deficiency is ____ mcg monthly

100

Oral B12 therapy uses very high doses of about ____ mcg/day.

1000

High protein diet recommendation is ____ g/kg for liver function and blood regeneration in vitamin B12 deficiency

1.5

Avoid ____ and ____ to improve iron absorption.

coffee; tea

Food sources vitamin B12

clams, beef liver, fortified breakfast cereals

Cooking in ____ cookware increases iron intake.

cast iron

Oral iron commonly causes constipation, diarrhea, and…

heartburn

Liver and kidney are rich sources of ___ iron

heme

Dried fruits, peas, beans, green leafy veggies, and nuts provide ____ iron

nonheme

Chronic alcoholism causes folate deficiency due to poor ___ and utilization

intake

Celiac disease causes folate deficiency due to impaired ___

absorption

Kidney dialysis increases folate___

excretion

Pairing heme with ___ iron increases absorption

nonheme