Family Nurse Practitioner Exam

Which condition is not associated with an increased risk for normocytic anemia?

1. Rheumatoid arthritis

2. Lupus

3. Chronic autoimmune disorders

4. Pregnancy

The correct answer is: Pregnancy

Normocytic anemia is characterized by red blood cells that are of normal size but are decreased in number. It is often associated with chronic diseases that lead to inflammation or bone marrow suppression. Rheumatoid arthritis, lupus, and other chronic autoimmune disorders can lead to chronic inflammation, which can impede erythropoiesis (the production of red blood cells) and contribute to anemia. These conditions activate the immune system and can lead to cytokine production, which affects red blood cell production and lifespan. Pregnancy, on the other hand, does not cause normocytic anemia by itself, but rather can result in a dilutional effect known as physiological anemia of pregnancy. During pregnancy, plasma volume expands significantly, which can dilute hemoglobin concentrations and lead to a decrease in red blood cell numbers relative to plasma. This is not classified as normocytic anemia because it is not primarily due to issues with the production or survival of red blood cells; instead, it's a normal physiological adaptation to pregnancy. Therefore, pregnancy is not inherently associated with an increased risk for normocytic anemia in the same way chronic autoimmune disorders are. Understanding these distinctions helps recognize how various conditions can uniquely impact red blood cell production and overall hematological health.