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Pre Reg Exam > Blood And Nutrition > Flashcards

Blood And Nutrition Flashcards

1
Q

What is iron deficiency anaemia?

A

Reduced Red blood cells production due to low iron in the body

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2
Q

What else can cause IDA?

A

Gastric erosion
Gastrointestinal cancer

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3
Q

What is prophylaxis?

A

To prevent IDA

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4
Q

When do you give iron preparation with prophylaxis?

A

Pregnancy
Malabsorption
Low birth infants - preterm neonates
Haemodialysis
Menorrhagia
Gastrectomy

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5
Q

Iron salts should be given by mouth. True or False?

A

True

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6
Q

How long should pt be monitored when given iron salts and how long should trt continue for?

A

4 weeks monitoring to stabilize the hemoglobin

3 months continuation after hemoglobin stabilizes

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7
Q

Megaloblastic anaemia is due to lack of?

A

Vitamin b12 or
Folate

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8
Q

What is the cause of megaloblastic anaemia in the UK

A

Pernicious anaemia

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9
Q

When do you also need vitamin 12?

A

treatment of megaloblastosis caused by prolonged nitrous oxide anaesthesia

And rare syndrome of congenital transcobalamin II deficiency.

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10
Q

Which drug is retained in the body shorter and can be given initially intravenously?

A

cyanocobalamin

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11
Q

Which one between hydroxocobalamin or cyanocobalamin is retained in the body longer?

A

Hydroxocobalamin

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12
Q

What’s the dose of cyanocobalamin in vb12 deficiency ?

A

50-150mcg daily
Taken between meals

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13
Q

What is the dose of cyanocobalamin in pernicious anaemia

A

300mcg daily, taken between meals

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14
Q

What is the dose of Hydroxocobalamin?

A

Maintenance 1mg every 2-3 months

Initial 1mg tds for 2 weeks

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15
Q

Why should folic acid not be used in undiagnosed megaloblastic anaemia

A

Neuropathy may increase

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16
Q

What do you take in folate deficient megaloblastic anaemia?

A

Daily Folic acid for 4 months

Helps replenish body stores

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17
Q

What is the dose of folic acid?

A

5mg once daily for 4 months

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18
Q

How long should pregnant lady take it for?

A

12 weeks

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19
Q

Prophylaxis in chronic hemolytic state, malabsorption or renal dialysis, when should you take folic acid?

A

5mg every 1-7 days
Daily or weekly sometimes

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20
Q

In prevention of methotrexate induced side effects in Crohn’s disease, rheumatic disease and severe psoriasis, what is the dose of folic acid?

A

5mg Once weekly

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21
Q

How do you take folic acid dose when taking methotrexate?

A

5mg once weekly, take on different day that you take methotrexate dose

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22
Q

What is also effective in the treatment of folate deficient megaloblastic anaemia?

A

Folinic acid

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23
Q

What is folinic acid generally used for?

A

Cytotoxic drugs - given as calcium folinate

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24
Q

What is sickle cell anaemia?

A

Abnormality of hemoglobin causing deformity, less flexible rbc

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25
Q

What is sickle cell anaemia?

A

Abnormality of hemoglobin causing deformity, less flexible rbc

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26
Q

What is sickle cell anaemia?

A

Abnormality of hemoglobin causing deformity, less flexible rbc

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27
Q

What vaccines should you take for sickle cells?

A

Annual influenza vaccine
Hepatitis B vaccine if not immune
Pneumococcal vaccine
Haemophilus influenza b vaccine

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28
Q

What lifelong prophylactic antibiotics should you take in sickle cell?

A

Phenoxymethylpenicillin or erythromycin if allergic to penicillin

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29
Q

What do you take to reduce crisis episodes and need for blood transfusions or prevent acute chest syndrome on sickle cell?

A

Hydroxycarbamide

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30
Q

What can you use to prevent recurrent sickle cell crisis?

