Anaemias Flashcards

1
Q

Sickle-cell crisis usually requires hospitalisation, (?), (?), and treatment of any concurrent infection.

A

Fluid replacement

Analgesia

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2
Q

Sickle-cell crisis usually requires hospitalisation, fluid replacement, analgesia, and treatment of any concurrent (?).

A

infection

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3
Q

In patients with sickle cell, what can be given to reduce the risk of infection? (4)

A

Pneumococcal vaccine
Haemophilus influenzae type b vaccine
Annual influenza vaccine
Lifelong prophylactic penicillin

(hepatitis B vaccine should also be given if patient is not immune)

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4
Q

In most forms of sickle-cell disease, varying degrees of (?) anaemia are present which is accompanied by increased erythropoiesis; this may increase folate requirements and supplementation with folic acid is recommended.

A

haemolytic

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5
Q

In most forms of sickle-cell disease, varying degrees of haemolytic anaemia are present which is accompanied by increased (?); this may increase folate requirements and supplementation with folic acid is recommended.

A

erythropoiesis

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6
Q

In most forms of sickle-cell disease, varying degrees of haemolytic anaemia are present which is accompanied by increased erythropoiesis; this may increase (1?) requirements and supplementation with (2?) is recommended.

A
  1. folate

2. folic acid

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7
Q

What drug can prevent acute chest syndrome, reduce the frequency of painful crises, and reduce transfusion requirements in sickle-cell disease?

A

Hydroxycarbamide

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8
Q

How long does it take for the benefits of hydroxycarbamide in a sickle cell patient to become evident?

A

Several months

Hydroxycarbamide can prevent acute chest syndrome, reduce the frequency of painful crises, and reduce transfusion requirements in sickle-cell disease.

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9
Q

Glucose 6-phosphate dehydrogenase (G6PD) deficiency is common in individuals originating from (?), (?), the (?) region, and the (?)

A

Africa
Asia
Mediterranean
Middle East

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10
Q

Is G6PD more common in males or females?

A

Males

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11
Q

Individuals with G6PD deficiency are susceptible to developing (?) anaemia when they take a number of common drugs or when they have an infection.

A

acute haemolytic

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12
Q

What food can cause an acute haemolytic anaemia in patients with G6PD deficiency?

A

Fava beans (broad beans)

This is termed favism

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13
Q

G6PD deficiency is genetically (?); susceptibility to the haemolytic risk from drugs varies; thus, a drug found to be safe in some G6PD-deficient individuals may not be equally safe in others

A

heterogeneous

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14
Q

Do manufacturers routinely test drugs for their effects in G6PD-deficient inidividuals?

A

NO

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15
Q

The risk and severity of haemolysis is almost always (?)-related.

A

dose-related

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16
Q

Which drugs have a DEFINITE risk of haemolysis in most G6PD-deficient individuals? (8)

A
  1. Dapsone and other sulfones
  2. Fluoroquinolones (including ciprofloxacin, moxifloxacin, norfloxacin, and ofloxacin)
  3. Methylthionium chloride
  4. Nitrofurantoin
  5. Primaquine
  6. Quinolones
  7. Rasburicase
  8. Sulfonamides (including co-trimoxazole)
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17
Q

Dapsone has a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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18
Q

Fluoroquinolones have a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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19
Q

Ciprofloxacin has a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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20
Q

Moxifloxacin has a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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21
Q

Norfloxacin has a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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22
Q

Ofloxacin has a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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23
Q

Methylthioninium chloride has a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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24
Q

Nitrofurantoin has a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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25
Q

Primaquine has a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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26
Q

Quinolones have a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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27
Q

Rasburicase has a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

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28
Q

Sulfonamides have a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

29
Q

Co-trimoxazole has a definite risk of (?) in most G6PD-deficient individuals

A

haemolysis

30
Q

Dapsone has a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

31
Q

Fluoroquinolones have a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

32
Q

Ciprofloxacin has a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

33
Q

Moxifloxacin has a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

34
Q

Norfloxacin has a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

35
Q

Methylthioninium chloride has a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

36
Q

Nitrofurantoin has a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

37
Q

Primaquine has a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

38
Q

Quinolones have a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

39
Q

Rasburicase has a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

40
Q

Sulfonamides have a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

41
Q

Co-trimoxazole has a definite risk of haemolysis in most (?) individuals

A

G6PD-deficient

42
Q

Which drugs have a POSSIBLE risk of haemolysis in some G6PD-deficient individuals? (5)

A
Aspirin
Chloroquine
Menadione
Quinine
Sulfonylureas
43
Q

(?) in mothballs also causes haemolysis in individuals with G6PD deficiency.

