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Blood and Nutrition Flashcards

1
Q

Which supplement is advised to take to a patient with sickle cell disease?

A

Folate (folic acid)

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2
Q

What complications are associated with sickle cell disease?

A

Anaemia, leg ulcers, renal failure, increased susceptibility to infection.

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3
Q

What is given to sick cell patients to prevent infection?

A

Pneumoccocal vaccine, hep b, flu vaccine, and lifelong prophylactic penicillin to reduce the risk of infection

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4
Q

What drug can reduce the frequency of sickle cell crises?

A

Hydroxycarbamide

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5
Q

Who is G6PD deficiency common in?

A

Individuals from africa, asia, the med region and the midddle east, more common in males than females.

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6
Q

What are the individuals with G6PD deficiency susceptible to developing what?

A

Acute haemolytic anaemia

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7
Q

Which foods can cause acute haemolytic anaemia?

A

Fava beans, broad beans, fresh fava beans

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8
Q

State the drugs with definite risk of haemolysis in most G6PD-deficient individuals?

A

Dapsone and other sulfones, fluoroquinolones, nitrofurantoin, rasburicase, sulfonamides

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9
Q

What is used to treat anaemia associated with erythropoeitin deficiency in chronic renal failure?

A

Epoetins

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10
Q

What are the adverse effects associated with antithymocyte globulin treatment?

A

fever, rash, fluid retention, rigours, acute resp distress, anaphylaxis, serum sickness. Managed with pred

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11
Q

Which erythropoietin is used to treat anaemia in preterm neonates of low-birth weight?

A

Epoetin beta

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12
Q

Which erythropoietin has a longer half-life and can be administered less frequently?

A

Darbepoetin

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13
Q

State the MHRA warning for epoetins?

A

Steven-johns syndrome, toxic epidermal necrolysis
Advise patients of symptoms of severe skin reactions, stop treatment if: They develop widespread rash / blistering

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14
Q

What are the symptoms of iron deficiency anaemia?

A

Lethargy, shortness of breath, heart palpitations, pale skin

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15
Q

What are the specific side effects with epoetins?

A

Hypertensive crisis has occured
pure red cell aplasia has occurred, must discontinue tx

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16
Q

What is important to rule out with anaemia?

A

Any serious underlying cause

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17
Q

Stat the conditions in which prophylaxis is required with iron?

A

Malabsorption, gastrectomy, menorrhagia, haemodialysis, pregnancy, premature infants

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18
Q

What patient counselling advice do you give to patients taking iron?

A

Take with or after food, and take with glass of orange juice to aid absorption

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19
Q

When are preparations with iron and folic acids given during pregnancy?

A

To women who are at high risk of developing folic acid and iron deficiency

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20
Q

State the MHRA advice for intravenous iron?

A

Serious hypersensitivity reactions have been associated.
Caution with every IV dose
Monitor for 30 mins after each injection High risk in allergies
Avoid in pregnancy, especially first trimester

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21
Q

What are the specific side effects with oral iron?

A

Can be constipating and can lead to faecal impaction. Can exacerbate diarrhoea. Best absorbed on an empty stomach, may colour stools

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22
Q

How is neutropenia treated?

A

Granulocyte colony stimulating factors eg filgrastim

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23
Q

When is compensation for potassium loss especially necessary

A

those taking digoxin or anti-arrythmic drugs, where potassium depletion can induce arrythmias
patietns where secondary hyperaldosteronism occurs
patients with severe loss of k+ in faeces

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24
Q

What is recommended for prevention of hypokalaemia due to diuretics such as furosemide and thiazides?

