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Anemia Frei Flashcards

1
Q

Which of the following is the definition of Anemia for Women? (select all)

A. Hgb<12g/dL

B. Hgb<13.5g/dL

C. Hct<41%

D. Hct<36%

A

A. Hgb<12g/dL

D. Hct< 36%

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2
Q

Which of the following is the definition of Anemia for Men? (select all)

A. Hgb<12g/dL

B. Hct<36%

C. Hgb<13.5g/dL

D. Hct<41%

A

C. Hgb<13.5g/dL

D. Hct<41%

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3
Q

Hct is the percent of blood volume that is composed of ___.

A. Leukocytes

B. Lymphocytes

C. Erythrocytes

D. Chondrocytes

A

C. Erythrocytes

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4
Q

MCV stand for mean corpuscular volume and represents the ___ of the blood cell.

A. Density

B. Size

C. Concentration

D. Color

A

B. Size

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5
Q

Reticulocyte count is the percentage of RBC that are ___.

A. Immature

B. Mature

C. Malformed

D. Deficient

A

A. Immature

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6
Q

All of the following are reasons for a low Reticulocyte count EXCEPT:

A. Iron Deficiency

B. Aplastic anemia

C. Chronic infections

D. Untreated pernicious anemia

E. Folic acid toxicity

A

E. Folic acid toxicity

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7
Q

Which of the following patients is considered anemic?

A. DD, male, HCT-22%

B. LA, female, HCT- 37%

C. PP, female Hgb-11g/dL

D. RA, male, Hgb 14 g/dL

E. TA, female, HCT- 35%

A

A. DD, male, HCT-22%

C. PP, female Hgb-11g/dL

E. TA, female, HCT- 35%

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8
Q

The normal range for Hct in men is:

A. 36-46%

B. 40-50%

C. 41-53%

D. 13.5-17.5

A

C. 41-53%

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9
Q

The normal range for Hct in women is:

A. 36-46%

B. 12-16

C. 13.5-17.5

D. 41-53%

A

A. 36-46%

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10
Q

The normal range for Hgb in men is:

A. 36-46%

B. 13.5-17.5

C. 12-16

D. 41-53%

A

B. 13.5-17.5

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11
Q

The normal range Hgb in women is:

A. 36-46%

B. 13.5-17.5

C. 12-16

D. 41-53%

A

C. 12-16

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12
Q

What is the normal range of MCV?

A. 70-80

B. 80-90

C. 70-100

D. 80-100

A

D. 80-100

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13
Q

T/F Hypovolemic anemia typically presents without any obvious symptoms while general anemia is a result of sudden blood loss and patients are much more symptomatic

A

False

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14
Q

Which of these symptoms coincides with an Acute Onset of anemia?

A. Tachycardia

B. Lightheadedness

C. Vertigo

D. Pallor

E. Dyspnea

A

A. Tachycardia

B. Lightheadedness

E. Dyspnea

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15
Q

A motor vehicle onset resulting in sudden blood loss will most likely result in:

A. Acute Anemia

B. Chronic Anemia

A

A. Acute Anemia

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16
Q

A change in diet over an extended period of time is likely to result in:

A. Acute Anemia

B. Chronic Anemia

A

B. Chronic Anemia

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17
Q

Which of the following are risks with PRBC transfusion in patients with anemia? (Select All)

A. Transfusion-related reactions

B. Congestive Heart Failure

C. Bacterial and Viral infection risk

D. Iron overload

E. Increased GI discomfort

A

A. Transfusion-related reactions

B. Congestive Heart Failure

C. Bacterial and Viral infection risk

D. Iron overload

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18
Q

1 unit of PRBC will usually raise the Hgb of a patient by __ or Hct by __

A. 1g/dL, 5%

B. 2g/dL, 3%

C. 1g/dL, 3%

D. 2g/dL, 5%

A

C. 1g/dL, 3%

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19
Q

When transfusing an Asymptomatic patient the target Hgb should be__

A. 8-10g/dL

B. >10g/dL

C. >11g/dL

D. 7-9g/dL

A

D. 7-9g/dL

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20
Q

When transfusing a Symptomatic patient the target Hgb should be__

A. 8-10g/dL

B. >11g/dL

C. 7-9g/dL

D. >10g/dL

A

A. 8-10g/dL

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21
Q

When transfusing a Symptomatic patient with ACS or MI the target Hgb should be__

A. 7-9g/dL

B. >10g/dL

C. >11g/dL

D. 8-10g/dL

A

B. >10g/dL

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22
Q

What is the target Hgb for a patient who has an acute hemorrhage with evidence of hemodynamic instability?

