NP AANP Adult Gero Boards 283 Questions with Complete Solutions
NP AANP Adult Gero Boards 283 Questions with Complete Solutions What are the conditions needed for RBC Formation? - Correct Answer -Functional Erythropoietin mechanism (90% from kidney, 10% hepatic production) ----Erythropoietin supply is diminished in advancing renal failure, usually beginning with GFR -Uncompromised DNA Synthesis ---- Chronic inflammation, from autoimmune disorders (systemic lupus erythematous, rheumatoid arthritis and chronic infection) -Hemoglobin synthesis unimpaired by lack of iron, vitamin or global production -Intact marrow microenvironment Hemoglobin- what is it and what do you need to produce it? - Correct Answer iron-containing oxygen-transport protein found in red blood cells Adequate nutrition (iron, B vitamins, Vit C, Protein) and absorption (heme=iron, globin= protein) How do you know if the bone marrow is working - Correct Answer check the reticulocytes Healthy: reticulocytes=1-2% of total RBC or replacement of RBC In the presence of acute anemia: Healthy pt should increase reticulocytes If pt's reticulocytes don't increase(reticulocytopenia) - bone marrow might not be working appropriately Reticulocyte-cell, osis-increase in number of cells, penia- decreased number Causes of anemia - Correct Answer -blood loss (need 1 L or more for significant drop of hgb) (acute or chronic blood loss-erosive gastritis, menorrhagia, GI malignancy) -reduced RBC production (Vit B12, Folic acid, iron deficiency, use of chronic PPI) -Premature destruction of RBC (lifespan: 90-120d)
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