A

Potassium sparing diuretics eg epelerone

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25
What can potassium salts cause?
Nausea and Vomitting
26
How is acute severe hypokalaemia treated?
IV calcium chloride
27
What can be given to reduce serum potassium
Insulin or salbutamol IV
28
What is used for acidosis?
Sodium bicarbonate infusion
29
What is given in states of sodium depletion?
Sodium chloride
30
What should oral rehydration solutions do?
Enhance absorption of water and electrolytes, replace electrolyte defecit, contain alkalinising agent, hypo-osmolar, simple to use, palatable, available
31
What is given for chronic acidotic states such as uraemic acidosis/metabolic acidosis?
Sodium bicarbonate
32
When are glucose solutions used?
To replace water deficit and correct or prevent hypoglycaemia
33
How is severe hypercalcaemia treated?
Drugs which inhibit the mobilisation of calcium from the skeleton such as bisphosphonates
34
What is hyperparathyroidism and what can it cause?
Excess production of parathyroid hormone leading to hypercalcaemia, hypophosphotaemia and hypercalcuria. Main symptoms of hypercalcuriruia is thirst, memory impairment
35
Discuss magnesium and associated imbalances
Magnesium salts are not well absorbed from the GI tract, which explains use of magnesium sulfate as a laxative excreted from kidneys, and retained during renal failure which can cause hypermagnesia causing muscle weakness and arrythmias, tx is calcium gluconate injection. Give oral magnesium for asymptomatic hypo
36
What are the fat soluble vitamins?
DEAK
37
When is supplementation with folic acid recommended for women?
Pregnant women or women wishing to become pregnant should take folic acid before conception and until week 12.
38
When is supplementation with folic acid recommended for women?
Pregnant women or women wishing to become pregnant should take folic acid before conception and until week 12 to prevent neural tube defects. Higher doses used in women at higher risk of developing neural tube defects. Eg sickle cell, antiepileptics and diabetes
39
What is megaloblastic anaemia?
Anaemia from a lack of vitamin b12 or folate
40
Why has hydroxycobalamin replaced cyanocobalamin in the treatment of megaloblastic anaemia?
Because it is retained in the body for longer periods of time and can be given in intervals of up to 3 months
41
How long is treatment usually for folate deficient anaemia?
Usually 4 months is adequate
42
Why is folic acid used alongside methotrexate?
For the prevention of methotrexate induced side effects
43
Which patients are at risk of a zince deficieny?
Patients with malnutrition, alcoholism, ibd
44
What is another name for vitamin a
retinol
45
How is vitamin b deficiency treated?
Thiamine, riboflavin, nicotinamide. nicotinic acid but can cause vasodilation
46
How is wernicke's encephelapothy treated
Parenteral thiamine
47
What are the symptoms of scurvy
Gingival swelling, bleeding and petheciae on the skin. vit c deficiency
48
What should be prescribed for patients with severe renal impairment requiring vitamin d supplementation
Activated form such as alfacalcidol or calcitriol
49
Which vitamin is teratogenic
Vitamin A
50
What is the water soluble form of vitamin k that can be given to patients with malabsorption syndromes
menadiol sodium
51
What is a neural tube defect
Congenital defects caused by the incomplete closure of the neural tube within 28 days of conception. Most common are spina bifda
52
What are the main risk factors for neural tube defects?
Folate deficiency, b12 deficiency, previous hx of it, smoking, diabetes, obesity, antiepileptic drugs.
53
What are the symptoms associated with hyponatraemia?
Nausea and vomitting, loss of energy, seizures
54
Which drugs can cause hyponatraemia
Carbamazepine, bendrofluoromethiazide, other diuretics, PPI, SSRI, ACEi
55
What symptoms are associated with potassium imbalances
muscular/cardiac function effects
56
Which drugs can cause hypokalaemia
Diuretics, salbutamol and theophylline
57
Which drugs can cause hyperkalaemia
ACEI, NSAID, ARB, potassium sparing diuretics, trimethoprim
58
What are the symptoms of a calcium imbalance
Numbness, tingling sensations and muscle cramps
59
Which drugs can cause hypocalcaemia
Bisphosphonates, phenytoin, phenobarbital
60
Which drugs can cause hypercalcaemia
Cancer, vitmain d od
61
What are the symptoms of hypomagnamaesia
Abnormal eye movements, seizures
62
Which drugs can cause hypomagnemaesia
PPI

PRE REG (24 decks)

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