Question

A student asks the nurse about the causes of anemia secondary to destructive/loss of red blood cells. The nurse will respond to the student by stating these types of anemias may be due to:

1. Peptic ulcer disease

2. Chronic kidney disease

3. Fibrosis in the bone marrow

4. Folic acid deficiency***

Answer 1

Peptic Ulcer disease: Peptic ulcers are gastric ulcers produced as a result of gastric enzymes and gastric acid damaging the gastric mucosa. With mucosal destruction the underlying blood vessels are eroded and it results in bleeding. This bleeding may be minor and undetected or may be catastrophic and life-threatning. Thus Peptic ulcer is one of the causes of anaemia secondary to blood loss.

In Chronic kidney disease(CKD): Anaemia is due to a combination of factors like - decreased red cell production(erythropoietin deficiency), chronic inflammatory state, loss of destruction of red cells (due to haemodialysis) and iron deficiency (due to loss of appetite). Thus "destruction/loss of blood cells" could be one of the reasons for anaemia in CKD.

In Fibrosis of bone marrow and Folic acid deficiency : Anaemia is due to decreased production of red cells.

If this question allows single best answer then its peptic ulcer disease,if it allows multiple answer then both petic ulcer disease and chronic kidnet disease are correct.