BLOODS + NUTRITION Flashcards by thurica jeyaselan

What are the 3 types of anaemia?

Sickle cell

iron deficiency

Megaloblastic

How well did you know this?

Not at all

Perfectly

What is sickle cell anaemia?

Deformed, less flexible RBC

Causes less blood supply to organs

How well did you know this?

Not at all

Perfectly

What to do if someone goes through sickle cell crisis?

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

How well did you know this?

Not at all

Perfectly

What are 4 sickle cell complications?

Leg ulcers, anaemia, renal failure, infections

How well did you know this?

Not at all

Perfectly

What drug reduces sickle cell crisis?

Hydroxycarbamide

How well did you know this?

Not at all

Perfectly

If someone develops haemolytic anaemia, what to give them?

Folate supplementation

How well did you know this?

Not at all

Perfectly

What is G6PD deficiency?

glucose 6 phosphate dihydrognase

More common in males- from africa/asian countries.

Causes breakdown of RBC = haemolytic anaemia

How well did you know this?

Not at all

Perfectly

What 3 drugs can highly increase haemolysis in G6PD deficiency?

Quinolones,

nitrofurantoin

dapsone

How well did you know this?

Not at all

Perfectly

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

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

Sulfonylureas

How well did you know this?

Not at all

Perfectly

What are 4 signs of iron deficiency?

Tiredness

SOB

pale skin

palpitations

How well did you know this?

Not at all

Perfectly

When can iron medicines be used?

After iron deficiency is proven

How well did you know this?

Not at all

Perfectly

What 2 conditions to exclude before treating with iron?

GI erosion/ cancer

How well did you know this?

Not at all

Perfectly

What 6 conditions can iron be used as prophylaxis?

Pregnancy

Malabsorption

Menorrhagia

Haemodialyis patients

Underweight neonates

total gastrectomy

How well did you know this?

Not at all

Perfectly

What is daily elemental dose of Iron?

60-70mg a day

How well did you know this?

Not at all

Perfectly

What does MR form of iron do?

Reduce absorption

How well did you know this?

Not at all

Perfectly

What does taking iron after food do?

reduces SEs

How well did you know this?

Not at all

Perfectly

What is iron taken with to increase absorption?

Vitamin C

How well did you know this?

Not at all

Perfectly

What are the 2 main SEs of iron?

black Tarry stool

constipation + diarrhoea

How well did you know this?

Not at all

Perfectly

How long does iron need to be taken?

3 months after hb in normal range

How well did you know this?

Not at all

Perfectly

What is iron toxicity antidote?

desferrioxamine

How well did you know this?

Not at all

Perfectly

List 3 parenteral iron?

iron dextran

Iron sucrose

Ferric carboxymaltose

ferric derisomaltose

How well did you know this?

Not at all

Perfectly

What 3 criteria is parenteral iron prep used in?

Oral therapy Not tolerated

chemo induced anaemia

chronic renal failure with haemodialysis

How well did you know this?

Not at all

Perfectly

How is iron given to pregnant women?

With folic acid

How well did you know this?

Not at all

Perfectly

What is an MHRA warning linked to IV iron?

Hypersensitivity- NO test doses

Monitor for 30 mins after each injection.

How well did you know this?

Not at all

Perfectly

Can IV iron be used in pregnancy?

Avoid - especially in 1st trimester

What are 2 causes of megaloblastic anaemia?

Vit B12 or folate deficiency

What to do if emergency megaloblastic anaemia?

Give both folic acid + b12

What happens if folic acid given alone?

Neuropathy

What to give if Vit b12 deficiency?

Hydroxycobalamin given as IM. Initially given more frequent, then 3 monthly.

What are 5 risk factors for neural tube defects?

Smoking diabetes obesity sickle cell anaemia using anti-epileptics/anti-malarials

What are 4 symptoms of megaloblastic anaemia?

Numbness tingling hands/feet, muscle weakness depression

How long to give folic acid for?

4 month supplementation

What are 4 reasons for folate deficiency?

Poor diet coeliac disease, malabsorption pregnancy anti-epileptics

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

400mcg from start to week 12 of pregnancy

What is regular prescribed folic acid dose in pregnancy?

5mg - used if at risk of neural tube defects

What is neutropenia + treatment?

low platelets <1.5 x 10^-9 Filgrastim

immune thrombocytopenic purpura 1st line treatment?

Prednisolone

What is sodium range?

133-146mmol/L

What is potassium range?

3.5-5.3mmol/L

What is phosphate range?

0.87-1.45 mmol/L

What is magnesium range?

0.6-1mmol/L

What is calcium range?

2.2-2.6 mmol/L

What are 5 signs of hyperkalaemia?

Palpitations SOB chest pain fatigue numbness

What are signs of Hyponatraemia?

confusion + headache fatigue seizures

What are signs of hypernatraema?

