AHN 577 STUDY GUIDE 2025/2026 QUESTIONS AND
SOLUTIONS GRADED A+ TIP
✔✔S/S of iron deficiency anemia - ✔✔Pica, dyspnea, mild fatigue, h/a, palpitations,
weakness, tachycardia, postural hypotension, pallor
- Cheilosis- cracking on side of mouth
-spoon shaped, brittle nails
✔✔What kind of murmur does a pt with iron deficient anemia have? - ✔✔Apical systolic
heme murmur
✔✔TIBC for iron deficiency anemia - ✔✔>300, just remember TIBC is like seats at the
table, low iron= need more seats for the iron to bind to
✔✔Ferritin levels in iron deficiency - ✔✔<10-12
✔✔Gold standard for iron deficiency anemia - ✔✔negative Prussian blue reaction on
bone marrow stain
✔✔Treatment of iron deficiency anemia - ✔✔-300-325mg ferrous sulfate PO TID for 6
months
-PRBC has 1mg iron per 1ml of PRBC with ~300-350ml per bag of PRBC
-Constipation is s/e of PO iron
-Should see response in 7-10 days with increased HCT and reticulocyte counts
-Refer to heme/onc if they don't respond in 5-8 weeks
✔✔What kind of anemia is anemia of chronic disease (AOCD)? - ✔✔normocytic
normochromic typically
-can be hypochromic/microcytic
✔✔Causes of AOCD - ✔✔- chronic inflammation, illnesses, infections
-Caused by decreased RBC production in marrow
-cirrhosis, hypothyroidism, hyperparathyroidism (often from CKD), hypopitutaryism,
hypogonadism
-Persistent bacterial/fungal infection lasting >2 weeks can cause anemia
✔✔s/s of AOCD - ✔✔- fatigue, weight loss, SOB, loss of appetitive, light headed,
activity intolerance
✔✔Lab testing for AOCD - ✔✔- CBC w/diff
-ESR
-normal/high iron stores help differentiate from IDA
-usually TIBC is low/normal (if they have enough iron, don't need more seats at the
table)
, ✔✔Treatment of AOCD - ✔✔- treat underlying causes
-Can trial iron in pre-menopausal women, but don't give iron in men or post-menopausal
women
-Epogen for CKD and RA pts
✔✔What does ESR measure? - ✔✔velocity of RBC that settles outside of the plasma
✔✔What kind of Anemia is Thalassemia? - ✔✔microcytic, hypochromic
✔✔Typical causes of thalassemias - ✔✔inherited disorder producing a defect in the -
globin part of hemoglobin.
-more prevelant in mediterranean, african and asian populations
✔✔s/s of thalassemia - ✔✔1. Pale
2. Tachycardia/Tachypnea
3. Hepatosplenomegaly
4. Frontal bossing with bone changes
5. high risk of pathologic fractures
6. amenorrhea
7. dark urine, poor hair growth
8. square/rectangle shaped RBC
✔✔lab findings with thalassemia - ✔✔- microcytic, hypochromic anemia
- elevated indirect bilirubin (from hemolysis)
-elevated iron (differentiates from IDA)
- HGB electrophoresis is confirmatory test
-will have elevated alpha light chains with Beta-thalassemia
-elevated beta chains with alpha-type thalassemias
- Elevated alpha chains in H- thalassemia
✔✔Treatment of thalassemia - ✔✔- blood transfusions
-iron chelation therapy
-vitamin C to help reduce iron stores
- Splenectomy
-High risk for developing iron overload
✔✔cause of sickle cell anemia - ✔✔inherited defect in hemoglobin molecule
✔✔Hallmark of sickle cell anemia - ✔✔vaso-occlusive phenomena and hemolytic
anemia.
- shortened RBC survival and erythropoiesis is unable to keep up with shortened RBC
survival.
