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Clinical Therapeutics > Anameia > Flashcards

Anameia Flashcards

1
Q

What is HCT

A

Volume of rbc in blood (%)

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2
Q

What is MCV

A

Average volume of a single rbc

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3
Q

What is MCH

A

Average weight of Hb in rbc

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4
Q

What is MCHC

A

Average conc of Hb in guven volume of rbc

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5
Q

What is reticulocytes

A

Conc of immature rbc

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6
Q

What is Ferratin

A

Iron storage protein- amount of iron stored in body

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7
Q

What is transferrin

A

Plasma iron binding protein for transport anout the body

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8
Q

Iron

A

Iron in the blood( least sensitive )

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9
Q

Iron saturation

A

Serum iron : iron binding capacity

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10
Q

What are platelets

A

Cell fragments that function in the clotting system

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11
Q

Causes for increase in Hb loss

A

Haemorrhage
Haemolysis

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12
Q

Causes for reduction in Hb synthesis

A

Lack of nutrients
Bone marrow failure

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13
Q

Hb levels anamia

A

Men >15 - less than 130g/L
Women > 15 - less than 120 g/L
Pregnant women - less than 110 g/L

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14
Q

Microlytic anaemia

A

MCV <80 fl

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15
Q

Normocytic anamia

A

MCV 80-100 fl

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16
Q

Macrocyclic anaemia

A

MCV > 100 fl

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17
Q

Micro cytic causes

A

Iron deficiency
Body nit producing enough Hb

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18
Q

Normocytic causes

A

Acute blood loss
Chronic disease

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19
Q

Macrocyctic causes

A

Vit b12 deficiency
Folate deficiency
Hypothyroidism
Drug induced
Alcohol abuse

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20
Q

Causes of iron deficiency anaemia

A

INCREASE IN BLOOD LOSS
INCREASED DEMANDS
POOR ABSPORPTION
DECREASED INTAKE DUE TO POOR NUTRITION

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21
Q

Signs and symptoms of IDA

A

fatigue
Hair loss
Brittle nails
Pale
Cognitive dysfunction
SOB
Headache
Restless leg syndrome
cold intolerance

22
Q

Investigating IDA

A

FBC - HB- MCV (<80fl)- ferritin <30mcg/l= iron deficiency anamia

23
Q

Iron rich foods

A

Brown rice
Pulses
Beans
Nuts
Seeds
Meat
Fish
Tofu
Eggs
Dried fruits
Dark green leafy vegetables
Iron fortified cereals / bread

24
Q

Treatment for IDA

A

OD dose of 50-100 mg of elemental iron
Continue for 3 months after fe deficiency have been corrected to allow iron stores to be replenished

25
Q

What do you do if yiu get dose related side effects when taking iron supplement s

A

Lower the dose - ie trie alternative days
Take an alternative fe oral prep
Parenteral fe
Taking supplements with food

26
Q

Iron salt , dose and content of ferrous iron

A

Ferrous sulphate 200mg. 65mg

Ferrous fumerate 200mg. 65mg

Ferrous gluconate. 300mg. 35 mg

27
Q

Side effects of iron supplements

A

GI- N/V , heartburn
Constipation and diarrhoea
Black stools

These are all dose dependant and should settle over time

28
Q

Monitoring needed with IDA

A

check Hb levels after 4 weeks to asses the response for treatemnt.

Once the Hb is in range , continue for a further 3 months to replenish the fe stores

29
Q

Interactions with fe supplemts

A

THOSE THAT CAUSE REDUCED IRON ABS
antacids eg peptac
PPI
calcium supplements

THOSE WHOS ABS IS REDUCED DUE TO IRON
levothryoxine
Antibiotics like doxycycline and ciprofloxacin
Bisphosphonates

Give at separate administration times

30
Q

Examples of iv iron preps

A

Ferinject
Venofer

31
Q

How is dose calculated for iv fe

A

Based on weight and Hb

32
Q

Options for Iv fe

A

Cannot tolerate oral fe
Severe anaemia
Around the time of an operation
Hameodialysis

33
Q

What happens if you leave IDA Untreated ?

A

Increased risk of infection - lack of fe effects immune system

Pregnant women have a high risk of complications before and after birth

Symptoms can progress - restless leg syndrome , angina and or heart failure

34
Q

Medical term for iron overload

A

Haemochromatosis

35
Q

How is haemochromatosis caused

A

Hereditary condition were excessive amounts of iron are absorbed from food.

36
Q

What can happen If haemochromatosis is not treated

A

Severe organ damage
Premature death - iron deposited in organs

37
Q

What is measured to establish the degree of iron overload

A

Ferritin

38
Q

What is levels in Vit b12 deficiency

A

2-3mg

39
Q

What is levels in folate deficiency

A

10-12 mg

40
Q

How long does Vit b12 def take to present

A

May take 2-3 years to present as a deficiency

41
Q

How long does it take for folate def to present

A

Folate stores can deplete in four months

42
Q

Vit b12 def causes

A

Pernicious anaemia (auto immune dowses affecting stomach )
Malnuturikn
Vegan diet
Instestinal disease eg chrons disease

43
Q

Folate def causes

A

Alchohol consumption
Malnuturion
Increased requirements - pregnancy , chrons disease , malignancy

44
Q

Meds that may cause Vit b12 def

A

Cochine
Metform
Ppl
CMP

45
Q

Meds that may cause folate def

A

Folate antagonist = methotrexate , trimethoprim.

46
Q

Other symptoms associated with macrocytic anaemia

A

Glossitis - inflammation of tongue
Anorexia
Mild jaundice
Gi symtoms - diahrroa

47
Q

Signs and symptoms of Vit b12 def

A

NUEROLOGICAL
visual disturbances
Prickly sensation in hands and feet
Cognitive changes

PHYSCOLGICAL
mood swings
Depression
Physxosis
Dementia.

Progressive pain numbness , weakness in legs - increase risk in falls

48
Q

Macrolutic anaemia invetsuganyjins

A

FBC

HB

MCV ->100fl

Low Vit b12- <200ng/L
Low folate - < 3mcg/L

49
Q

Vit b12 def management

A

IM hydroxycobalamin
Doses / duration and frequency depends on cause - usually every 2-3 months
Side eeffts - diagrroa , neausea, dizziness , IM pain , arrythrmia , chills

Neurological recovery can take up to 6 months

Diet- meat eggs dairy products sal,on cod foods fortified with Vit b12 eg soy products

50
Q

Folate deficiency management

A

Folic acid - 5mg daily PO
treatemnt required for atleast 4 months
Side effects - abdominal distension , naseua , appetite decrease

Check Vit 12 levels bedofe starting sms correct this first

Diet- brocilli, chickpeas , peas , brown rice

Alcohol advice

Clinical Therapeutics (5 decks)

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