A. Hgb>10 g/dL

B. Hct>37%

C. Transfuse to correct and maintain O2 delivery

D. Hgb 8-10 g/dL

A

C. Transfuse to correct and maintain O2 delivery

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23
Q

Regarding the classification of Anemia by Morphology, match the MCV size with the classification of anemia:

I: MCV 80-100

II: MCV<80

III: MCV>100

A. Normocytic=I, Macrocytic=II, Microcytic=III

B. Macrocytic=I, Microcytic=II, Macrocytic= III

C. Normocytic=I, Microcytic=II, Macrocytic= III

D. Microcytic= I, Normocytic=II, Macrocytic= III

A

C. Normocytic=I, Microcytic=II, Macrocytic= III

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24
Q

Which of these is the common differential diagnosis for a Microcytic Anemia?

A. Acute blood loss

B. Iron deficiency anemia

C. Folic acid deficiency

D. Anemia of Chronic disease

E. B12 deficiency

A

B. Iron deficiency anemia

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25
Q

Which of these is a common differential diagnosis for Normocytic Anemia? (select all)

A. Acute blood loss

B. B12 Deficiency

C. Anemia of chronic disease

D. Chronic renal insufficiency

E. Iron Deficiency anemia

A

A. Acute blood loss

C. Anemia of chronic disease

D. Chronic renal insufficiency

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26
Q

Which of these is a common differential diagnosis for Macrocytic Anemia? (Select All)

A. Iron deficiency anemia

B. Anemia of chronic disease

C. Chronic renal insufficiency

D. B12 deficiency

E. Folic acid deficiency

A

D. B12 deficiency

E. Folic acid deficiency

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27
Q

Patient TT is a 24 yo woman who presents to the clinic presenting symptoms of fatigue, Pallor and Dyspnea on exertion. The patient reveals a gash on their leg that was received 2 days ago and was being managed from home. Upon further work-up you find the patient has an Hgb of 7.3 and is transfused with 1 unit of PRBC and their MCV shows 85. What is the most likely differential diagnosis for this patient’s anemia?

A. Anemia of Chronic disease

B. Anemia of Chronic kidney disease

C. Anemia of acute blood loss

D. B12 deficiency anemia

A

C. Anemia of acute blood loss

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28
Q

Patient CM is a 30 yo woman who presented to the clinic for general blood work. Patient did not present any noteworthy symptoms and otherwise appears to be in good health. One day has passed since the checkup and her results are as follows: MCV: 74, Hgb: 11.2, Serum Iron: 38, ferritin: 11.4. Based on these results which of the following could be the most likely be the differential diagnosis for this patient’s anemia?

A. Anemia of Chronic disease

B. Iron deficiency anemia

C. Anemia of acute blood loss

D. B12 deficiency anemia

A

B. Iron deficiency anemia

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29
Q

Short answer:

What does it mean if Serum Ferritin is considered an Acute Phase Reactant? Why does this matter in cancer patients?

A
  • Acute phase reactant means that the serum ferritin will elevate when the body is experiencing inflammation (chronic). So if a patient has their blood drawn and they have an inflammatory condition then their ferritin reading may not be accurate. This is especially a problem with cancer patients who have iron deficiency anemia because cancer causes inflammation and their ferritin may appear elevated when it actually could be deficient.
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30
Q

Which is the most common form of Anemia?

A. Iron deficiency anemia

B. B12 deficiency anemia

C. Anemia of chronic kidney disease

D. Folic acid deficiency anemia

A

A. Iron deficiency anemia

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31
Q

Absolute Iron Deficiency is defined as:

A. Serum ferritin < 30 ng/ml

B. Transferrin Saturation < 16%

C. Serum ferritin < 30 ng/ml AND Transferrin Saturation < 16%

D. Serum ferritin > 30 ng/ml AND Transferrin Saturation > 16%

A

C. Serum ferritin < 30 ng/ml AND Transferrin Saturation < 16%

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32
Q

How do you calculate Transferrin Saturation?

