NURS 5432 Actual Final Exam UPDATED Questions and
Answers
What type of anemia is B12 deficiency? - Macrocytic.
What causes B12 deficiency? - Lack of intrinsic factor, Crohn's, celiac, vegetarian
diet, alcoholism, surgery.
What is pernicious anemia? - Lack of intrinsic factor causing B12 deficiency.
What are classic neurologic symptoms of B12 deficiency? - Paresthesias, ataxia,
decreased reflexes.
How long should iron therapy continue after levels normalize? - 2-3 months.
What is the adult elemental iron dose? - 65-130 mg/day.
What is the pediatric elemental iron dose? - 3-6 mg/kg/day.
First-line step in suspected myelodysplastic syndrome? - Hematology referral.
Second-line treatments for myelodysplastic syndrome? - Transfusions; bone
marrow transplant if candidate.
, First-line treatment for CKD anemia? - Epoetin alfa.
Second-line options for CKD anemia? - Iron supplementation or transfusion if
severe.
Microcytic + low ferritin → ? - Oral iron.
Macrocytic + neurologic symptoms → ? - IM B12.
Normocytic + chronic inflammation → ? - Treat underlying disease.
Pain crisis + sickle cell → ? - Hydration + pain control.
Lead level ≥45 → ? - Chelation.
Hgb <7 (stable adult) → ? - Transfusion.
What are the 3 main causes of IDA? - Decreased intake, increased demand
(pregnancy/growth), blood loss.
What decreases iron absorption? - PPIs and antacids.
What is a common side effect of oral iron? - Constipation.
, When is IV iron indicated? - Malabsorption, bariatric surgery, IBD, failure of oral
therapy.
Is anemia of chronic disease usually microcytic or normocytic? - Normocytic.
What happens to ferritin in anemia of chronic disease? - It increases.
What happens to TIBC in anemia of chronic disease? - It decreases.
What lab confirms B12 deficiency? - B12 <200 pg/mL and elevated
methylmalonic acid (MMA).
What inflammatory markers may be elevated? - ESR and CRP.
What is the treatment of anemia of chronic disease? - Treat underlying cause,
epoetin alfa, transfusion if severe.
What increases iron absorption? - Vitamin C.
What does MCV measure? - Average size of red blood cells.
What MCV value defines microcytic anemia? - Less than 80.
What MCV value defines macrocytic anemia? - Greater than 100.
Answers
What type of anemia is B12 deficiency? - Macrocytic.
What causes B12 deficiency? - Lack of intrinsic factor, Crohn's, celiac, vegetarian
diet, alcoholism, surgery.
What is pernicious anemia? - Lack of intrinsic factor causing B12 deficiency.
What are classic neurologic symptoms of B12 deficiency? - Paresthesias, ataxia,
decreased reflexes.
How long should iron therapy continue after levels normalize? - 2-3 months.
What is the adult elemental iron dose? - 65-130 mg/day.
What is the pediatric elemental iron dose? - 3-6 mg/kg/day.
First-line step in suspected myelodysplastic syndrome? - Hematology referral.
Second-line treatments for myelodysplastic syndrome? - Transfusions; bone
marrow transplant if candidate.
, First-line treatment for CKD anemia? - Epoetin alfa.
Second-line options for CKD anemia? - Iron supplementation or transfusion if
severe.
Microcytic + low ferritin → ? - Oral iron.
Macrocytic + neurologic symptoms → ? - IM B12.
Normocytic + chronic inflammation → ? - Treat underlying disease.
Pain crisis + sickle cell → ? - Hydration + pain control.
Lead level ≥45 → ? - Chelation.
Hgb <7 (stable adult) → ? - Transfusion.
What are the 3 main causes of IDA? - Decreased intake, increased demand
(pregnancy/growth), blood loss.
What decreases iron absorption? - PPIs and antacids.
What is a common side effect of oral iron? - Constipation.
, When is IV iron indicated? - Malabsorption, bariatric surgery, IBD, failure of oral
therapy.
Is anemia of chronic disease usually microcytic or normocytic? - Normocytic.
What happens to ferritin in anemia of chronic disease? - It increases.
What happens to TIBC in anemia of chronic disease? - It decreases.
What lab confirms B12 deficiency? - B12 <200 pg/mL and elevated
methylmalonic acid (MMA).
What inflammatory markers may be elevated? - ESR and CRP.
What is the treatment of anemia of chronic disease? - Treat underlying cause,
epoetin alfa, transfusion if severe.
What increases iron absorption? - Vitamin C.
What does MCV measure? - Average size of red blood cells.
What MCV value defines microcytic anemia? - Less than 80.
What MCV value defines macrocytic anemia? - Greater than 100.