A

Crizanlizumab

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31
Q

What is G6PD deficiency?

A

Glucose 6 phosphate dehydrogenase

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32
Q

What is used to treat aplastic anaemia?

A

Intravenous horse antihymocyte globulin with ciclosporin

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33
Q

What do you use to prevent adverse effects related to antithymocyte globulin trt?

A

Prednisone

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34
Q

What is the early adverse reactions that may occur in antithymocyte globulin trt?

A

Rash
Fever
Fluid retention
Rigors (feeling cold)
Acute respiratory distress
Anaphylaxis

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35
Q

What adverse reaction may occur 7-14 days later when taking AG?

A

Serum sickness

36
Q

What are the other treatment options do we have for aplastic anaemia?

A

Ciclosporin alone or
Oxymetholone

37
Q

What is licensed for treatment of idiopathic sideroblastic anaemia?

A

High dose pyridoxine hydrochloride

38
Q

What do you use to manage haemotalogical disorders?

A

Corticosteroids

39
Q

What is used to treat erythropoietin deficiency in chronic renal failure?

A

Epoetins

40
Q

What is the aim of treatment in erythropoietin deficiency?

A

To shorten period of symptomatic anaemia in patient receiving cytotoxic chemotherapy

41
Q

What is licensed for prevention of anaemia in preterm neonates of low birth weight?

A

Epoetin beta

Response takes several weeks

42
Q

What is the drug that has longer half life and can be administered less frequently than epoetin?

A

Darbepoetin alfa

43
Q

What is used to treat symptomatic anaemia in chronic kidney failure and has a longer half life and action?

A

Methoxy polyethylene glycol epoetin beta

44
Q

What is the initial treatment in adults with immune thrombocytopenic purpura?

A

Corticosteroids (prednisone)

45
Q

What is the appropriate treatment in patients with immune thrombocytopenic purpura who are bleeding or at high-risk of bleeding or require a surgical procedure, or unresponsive to corticosteroids?

A

Intravenous normal immunoglobulin, or intravenous anti-D (Rh0) immunoglobulin

46
Q

What is the treatment options for persistent or chronic immune thrombocytopenic purpura?

A

thrombopoietin receptor agonists
(Avatrombopag, eltrombopag,romiplostim)

47
Q

What treatment for refractory immune thrombocytopenic purpura?

A

azathioprine, ciclosporin, cyclophosphamide, danazol, dapsone, mycophenolate mofetil, and vincristine sulfate

48
Q

What neutropenia?

A

Decreased neutrophils- white blood cells- which leads to increased risk of infections

49
Q

What are the risk factors of neutropenia?

A

Chemotherapy
Certain medications
Autoimmune disease
Bone marrow disorders
Genetic predisposition

50
Q

List the drugs that can cause neutropenia?

A

Clozapine, Methotrexate, olanzapine, carbimazole, haloperidol, azathioprine, cytotoxic drugs, atovaquone, sulfasalazine, zidovudine

51
Q

What are the symptoms of neutropenia?

A

Sore throat
Fever
Mouth ulcers

52
Q

What is the pharmacological treatment of neutropenia?

A

Recombinant human granulocyte colony stimulating factor

53
Q

What does human granulocyte colony stimulating factor do?

A

Stimulates production of neutrophils
Reduce duration of chemotherapy induced neutrophenia

54
Q

Lost examples of granulocyte colony stimulating factors

A

Filgrastim
Pegfilgrastim
Lenograstim
Lipegfilgrastim

55
Q

Filgrastim and lenograstim have similar effects. True or false?

A

True

56
Q

Pegfilgrastim and lipegfilgrastim have longer actions than filgrastim. True or false

A

True

57
Q

Why does lipegfilgrastim and Pegfilgrastim have longer action?

A

They have a reduced kidney clearance

58
Q

Lenograstim (glycosylated) is more active than filgrastim. True or false?

A

True

59
Q

What is parental nutrition

A

Nutrients giving intravenously

60
Q

What is total parenteral nutrition?

