BUTTARO 6 ED CHAPTER 216 ANEMIA GUARRANTEED A+

2. A child weighing 20 kg has been diagnosed with iron-deficiency anemia and will begin taking an oral iron preparation. What will the provider teach the child's parents about administration of this medication? a. Iron supplements should be given with food. b. The child must take the iron for 3 months. c. The correct dose is 30 mg twice daily. d. The iron is stopped when the hemoglobin increases. -ANSWER- ANS: C The dose for children is 3 mg/kg/day in divided doses. This child should get 60 mg/day, which is 30 mg/dose twice daily. Iron supplements are best absorbed on an empty stomach. Iron is given for at least 4 to 6 months. Hemoglobin levels will begin to increase in 1 to 2 weeks, but the iron is given until the serum ferritin increases sufficiently in 4 to 6 months. 3. A 60-year-old female patient has recently lost weight and a physical examination reveals a beefy-red, sore tongue, with no neurological findings. Based on these clinical findings, what will the provider anticipate finding in the laboratory data? a. Decreased homocysteine levels b. Leukopenia and thrombocytopenia c. Low hemoglobin and elevated MCV d. Normal methylmalonic acid level -ANSWER- ANS: C Macrocytic anemia caused by vitamin B12 deficiency will have symptoms described above. Although folate acid deficiency causes macrocytic anemia, there are rarely any symptoms. Hemoglobin will be decreased and MCV will increase. Homocysteine levels will be increased. The patient with B12 deficiency will have leukopenia and thrombocytopenia with severe deficiency, characterized by neurologic findings, which this patient does not have. Methylmalonic acid level will decrease.