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Chapter 9 and 14-16 > Chapter 9 Nutrition and Blood > Flashcards

Chapter 9 Nutrition and Blood Flashcards

1
Q

what conditions require iron prophylaxis

A 
heavy period
pregnancy
malabsorption
gastrectomy
dialysis
low birth weight infants
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2
Q

iron salts

A

iron salts are given mouth
little difference between the salts
choice dependant on side effects and cost
oral elemental iron for iron deficiency anaemia should 100-200mg daily usually as ferrous sulphate

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3
Q

what are the amounts of iron each iron each salt

A

ferrous fumarate 210mg- 65mg
gluconate 300mg- 35
ferrous sulfate dried 200mg- 65mg
ferrous sulphate 300mg

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4
Q

iron and folic compounds

A

iron and folic acid
used in pregnancy in women who are at high risk of developing iron folic acid deficiency 400mcg
folic acid 5mg for neural tube defects
some preps contain ascorbic aci to aid absorption

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5
Q

examples of iv iron

A 
iron sucrose
iron dextran
ferric carboxymaltose
iron isomaltoside 100
unsuccessful oral
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6
Q

when to give parenteral iron

A 
oral therapy unsuccessful
continued blood loss
haemodialysis
chemo
malabsorption
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7
Q

side effects of iron

A 
diarrhoea- oral MR can exacerbate this in IBS
constipation- more likely in elderly
black starry stool
gi irritation
nausea
epigastric pain
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8
Q

COUNSELLING for iron tabs

A

take after to reduce side effects
best absorbed on empty stomach
discolours stools

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9
Q

what is G6PD Deficiency

A

Genetic: heterogenous so safe in some and not in others - most common in africans, asians, oceania and south europe and in men
bresk down of red blood cells due to
when you take certain drugs or eat fava beans it causes haemolytic anaemia
risk and severity is dose related

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10
Q

which drugs can cause anaemia in pts with g6pd defiiency

A 
dapsone and other sufones
nitrofurantoin
gluroquinolones
sulponamides
quionilones e.g nalidix acid
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11
Q

which drugs pose a possible riskof anaemia in g6pd deficeny ppl

A

sulphonyureas
aspirin
chloroquine
quinine

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12
Q

what is oral replacement therapy and how does it work?

A

intestinal absorption of sodium and water is enhanced by glucose and carbs
replaces electrolyet deficit safely
contains alkalising agent to neutralise the acidosis
slightly hypo-osmolar so prevents possible indcution of osmotic diarrhoea
Simple to use in a hospital and home
palatable, child friendly and readilty available

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13
Q

what are hydroxycolbalamin used for

A

prophylaxis for anemias assocaited with vitamin B12 deficiency
used over cyanocolbalamin because this stays in the bosy for too long
given at 3 month intervals

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14
Q

what is folic acid megaloblastic anaemia

A

megaloblastic anaemia- due to lack of vitamin b12 or folic acid
another cause is pernicious anaemia
folic acid need to take for 4 months before seeing the benefits

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15
Q

when is folic acid used, what strenghth and for how long

A

gievn in pregnancy, poor nutrition, antiepileptics, methotrexate
folate deficiency in megaloblastic anemia as well as prophylaxis
taken before and during pregnancy to reduce chance of neural tube defects
women at low risk take 400mcg- taken 12 weeks into pregnancy
women at high risk take 5mg up to 12 weeks
high risk couples e.g one partner had a defect or family hostory or malabosption stte- sickle cell, diabetes, anti-epileptics meds

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16
Q

what is epoetins used for

A

treat aneamias where ther are low blood cells- such as in aki
darbapoetin has a longer half life

17
Q

what is sicke cell
what medicine can be used to reduce frequency of crises
what are the complications

A

abnormal shape of haemoglobin resulting in reduced amount of oxygen to organs and severe pain
increased susceptibility to infection and various vaccines required and prophylatic peniciillin
hydroxycarbamide can reduce frequency of crises and for blood transfusion
chronic complications include: skin infections renal failure and increased risk of infections

