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PRE-REG-Thuri > BLOODS + NUTRITION > Flashcards

BLOODS + NUTRITION Flashcards

1
Q

What are the 3 types of anaemia?

A

Sickle cell

iron deficiency

Megaloblastic

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2
Q

What is sickle cell anaemia?

A

Deformed, less flexible RBC

Causes less blood supply to organs

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3
Q

What to do if someone goes through sickle cell crisis?

A

Immediate hospital + give fluid replacement, pain management and treat infections

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4
Q

What are 4 sickle cell complications?

A

Leg ulcers, anaemia, renal failure, infections

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5
Q

What drug reduces sickle cell crisis?

A

Hydroxycarbamide

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6
Q

If someone develops haemolytic anaemia, what to give them?

A

Folate supplementation

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7
Q

What is G6PD deficiency?

A

glucose 6 phosphate dihydrognase

More common in males- from africa/asian countries.

Causes breakdown of RBC = haemolytic anaemia

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8
Q

What 3 drugs can highly increase haemolysis in G6PD deficiency?

A

Quinolones,

nitrofurantoin

dapsone

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9
Q

What 5 drug classes may have possible increase in haemolysis in G6PD deficiency?

A

Aspirin
Chloroquine
Menadione
Quinine (may be acceptable in acute malaria)

Sulfonylureas

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10
Q

What are 4 signs of iron deficiency?

A

Tiredness

SOB

pale skin

palpitations

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11
Q

When can iron medicines be used?

A

After iron deficiency is proven

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12
Q

What 2 conditions to exclude before treating with iron?

A

GI erosion/ cancer

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13
Q

What 6 conditions can iron be used as prophylaxis?

A

Pregnancy

Malabsorption

Menorrhagia

Haemodialyis patients

Underweight neonates

total gastrectomy

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14
Q

What is daily elemental dose of Iron?

A

60-70mg a day

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15
Q

What does MR form of iron do?

A

Reduce absorption

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16
Q

What does taking iron after food do?

A

reduces SEs

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17
Q

What is iron taken with to increase absorption?

A

Vitamin C

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18
Q

What are the 2 main SEs of iron?

A

black Tarry stool

constipation + diarrhoea

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19
Q

How long does iron need to be taken?

A

3 months after hb in normal range

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20
Q

What is iron toxicity antidote?

A

desferrioxamine

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21
Q

List 3 parenteral iron?

A

iron dextran

Iron sucrose

Ferric carboxymaltose

ferric derisomaltose

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22
Q

What 3 criteria is parenteral iron prep used in?

A

Oral therapy Not tolerated

chemo induced anaemia

chronic renal failure with haemodialysis

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23
Q

How is iron given to pregnant women?

A

With folic acid

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24
Q

What is an MHRA warning linked to IV iron?

A

Hypersensitivity- NO test doses

Monitor for 30 mins after each injection.

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25
Q

Can IV iron be used in pregnancy?

A

Avoid - especially in 1st trimester

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26
Q

What are 2 causes of megaloblastic anaemia?

A

Vit B12 or folate deficiency

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27
Q

What to do if emergency megaloblastic anaemia?

A

Give both folic acid + b12

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27
Q

What happens if folic acid given alone?

A

Neuropathy

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28
Q

What to give if Vit b12 deficiency?

A

Hydroxycobalamin given as IM.

Initially given more frequent, then 3 monthly.

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28
Q

What are 5 risk factors for neural tube defects?

A

Smoking

diabetes

obesity

sickle cell anaemia

using anti-epileptics/anti-malarials

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28
Q

What are 4 symptoms of megaloblastic anaemia?

A

Numbness

tingling hands/feet,

muscle weakness

depression

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28
Q

How long to give folic acid for?

A

4 month supplementation

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29
Q

What are 4 reasons for folate deficiency?

A

Poor diet

coeliac disease, malabsorption

pregnancy

anti-epileptics

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29
Q

What is regular folic acid dose in pregnancy which can be OTC?

A

400mcg from start to week 12 of pregnancy

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29
Q

What is regular prescribed folic acid dose in pregnancy?

A

5mg - used if at risk of neural tube defects

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30
Q

What is neutropenia + treatment?

A

low platelets <1.5 x 10^-9

Filgrastim

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30
Q

immune thrombocytopenic purpura 1st line treatment?

A

Prednisolone

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31
Q

What is sodium range?

A

133-146mmol/L

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32
Q

What is potassium range?

A

3.5-5.3mmol/L

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33
Q

What is phosphate range?

A

0.87-1.45 mmol/L

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34
Q

What is magnesium range?

A

0.6-1mmol/L

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35
Q

What is calcium range?

A

2.2-2.6 mmol/L

36
Q

What are 5 signs of hyperkalaemia?

A

Palpitations

SOB

chest pain

fatigue

numbness

37
Q

What are signs of Hyponatraemia?

A

confusion + headache

fatigue

seizures

38
Q

What are signs of hypernatraema?

A

Thirst

fatigue

confusion

39
Q

What are 5 signs of hypokalaemia?

A

muscle cramps

rhabdomyolysis

fatigue

palpitations

arrhythmias

40
Q

What are signs of Hypocalcaemia?

A

Muscle cramp

confusion

depressed

forgetful

41
Q

What are signs of Hypercalcaemia?

A

Nausea

lethargy

muscle cramps

confusion

arrhythmias

42
Q

What 6 drugs cause hypokalaemia? (ABCDE I

A

Aminophyline

Beta agonist

Corticosteroids

Diuretics

Erythromycin

Insulin

43
Q

What 6 drugs cause hyperkalaemia? (THANKS B )

A

trimethoprim

heparin

Ace- inhibitor

NSAIDS

Ksparing diuretics

Beta blockers

44
Q

What is treatment for mild- moderate hypokalaemia?

