NP AANP Adult Gero Boards Questions and Answers Fully solved 2023

NP AANP Adult Gero Boards Questions and Answers Fully solved 2023 What are the conditions needed for RBC Formation? - ANS ️️ -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? - ANS ️️ 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 - ANS ️️ 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 - ANS ️️ -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) Chronic PPI use can cause which type of deficiency? - ANS ️️ Vit B12 and iron malabsorption Metformin use can cause which type of deficiency? - ANS ️️ Vit B12 malabsorption and deficiency Beta Thalassemia minor - ANS ️️ Check homogenetic electrophoresis once microcytic hypochromic anemia Mediterranean ancestry To have a child with a thalassemia major both parents must have trait (1 in 4 chance with each pregna