A. Serum Iron/ Serum Ferritin

B. Serum Ferritin/ Total Iron Binding Capacity (TIBC)

C. Serum Iron/ Total Iron Binding Capacity (TIBC)

D. Serum Iron/ Total iron

A

C. Serum Iron/ Total Iron Binding Capacity (TIBC)

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33
Q

Functional Iron Deficiency for patients on ESA therapy is defined as:

A. Serum Ferritin < 30 ng/ml AND Transferrin Saturation 20-50%

B. Serum Ferritin 30-800 ng/ml AND Transferrin Saturation 20-50%

C. Serum Ferritin < 30 ng/ml AND Transferrin Saturation < 16%

D. Serum Ferritin > 30 ng/ml AND Transferrin Saturation > 16%

A

B. Serum Ferritin 30-800 ng/ml AND Transferrin Saturation 20-50%

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34
Q

Patient labs reveal serum ferritin of 28 ng/ml and a transferrin saturation of 14%. Patient is currently not taking any medications. Does this patient have iron deficiency and if so what type?

A. No, patient values are within normal range

B. Yes, patient values coincide with Absolute Iron Deficiency

C. Yes, patient values coincide with Functional Iron deficiency in ESA patients

D. Yes, but patient values are not indicative of any specific type of Iron deficiency

A

B. Yes, patient values coincide with Absolute Iron Deficiency

35
Q

Patient labs reveal serum ferritin of 50 and transferrin saturation of 32%. Patient is currently taking Procrit and has a history of taking Aranesp. Does this patient have iron deficiency and if so what type?

A. No, patient values are within normal range

B. Yes, patient values coincide with Absolute Iron Deficiency

C. Yes, patient values coincide with Functional Iron Deficiency in ESA patients

D. Yes, but Patient values are not indicative of any specific type of iron deficiency

A

C. Yes, patient values coincide with Functional Iron Deficiency in ESA patients

36
Q

Which of the following are examples of Iron deficiency in patients with Increased Iron Requirements? (Select all)

A. GI tract and Genitourinary tract blood loss

B. Blood donations

C. Insufficient dietary iron

D. Pregnancy and Lactation

E. NSAID and/or PPI therapy

A

A. GI tract and Genitourinary tract blood loss

B. Blood donations

D. Pregnancy and Lactation

37
Q

Which of the following are examples of Iron Deficiency in patients with Inadequate Iron Supply? (Select all)

A. GI tract and Genitourinary tract blood loss

B. Insufficient dietary iron

C. Impaired iron absorption

D. Intestinal malabsorption and gastric surgery

E. PPI and NSAID therapy

A

B. Insufficient dietary iron

C. Impaired iron absorption

D. Intestinal malabsorption and gastric surgery

38
Q

Which of the following medication classes can cause Iron Deficiency? (Select all)

A. NSAIDs

B. SSRIs

C. PPIs

D. SNRIs

E. Anticoagulants

A

A. NSAIDs

C. PPIs

E. Anticoagulants

39
Q

What is the dose of Elemental Iron that is given to Adults who are iron deficient?

A. 3-6 mg/kg of elemental iron

B. 100-200 mg of elemental iron

C. 5-10 mg/kg of elemental iron

D. 15-20 mg/kg of elemental iron

A

B. 100-200 mg of elemental iron

40
Q

What is the dose of Elemental Iron that is given to Children who are iron defieicent?

