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Pre-reg revision > Blood and nutrition > Flashcards

Blood and nutrition Flashcards

1
Q

What is GPD6 deficiency?

A

An inborn error of carbohydrate metabolism

Sufferers are susceptible to haemolytic anaemia

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2
Q

Which of these does NOT have a risk of haemolysis in GPD6 deficiency?

  • Dapsone
  • Nitrofurantoin
  • Ciprofloxaicn
  • Gentamicin
  • Co-trimoxazole
A

Gentamicin

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3
Q

‘Risk and severity of haemolysis in GPD6 deficiency is almost always dose-related’
TRUE OR FALSE?

A

TRUE

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4
Q

Which safety warnings should be remebered with epoetnis?

A
  • Risk of severe cutaneous adverse reactions including SJS
  • Chance of over-correction of Hb conc in patients with CKD, range 10-12ng/L
  • Risk of tumour progression and reduced survival in cancer patients, only if associated with chemo
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5
Q

Which of these conditions do NOT usually require prophylaxis of iron-deficient anaemia?

  • Crohns disease
  • Pregnancy
  • Menorrhagia
  • Diabetes
  • Haemodialysis
A

Diabetes

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6
Q

How can iron deficiency anaemia be treated in pregnancy?

A

Ferrous sulphate 200mg BD/TDS

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7
Q

How much elemental iron is in 300mg ferrous sulphate?

A

60mg

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8
Q

How much elemental iron is in 200mg ferrous fumarate?

A

65mg

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9
Q

Which oral iron is usually given for prophylaxis of iron-deficient anaemia?

A

Ferrous sulphate 200mg OD

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10
Q

What counselling should be given to patients on oral iron?

A
  • Take with food to reduce GI side effects
  • Take with a full glass of orange juice as vitamin C can aid absorption
  • May colour stools
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11
Q

How long should treatment for iron-deficiency anaemia continue for?

A

3 months after blood levels return to normal

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12
Q

Can IV iron be given in pregnancy?

A

Should be avoided if possible, especially in the first trimester

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13
Q

What is the most serious side effect associated with IV iron?

A

Severe hypersensitivy reactions such as life-threatening anaphylaxis

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14
Q

‘Oral iron can cause constipation’

True or false?

A

True - avoid in faecal impaction

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15
Q

Why should iron tablets ALWAYS be kept out of reach of children?

A

Important cause of accidental overdose in children

20mg/kg can cause symptoms of toxicity

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16
Q

Why should folic acid not be given alone for emergency treatment of undiagnosed megaloblastic anaemia?

A

May cause neuropathy

Given with B12

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17
Q

Which vitamins are deficient in megaloblastic anaemia?

A

B9 (folic acid) and B12 (hydroxocobalamin)

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18
Q

How should folic acid be given to prevent methotrexate side effects?

A

5mg once weekly, given on a different day to methotrexate

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19
Q

For megaloblastic anaemia, how long is folic acid treatment usually given for?

A

4 months

5mg OD

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20
Q

How is iron overload treated?

A

Dessferioxamine

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21
Q

What supplement is given to treat thassalaemia?

A

Iron

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22
Q

What is the normal serum conc of sodium?

A

133-146mmol/L

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23
Q

What are some symptoms of hypernatraemia?

A
  • Convulsions
  • Thirst/dehydration
  • Postural hypotension
  • Tachycardia
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24
Q

Name some drugs that can cause HYPERnatraemia?

A
  • Oral contraceptives
  • Corticosteroids
  • Lithium
  • Sodium bicarb / sodium in IV abx
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25
Q

What are some symptoms of hyponatraemia?

A
  • Drowsiness
  • Confusion
  • Convulsions
  • Headaches
  • Cramps
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26
Q

Which do NOT cause hyponatraemia?

  • Antidepressants
  • Loop diuretics
  • Desmopressin
  • Prednisolone
  • Carbamazepine
A

Prednisolone - corticosteroids cause high Na

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27
Q

‘Intestinal absorption of sodium and water is decreased by glucose/carbohydrates’
True or false?

A

FALSE - absorption is enhanced by these

28
Q

How is hyperchloraemia (high Cl-) treated?

A

Sodium bicarbonate

29
Q

What is the normal serum Ca level?

A

2.1 - 2.58 mmol/L

30
Q

How is hypercalcaemia treated?

A

Bisphosphonates or corticosteroids

31
Q

Which is a side effect of alendronic acid?

