Blood and nutrition

Question 1

Megaloblastic anaemia is due to deficiency in _____ and ______

Answer 1

Folate

Vitamin B12

Question 2

What additional endorsement is needed on a Rx for cyanocobalamin if used for anaemia

Answer 2

SLS

Question 3

What is phenylketonuria

Answer 3

A condition where someone cannot metabolise the AA phenylalanine
Dietary intake should be restricted

Question 4

Scurvy is caused by deficiency of which vitamin

Answer 4

Vitamin C

Question 5

What are the fat soluble vitamins?

Answer 5

K
A
D
E

Question 6

Which vitamin is found in eggs, butter and fish oils

Answer 6

Vitamin A

Question 7

True or false:

Vitamin A deficiency is rare in the UK

Answer 7

TRUE

Question 8

True or false:

Vitamin A is good for the eyes

Answer 8

TRUE

a.k.a retinol. Think retina!

Question 9

Which B vitamin is also known as riboflavin

Answer 9

Vitamin B2

Question 10

Vitamin B1 is also known as ______

Answer 10

Thiamine

Question 11

Vitamin B12 is also known as ______

Answer 11

Cyanacobalamin

Question 12

What electrolyte imbalance is caused by too much vitamin D

Answer 12

Hypercalcaemia

remember, vitamin D promotes calcium absorption

Question 13

Deficiency of which vitamin results in osteomalacia ?

Answer 13

Vitamin D

note: osteomalacia is known as Ricketts in children

Question 14

Vitamin E is also known as _______

Answer 14

Tocopherol

Question 15

What is the water soluble form of vitamin K?

Answer 15

Menadiol

Question 16

Which vitamin is found in green leafy veg?

Answer 16

Vitamin K
(important warfarin counselling point!)

Question 17

Signs of hyponatraemia

5 points

Answer 17

1. Dizziness
2. Drowsiness
3. Confusion
4. Muscle cramps/weakness
5. Vomiting

Question 18

Signs of hypokalaemia

5 points

Answer 18

1. Muscle weakness
2. Palpitations and ECG changes
3. Constipation
4. Vomiting
5. Confusion

Question 19

What drug is used to reduce the frequency of sickle cell crisis?

Answer 19

Hydroxycarbamide

Question 20

Which drugs have a definite haemolysis risk of G6PD deficiency?
(4 points)

Answer 20

1. Nitrofurantoin
2. Quinolones
3. Sulfonamides (includes co-trimoxazole!)
4. Primaquine

Question 21

Which drug is used to prevent anaemia in pre-term neonates of low birth weight ?

Answer 21

Epoetin Beta

Question 22

How does pernicious anaemia cause b12 deficiency?

Answer 22

Lack of gastric intrinsic factor resulting from autoimmune gastritis causes malabsorption of B12

Question 23

True or false:

Most causes of folate deficiency are self limiting

Answer 23

TRUE

Question 24

How long should daily folic acid be given in megaloblastic anaemia

Answer 24

4 months to replenish stores

Question 25

True or false: | Iron overload can be due to repeated blood transfusions

Answer 25

TRUE

Question 26

Which drug is used to chelate iron in iron overload

Answer 26

Desferrioxamine mesilate | note: It can also be used to chelate aluminium in dialysis patients

Question 27

What is used to stimulate neutrophil production in neutropenia ?

Answer 27

Recombinant human granulocyte-colony stimulating factor (rhG-CSF) Filgrastim is unglycosylated rhG-CSF

Question 28

True or false: | Potassium supplements may cause nausea and vomiting

Answer 28

TRUE | This may hinder adherence

Question 29

What percentage glucose can be used to correct water deficit in dehydration?

Answer 29

Glucose 5%

Question 30

Hyperparathyroidism causes hypo- or hyper- calcaemia?

Answer 30

Hypercalcaemia

Question 31

________ is a bone resorption inhibitor. It reduces PTH which leads to a decrease in serum calcium. Beneficial in hyperparathyroidism

Answer 31

Cinacalcet

Question 32

Unsafe drugs in acute porphyrias include: | give 5 examples

Answer 32

``` Alcohol Amiodarone Valproate TCAs MAOIs Anabolic steroids Hormonal contraceptives Sulfonylureas Triazole and Imidazole antifungals ```

Question 33

What is phenylketonuria

Answer 33

The inability to metabolise the AA phenylalanine | Restrict intake of aspartame which contains phenylalanine

Question 34

Vitamin B2 is also known as ______

Answer 34

Riboflavin

Question 35

Which B vitamin is folate?

Answer 35

B9

Question 36

What are the two forms of vitamin B12

Answer 36

Hydroxocobalamin and Cyanacobalamin

Question 37

B1 (Thiamine) is used in ________

Answer 37

Alcoholism to prevent Wernicke's encephalopathy

Question 38

Another name for vitamin C is _____

Answer 38

Ascorbic acid

Question 39

What is the active form of vitamin D ?

Answer 39

Calcitriol

Question 40

Which vitamin D supplement is used in renal disease and why?

Answer 40

Alfacilcidol To activate vitamin D it needs to be hydroxylated in the 1 and 25 positions. The first step happens in the kidneys. This cannot occur in renal impairment. Alfaclcidol has already been hydroxylated in the 1- position which is normally done by the kidney. Could alternatively give calcitriol which is fully activated

Question 41

Vitamin D2 is _____

Answer 41

Ergocalciferol

Question 42

Vitamin D3 is _______

Answer 42

Colecalciferol

Question 43

Tocopherol is another name for vitamin _____

Answer 43

E

Question 44

What is the water soluble form of vitamin K?

Answer 44

Menadiol sodium phosphate

Question 45

What are the main risk factors for neural tube defects in pregnancy? (5 points)

Answer 45

``` Anti-epileptic drugs Diabetes Folate deficiency B12 deficiency Smoking ``` All need high dose folate supplement (5 mg OD)

Question 46

How long should folate be taken to prevent neural tube defects?

Answer 46

Pre-conception up to week 12 of pregnancy