A

Provide all daily nutritional requirements

61
Q

List indications of TPN

A

Preterm babies
Major surgeries
Severe malnutrition
Severe pancreatitis
Bowel obstruction

62
Q

What are the components of TPN

A

Macronutrients- amino acid, carbohydrates, fats

Micronutrients - vitamins, minerals and trace elements

Electrolytes- helps maintain fluid balance, nerve and muscle function

63
Q

How is TPN administered and why?

A

Through central venous catheter- tube inserted into a vein below your collar bone

This is due to high osmolarity

64
Q

What else do you give in TPN

A

Vitamin B12 - hyrdroxocobalamin
And folic acid intravenously with other minerals. Can also give orally if tolerated

65
Q

What is selenium deficiency

A

Inadequate diet or prolong TPN

66
Q

When do you give supplements for selenium deficiency?

A

When deficiency is confirmed

67
Q

What is the role of selenium?

A

Antioxidant defense
Thyroid hormone metabolism

68
Q

When there is selenium deficiency, how does it affect its role?

A

Leads to thyroid dysfunction
Oxidative stress

69
Q

What are the risk factors of selenium?

A

Prolonged TPN
Inadequate diet
Gastrointestinal disorder affecting absorption

70
Q

What are the clinical features of selenium deficiency?

A

Depression
Anxiety
Immune dysfunction
Cardiomyopathy

71
Q

List the foods high in selenium

A

Pork, beef, turkey, chicken, fish, eggs and shellfish

72
Q

What happens when you have zinc deficiency?

A

Impairs cellular metabolism
Impairs immune responses
Impairs protein synthesis

73
Q

List the risk factors of zinc deficiency

A

Malnutrition
Alcoholism
IBD

74
Q

What happens when you gave zinc deficiency?

A

Delayed wound healing
Diarrhea
Loss of smell/taste
Frequent cold/flu
Alopecia - hair loss
White nails

75
Q

What route is initially given for zinc deficiency

A

Oral route

76
Q

When is parental zinc given?

A

Severe malabsorption

77
Q

List foods rich in zinc

A

Fish
Cereals
Seeds
Nuts
Red meat, oysters, poultry, dairy products, legumes

78
Q

When can zinc supplements be given?

A

Zinc deficiency or zinc losing conditions

79
Q

What is zinc used to treat?

A

Wilson disease
Ancrodermatitis enteropathica

80
Q

What is zinc used to treat?

A

Wilson disease
Ancrodermatitis enteropathica

81
Q

What is the side effect of potassium?

A

Nausea

82
Q

Who are mainly the ones that might lack potassium and which drug causes low potassium level?

A

Patient with cardiac arrhythmia, hyper aldosterism

Digoxin

83
Q

List drugs that causes hyponatramia

A

• ANTIDEPRESSANTS
• LOOP AND THIAZIDE DIURETICS
• CARBAMAZEPINE
• DESMOPRESSIN

84
Q

Drugs that cause hypernatraemia?

A
  • ORAL CONTRACEPTIVES
    •- CORTICOSTEROIDS
    • SODIUM BICARBONATE
    • SODIUM CONTENT IN INTRAVENOUS ANTIBIOTICS
    • L I T H I U M
85
Q

Drugs that causes hypernatraemia?

A

ORAL CONTRACEPTIVES
• CORTICOSTEROIDS
• SODIUM BICARBONATE
• SODIUM CONTENT IN INTRAVENOUS ANTIBIOTICS
• L I T H I U M

86
Q

Drugs that causes hypernatraemia?

A

ORAL CONTRACEPTIVES
• CORTICOSTEROIDS
• SODIUM BICARBONATE
• SODIUM CONTENT IN INTRAVENOUS ANTIBIOTICS
• L I T H I U M

87
Q

What is the treatment of severe hypernatraemia?

A

IV saline

Pre Reg Exam (11 decks)

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