Blood extra Flashcards
Given the electrolyte abnormality of hypokalaemia , which sign, or symptom is Mrs. Smith most likely to experience?
Choose only ONE best answer.
A
Tetany
B
Thirst
C
Falls
D
Muscle cramps
E
Seizures
Muscle cramps
During your PCN review of a 27-year-old male with a history of sickle cell anaemia, he presents with severe abdominal pain and signs of infection. His current haemoglobin level is 98 g/L, reflecting a drop of at least 20 g/L from his reading two months ago. Which medication would be most appropriate to prescribe in this situation?
Choose only ONE best answer.
A
Darbepoetin alfa
B
Ferrous sulphate
C
Hydroxocobalamin
D
Folic acid
E
Hydroxycarbamide
E – Hydroxycarbamide is the preferred treatment to prevent acute chest syndrome (a complication of sickle cell anaemia), reduce the frequency of painful crises, and decrease the need for transfusions. However, the beneficial effects may take several months to become apparent.
20-year-old male patient presents with painful sickle cell crisis. He has developed acute chest syndrome and haemolytic anaemia as a complication. You recommend to the GP he is supplemented with one of the following to help with his haemolytic anaemia, but he advises you he might need to consult with secondary care. Which of the following supplementation is needed?
Choose only ONE best answer.
A
Epoetin alfa
B
Cyanocobalamin
C
Ferrous fumarate
D
Folic acid
E
Hydroxocobalamin
D – In sickle-cell disease, haemolytic anaemia often leads to increased erythropoiesis and higher folate needs, so folic acid supplementation is recommended.
You are counselling a patient who was recently diagnosed with iron deficiency anaemia about taking iron tablets. Which of the following is NOT a common side effect of ferrous sulfate?
Choose only ONE best answer.
A
Black tarry stools
B
Diarrhoea
C
Constipation
D
Nausea
E
Paralytic ileus
E
A 52-year-old man had routine blood tests done at her GP surgery, and the following results are available for review. His eGFR is currently 48.2 ml/min/1.73m2
Electrolyte
Result
Reference Range
Sodium
151
135 - 145 mmol/L
Potassium
4.1
3.5 - 5 mmol/L
Creatinine
64
70 - 150 μmol/L
Urea
3.6
2.5 - 6.7 mmol/L
Which of the following medications is LEAST likely to have contributed to these test results?
Choose only ONE best answer.
A
Lithium citrate
B
Prednisolone
C
Dapagliflozin
D
Soluble co-codamol
E
Estradiol valerate
C – Medications like lithium citrate, prednisolone, and to some extent soluble co-codamol can influence sodium levels and kidney function, dapagliflozin is the least likely to have contributed to these specific test results.
Hyperparathyroidism is a medical condition characterized by the overproduction of parathyroid hormone by the parathyroid glands. You know this can sometimes cause hypercalcaemia as a result. Which of the following is a treatment option for hyperparathyroidism?
Choose only ONE best answer.
A
Niacin
B
Romosozumab
C
Calcium carbonate
D
Cinacalcet
E
Lanthanum
D – Cinacalcet is the appropriate treatment for managing hyperparathyroidism as it helps reducing excessive PTH production and addresses the resulting hypercalcemia.
A 71-year-old man presents to the hospital with palpitations, fatigue, and muscle weakness. He has recently been diagnosed with high blood pressure and is on the following medications:
Ibuprofen 600mg tablets – one to be taken three times a day with food
Eplerenone 25 mg tablets, one daily
Atorvastatin 20 mg tablets, one daily
Lisinopril 5 mg tablets, one daily
Fragmin (dalteparin) 15000 units/4ml solution for injection
Considering his presentation which of the following medications is NOT a likely cause of his symptoms?
Choose only ONE best answer.
A
Ibuprofen
B
Eplerenone
C
Atorvastatin
D
Lisinopril
E
Dalteparin
C – The patient is presenting with symptoms consistent with hyperkalaemia. His medications, particularly lisinopril, ibuprofen, dalteparin and eplerenone, increase the risk of hyperkalaemia. Atorvastatin does not induce electrolyte disturbance therefore is not the cause of the patient’s symptoms.
a patient known to you visits the pharmacy complaining of severe abdominal pain, vomiting and haematemesis. He tells you he ingested a whole pack of 56 tablets of his ferrous gluconate around 2 hours ago. You immediately decide to call 999 as you know you do not have the antidote available. What is the antidote for iron salt poisoning?
Choose only ONE best answer.
A
Dantrolene
B
Desferrioxamine
C
Octreotide
D
Flumazenil
E
Pyridoxine
B
You check her patient medication record and find she is on the following medications- low potassium
Terbutaline 100mcg inhaler
Beclomethasone 200mcg inhaler
Theophylline 300mg M/R tablets
Bumetanide 1mg tablets
Verapamil 120mg M/R tablets
Considering his presentation which of the following medications is NOT a likely cause of his symptoms
E – Verapamil is a calcium channel blocker, and unlike the other medications listed, it is the least likely to cause hypokalaemia (low potassium levels). The other medications, particularly terbutaline, theophylline, and bumetanide, are associated with lowering potassium levels, making them more likely to contribute to this electrolyte abnormality.
A 56-year-old patient with a known history of G6PD deficiency presents with unusual abdominal pain, a temperature of 39.1°C, and jaundice. He recently completed a course of antibiotics for an acute exacerbation of his bronchiectasis. Which of the following medications could have triggered these symptoms?
Choose only ONE best answer.
A
Paracetamol
B
Co-trimoxazole
C
Allopurinol
D
Apixaban
E
Cyanocobalamin
B – Co-trimoxazole, which contains a sulphonamide, is known to pose a risk of haemolysis in patients with G6PD deficiency. This matches the patient’s symptoms, which are consistent with a hemolytic reaction.
