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PRE-REG own > Blood and nutrition > Flashcards

Blood and nutrition Flashcards

1
Q

Name 5 drugs with definite risk of haemolytic anaemia in G6PD deficiency?

A 
Nitrofurantoin
Quinolones
Dapsone/sulfones
Sulfonamides 
Rsbirucase
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2
Q

What drugs have a possible risk of haemolytic anaemia in G6PD deficiency?

A

Aspirin (acceptable to 1 day)
Chloroquine
sulfonylureas

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3
Q

What is a risk of using EpoBeta and monitoring?

A
  1. Hypertension
  2. Skin reactions/SJS
  3. thrombus, tumour progressions
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4
Q

What are symptoms of iron deficiency anaemia

A 
Pallor
tiredness
SOB
palpitations
pale skin
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5
Q

When would you use iron prophylaxis for iron deficiency anaemia

A 
Pregnancy 
malabsorption syndromes, chrons, 
menorrhagia 
gastrectomy 
low birth weight/neonates
haemodialysis
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6
Q

what are counselling points for iron?

A

With food to reduce S/E (better absorbed without but S/E) e.g. diarrhoea/constipation

With orange juice/vit C

Black stools/urine

Continue for 3M after bloods normal

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7
Q

What is the MHRA warning regarding ferrinject (IV iron)?

A

Cautions with every dose due to risk of severe hypersensitivity rxns
Monitor for 30 mins after each injection, resus facilities and trained staff
NO TEST Doses
Higher risk in allergy patients/cross sensitivity-only if benefit>risk
Avoid in pregnancy esp 1st trimester

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8
Q

What are symptoms of megaloblastic anaemia and subcategories?

A

B12 and folate deficiency

  • numb/tingling in hands/feet
  • numbness
  • muscle weakness
  • depression
  • lethargy
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9
Q

What are causes of B12 deficiency?

A

Diet and malabsoption syndromes

common in vegans

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10
Q

How is Vitamin B12 deficiency treated?

A

Dietary cause: Oral hydroxycobalamin

malabsorption: IM Hydroxycobalamin every 3 months

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11
Q

In an emergency - would you give B12 or folate?

A

BOTH - never give one alone (i.e. never give folate alone) - would cause neuropathy of the spinal cord

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12
Q

What are causes of folate deficiency

A

Poor diet
pregnancy
coeliac, malabsorption

antiepileptics/mtx/trimethoprim /antifolate drugs

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13
Q

what is treatment of folate deficiency?

A

Folic acid daily 4 months

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14
Q

What are the 2 different doses for prevention of neural tube defects in pregnancy?

A

Regular OTC pregnancy dose:400 mcg daily from before/at conception to week 12

Pts at higher risk of NTD: 5mg daily at concption/before to week 12

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15
Q

Which pregnant patients are at higher risk of neural tube defects?

A 
diabetics
anti-epileptics
sickle cell 
obesity
anti-malarials
smoking
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16
Q

What is the antidote for iron overdose

A

Dexferrioxamine

17
Q

what is treatment for neutropenia?

A

Filgrastim

18
Q

What happens to MCV in:

  • iron deficiency
  • B12
  • Folate
A

Iron: MCV and Hb low
B12: MCV high and HB low
Folat: MCV high and Hb low

19
Q

What foods can you receive

iron, b12 and folate from

A

Iron: red meat, kidney beans/chickpeas, nuts
B12: eggs, fish, meat, milk, cheese
Folate: leafygeens, brussels/broccoli, chickpeas etc

20
Q

What are the effects of vitamin D deficiency and what is it caused by

A

Rickets
osteomalacia

  • causes:
  • lack of sunlight
  • lack of dietary intake
  • asians eating roti

.

21
Q

What is the effect of vitamin A retinol deficiency ? what are thee sources?

A

effects: ocular effects - dry eyes, risk of infection, poor night vision, poor skin

Sources- pate, fish oil, raw eggs, oilyfish, milk

22
Q

Which vitamin should be avoided in pregnancy and what foods to avoid

A

Vitamin A- teratogenic

avoid liver pate etc

23
Q

If a patient had vitamin K deficiency and renal impairment - what is the drug of choice?

A

Menadiol - water soluble, used in renal impairment and malabsorption syndrome

24
Q

What are the sources of vitamin K

A

Green leafy veg, veg oils, cereal grains

25
Q

What is vitamin E and its effects?

A

Tocopherol - antioxidant, healthy skin and eyes protecting against free radicals
sources-plant oils e.g. olive oil, nuts seeds

26
Q

What is effect of deficiency of vitamin E

A

Neuromuscularr abnomalities

27
Q

What are the effects of vitamin C deficiency

A

Scurvy, gingival bleeding, peteichae, infections, poor wound healing,

28
Q

What is thiamine B1 important for and what is the deficiency?

A

Healthy CNS, release of energy from food - common in alcoholics - causes wernickes encephalopathy

29
Q

Which B vitamin can be used to reduce triglycerides and cholesterol in hyperlipidaemia under specialist use?

30
Q

What is the effect of deficiency of pyridoxine B6?

A

peripheral neuropathy

31
Q

Which B vitamin is hydroxocobalamin and what is its use?

A

B12

Use for healthy nervous system, making RBC, processing folic acid

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