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cardiovascular system 1 > Blood and Nutrition > Flashcards

Blood and Nutrition Flashcards

1
Q

State when to offer Iron to patient

A

It should only be given in the presence of a demonstratable iron deficiency state

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2
Q

What is Iron Deficiency Anaemia

A

Fewer RBCs than normal or less haemoglobin than normal
Less oxygen carried round the body
Iron is required to make Haemoglobin

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3
Q

State the underlying cause of anaemia to be excluded before starting treatment

A

Gastric erosion
Gastrointestinal cancer

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4
Q

State the conditions that require iron prophylaxis

A

Pregnancy
Menorrhagia
Malabsorption
Haemodialysis patients
Management of low birth weight infant such as preterm neonates
After subtotal or total gastrectomy

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5
Q

What’s the preferred route of administration for Iron salt?

A

Mouth( oral route)

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6
Q

What’s the oral dose of elemental iron for Iron Deficiency Anaemia

A

100-200mg daily( usually dried ferrous sulphate)

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7
Q

What’s the content of ferrous Iron in ferrous fumarate 210mg

A

65mg

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8
Q

What’s the content of ferrous iron in ferrous gluconate 300mg

A

35mg

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9
Q

What’s the content of ferrous iron in ferrous sulphate 300mg

A

60mg

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10
Q

What’s the content of ferrous iron in ferrous sulfate dried 200mg

A

65mg

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11
Q

Compound preparation of iron contains

A

Iron and folic acid

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12
Q

Compound preparation in used for…

A

It’s used in pregnancy in women who are high risk of developing iron and folic acid deficiency

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13
Q

Whats the role of ascorbic acid in iron preparation

A

To aid absorption of iron

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14
Q

Facts about MR preparations of Iron

A

Licensed for OD
Have no therapeutic advantage and should not be used

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15
Q

List examples of parental Iron

A

Iron dextran
Iron sucrose
Ferric carboxymaltose
Iron Isomaltoside 1000

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16
Q

State when parenteral Iron is given

A

Oral therapy is unsuccessful
Adherence issues
Continuing blood loss
Malabsorption
Chemotherapy induced anaemia
Haemodialysis patient

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17
Q

Symptoms of Iron Deficiency

A

Tiredness
Struggling to concentrate
Memory problems
Reduce ability to exercise
Hair losing it condition, possible hair loss
Brittle nails, break, change shape and colour
Cuts and grazes taking ages to heal
A sore tongue
Sores at the corner of your mouth

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18
Q

Some side effects of Iron

A

GI irritation, nausea and epigastric pain
Constipation or diarrhoea

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19
Q

What preparation of oral Iron can exacerbate diarrhoea in patients with IBS

A

MR preparations

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20
Q

Counselling for pts on Iron

A

Take after food to reduce GI side effects if needed
Best absorbed on empty stomach
discolouration of stool

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21
Q

What’s G6PD ( Glucose 6 phosphate dehydrogenase)deficiency

A

A genetic condition where individuals are susceptible to developing acute hemolytic anaemia when they take a number of drugs and also when they eat Fava beans

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22
Q

G6PD deficiency is prevalence in

A

African, Asians, Oceania and South Europe
Most common in men than women

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23
Q

List drugs that have DEFINITE Risk of haemolysis in most G6PD deficient individuals

A

Dapsone and other sulfones
Nitrofurantoin
Fluroquinolones
Sulphanamide ( Co-trimoxazole
Methylthioninium chloride
Primaquine
Quinolones
Rasburicase

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24
Q

List drugs with POSSIBLE Risk of haemodialysis in some G6PD deficient individual

A

Sulfonylureas
Aspirin
Chloroquine
Menadione
Quinine
Naphthalene

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25
Q

Whats hydroxycobalamin injections used for

A

Prophylaxis of anaemia associated with vit B12 deficiency, pernicious anaemia
Given at 3 months intervals

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26
Q

What’s megaloblastic anaemia

A

Anaemia due to lack of either vit B12 or folic acid
Or due to pernicious Anaemia
Folic acid needed for around 4months until replenish body stores

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27
Q

What’s is pernicious anaemia

A

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

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28
Q

Indication of folic acid

A

Given in pregnancy
Poor nutrition
AED
Methotrexate
Used in folate deficient megaloblastic anaemia as well as prophylaxis

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29
Q

Why is folic acid taking in pregnancy

A

It’s taken to prevent neural tube defects
High risk couples ( if one partner had the defect, family hx or other malabsorption state such as sickle cell, diabetes, AED)

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30
Q

Dose of folic acid for women at low risk of neural tube defect

A

400mcg daily before conception and until week 12

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31
Q

Dose of folic acid for women at high risk of neural tube defect

A

5mg daily until week 12

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32
Q

What are epoteins used for

A

Treat anaemia associated with erythropoietin deficiency in chronic kidney injury

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33
Q

What’s the indication of EPO-beta

A

Prevention of anaemia in pre term neonates with low birth weight

34
Q

What is sickle cell disease

A

Structural abnormality of hb deformed less flexible RBC
Reduced oxygen to organs and severe pain

35
Q

Drug used in the management of sickle cell disease

A

Hydroxycarbamide
Used to reduce frequency of crises and for blood transfusion

36
Q

What are the chronic complications of sickle cell

A

Skin Ulceration
Renal failure
Increased risk of infections

37
Q

Indication of folinic acid

A

Effective in the treatment of folate deficient megaloblastic anaemia but generally used with cytotoxic
It’s given as calcium folate

38
Q

Facts about Magnesium ( electrolytes)

A

Involves in energy production
Not well absorbed from GI
Largest stores are in skeleton

39
Q

What’s the side effect of Magnesium

A

Diarrhea ( occur at higher doses)
Interrupt tx and restart tx at lower dose if side effect occurs

40
Q

State when to give zinc supplements

A

Only give Zinc supplements when there is good evidence of deficiency or in zn losing condition

41
Q

Indication of Zinc

A

Used to treat Wilsons disease

41
Q

Zinc deficiency occurs in..

