Chapter 9 - Blood and Nutrition

Question 1

What are the side effects associated with oral iron salts?

Answer 1

Discolour stools (black colour)
Constipation/ diarrhoea
GI disturbance

Question 2

Anaemia can be broadly categorised into 3 subtypes. What are these?

Answer 2

Microcytic - smaller RBC size in comparison to normal
Macrocytic - larger RBC size in comparison to normal
Haemolytic

Question 3

What types of anaemia comes under microcytic?

Answer 3

iron deficiency anaemia

chronic disease anaemia (e.g anaemia associated with CKD)

Question 4

What types of anaemia comes under macrocytic?

Answer 4

Folate deficiency anaemia

Vitamin B12 deficiency anaemia

Question 5

Haemolytic anaemias include generic disorders of what types of diseases?

Answer 5

Sickle cell disease
G6PD (glucose 6 phosphate dehydrogenase deficiency)
Thalassaemia
autoimmune haemolytic anaemia

Question 6

In patients with anaemia associated with chronic kidney disease, what hormone is lacking in these patients which results in anaemia?

Answer 6

Erythropoetin - hormone released by renal cortex in response to hypoxia and anaemia.
Failure to produce this hormone in patients with renal disease means development of anaemia.

Question 7

Which drugs are used to treat anaemias associated with renal disease?

Answer 7

epoetins

Question 8

It’s important to keep haemoglobin levels between what range in patients with renal disease anaemia receiving epotetins for treatment. Why?

Answer 8

Range should be between 10-12g/100ml

Overcorrection of haemoglobin - increase risk of death/cardiovascular events

Question 9

What is iron-deficiency anaemia treated with?

Answer 9

iron salts

e.g ferrous sulfate
ferrous gluconate
ferrous fumarate

Parenteral preparations include

ferric carboxymaltose (ferrinject)

Question 10

Tx for Vitamin B12 deficiency anaemia?

Answer 10

Hydroxocobalamin - effective treatment and can be given at 3 monthly intervals via intramuscular injection to replenish depleted body stores

Question 11

Tx for folate deficiency anaemia?

Answer 11

Folic acid - short course is enough to replenish body body stores (4 months)

Question 12

True or False: Potassium-sparing diuretics are preferred over potassium supplements for Tx of hypokalaemia in patients are taking medicines such as diuretics or digoxin

Answer 12

True - potassium salts cause nausea and vomiting and poor compliance is a major limitation to their effectiveness