Chapter 9 - Blood And Electrolytes Flashcards Preview

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Flashcards in Chapter 9 - Blood And Electrolytes Deck (66)
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1

What's included in chapter 9?

Different types of anaemia
Blood and Electrolytes
Vitamins

2

Different types of anaemia

Sickle Cell Anaemia
G6PD deficiency
Hypolastic
Haemolytic
Aplastic
Iron deficiency anaemia
Megaloblastic

3

Sickle cell anaemia

Might need folate supplements

4

Hydoxycarbamide

Reduce frequency of sickle cell crisis which would lead to hospitalisation

5

G6PD

More common in men
Mostly seen in Asian, African and south European Union

6

Some drugs cause risk of haemolysis in G6PD deficiency

Quinolones like ciprofloxacin
Nitrofurantoin
Sulfonamide such as co-trimoxazole

7

Drugs with higher risk in G6PD deficiency

Aspirin
Quinine
Sulfonylurea

8

Hypoblastic and haemolytic anaemia

Can be treated with anabolic steroids

Various corticosteroids and pyridoxine

9

Aplastic anaemia

Treated with anti-lymphocyte immunoglobulin

Given IV through central line - 12 to 18 hours each day for 5 days; can cause severe reaction first two days and immunosupression can occur

Rate response may increase if ciclosporin given as well

10

Anaemia associated with erythopoietic deficiency

Can be seen in patients with chronic kidney failure

Treatment option eproietin

Eproietin beta - neonates with low birth weight (non benzoyl alcohol version)

Darbopretin long half life don't have to administer frequently

11

Iron deficiency anaemia

Quiet common

Important not underlying conditions like GI cancer or gastric erosion

12

Prophylaxis with Iron

Menorraghea
Pre-term neonates with low birth weight
Pregnancy

13

Iron

Oral version and m/r versions

Therapeutically m/r has no benefit except u can take once a day

Parenteral versions - iron dextrose, iron sucrose: when oral version ineffective or can't rake; main side effect hypersensitivity anaphylaxis, eczema and asthma patients at higher risk

14

Iron side effects

Constipation
Diarrhoea in patients with IBD taking m/r preparation
Discolour stools (black stools)

15

Iron administration

On an empty stomach because absorbs better that way
But if can't tolerate side effects it's fine to take after food
Advise patient to take with orange juice rather than water because it absorbs better with vitamin c

16

Megaloblastic anaemia

Usually due to lack of vitamin b12 also known as cyanocobalamine or folate

Establish underlying cause - pernicious anaemia causes malabsorption of vitamin b 12

17

Total gastectomy or total iliolresection

B12 prophylactically

18

Cyanocobalamin for b12 deficiency

Needs to be endorsed SLS

19

Cyanocobalamin replaced by

Hydroxycobalomine because it can be retained longer in the body

Maintenance treatment usually up to 3 months by IM injections

20

Folate deficiency

Due to pregnancy
Poor nutrition
Or even some antiepileptic medication

Folic acid treatment usually 4 months

21

Folic acid use in

Methotrexate therapy as folate antagonist

Also folinic acid but to do with cytotoxic therapy

22

Iron overload

Repeated blood transfusions

Treatment repeated venesection but if that's contraindicated then iron chelating compound e.g desferrioxamine mesilate with ascorbic acid given separate from food and should be avoided in patients with cardiac dysfunction

23

In what situations would we need to give someone fluid and electrolytes

Vomiting
Diarrhoea
Particularly sodium and water in these states

24

Hyperkalaemia treatment >6.5mmol/l

Calcium gluconate 10%
Soluble insulin
Glucose 50%
Calcium polystyrene sulfonate
Salbutamol injection/nebuliser

25

Oral potassium <3.5
Potassium bicarbonate
Potassium chloride

Digoxin therapy
Anti-arrhythmic
Chronic diarrhoea
Laxatives

26

Sodium bicarbonate

Chronic acidosis state
Metabolic acidosis
Renal tubular acidosis
Dyspepsia
Increasing pH of urine

27

Calcium supplementation

In children
Pregnancy
Osteoporosis

28

Hypocalcaemia

Calcium + vitamin D

In the form of:
Calcium carbonate or
Calcium chloride

29

Hypercalcaemia treatment

Bisphosphonates
Corticosteroids
Calcitonin
Phosphate salts
Pamidronate
Cinacalcet

Dietary restrict calcium

Medicines - thiazides and vitamin D contribute

30

Hyperparythyroidism

Cinacalcet
Paricalcitol
Parathyroidectomy