A

Inadequate diet, malabsorption, trauma, burns, protein losing conditions

42
Q

What conditions require TPN

A

Undernourished patients for surgery
Chemotherapy
Radiation therapy
Major surgery
Prolonged disorder of GI tract
Coma, trauma, refusal to eat,
Some pt with Renal or kidney failure

43
Q

What is included in TPN

A

Amino acids
Glucose
Fat
Electrolytes
Trace elements
Vitamins
Eg Nutriflex

44
Q

What are special diets?

A

Preparations which have been modified to eliminate a particular constituent from a food eg (gluten free]

45
Q

What’s phenylketonuria

A

Inability to metabolise phenylalanine

46
Q

How to manage PKU

A

Restrict dietary intake of phenylalanine

47
Q

What contributes to phenylalanine intake

A

Aspartame

48
Q

Symptoms of PKU

A

Moldy smell to breath, tremors , epilepsy, eczema, brain damage

49
Q

See photo for electrolytes state

A

Fav

50
Q

What drug is licensed for the tx of hypophosphataemia for pt on haemodialysis and peritoneal dialysis

A

Sevelamer and lanthanum

51
Q

Phosphate depletion occur in severe …

A

Ketoacidosis

52
Q

Phosphate infusion is occasionally used in..

A

Alcohol dependence

53
Q

Oral phosphate supplements and vit D is required in small number of pts with….

A

Hypophosphataemic vit D resistant rickets

54
Q

What is acute Porphyria

A

Metabolic disorder of haem biosynthesis

55
Q

Treatment of acute porphyrias

A

Haem arginate IV infusion

56
Q

Symptoms of acute Porphyria

A

Severe abdominal pain
Pain in the chest, legs or back
Constipation or diarrhoea
Nausea and Vomiting
Red or brown urine
Muscle pain, tingling, numbness, weakness or paralysis

57
Q

What’s vit A ( Retinol)used for

A

Keeps skin healthy
Helps vision in dim light
Helps boost immune system

58
Q

Good sources of Vit A

A

Cheese eggs, oily fish, liver and liver products

59
Q

State why Vit A should be avoided in pregnancy

A

Too much vit Harmful to unborn babies

60
Q

Should pregnant women eat liver?

A

No

61
Q

Vit B deficiency is treated with

A

Thiamine(B1), riboflavin (B2) and nicotinamide

62
Q

What are the severe deficiency state of Vitamin B

A

Wernicke’s encephalopathy and Korsakoff psychoses

63
Q

How to tx wernike’s encephalopathy and Korsakoff’s psychosis especially in chronic alcoholism

A

I.V vitamin B followed by oral thiamine

64
Q

What VITAMIN is deficient in patients treated with Isoniazid or penicillamine

A

PYRIDOXINE (B6)

65
Q

Function of Vitamin C

A

Essential in scurvy

66
Q

Symptoms of vitamin C deficiency

A

Bleeding gums

67
Q

Use of vit D

A

Prevention and treatment of rickets

68
Q

Examples of Vitamin D

A

Ergocalciferol( calciferol, vitamin D2)
Cholecalciferol ( vitamin D3) alfacalcidol and calcitriol)

69
Q

What causes vit D deficiency

A

Limited exposure to sunlight or diet deficiency

70
Q

A synthetic vit D analogue used to prevent and treat secondary hyperparathyroididm associated with chronic renal failure

A

Paricalcitol

71
Q

Individuals at risk of Vitamin D deficiency

A

Dark skin( African, afro carribean, South Asian Origin)
Individual >65yrs
Individual with low or no exposure to sunlight
Pregnant and Breastfeeding women esp teenagers and young women
Children under 4

72
Q

Facts about Vitamin E ( Tocopherol)

A

No evidence of value in adults
Very low amounts may be linked to neuromuscular activities in young children

73
Q

Uses of vitamin k

A

Production of blood clotting factors
Proteins for normal calcification of bones

74
Q

A water soluble synthetic vitamin k given orally to prevent vitamin k deficiency is called

A

MENADIOL SODIUM PHOSPHATE

75
Q

Antidote for oral coumarin Anticoagulant is

A

Vit K

76
Q

Examples of fat soluble vitamins

A

ADEK

77
Q

What’s neural tube defect

A

Congenital defect caused by incomplete closure of neural tube within 28days of conception

78
Q

List examples of neural tube defect

A

Spina bifida
Encephalocele
Anencephally

79
Q

Main risk factors

A

Maternal folate deficiency
Maternal vit B12 deficiency
Previous hx of infant with neural defects
Smoking obesity , diabetes and use of AED

80
Q

Neural tube defect prevention in pregnancy

A

Supplement with folic acid before conception and until week 12 of pregnancy
High dose recommended for women at higher risk

81
Q
A

cardiovascular system 1 (42 decks)

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