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Questions and Answers
A patient with chronic kidney disease presents with anemia. Which of the following treatments would be most appropriate for this patient?
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A patient with iron deficiency anemia is prescribed ferrous sulfate. Which of the following adverse effects is most likely to occur?
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A patient is receiving iron dextran injections for severe iron deficiency anemia. Which of the following precautions should be taken during administration?
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A child accidentally ingests a large number of iron tablets. What is the most appropriate initial treatment?
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Which of the following drugs can decrease the absorption of oral iron supplements?
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A patient with pernicious anemia requires lifelong treatment with which of the following?
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Which of the following drugs can impair the absorption of vitamin B12?
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A patient is taking methotrexate for rheumatoid arthritis. Which vitamin supplement should be given to prevent potential toxicity?
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Which of the following is NOT a potential adverse effect of erythropoietin (EPO) therapy?
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A patient with chronic renal failure on EPO therapy develops iron deficiency. What is the most likely explanation?
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Which of the following statements is true regarding the treatment of iron deficiency anemia?
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Which of the following is a characteristic feature of megaloblastic anemia?
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In the treatment of megaloblastic anemia, why is it important to address vitamin B12 deficiency before folic acid deficiency?
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Which of the following statements is true regarding folic acid?
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Which of the following drug classes can decrease the absorption of folic acid?
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Which of the following is the most common adverse effect of oral iron therapy?
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Which of the following conditions is an indication for parenteral iron administration?
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What is the primary function of erythropoietin (EPO)?
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Which vitamin is essential for the conversion of dihydrofolic acid into its active form?
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What type of anemia is associated with chronic renal failure?
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Which of the following is a characteristic feature of iron deficiency anemia?
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What is the recommended treatment for pernicious anemia?
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Which drug can decrease the absorption of iron by increasing gastric pH?
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Which of the following is a potential adverse effect of erythropoietin therapy?
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What is the main cause of megaloblastic anemia?
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A 30-year-old pregnant woman presents with fatigue and pallor. Her blood tests reveal microcytic, hypochromic anemia. Which of the following is the most likely cause and appropriate treatment for her condition?
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A 55-year-old man with a history of heavy alcohol use presents with numbness and tingling in his hands and feet, along with macrocytic anemia. Which of the following deficiencies is most likely contributing to his neurological symptoms?
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A 40-year-old woman with a history of gastrectomy presents with fatigue, shortness of breath, and a smooth, red tongue. Blood tests show macrocytic anemia. Which of the following is the most appropriate long-term treatment for her condition?
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A 60-year-old man with chronic kidney disease develops anemia. His iron levels are normal. Which of the following medications would be most effective in treating his anemia?
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A patient is taking oral iron supplements for iron-deficiency anemia. Which of the following medications should be avoided or taken at a different time due to potential drug interactions?
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A patient with hemochromatosis, a condition characterized by excessive iron absorption, is at risk for which of the following complications?
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A patient is being treated with methotrexate, an antifolate drug, for cancer. Which of the following supplements is often given to prevent potential side effects of methotrexate therapy?
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Which of the following statements is true regarding the absorption of iron?
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A patient presents with acute iron toxicity after accidentally ingesting a large number of iron tablets. Which of the following treatments would be most appropriate in this emergency situation?
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Which of the following statements is true regarding chronic iron toxicity?
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A patient with pernicious anemia experiences neurological symptoms. Which of the following explains the link between pernicious anemia and neurological manifestations?
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A patient with a history of peptic ulcer disease is diagnosed with iron-deficiency anemia. Which of the following factors might have contributed to their anemia?
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Which of the following laboratory findings would be consistent with iron deficiency anemia?
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A patient is prescribed erythropoietin injections for anemia associated with chronic renal failure. Which of the following parameters should be closely monitored during therapy?
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Which of the following statements is incorrect regarding folic acid?
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Study Notes
Anemia and Its Treatments
- Chronic kidney disease patients often develop anemia due to reduced erythropoietin production.
- Anemia treatment options include erythropoietin (EPO) injections, oral iron supplements, and vitamin injections depending on the underlying deficiency.
- Iron deficiency anemia is mainly treated with oral iron supplements; adverse effects include constipation.
- Severe iron deficiency that requires iron dextran injections necessitates a test dose to monitor for allergic reactions.
Iron Toxicity and Deficiency
- Accidental ingestion of large amounts of iron tablets can lead to acute iron toxicity; initial treatment includes gastric lavage with phosphate solutions.
- Antacids can decrease oral iron absorption due to increased gastric pH.
- Symptoms of iron overload can result in liver damage and other complications.
Specific Anemia Forms and Monitoring
- Megaloblastic anemia is characterized by macrocytic, normochromic red blood cells and can be caused by deficiencies in vitamin B12 or folic acid.
- Vitamin B12 and folic acid deficiencies should be addressed in that order, as folic acid can mask B12 deficiency symptoms.
- Pernicious anemia requires lifelong vitamin B12 injections due to impaired absorption.
Drug Interactions and Effects
- Medications like methotrexate may necessitate folic acid supplementation to prevent toxicity.
- Certain medications impair the absorption of vitamins, such as metformin (B12) and antacids (iron).
- Monitoring parameters for patients on EPO include blood pressure and serum ferritin levels to assess therapy effectiveness.
Nutritional Considerations
- Folic acid deficiency in pregnant women can lead to neural tube defects in the fetus; supplementation can prevent these outcomes.
- Iron therapy should be continued until hemoglobin levels normalize, with awareness of dietary factors that may impact absorption.
General Knowledge on Vitamins
- Folic acid is necessary for DNA synthesis and primarily stored in the liver.
- Vitamin B12 absorption requires intrinsic factor and has neurological implications if deficient.
- High doses of folic acid are not toxic but insufficient levels can lead to severe consequences for fetal development.
Lab Findings
- Low transferrin saturation and macrocytic red blood cells indicate iron deficiency anemia.
- Monitoring serum ferritin is crucial during anemia treatment, especially in patients receiving iron supplementation.
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