✔✔physical s/s of sickle cell anemia - ✔✔-hemolytic anemia
-dactylitis (swelling of fingers and toes, sausage fingers)
SOLUTIONS GRADED A+ TIP
✔✔S/S of iron deficiency anemia - ✔✔Pica, dyspnea, mild fatigue, h/a, palpitations,
weakness, tachycardia, postural hypotension, pallor
- Cheilosis- cracking on side of mouth
-spoon shaped, brittle nails
✔✔What kind of murmur does a pt with iron deficient anemia have? - ✔✔Apical systolic
heme murmur
✔✔TIBC for iron deficiency anemia - ✔✔>300, just remember TIBC is like seats at the
table, low iron= need more seats for the iron to bind to
✔✔Ferritin levels in iron deficiency - ✔✔<10-12
✔✔Gold standard for iron deficiency anemia - ✔✔negative Prussian blue reaction on
bone marrow stain
✔✔Treatment of iron deficiency anemia - ✔✔-300-325mg ferrous sulfate PO TID for 6
months
-PRBC has 1mg iron per 1ml of PRBC with ~300-350ml per bag of PRBC
-Constipation is s/e of PO iron
-Should see response in 7-10 days with increased HCT and reticulocyte counts
-Refer to heme/onc if they don't respond in 5-8 weeks
✔✔What kind of anemia is anemia of chronic disease (AOCD)? - ✔✔normocytic
normochromic typically
-can be hypochromic/microcytic
✔✔Causes of AOCD - ✔✔- chronic inflammation, illnesses, infections
-Caused by decreased RBC production in marrow
-cirrhosis, hypothyroidism, hyperparathyroidism (often from CKD), hypopitutaryism,
hypogonadism
-Persistent bacterial/fungal infection lasting >2 weeks can cause anemia
✔✔s/s of AOCD - ✔✔- fatigue, weight loss, SOB, loss of appetitive, light headed,
activity intolerance
✔✔Lab testing for AOCD - ✔✔- CBC w/diff
-ESR
-normal/high iron stores help differentiate from IDA
-usually TIBC is low/normal (if they have enough iron, don't need more seats at the
table)
, ✔✔Treatment of AOCD - ✔✔- treat underlying causes
-Can trial iron in pre-menopausal women, but don't give iron in men or post-menopausal
women
-Epogen for CKD and RA pts
✔✔What does ESR measure? - ✔✔velocity of RBC that settles outside of the plasma
✔✔What kind of Anemia is Thalassemia? - ✔✔microcytic, hypochromic
✔✔Typical causes of thalassemias - ✔✔inherited disorder producing a defect in the -
globin part of hemoglobin.
-more prevelant in mediterranean, african and asian populations
✔✔s/s of thalassemia - ✔✔1. Pale
2. Tachycardia/Tachypnea
3. Hepatosplenomegaly
4. Frontal bossing with bone changes
5. high risk of pathologic fractures
6. amenorrhea
7. dark urine, poor hair growth
8. square/rectangle shaped RBC
✔✔lab findings with thalassemia - ✔✔- microcytic, hypochromic anemia
- elevated indirect bilirubin (from hemolysis)
-elevated iron (differentiates from IDA)
- HGB electrophoresis is confirmatory test
-will have elevated alpha light chains with Beta-thalassemia
-elevated beta chains with alpha-type thalassemias
- Elevated alpha chains in H- thalassemia
✔✔Treatment of thalassemia - ✔✔- blood transfusions
-iron chelation therapy
-vitamin C to help reduce iron stores
- Splenectomy
-High risk for developing iron overload
✔✔cause of sickle cell anemia - ✔✔inherited defect in hemoglobin molecule
✔✔Hallmark of sickle cell anemia - ✔✔vaso-occlusive phenomena and hemolytic
anemia.
- shortened RBC survival and erythropoiesis is unable to keep up with shortened RBC
survival.
✔✔physical s/s of sickle cell anemia - ✔✔-hemolytic anemia
-dactylitis (swelling of fingers and toes, sausage fingers)
