Anaemias

Question 1

what is sickle cell anaemia and its treatment

Answer 1

structural abnormality in Hb
tx - is folate supplementation helps make new RBC

Question 2

complications of sickle cell anaemia

Answer 2

renal failure, skin ulcers, increase susceptible to infection

Question 3

sickle cell crises what happens and tx?

Answer 3

severe pain + hospital + blood transfusion required
- treat hydroxycarbamide - reduce freq of crises can take months for effect

Question 4

s/e of hydroxycarbamide( an antineoplastic)

Answer 4

myelosuppression and skin reaction

Question 5

what is g6dp deficiency and what happens , common groups

Answer 5

inborn deficiency in carbohydrate metabolism
1) predisposes to haemolytic anemia]
2) trigger by certain food or drugs
asians, African , south europeans male >female

Question 6

drugs with definite g6dp risk

Answer 6

quinolone, sulphonamide, nitrofurantoin

Question 7

drug possible risk g6dp

Answer 7

quinine, SFU, aspirin (>1g), chlorquine

Question 8

what to rule out before treating iron deficiency anaemia

Answer 8

GI cancer, gastric erosion

Question 9

symptoms of iron def anaemia

Answer 9

tired , pallor, shortness of breath, fatigue

Question 10

prophylaxis for iron def anaemia

Answer 10

• malabsorption i.e. crohns
• gastrectomy
• mennorhagia
• low birth weight infants
• pregnancy
• chronic renal failure/haemodialyis

Question 11

counselling iron def anaemia

Answer 11

• take with or after food (reduce gi s/e)
• take with orange juice aid absorption
  -continue Tx 3 months after blood levels return to normal

Question 12

usual ferrous sulphate dose

Answer 12

200mg TDS

Question 13

Who to use compound preparations in (folic and iron)

Answer 13

pregnant women

Question 14

who to use parenteral iron

Answer 14

chemotherapy induced anemia, malabsorption therapies, chronic renal failure with haemodialysis

Question 15

Megaloblastic anemia what is it and symptoms

Answer 15

B12 or folic deficiency
numbness ,tingling hands and feet, weak muscle and depression

Question 16

Treatment of B12 deficiency

Answer 16

oral hydroxocobalamin (B12)

Question 17

when to give IM hydroxocobalamin

Answer 17

malabsorption syndrome, pernicious anaemia (lack gi intrinsic factor) , gastrectomy

• give injection every 3months

Question 18

in emergencies you give folic and B12 together why

Answer 18

you cant give folic IV alone due to neuropathy in spinal cord

Question 19

Folate megaloblastic causes and tx

Answer 19

anti epileptics ,MTX ,malabsorption crohns, pregnancy , poor diet, coeliac (malabsorption)

folic 5mg daily for 4m

Question 20

can you give folic acid alone for undiagnosed meglaloblastic anaemia

Answer 20

no have to give folic and B12 together due to risk of spinal chord neuropath!!!

Question 21

What to do in cases of iron overload

Answer 21

fatal for children tx with desferrioxamine