18
Q

what is folinic acid

A

effective treatment in folate deficiency megaloblastic anaemia but used with cytotoxics
given as calcium foliate

19
Q

what is magnesium used for in the bosy

A

essential constituent of many enzymes systems
involved in energy generation
not well absorbed in GI
Largest stores in skeleton
s/e= diarrhoea
interupt treatment and restart at reduced dose if side effects occur

20
Q

effects of zinc defiency

what condition is zinc usde totreat

A

only give wen there is deficiency
occurs: malabsorption, trauma, burns, protein losing conditions, inadequate diet
used to treat wilsons disease which is a rare inherited abnormality of zinc absorption

21
Q

what conditions require TPN- Total

A 
gives electrolytes IV
-Undernourished pts
chemo
radiotherapy
major surgery
kideny failre
22
Q

what is in tpn

A 
amino acids
trace elements
glucose
fats
Electrolytes 
vitamins
23
Q

what are special diets

what is phenylketonuria and what are teh symptoms

A

preparations modified to elimate a particular consistent of food
Phenylketonuria - inability to breakdwon amino acid phenylalanine
common in aspartame containing producst
symptoms include: mouldy smell to breath, tremors, epilepsy, eczema, brain damage

24
Q

when is phospate replacement required

A

oral phosphate supplements and vitamin d required in pts with hypophosphataemic vitamin D resisitant rickets
phosphate infusion can be used in alchol depedence
phosphate depletion occurs in severe ketoacidosis
sevelamer and lanthanum licensed for hyperphosphataemia for pts on dialysis

25
Q

what is acute porphyuria

A

not producing enough haem- herediatry
if u give certain meds can induce a porphyric crises
treatment- haem arginate IV infusoion

26
Q

symptoms of acute poryura

A 
sevre abdo pain
pain in chest back or legs
diarrhoea or constipation
n and v
red or brwon urine
muscle pain, tingle, numbeness, weakness or paralysis
27
Q

what is vitamin a used for and can it be used in pregnancy

A

help boost immune system
help vision in dim lights
keeps skin healthy
good sources: eggs, cheese, oily fish, liver, pate
Pregnancy - dont give because can effect the baby

28
Q

what is vitamin b group used for

A

rare in uk
treat with thiamine (B1), riboflavin (B2), nicotinamide
Used in wernickes encephalopathy and korsakoff’s psychosis which are severe deficiency states esp seen in alcoholism- treated with IV vitamin B followed by oral thiamine long term
pyridoxine (B6’) rare but can occur during treatment with isoniazid or penicillamine

29
Q

what is vitamin c used for

A

essential in scurvy- symptoms: bleeding gums

30
Q

what is vitamin d usd for

A

prevents and trement of rickets
occurs with limited exposure to sunlight
parcaltitol is a synthetic vit d analogue for prevention and treatment of secondary hyperthyroidism associated with chronic renal failure

31
Q

pts Temi risk of viatmin d defiecy

A 
over 65
black and asian
low sun exposure due to religion or housebound etc
pregnany or breast feeding
children under 4
32
Q

what is vitamin k used for

A

Production of blood clotting factors
proteins for teh normal calcificaof bones
fat soluble- ppl with fat malabsorption may become defiecient
menadiol sodium phophate - water synthetic k can be given to prevernt deficiency
oral coumarin anticoagulants interfere with vit k metabolism and effects antagonised by giving vitamin k

33
Q

FAT soluble vitamins

A

ADEK

34
Q

neural tube defects

A

caused by incomplete closure of neural tube within 28 days of conception e.g spina bifida, encephalocele
main risk factors
maternal : folate deficiency , vit b12 deficiency
smoking, obesity, diabetes , use of antiepileptic drugs
previous infant with a neural defect
ppl who should get 5mg folic acid:sickle cell, antieplipetics, antidiabetic meds or previous child with neural tube defects

Chapter 9 and 14-16 (4 decks)

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