MISC Flashcards
Name the antiretroviral drug used to treat HIV infections that is most likely to cause anaemia as a side effect (1)
AZT
List three (3) side effects of iron, when administered orally at therapeutic doses to treat iron deficiency anaemia (1½)
(Any 3)
Nausea, epigastric discomfort, abdominal cramps, constipation, diarrhoea, black stools
Outline the mechanism of action of desferoxamine. Give an indication for its use (2) (NB)
Chelates iron (1). The resulting complex is then excreted from the body in the urine (1). Used in the management of acute iron poisoning (1). (Also used in the treatment of chronic iron overload states)
Discuss the role, if any, of vitamin B12, folate and iron in the management of a patient with anaemia due to vitamin B12 deficiency due to previous ileal resection (5)
Important to replace vitamin B12 by injection in this patient, as she is no longer absorbing this vitamin.
It is necessary to supplement with iron, as rapid production of red blood cells may deplete stores.
Folate is NOT usually necessary and may inadvertently worsen neurological symptoms.
Discuss the role, if any, of vitamin B12, folate and iron in the management of a patient with anaemia due to vitamin B12 deficiency due to previous ileal resection (5)
Important to replace vitamin B12 by injection in this patient, as she is no longer absorbing this vitamin.
It is necessary to supplement with iron, as rapid production of red blood cells may deplete stores.
Folate is NOT usually necessary and may inadvertently worsen neurological symptoms.
Describe three (3) examples of the role the liver plays in haemostasis (3)
Synthesis of: Most procoagulants (including fibrinogen), Natural anticoagulants, Components of fibrinolytic/ antifibrinolytic system (α2-antiplasmin, plasminogen, TAFI). Clearance of: tPA, activated clotting factors. Bile salt secretion: Aids vitamin K absorption (VKOR gamma-carboxylation of vitamin K dependent factors gives them their biological activity).
Outline two (2) changes that may occur with respect to platelets in chronic liver disease (2)
Low platelet count due to TPO deficiency, immune destruction, hypersplenism, DIC, toxins or folate deficiency
Platelet function defects: Altered arachidonic acid metabolism, defective signal transduction, storage pool and membrane glycoprotein defects, increased NO/ prostacyclin (platelet inhibitors).