A

oral replacement

45
Q

What is treatment for severe hypokalaemia?

A

IV KCL in nacl

46
Q

What to be careful in elderly patients with renal impairment and K+ defficiency?

A

Can lead to hyperkalaemia due to poor excretion

47
Q

What is 1st line acute severe hyperkalaemia treatment?

A

IV Cacl or calcium gluconate 10%

can use insulin, salbutamol

48
Q

What is 1st line Mild-moderate hyperkalaemia treatment?

A

Ion exchange resins- calcium resonium

49
Q

What 4 drugs cause hyponatraemia?

A

Carbamazepine
Diuretics
Desmopressin
SSRIs

50
Q

What 4 drugs cause hypernatraemia?

A

sodium chloride/ bicarb

Corticosteroids

effervescent formulations

oestrogen

51
Q

What is treatment for mild- moderate hyponatraemia?

A

oral supplements

52
Q

What is treatment for severe hyponatraemia?

A

IV nacl

53
Q

What is given for mild-moderate hypocalcaemia?

A

Vit D + Ca supplements

54
Q

What amount of calcium recommended in osteoporosis?

A

double

55
Q

What is given in severe acute hypocalcaemia or hypocalcaemic tetany?

A

Slow IV calcium gluconate

56
Q

What happens if calcium given too quickly?

A

Arrhythmias

57
Q

What to give in severe hypercalcaemia?

A

Fix dehydration first with IV NaCL

Restrict calcium, stop drugs which increase it

Bisphosphonates

58
Q

When is corticosteroids given in hypercalcaemia?

A

if cause is due to sarcoidosis or vit D toxicity

59
Q

When is calcitonin used?

A

If hypercalcaemia in malignancy

60
Q

How to treat hypercalcuria?

A

Increase fluid intake + give bendroflumethiazide

reduce calcium slightly

61
Q

What is hyperparathyroidism?

A

Excess parathyroid hormone causing hypercalcaemia, hypercalciuria, hypophosphataemia

62
Q

Symptoms of hyperparathyroidism?

A

Thirst, polyuria, dehydration, constipation, fatigue, CVD, osteoporosis, kidney stones

63
Q

1st line for hyperparathyroidism?

A

Surgery- remove it

Access CVD + fracture risk

64
Q

What drug can be given for hyperparathyroidism if surgery not working?

A

Cinacalcet

measure vit D + give bisphosphonates to reduce fracture.

65
Q

Function of Magnesium?

A

stored in bones- for energy

66
Q

How is Magnesium excreted?

A

Renally

67
Q

What are 2 symptoms of hypermagnesesaemia?

A

muscle weakness

arrhythmia

68
Q

What is 1st line for hypomagnesesaemia?

A

IV/IM mgso4 if severe

mild- oral tabs

69
Q

What is 1st line for hypermagnesesaemia?

A

Calcium gluconate

70
Q

What is 1st line for hypophophataemia?

A

oral phosphate supplements

71
Q

What is 1st line for hyperphophataemia?

A

phosphate binding agents (calcium based or non)

72
Q

What is 1st line hyperphophataemia treatment if CKD stage 4/5?

A

Diet + dialysis

73
Q

What is hyperphophataemia drug 1st line treatment if CKD stage 4/5?

A

calcium acetate

74
Q

What is hyperphophataemia drug 2nd line treatment if CKD stage 4/5?

A

Sevelamer

75
Q

What is acute porphyrias?

A

genetic defect in haem biosynthesis

1 in 75000

can cause acute porphyric crisis

76
Q

What is treatment for acute porphyric crisis?

A

IV Haem arginate

77
Q

List some drugs which are cautioned due to acute porphyrias?

A

Amiodarone

nitro

diltiazem/ verapamil

carbamazepine/ phenytoin

rifampicin

spironolactone

78
Q

What are 2 methods of IV nutition?

A

SPN (supplemental)

TPN

79
Q

How if IV nutrition give?

A

Central catheter or peripheral vein

80
Q

What does IV nutrition contain?

A

Glucose, fat, amino acids, carbs, electrolytes, vit + trace elements

81
Q

How is glucose given to avoid thrombosis?

A

central vein

82
Q

Why is fructose + sorbitol given as IV nutrition?

A

Avoid hyperosomolar hyperglycaemic non-ketotic acidosis

83
Q

Why is phosphate given in IV nutrition?

A

Phosphorylate glucose

84
Q

List 4 fat soluble vitamins?

A

A D E K

85
Q

What 2 vitamins are water soluble?

A

B + C

86
Q

What does vit A deficiency do?

A

Ocular defects + increased risk of infection

87
Q

When to avoid vit A?

A

Pregnancy - teratogenic

88
Q

What does vit D deficiency cause?

A

Rickets

89
Q

What is normal vit D dose?

A

10 mcg or 400 units

90
Q

What is name of Vit E + what does deficiency do?

A

Tocopherol

Neuromuscular abnormalities

91
Q

What does Vit K do?

A

Reverses warfarin, in green leaf, clotting factor

92
Q

When is vit K given?

A

All new born babies to prevent neonatal haemorrhage

93
Q

What is water soluble version of vit K called?

A

Menadiol - used in liver impairment

94
Q

What does vit C do?

A

Ascobic acid- wound healing

found in fruit

95
Q

What are the 4 types of VIT B?

A

B1 = thiamine

B2 = riboflavin

B3 = niacin

B6 = pyridoxine
B7= biotin

B12 = hydroxycobalamin

96
Q

Use of thiamine?

A

Wernicke’s encephalopathy

97
Q

When is hydroxycobalamin used?

A

Megaloblastic anaemia

PRE-REG-Thuri (44 decks)

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