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Blood and nutrition Flashcards

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1
Q

Iron deficiency anaemia symptoms

A

Dysponea, Fatigue, Headaches, Cognitive Dysfunction, Restless leg syndrome

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2
Q

Iron deficiency anaemia causes

A

Diet, Malabsorption, Increased blood loss, Pregnancy

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3
Q

Iron deficiency anaemia complications

A

Adverse effects on immune system, Heart Failure, Impaired muscle function, Increased morbidity in Pregnancy

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4
Q

Meds that worsen iron deficiency anaemia

A

NSAIDS, PPI, CLOP, SSRI, Corticosteroids

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5
Q

Iron deficiency anaemia management

A

Diet if caused by dietary deficiencies. 1st line- Oral iron for 3 months. 2nd line- IV iron if oral not tolerated or ineffective.

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6
Q

Oral iron how to take

A

Take on empty stomach for better absorption. Monitor for 4 weeks and continue for 3 months.

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7
Q

Oral iron in elderly

A

Max dose of 200mg elemental iron a day.

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8
Q

Oral iron side effects

A

GI disturbances (take with food), Constipation, Black stools, Nausea, Diarrhoea (especially in IBD)

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9
Q

IV iron types

A

Cosmofer, Venofer, Ferrinject, Monofer

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10
Q

IV iron dosing

A

Dose dependent on Hb and weight.

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11
Q

IV iron cautions

A

Hypersensitivity/Anaphylaxis, Infection (avoid in bacteremia), Oral iron should not be given until 5 days after IV, Avoid in hepatic dysfunction.

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12
Q

IV iron side effects

A

Hyper/Hypotension, Dizziness, Flushing, Headache, Nausea, Skin reactions (if fishbane continue but lower the dose)

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13
Q

Hypercalcemia symptoms

A

Skeletal (fractures, bone pain), Neurological (drowsiness, fatigue), GI (Nausea, Abdominal pain), Hypertension, Renal Impairment

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14
Q

Hypercalcemia causes

A

90% due to hyperparathyroidism or malignancy, Drug induced, Renal failure, Dehydration

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15
Q

Hypercalcemia treatment

A

Mild/Moderate: IV fluids. Severe/Malignant: IV fluids + IV Bisphosphonates (pamidronate or zoledronate)

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16
Q

Hypocalcemia symptoms

A

Mild/Moderate: Asymptomatic. Tetany, muscle cramps, cardiac disturbances, irritability, confusion, seizures

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17
Q

Hypocalcemia causes

A

Diet, Hypoparathyroidism, Hypomagnesemia, Hyperphosphatemia, Vitamin D deficiency, Renal failure, Drug induced (Post IV bisphosphonate treatment)

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18
Q

Hypocalcemia treatment

A

Mild/Moderate: Oral calcium (+vit D). Severe: Calcium gluconate 10% injection.

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19
Q

Oral calcium side effects and counselling

A

Can reduce absorption of meds (tetracyclines, iron, bisphosphonates) - leave 3 hour gap. Side effects: GI discomfort.

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20
Q

Calcium gluconate counselling and side effects

A

Side effects: extravasation, hot flushes. Monitor ECG as rapid administration can lead to cardiac arrest. Calcium enhances digoxin -> digoxin toxicity.

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21
Q

Hypermagnesemia symptoms

A

Hypotension, Respiratory depression, Cardiac arrest

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22
Q

Hypermagnesemia causes

A

Renal failure, Drug induced, Tumor-lysis syndrome

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23
Q

Hypermagnesemia treatment

A

Calcium gluconate 10% injections (binds to excess magnesium).

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24
Q

Hypomagnesemia symptoms

Study These Flashcards
A

Loss of appetite, Nausea and Vomiting, Fatigue. Severe: numbness, tingling, seizures.