  • Hyperkalaemia
  • Hypercalcaemia
  • Hyperphosphatemia
  • Hypocalcaemia
A

Hypocalcaemia

32
Q

Some symptoms of hypercalcaemia?

A
  • Nausea and vomiting
  • Confusion
  • Loss of appetite
  • Headache
  • Depression
33
Q

What can be used to treat hypercalcaemia in malignancy?

A

Calcitonin

34
Q

What is the normal serum potassium range?

A

3.5-5.3 mmol/L

35
Q

Symptoms of hyperkalaemia?

A

Ventricular fibrillation, cardiac arrest

36
Q

Name some drugs that cause hyperkalaemia?

A
  • ACEi/ ARBs
  • Heparins
  • Beta blockers
  • Potassium sparing diuretics (eplenerone, amiloride,spiro)
  • NSAIDs
  • Ciclosporin + tacrolimus
  • Trimethoprim
37
Q

Which drug does NOT cause hyperkalaemia?

  • Losartan
  • Enoxaparin
  • Simvastatin
  • Co-trimoxazole
  • Nebivolol
A

Simvastatin

38
Q

How should hyperkalaemia be treated?

A

Mild+ no ECG changes - calcium resonium
Severe - IV calcium gluconate

Also insulin, glucose + salbutamol

39
Q

What are some signs of hypokalaemia?

A

Arrythmias, muscle hypotonia

40
Q

Which drugs can cause hypokalaemia?

A
  • Insulin
  • Beta agonists
  • Diuretics
  • Theophylline
  • Corticosteroids
41
Q

Which does NOT cause low potassium?

  • Terbutaline
  • Dexamethasone
  • Levemir
  • Bumetanide
  • Tamsulosin
A

Tamsulosin

42
Q

How should hypokalaemia caused by a loop diuretic be treated?

A

Potassium sparing diuretic

Preferred if caused by diuretic

43
Q

What is an ‘acute porphyria’?

A

Genetic deficiency in haem biosynthesis

Can cause haemolytic anaemia

44
Q

Name the fat soluble vitamins?

A

D, E, A, K

45
Q

Is vitamin C water soluble?

A

Yes

46
Q

What is retinol?

A

Vitamin A

47
Q

Can vitamin A be given in pregnancy?

A

No, teratogenic

48
Q

What can vitamin A deficiency cause?

A

Ocular defects/dry eyes

Increased susceptibility to infection

49
Q

What is ascorbic acid?

A

Vitamin C

50
Q

Scurvy is caused by which deficiency?

A

Vitamin C

Can also cause gingival bleeding

51
Q

Rickets is caused by which deficiency?

A

Rickets

52
Q

What is colecalciferol?

A

Vitamin D3

53
Q

‘Vitamin D is needed for dietary absorption of calcium’

True or false?

A

True

54
Q

How is vitamin D replaced in renal impairment?

A

Alfacalcidol / calcitriol

Hydroxylated version

55
Q

What is tocopherol?

A

Vitamin E

56
Q

What is another name for vitamin K?

A

Phytomenadione

57
Q

Which vitamin is given to newborn babies to prevent neonatal haemorrhage?

A

Vitamin K

58
Q

What is vitamin B1?

A

Thiamine

59
Q

What is niacin / nicotinic acid?

A

Vitamin B3

60
Q

What is vitamin B6 and when is it used?

A

Pyridoxine
Given with isoniazid/penicillamine to prevent neuropathy
Can also treat PMT

61
Q

Which B vitamin can strengthen hair and nails?

A

B7 biotin

62
Q

Which vitamin is often deficient in vegans?

A

B12

63
Q

What is vitamin B9?

A

Folic acid

64
Q

What dose of folic acid is recommended in pregnancies with a high risk of neural tube defects?

A

5mg OD before conception till 12 weeks

65
Q

Which of these woman should be told to take folic acid 400mcg once daily until week 12 of their pregnancy?

  • 20 year old woman expecting first child who has asthma
  • 35 year old woman expecting second child, whos first child was born with a congenital malformation
  • 27 year old woman with epilepsy taking levetiracetam
  • 30 year old woman with type 2 diabetes expecting her first child
  • 32 year old woman with sickle cell anaemia expecting her third child
A

20 year old woman expecting first child who has asthma

The rest all have high risk of neural tube defects and should take folic acid 5mg OD

66
Q

What supplements are recommended for a pregnant woman with sickle cell anaemia?

A

5mg folic acid daily for whole pregnancy

Pre-reg revision (14 decks)

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