A

Naphthalene

44
Q

Intravenous horse (?) globulin in combination with ciclosporin, may be used as immunosuppressive treatment for aplastic anaemia

A

antithymocyte

45
Q

Intravenous horse antithymocyte globulin in combination with (?), may be used as immunosuppressive treatment for aplastic anaemia

A

ciclosporin

46
Q

Intravenous horse antithymocyte globulin in combination with ciclosporin, may be used as immunosuppressive treatment for (?) anaemia

A

aplastic

47
Q

What drug can be used for the prevention of adverse effects associated with antithymocyte globulin treatment in aplastic anaemia?

A

Prednisolone

Intravenous horse antithymocyte globulin in combination with ciclosporin, may be used as immunosuppressive treatment for aplastic anaemia

48
Q

What drug is licensed for the treatment of idiopathic sideroblastic anaemia?

A

Pyridoxine hydrochloride

The dose required is usually high

49
Q

(?) (recombinant human erythropoietins) are used to treat anaemia associated with erythropoietin deficiency in chronic renal failure

A

Epoetins

50
Q

Epoetins (recombinant human erythropoietins) are used to treat anaemia associated with erythropoietin deficiency in (?)

A

chronic renal failure

51
Q

(?) is also licensed for the prevention of anaemia in preterm neonates of low birth-weight

A

Epoetin beta

A therapeutic response may take several weeks

52
Q

Epoetin beta is also licensed for the prevention of anaemia in (?) neonates of low birth-weight

A

preterm

53
Q

Epoetin beta is also licensed for the prevention of anaemia in preterm neonates of (?)

A

low-birth weight

54
Q

What hyperglycosylated derivative of epoetin has a longer-half life and can be administered less frequently than epoetin?

A

Darbepoetin alfa

55
Q

Darbepoetin alfa is a hyperglycosylated derivative of epoetin; it has a (?) half-life and can be administered less frequently than epoetin.

A

longer

56
Q

Darbepoetin alfa is a hyperglycosylated derivative of epoetin; it has a longer half-life and can be administered (?) frequently than epoetin.

A

less

57
Q

(?) is a hyperglycosylated derivative of epoetin; it has a longer half-life and can be administered less frequently than epoetin.

A

Darbepoetin alfa

58
Q

Methoxy polyethylene glycol-epoetin beta is a continuous erythropoietin receptor activator that is licensed for the treatment of symptomatic (?) associated with chronic kidney disease.

A

anaemia

59
Q

Methoxy polyethylene glycol-epoetin beta is a continuous erythropoietin receptor activator that is licensed for the treatment of symptomatic anaemia associated with (?).

A

chronic kidney disease

60
Q

Methoxy polyethylene glycol-epoetin beta has a (?) duration of action than epoetin?

A

longer

61
Q

What very rare but severe cutaneous side effects are associated with epoetins?

A

Stevens-Johnson syndrome

Toxic epidermal necrolysis

62
Q

Overcorrection of haemoglobin concentration in patients with chronic kidney disease may increase the risk of (1?) and serious (2?) events, and in patients with cancer may increase the risk of thrombosis and related complications

A
  1. death

2. cardiovascular

63
Q

Overcorrection of haemoglobin concentration in patients with chronic kidney disease may increase the risk of death and serious cardiovascular events, and in patients with cancer may increase the risk of (?) and related complications

A

thrombosis

64
Q

In patients being treated with erythropietins, haemoglobin concentration should be maintained within the range (?)g/100 mL

A

10-12 g/100mL

65
Q

What are the contraindications to treat a patient with epoetins? (3)

A

Patients unable to receive thromboprophylaxis
Pure red cell aplasia following erythropoietin therapy
Uncontrolled hypertension

66
Q

What are the common side effects of epoetins? (7)

A
Arthralgia
Embolism and thrombosis
Headache
Hypertension (dose-dependent)
Influenza-like illness
Skin reactions
Stroke
67
Q

In isolated patients with normal or low blood pressure, a hypertensive crisis with (?)-like symptoms and generalised tonic-clonic seizures requiring immediate medical attention has occurred with epoetin.

A

encephalopathy

68
Q

In isolated patients with normal or low blood pressure, hypertensive crisis with encephalopathy-like symptoms and (?) requiring immediate medical attention has occurred with epoetin.

A

generalised tonic-clonic seizures

69
Q

What needs to be monitored in patients taking epoetins?

A

BP
Reticulocyte counts
Haemoglobin
Electrolytes