A. 3-6 mg/kg of elemental iron

B. 100-200 mg of elemental iron

C. 5-10 mg/kg of elemental iron

D. 15-20 mg/kg of elemental iron

A

A. 3-6 mg/kg of elemental iron

41
Q

A 24 yo patient is found to have iron deficiency anemia and require iron supplementation. Which of the following are acceptable dosages of Iron supplementation? (select all)

A. Ferrous Sulfate 325 mg tablet, 1 tab PO BID

B. Ferrous Sulfate 160 mg tablet, 1 tab PO daily

C. Ferrous Gluconate 325 mg tablet, 1 tab PO TID

D. Ferrous Fumarate 300 mg tablet, 1 tab PO BID

E. Polysaccharide iron complex (Niferex), 1, 50mg tab PO Daily

A

A. Ferrous Sulfate 325 mg tablet, 1 tab PO BID

C. Ferrous Gluconate 325 mg tablet, 1 tab PO TID

D. Ferrous Fumarate 300 mg tablet, 1 tab PO BID

42
Q

A 33 yo patient is found to have iron deficiency anemia and requires iron supplementation. Which of the following are acceptable dosages of Iron supplementation? (select all)

A. Ferrous Sulfate 325 mg tablet, 1 tab PO daily

B. Ferrous Sulfate 160 mg tablet, 1 tab PO BID

C. Polysaccharide Iron Complex, Niferex, 1 tab PO TID

D. Polysaccharide Iron Complex, Hytinic, 1 tab PO daily

E. Ferrous Gluconate 325 mg tablet, 1 tab PO BID

A

B. Ferrous Sulfate 160 mg tablet, 1 tab PO BID

C. Polysaccharide Iron Complex, Niferex, 1 tab PO TID

D. Polysaccharide Iron Complex, Hytinic, 1 tab PO daily

43
Q

Which of these is the correct iron supplementation dosage for an adult patient with iron deficiency anemia?

A. Ferrous Sulfate 325 mg, 1 Tab PO Daily

B. Ferrous Gluconate 325 mg, 1 Tab PO TID

C. Ferrous Fumarate 300 mg, 1 Tab PO daily

D. Polysaccharide Iron Complex, Niferex, 1 Tab PO daily

E. Ferrous sulfate 160 mg, 1 Tab PO daily

A

B. Ferrous Gluconate 325 mg, 1 Tab PO TID

44
Q

Which of the following is a disadvantage of Oral Iron Therapy? (Select all)

A. GI adverse effects and BA relies on GI acidity

B. Risk of Iron overload

C. Efficacy significantly reduced as GFR declines

D. Difficult adherence with multiple dosing

E. Common Drug-Drug Interactions

A

A. GI adverse effects and BA relies on GI acidity

C. Efficacy significantly reduced as GFR declines

D. Difficult adherence with multiple dosing

E. Common Drug-Drug Interactions

45
Q

Which of the following are advantages of Oral iron therapy? (Select all)

A. Convenient Dosage Form

B. Avoidance of anaphylaxis that is seen with IV iron

C. Fastest method of restoring Iron levels

D. Avoids risk of iron overload

A

A. Convenient Dosage Form

B. Avoidance of anaphylaxis that is seen with IV iron

D. Avoids risk of iron overload

46
Q

Iron supplementation could decrease the absorption of which of these agents? (Select all)

A. Levothyroxine

B. H2-Blockers

C. Fluroquinolones

D. PPIs

E. Tetracyclines

A

A. Levothyroxine

C. Fluroquinolones

E. Tetracyclines

47
Q

Which of the following can reduce the absorption of Iron? (Select all)

A. H2 blockers

B. Levothyroxine

C. PPIs

D. Calcium

E. Levothyroxine

A

A. H2 blockers

C. PPIs

D. Calcium

48
Q

Rank each of these Parenteral Iron formulations from the Highest risk of anaphylaxis to the Lowest risk of anaphylaxis.

I: Iron sucrose (Venofer)

II: Ferric Na Gluconate (Ferrlecit)

III: Iron Dextran (Infed)

A. I, II, III

B. II, I, III

C. III, I, II

D. III, II, I

A

D. III, II, I

49
Q

T/F The lower the molecular weight of iron the higher the risk of anaphylaxis

A

True

50
Q

Which of the following Parenteral iron formulations requires a test dose before administering to a patient?