25
Hypomagnesemia causes
Excessive loss in diarrhea, Stoma, Alcohol, Renal disorders, Drug induced.
26
Drugs that can cause hypomagnesemia
Aminoglycosides, Ciclosporin, Cisplatin, Laxatives, Theophylline, PPI, Digoxin, Diuretics.
27
Hyperphosphatemia symptoms
Most asymptomatic. It can lead to hypocalcemia.
28
Hyperphosphatemia causes
Advanced CKD, Increased dietary intake, Hypoparathyroidism, Metabolic + Respiratory acidosis.
29
Hyperphosphatemia treatment
Limit dietary intake, Phosphate binders.
30
Phosphate binder choice if low calcium level
Calcium Acetate.
31
Phosphate binder choice if normal calcium levels
Sevelamer -> Calcium carbonate -> Velphoro -> Lanthanum. ONLY TREAT IF SEVERE.
32
Hypophosphatemia symptoms
Muscle weakness, Cramps, Arrhythmia, Confusion, Irritability.
33
Hypophosphatemia causes
Hyperparathyroidism, DKA, Malnutrition, Alcohol dependence, Vitamin D deficiency, Referring syndrome, Drug induced (LOOP).
34
Hypophosphatemia treatment
Moderate: Phosphate Sandoz 1-2 TDS. Severe: IV phosphate polyfusor.
35
Hyperkalemia symptoms
Fatigue, Nausea, Muscle pain, Dysponea, Chest pain.
36
Hyperkalemia causes
Most common: AKI, Chronic renal impairment, Drug induced, DKA, Addison's, Burns.
37
Hyperkalemia treatment
Mild- Monitor and adjust medications. Calcium gluconate 10% (cardiac protection), Insulin, Salbutamol, Sodium bicarbonate (shift K into cells). Furosemide, Patiromer calcium/calcium resonium - remove K from the body.
38
Hypokalemia symptoms
Muscle cramps/Pain/Rhabdomyolysis, Palpitations, Fatigue, Cardiac arrhythmia, Delirium.
39
Hypokalemia causes
GI loss (Vomiting), Secondary hyperaldosteronism, Drug induced, Refeeding syndrome.
40
Hypokalemia treatment
Mild/moderate: Oral replacement (Sando-K or Kay-Cee-Lee). Smaller doses in renal impairment. Severe: IV potassium replacement (risk of fatal overdose).
41
Drug induced hypokalemia
Laxatives (excessive), Diuretics, Theophylline, Beta-2-agonists, Insulin, Corticosteroids, Aminoglycosides.
42
Drug induced hyperkalemia
Beta blockers, Digoxin, ACEi/ARB, Heparin, NSAIDS, Trimethoprim, Potassium sparing diuretics, Potassium supplements, Ciclosporin, Tacrolimus. THANKS BCT
43
Drug induced hyponatremia
ACEi/ARB, PPI, Diuretics, Lithium, Heparin, SSRI/SNRI, Antipsychotics, Anti-epileptics, Desmopressin.
44
Drug induced hypernatremia
Steroids, Tolvaptan, IV phosphate, IV antibiotics (that contain sodium salts).
45
Pyridoxine (Vitamin B6) function
Helps body store and use proteins and carbohydrates and form hemoglobin.
46
Pyridoxine indications
Deficiency, Isoniazid induced neuropathy.
47
Sources of pyridoxine
Milk, Poultry, Peanuts, Oats, Bananas.
48
MHRA - Pyridoxine
Prolonged use of pyridoxine in 10mg daily is safe but long term >200mg has been associated with neuropathy.
49
Thiamine (Vitamin B1) function
Used in metabolic reactions (breaking down amino acids and glucose) and in CNS to make myelin and acetylcholine.
50
Thiamine indications
Deficiency.
51
Sources of thiamine
Fortified cereals, Liver, Bananas, Oranges, Peas, Nuts, Wholegrain bread.
52
Megaloblastic anemia characteristics
Large red blood cells with immature nuclei leading to large MCV.
53
Megaloblastic anemia symptoms
Dysponea, Headaches, Loss of appetite, Palpitations, Vision issues, Feeling tired, Cognitive changes, Sore mouth.
54
Megaloblastic anemia complications
B12 deficiency can lead to neurological complications (numbness, memory and cognitive impairment, poor coordination). Increased risk of neural tube defects in pregnancy.
55
Vitamin B12 deficiency causes
Pernicious anemia (most common), Drug induced (colchicine, metformin, nitrous oxide, PPI), Gastric, Inherited, Intestinal (malabsorption, Crohn's, parasites), Nutritional (vegan, malnutrition).
56
Folate deficiency causes
Drug induced (alcohol, anticonvulsants, nitrofurantoin, methotrexate, sulfasalazine), Increased requirements, Excessive urine excretion, Liver disease, Malabsorption, Nutrition.
57
Vitamin B12 treatment - initial
Hydroxycobalamin 1mg injection 3 times weekly for 2 weeks.
58
Vitamin B12 treatment - maintenance
If diet related, cyanocobalamin 50-150mcg between meals or hydroxycobalamin injection 1mg twice a year. If not diet related, hydroxycobalamin 1mg every 2-3 months or 500-1000mcg cyanocobalamin daily.
59
Folate deficiency treatment
Folic acid 5mg OD (usually for 4 months). Check vitamin B12 level before starting as folic acid can mask B12 deficiencies allowing for neurological damage to develop.

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