blood and nutrition

Question 1

what is iron deficiency anaemia?

what is the common cause?

Answer 1

fewer red blood cells or less haemoglobin

iron deficiency

Question 2

what must you assess in a patient before giving iron treatment for iron deficiency anaemia?

Answer 2

rule out any other underlying causes of the anaemia

Question 3

list some conditions that require iron prophylaxis

Answer 3

malabsorption
pregnancy
menorrhagia [heavy period blood]
subtotal or total gastrectomy [stomach removal]
kidney dialysis pt [haemodialysis]
low birth weight infants

Question 4

what is commonly given for prophylaxis of iron deficiency anaemia?

Answer 4

ferrous sulphate 100-200mg daily

Question 5

what is the content of ferrous iron in each of these preparations?
ferrous sulfate dried 200mg
ferrous fumarate 200mg
ferrous gluconate 300mg
ferrous sulphate 300mg

Answer 5

65mg
65mg
35mg
60mg

Question 6

what are compound preparations and who is normally given these?

Answer 6

mixture of iron and folic acid

pregnant women at high risk of folic acid/iron deficiency

Question 7

when is parenteral iron given? [6]

Answer 7

when oral route unsuccessful
pt does not like oral route 
chemotherapy induced anaemia
haemodyalysis patients
continuing blood loss
malabsorption

Question 8

give some examples of parenteral iron

Answer 8

iron dextran
iron sucrose
ferric carboxymaltose

Question 9

what are the symptoms of iron deficiency? [8]

Answer 9

tiredness
memory loss
brittle nails
hair loss/ hair losing its condition
struggling to concentrate
reduced ability to exercise
cuts or grazes taking long to heal
sore tongue/corners of mouth

Question 10

what are the side effects of iron medication?

Answer 10

nausea, vomiting, diarrhoea or constipation, upper abdomen pain

Question 11

what are the counselling points for iron?

Answer 11

best absorbed on an empty stomach
take after food if having GI side effects
may discolour stools

Question 12

what is a G6PD deficiency?

who does it affect more

Answer 12

genetic disorder that causes destruction of red blood cells [haemolytic anaemia] when person takes certain drugs or eats fava beans

affects men more from africa, middle east, asia, oceania etc

Question 13

list some drugs with DEFINITE risk of haemolysis in G6PD deficiency?

Answer 13

did not finish my quite special reliever

dapsone 
nitrofurantoin
fluroquinolones [ofloxacin, ciprofloxacin]
methylthionine chloride
quinolones [nalidixic acid]
sulphonamides eg co-trimoxazole
rasburicase

Question 14

list some drugs with POSSIBLE risk of haemolysis in G6PD deficiency

Answer 14

aspirin
sulfonylureas
chloroquine
quinine
naphthalene

Question 15

what is hydroxocobalamin injections used for?

how often are they given?

Answer 15

prophylaxis of anaemia associated with vitamin B12 deficiency

every 3 months

Question 16

what is megaloblastic anaemia

Answer 16

bone marrow produces large and structurally abnormal red blood cells
causes are folic acid/vitamin b12 deficiency

Question 17

who is folic acid given to?

Answer 17

given for folate deficiency anaemia

• pregnant women
• malnutrition
• methotrexate
• antiepileptic drugs

Question 18

why must folic acid be taken before and during pregnany?

Answer 18

to reduce neural tube defects

Question 19

/what is the dose for women at low risk of folate deficiency and women at high risk

Answer 19

low risk - 400mcg daily before conception and until week 12

high risk - 5mg daily until week 12

Question 20

which drugs treat anaemia associated with erythropoietin deficiency in chronic kidney injury?

Answer 20

epoetins

Question 21

what is sickle cell disease?

what is the treatment for it?

Answer 21

structurally deformed red blood cells - less flexible - delivers less oxygen to organs

hydroxycarbamide

Question 22

what are some chronic complications of sickle cell disease?

Answer 22

increased risk of infection, renal failure and skin ulcerations

Question 23

when is folinic acid given?

what is it given as?

Answer 23

for use with cytotoxic drugs, for folate deficiency megaloblastic anaemia

calcium foliate

Question 24

what are the side effects of magnesium?

what must you do if side effects occur?

Answer 24

diarrhoea

stop treatment and restart at lower dose bc side effects occur at higher doses

Question 25

what is wilsons disease and what is used to treat it?

Answer 25

inherited abnormality of zinc absorption zinc supplements

Question 26

what conditions require total parenteral nutrition [TPN]?

Answer 26

``` chemotherapy radiation therapy undernourished pt for surgery major surgery prolonged disorders of the GI tract coma, trauma, refusal to eat etc ```

Question 27

what are special diets

Answer 27

special preparations which have been modified to eliminate particular constituent from a food eg gluten free

Question 28

list some things included in total parenteral nutrition

Answer 28

``` amino acids glucose fat vitamins trace elements electrolytes ```

Question 29

what is phenylketonuria [PKU]? | what are some complications?

Answer 29

pt has inability to metabolise phenylalanine [protein] | brain damage, epilepsy, mouldy smell to breath, tremors

Question 30

which drugs are unsafe in patients with acute porphyrias?

Answer 30

``` sulfonylureas triazole antifungals antidepressant hormonal contraception sulphonamides ```

Question 31

what is the treatment of acute porphyria?

Answer 31

haem arginate IV infusion

Question 32

list some symptoms of acute porphyria

Answer 32

``` red/brown urine numbness/weakness/muscle pain nausea vomiting diarrhoea/constipation abdominal pain pain in chest/legs/back ```

Question 33

what organ is usually impaired if there is red/brown urine? | what organ is usually impaired if there is blood in stool?

Answer 33

kidneys | liver/intestine

Question 34

what conditions is vitamin A deficiency associated with?

Answer 34

occular defects and increased risk of infection

Question 35

what are used to treat vitamin B deficiency?

Answer 35

thiamine, riboflavin, nicotinamide

Question 36

what condition develops with extreme vitamin C deficiency?

Answer 36

scurvy

Question 37

what body functions does vitamin K help with? | what is given to treat vitamin K deficiency?

Answer 37

blood clotting factors menadiol sodium phosphate

Question 38

what are neural tube defects and what are the main risk factors?

Answer 38

congenital defects caused by incomplete closure of neural tube within 28 days of conception [birth defects of spine] risk factors: maternal folate deficiency, maternal vit b12 deficiency, smoking, obesity, antiepileptic drugs

Question 39

what is the important safety information related to parenteral iron?

Answer 39

serious hypersensitivity reactions

Question 40

what is the important safety advice with potassium chloride IV?

Answer 40

risk of fatal overdose

Question 41

what is the important safety information for pyridoxine [vitamin B6]

Answer 41

high doses increase risk of neuropathy

Question 42

what are is the important safety information for thiamine [B1]?

Answer 42

potential serious allergic reaction