A. Iron Dextran (Infed)

B. Iron Sucrose (Venofer)

C. Ferric Na Gluconate (Ferrlecit)

D. Ferumoxytol (Feraheme)

E. Ferric carboxylmaltose (FerInject)

A

A. Iron Dextran (Infed)

51
Q

Which of the following are Advantages of Parenteral Iron therapy? (Select all)

A. Significantly more effective than oral iron supplementation

B. Lack of GI side effects that is seen with oral iron

C. Avoidance of DDIs that is seen with oral iron

D. Convenient dosage form

E. Adherence is documented

A

A. Significantly more effective than oral iron supplementation

B. Lack of GI side effects that is seen with oral iron

C. Avoidance of DDIs that is seen with oral iron

E. Adherence is documented

52
Q

Which of the following are disadvantages of Parenteral Iron therapy? (Select All)

A. Numerous GI side effects

B. Increased risk of iron overload

C. Numerous daily doses

D. Increased risk of anaphylactoid reactions

E. Inconvenient dosage form

A

B. Increased risk of iron overload

D. Increased risk of anaphylactoid reactions

E. Inconvenient dosage form

53
Q

___ therapy is shown to be more effective and beneficial in oncology and heart failure patients.

A. Oral Iron Supplementation

B. Parenteral Iron Supplementation

A

B. Parenteral Iron Supplementation

54
Q

Iron overload is classified as Serum ferritin greater than ___ and Tsat that exceeds___.

A. 100 ng/mL, 5%

B. 1000ng/mL, 50%

C. 500 ng/mL, 5%

D. 5000ng/mL, 50%

A

B. 1000ng/mL, 50%

55
Q

Which of these are options for Iron chelation therapy in instances of iron overload? (select all)

A. Deferoxamine (Desferal, IV)

B. Calcium chelation therapy

C. Deferasirox (Exjade, PO)

D. Phosphate chelation therapy

E. Deferiprone (Ferriprox, PO)

A

A. Deferoxamine (Desferal, IV)

C. Deferasirox (Exjade, PO)

E. Deferiprone (Ferriprox, PO)

56
Q

Patients presenting with an MCV of 80-100 and a high reticulocyte count the differential diagnosis could be: (Select all)

A. Acute blood loss

B. Hemolysis

C. Bone marrow failure

D. Chronic infection

E. Splenic sequestration

A

A. Acute blood loss

B. Hemolysis

E. Splenic sequestration

57
Q

Patients presenting with an MCV of 80-100 and a Low reticulocyte count with Low WBCs and Platelets the differential diagnosis could be: (Select All)

A. Acute blood loss

B. Bone marrow failure

C. Aplastic Anemia Leukemia

D. Chronic infection

E. Splenic sequestration

A

B. Bone marrow failure

C. Aplastic Anemia Leukemia

58
Q

Patients presenting with an MCV of 80-100 and a Low reticulocyte count with normal-high WBCs and Platelets the differential diagnosis could be: (Select all)

A. Chronic Infection and Inflammation

B. Anemia of Chronic Disease

C. Hemolysis

D. Anemia of Chronic Kidney Disease

E. Malignancy

A

A. Chronic Infection and Inflammation

B. Anemia of Chronic Disease

D. Anemia of Chronic Kidney Disease

E. Malignancy

59
Q

(Short Answer) What drugs cause Aplastic Anemia? Remember the acronym GAS-CANN

A

Gancyclovir, Acyclovir, Sulfonamides, Chloramphenicol, Anti-eleptics, Nifedipine, NSAIDS

60
Q

What is the pathophysiology of Anemia of Chronic Disease (ACD)? (Select All)

A. Iron homeostasis

B. Decreased erythropoietin

C. Decreased production of cytokines

D. Increased production of cytokines interfering with differentiation and proliferation of erythroid progenitor cells

A

A. Iron homeostasis

B. Decreased erythropoietin

D. Increased production of cytokines interfering with differentiation and proliferation of erythroid progenitor cells

61
Q

Inflammation that occurs in Anemia of Chronic Disease (ACD) can cause (Select All)

A. Limited utilization of iron for erythropoiesis

B. Affects formation and biologic activity of erythropoietin

C. Inflammation decreases the secretion of cytokines

D. Inflammation increases the activity of erythropoietin and over-production of RBCs

E. Inflammation can interfere with differentiation and proliferation of erythroid progenitor cells

A

A. Limited utilization of iron for erythropoiesis

B. Affects formation and biologic activity of erythropoietin

E. Inflammation can interfere with differentiation and proliferation of erythroid progenitor cells

62
Q

Anemia of Chronic Disease is a diagnosis of exclusion. In order to diagnose someone with ACD they must present all of the following EXCEPT:

A. Normocytic and Normochromic

B. Decreased serum iron

C. Normal Serum iron

D. TIBC decreased

E. B12 normal

A

C. Normal Serum iron

63
Q

Inflammatory cytokines cause all of the following EXCEPT:

A. Reduced EPO production

B. Suppressed BFU-e and CFU-e

C. Impaired iron utilization

D. Anemia

E. Overproduction of RBC

A

E. Overproduction of RBC

64
Q

Which of the following statements is true regarding ESA therapy in Anemic patients who have cancer?

A. Not recommended due to cancer cells having receptors for ESA products and possibly growing and decreasing surivival of the patient.

B. Recommended due to the decreased RBC production that is caused by chemotherapeutic agents

C. Recommended in patients with certain types of lymphomas that have receptors for ESA products. Activating these receptors can put cancer cells in the dormant G0 phase

D. Not recommended due to cancer cell utilization of the ESA compounds to form reactive species that can cause cellular destruction of normal cells.

A

A. Not recommended due to cancer cells having receptors for ESA products and possibly growing and decreasing surivival of the patient.

65
Q

Which of these is a Benefit of using ESA in cancer patients with anemia?

A. ESA therapy prevents the need for Transfusions by promoting blood growth

B. Carries no risk of Thromboembolism that is seen with transfusions

C. Gradual improvement in fatigue status

D. Does not carry the risk of HTN that blood transfusions carry

A

A. ESA therapy prevents the need for Transfusions by promoting blood growth

C. Gradual improvement in fatigue status

66
Q

All of the following are risks of ESA therapy in cancer patients with anemia EXCEPT:

A. Increased mortality and tumor progression

B. Risk of Thromboembolism

C. Increased risk of anaphylaxis

D. Risk of HTN

D. Risk of Pure cell aplasia

A

C. Increased risk of anaphylaxis

67
Q

Which of these cancer patients are indicated for ESA treatment? (Select All)

A. patient with Cancer and chronic kidney disease

B. Patient on myelosuppressive chemotherapy with Curative intent

C. Patiet undergoing palliative/ noncurative treatment

D. Patients on myelosuppressive chemotherapy without other identifiable cause of anemia.

A

A. patient with Cancer and chronic kidney disease

C. Patiet undergoing palliative/ noncurative treatment

D. Patients on myelosuppressive chemotherapy without other identifiable cause of anemia.

68
Q

Which of the following cancer patients is NOT a candidate for ESA therapy?

A. Patient with cancer and chronic kidney disease

B. Patient on myelossuppresive chemotherapy with curative intent

C. Patientundergoing palliative/ non curative treatment

D. Patient on myelosuppressive chemotherapy without other identifiable cause of anemia.

A

B. Patient on myelossuppresive chemotherapy with curative intent

69
Q

Which of the following patients is a candidate for ESA OR RBC transfusions? (Select all)

A. Patient with cancer and chronic kidney disease

B. Patient on myelosuppressive chemotherapy with curative intent

C. Patient undergoing palliative/ noncurative treatment

D. Patient on myelosuppressive chemotherapy without other identifiable cause of anemia

A

C. Patient undergoing palliative/ noncurative treatment

D. Patient on myelosuppressive chemotherapy without other identifiable cause of anemia

70
Q

Short answer: Why do we not give ESA therapy in patients who are receiving cancer treatment with Curative intent?

