#52: Anemia: Tips, and tools for diagnosis and treatment
Published August 14, 2017
66 min
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    Master the anemia algorithm, and take a deep dive on iron deficiency, anemia of chronic kidney disease, anemia of chronic inflammation, causes of macrocytic anemia and more in this discussion with international expert, Dr. David P. Steensma, Senior Physician from Dana Farber Institute, and Associate Professor of Medicine at Harvard Medical School.

    Full show notes available at http://thecurbsiders.com/podcast

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    Cases from Kashlak Memorial:

    • 62 yo M with diabetes and CKD with asymptomatic Hgb 10, MCV 90, and Cr. 1.9?
    • 72 yo F with HTN with asymptomatic Hgb of 11, MCV 85 and Cr. 0.6.
    • 72 yo F with breast cancer in remission after lumpectomy, adjuvant chemo, and XRT treated 6 years ago presents with fatigue and some dyspnea on exertion. Hgb 9.6, MCV 102.

    Time Stamps

    00:00 Intro

    01:18 Listener feedback

    04:05 Announcement: We’re looking for on air correspondents to join The Curbsiders

    05:05 Picks of the week

    11:12 Getting to know our guest

    17:50 Case #1 Normocytic anemia

    19:15 Defining anemia (WHO criteria)

    21:10 Epidemiology of anemia

    23:45 Normocytic anemia

    25:55 Erythropoietin for diagnosis and treatment

    28:22 Anemia of CKD or chronic inflammation?

    31:37 Discussion of ferritin and soluble transferrin receptor

    33:47 Case #1 Conclusion

    35:45 Hemoglobin targets in CKD

    36:53 Case #2 Microcytic anemia

    37:43 Correct reticulocyte count and reticulocyte index

    40:45 Deciding on dose and route for iron repletion

    43:44 Does vitamin C improve iron absorption?

    45:27 Case #3 Macrocytic anemia

    46:54 Vitamin B12 deficiency

    51:54 Medication related B12 deficiency

    52:35 Myelodysplastic syndrome

    55:00 Side effects of common MDS treatments

    56:18 Take home points

    57:35 The Curbsiders post game analysis

    64:16 Outro

    Tags: anemia, hemoglobin, iron, supplementation, B12, vitamin, ferritin, kidney, chronic, inflammation, deficiency, oral, therapy, myelodysplastic, syndrome, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

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