Chapter 9 - Blood And Electrolytes Flashcards

(66 cards)

1
Q

What’s included in chapter 9?

A

Different types of anaemia
Blood and Electrolytes
Vitamins

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2
Q

Different types of anaemia

A
Sickle Cell Anaemia
G6PD deficiency 
Hypolastic
Haemolytic
Aplastic
Iron deficiency anaemia 
Megaloblastic
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3
Q

Sickle cell anaemia

A

Might need folate supplements

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4
Q

Hydoxycarbamide

A

Reduce frequency of sickle cell crisis which would lead to hospitalisation

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5
Q

G6PD

A

More common in men

Mostly seen in Asian, African and south European Union

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6
Q

Some drugs cause risk of haemolysis in G6PD deficiency

A

Quinolones like ciprofloxacin
Nitrofurantoin
Sulfonamide such as co-trimoxazole

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7
Q

Drugs with higher risk in G6PD deficiency

A

Aspirin
Quinine
Sulfonylurea

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8
Q

Hypoblastic and haemolytic anaemia

A

Can be treated with anabolic steroids

Various corticosteroids and pyridoxine

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9
Q

Aplastic anaemia

A

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

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10
Q

Anaemia associated with erythopoietic deficiency

A

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

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11
Q

Iron deficiency anaemia

A

Quiet common

Important not underlying conditions like GI cancer or gastric erosion

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12
Q

Prophylaxis with Iron

A

Menorraghea
Pre-term neonates with low birth weight
Pregnancy

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13
Q

Iron

A

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

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14
Q

Iron side effects

A

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

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15
Q

Iron administration

A

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

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16
Q

Megaloblastic anaemia

A

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

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

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17
Q

Total gastectomy or total iliolresection

A

B12 prophylactically

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18
Q

Cyanocobalamin for b12 deficiency

A

Needs to be endorsed SLS

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19
Q

Cyanocobalamin replaced by

A

Hydroxycobalomine because it can be retained longer in the body

Maintenance treatment usually up to 3 months by IM injections

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20
Q

Folate deficiency

A

Due to pregnancy
Poor nutrition
Or even some antiepileptic medication

Folic acid treatment usually 4 months

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21
Q

Folic acid use in

A

Methotrexate therapy as folate antagonist

Also folinic acid but to do with cytotoxic therapy

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22
Q

Iron overload

A

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

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23
Q

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

A

Vomiting
Diarrhoea
Particularly sodium and water in these states

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24
Q

Hyperkalaemia treatment >6.5mmol/l

A
Calcium gluconate 10% 
Soluble insulin 
Glucose 50%
Calcium polystyrene sulfonate
Salbutamol injection/nebuliser
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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
31
What causes hypomagnesia
Diarrhoea or even alcoholism Can cause secondary hypocalcaemia and hypokalamia
32
Treatment for hypomagnesia
Magnesium sulphate injection
33
Phosphate supplements
Severe diabetic ketoacidosis Alcohol dependency Ricketts
34
Hyperphosphataemia
Calcium containing preparation - Sevelamer - Lanthanum
35
Acute Porphyria
Hereditary condition Certain medication unsafe - antihistamines, anabolic steroids, antidepressant, contraceptives, HRT, phenytoin, rifampicin, valproate plus many more
36
Trace element deficiency
Selenium | Zinc - zinc sulphate (trauma or burns)
37
Nutrition
IV infusion in addition to tube feeding Reason for tube feeding - renal or liver dysfunction, severely ill, major surgery
38
Parenteral feeding
Amino acids, glucose, fat, vitamins
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Parenteral nutrition complications
Gall bladder slodging and colistasis
40
Phenylketonuria
Body can't metabolise phenylalanine Restrict dietary intake but still give sufficient small amount
41
Special diets
Cealiac disease - gluten free
42
Bleeding of gums
Scurvy causes bleeding of gums - lack of vitamin c
43
DEAK
Fat soluble vitamins
44
Water soluble vitamins
B and C
45
Retinol
Vitamin A
46
Lack of vitamin leads to ocular defects Helps with night vision
Vitamin A
47
Avoid in pregnancy
Vitamin A
48
Where can you find vitamin A
Eggs Butter Fish oils
49
Thiamine
Vitamin B1
50
Riboflavin
Vitamin B2
51
Pyridoxine
Vitamin B3
52
Cyanocobalamin
Vitamin B12
53
Thiamine given to
Alcoholics Wernicks encephalopathy Parenteral form pabrinex
54
Thiamine found
Cereal Bread Energy metabolism
55
Riboflavin
Energy metabolism: Milk Cereal
56
Pyridoxine
Used in protein metabolism Fish Meat
57
Cyanocobalamin
Red blood cell formation Vegans lacks in - meat, milk and cheese
58
Ascorbic acid
Vitamin C Orange juice Citrus fruit Antioxidant
59
Lacking vitamin c
Scurvy: Gingival bleeding Bleeding margins Petechia of skin
60
Vitamin D
Calciferol Ergocalciferol Cholecalciferol Alfacalcidol (Renally impaired) Too much lead to hypercalcaemia, too little rickets and osteomalacia
61
Vitamin E
Antioxidant Little evidence of benefit Found in whole grain
62
Blood clotting factors
Vit K Green leafy vegetables, nuts and fruits Given to newborn Can get water soluble version
63
Nicotinic acid
Inhibit synthesis of cholesterol and triglycerides
64
Protein and energy metabolism Found in kidneys and liver
Biotin
65
Beta-carotene
Carrot and peaches Antioxidants
66
Folate/folic acid
Kidney, liver and vegetables and helps with red blood cell formation Low risk of neural tubule defects - till 12 weeks Child at risk - family history, diabetes, cealiac disease, antiepileptic medicines