A

tumor progression

71
Q

T/F When receiving ESA therapy we must provide a medication guide to the patient

A

True

72
Q

All of the following are goals for ESA treatment in cancer patients with anemia EXCEPT:

A. Use lowest possible dose of ESA to prevent the need for blood transfusions

B. Discontinue when chemotherapy is complete

C. Maintain goal of Hgb of 10 mg/dL

D. patient must receive medication guide before administration

E. Highest possible dose of ESA should be used to improve quality of life in all cancer patients

A

E. Highest possible dose of ESA should be used to improve quality of life in all cancer patients

73
Q

Which of the following is a monitoring parameter for EPO? (Select All)

A. Monitor baseline iron levels and periodically

B. HgB/ Hct levels at each injection

C. Blood pressure at each injection

D. Clniical assessment for fatigue and signs of PE and DVT at each injection

E. Platelets and INR during each month of therapy

A

A. Monitor baseline iron levels and periodically

B. HgB/ Hct levels at each injection

C. Blood pressure at each injection

D. Clniical assessment for fatigue and signs of PE and DVT at each injection

74
Q

What are posbiel etiologies of Vitamin B22 deficiency Anemia? (Select All)

A. Inadequate intake

B. malabsorption syndromes

C. Increased renal elimination

D. Lack of sunlight exposure

E. Inadequate B12 utilization by the body

A

A. Inadequate intake

B. malabsorption syndromes

E. Inadequate B12 utilization by the body

75
Q

Which of these can decrease the absorption of B12?

A. Calcium supplementation

B. PPIs and H2RA

C. Fluoriquinolone antibiotics

D. Ethanol

E. Metformin

A

B. PPIs and H2RA

D. Ethanol

E. Metformin

76
Q

How do PPIs and H2RA decrease Vitamin B12 absorption?

A. Increase in gastric ph can impair activation of papsin that is necessary for freeing B12

B. PPI and H2RA can possibly chelate with B12 and inactivate it

C. Decrease in gastric Ph can impair activation of pepsin that is necessary for freeing B12

D. Impairs absorption from intestines possibly due to effects on pancreas

A

A. Increase in gastric ph can impair activation of papsin that is necessary for freeing B12

77
Q

How does Ethanol decrease Vitamin B12 absorption?

A. Increase in gastric pH can impair activation of pepsin that is necessary for freeing B12

B. Impair absorption from intestines possibly due to effects on the pancreas

C. Impair absorption from intestins possibly due to effects on the liver

D. Multifactorial causes

A

B. Impair absorption from intestines possibly due to effects on the pancreas

78
Q

Early stage B12 deficiency anemia is typically ___ and presents with elevated ___.

A. Symptomatic, Paresthesias

B. Symptomatic, MCV

C. Asymptomatic, MCV

D. Asymptomatic, Paresthesias

A

C. Asymptomatic, MCV

79
Q

Later stage B12 deficiency anemia typically presents with:

A. Paresthesias

B. Normalized Homocystene levels

C. Numbness

D. Decreased MMA

E. Memory loss and psychosis

A

A. Paresthesias

C. Numbness

E. Memory loss and psychosis

80
Q

All of the following are treatment goals of B12 deficiency anemia EXCEPT:

A. Reversal of hematologic manifestations

B. Replacement of body stores of B12

C. Prevention or reversal of neurologic manifestations that occur with deficiency

D. Treat and reverse permanent neurologic manifestations with B12 supplementation after restoring the natural bodily stores.

A

D. Treat and reverse permanent neurologic manifestations with B12 supplementation after restoring the natural bodily stores.

81
Q

Which of the following is an accurate definition of Pernicious Anemia?

A. Type of B12 deficiency that is caused by lack of intrinsic factor production that causes a decrease in oral absorption of B12

B. Type of B12 deficiency that is caused by a lack of digestive enzymes that activate B12

C. Type of Folate deficiency that is caused by a lack of digestive enzymes that activate B12

D. Type of folate deficiency that is caused by lack of intrinsic factor production that causes a decrease in oral absorption of Folate

A

A. Type of B12 deficiency that is caused by lack of intrinsic factor production that causes a decrease in oral absorption of B12

82
Q

Which test can be used to determine Intrinsic Factor levels in a patient and predict pernicious anemia?

A. Ashkenazi Test

B. Schilling Test

C. IF-TC Test

D. IF-Gene EX Test

A

B. Schilling Test

83
Q
  • T/F Mild-Severe malabsorption of B12 requires Cyanocobalamin supplementation in B12 deficient anemia. Dietary deficiency patients only require supplements or foods fortified with B12
A

True

Oncology (10 decks)

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