Thirst fatigue confusion

What are 5 signs of hypokalaemia?

muscle cramps rhabdomyolysis fatigue palpitations arrhythmias

What are signs of Hypocalcaemia?

Muscle cramp confusion depressed forgetful

What are signs of Hypercalcaemia?

Nausea lethargy muscle cramps confusion arrhythmias

What 6 drugs cause hypokalaemia? (ABCDE I

Aminophyline Beta agonist Corticosteroids Diuretics Erythromycin Insulin

What 6 drugs cause hyperkalaemia? (THANKS B )

trimethoprim heparin Ace- inhibitor NSAIDS Ksparing diuretics Beta blockers

What is treatment for mild- moderate hypokalaemia?

oral replacement

What is treatment for severe hypokalaemia?

IV KCL in nacl

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

Can lead to hyperkalaemia due to poor excretion

What is 1st line acute severe hyperkalaemia treatment?

IV Cacl or calcium gluconate 10% can use insulin, salbutamol

What is 1st line Mild-moderate hyperkalaemia treatment?

Ion exchange resins- calcium resonium

What 4 drugs cause hyponatraemia?

Carbamazepine Diuretics Desmopressin SSRIs

What 4 drugs cause hypernatraemia?

sodium chloride/ bicarb Corticosteroids effervescent formulations oestrogen

What is treatment for mild- moderate hyponatraemia?

oral supplements

What is treatment for severe hyponatraemia?

IV nacl

What is given for mild-moderate hypocalcaemia?

Vit D + Ca supplements

What amount of calcium recommended in osteoporosis?

double

What is given in severe acute hypocalcaemia or hypocalcaemic tetany?

Slow IV calcium gluconate

What happens if calcium given too quickly?

Arrhythmias

What to give in severe hypercalcaemia?

Fix dehydration first with IV NaCL Restrict calcium, stop drugs which increase it Bisphosphonates

When is corticosteroids given in hypercalcaemia?

if cause is due to sarcoidosis or vit D toxicity

When is calcitonin used?

If hypercalcaemia in malignancy

How to treat hypercalcuria?

Increase fluid intake + give bendroflumethiazide reduce calcium slightly

What is hyperparathyroidism?

Excess parathyroid hormone causing hypercalcaemia, hypercalciuria, hypophosphataemia

Symptoms of hyperparathyroidism?

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

1st line for hyperparathyroidism?

Surgery- remove it Access CVD + fracture risk

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

Cinacalcet measure vit D + give bisphosphonates to reduce fracture.

Function of Magnesium?

stored in bones- for energy

How is Magnesium excreted?

Renally

What are 2 symptoms of hypermagnesesaemia?

muscle weakness arrhythmia

What is 1st line for hypomagnesesaemia?

IV/IM mgso4 if severe mild- oral tabs

What is 1st line for hypermagnesesaemia?

Calcium gluconate

What is 1st line for hypophophataemia?

oral phosphate supplements

What is 1st line for hyperphophataemia?

phosphate binding agents (calcium based or non)

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

Diet + dialysis

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

calcium acetate

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

Sevelamer

What is acute porphyrias?

genetic defect in haem biosynthesis 1 in 75000 can cause acute porphyric crisis

What is treatment for acute porphyric crisis?

IV Haem arginate

List some drugs which are cautioned due to acute porphyrias?

Amiodarone nitro diltiazem/ verapamil carbamazepine/ phenytoin rifampicin spironolactone

What are 2 methods of IV nutition?

SPN (supplemental) TPN

How if IV nutrition give?

Central catheter or peripheral vein

What does IV nutrition contain?

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

How is glucose given to avoid thrombosis?

central vein

Why is fructose + sorbitol given as IV nutrition?

Avoid hyperosomolar hyperglycaemic non-ketotic acidosis

Why is phosphate given in IV nutrition?

Phosphorylate glucose

List 4 fat soluble vitamins?

A D E K

What 2 vitamins are water soluble?

B + C

What does vit A deficiency do?

Ocular defects + increased risk of infection

When to avoid vit A?

Pregnancy - teratogenic

What does vit D deficiency cause?

Rickets

What is normal vit D dose?

10 mcg or 400 units

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

Tocopherol Neuromuscular abnormalities

What does Vit K do?

Reverses warfarin, in green leaf, clotting factor

When is vit K given?

All new born babies to prevent neonatal haemorrhage

What is water soluble version of vit K called?

Menadiol - used in liver impairment

What does vit C do?

Ascobic acid- wound healing found in fruit

What are the 4 types of VIT B?

B1 = thiamine B2 = riboflavin B3 = niacin B6 = pyridoxine B7= biotin B12 = hydroxycobalamin

Use of thiamine?

Wernicke's encephalopathy

When is hydroxycobalamin used?

Megaloblastic anaemia