Chapter 9: Blood and Nutrition

Question 1

Front

Answer 1

Back

Question 2

Which vitamins are fat-soluble?

Answer 2

Vitamins A, D, E, and K (ADEK)

Question 3

Which vitamins are water-soluble?

Answer 3

B-complex vitamins and Vitamin C

Question 4

Which drugs can lead to a loss of fat-soluble vitamins?

Answer 4

Fat malabsorption-related drugs; e.g., orlistat, cholestyramine

Question 5

What are common sources of Vitamin A?

Answer 5

Liver pâté, liver sausage, fish liver

Question 6

What can high doses of Vitamin A lead to?

Answer 6

Toxicity

Question 7

Why should pregnant women avoid Vitamin A?

Answer 7

It may be teratogenic

Question 8

Which acne drug is a Vitamin A analogue and requires pregnancy prevention?

Answer 8

Isotretinoin

Question 9

What condition results from Vitamin C deficiency?

Answer 9

Scurvy - swollen gums and bleeding margins

Question 10

What is the effect of Vitamin C on iron?

Answer 10

It increases iron absorption

Question 11

Does Vitamin C help with cold and flu symptoms?

Answer 11

No strong evidence

Question 12

Is Vitamin C contraindicated in cardiac dysfunction?

Answer 12

Yes

Question 13

What is essential for Vitamin D production?

Answer 13

Sunlight exposure

Question 14

What can high Vitamin D levels lead to?

Answer 14

Hypercalcaemia

Question 15

Are many people in the UK Vitamin D deficient?

Answer 15

Yes

Question 16

What is Vitamin K necessary for?

Answer 16

Production of blood clotting factors

Question 17

Which anticoagulant antagonizes Vitamin K?

Answer 17

Warfarin

Question 18

Why is Vitamin K given to newborns?

Answer 18

To prevent bleeding, especially if the mother is on antiepileptics

Question 19

What foods contain Vitamin K?

Answer 19

Green leafy vegetables

Question 20

What is Vitamin E essential for?

Answer 20

Skin care

Question 21

Which group commonly lacks Thiamine (B1)?

Answer 21

Alcoholics

Question 22

What should thiamine-deficient mothers avoid?

Answer 22

Breastfeeding due to methyl-glyoxal in milk

Question 23

What is a danger of high-dose Pyridoxine (B6)?

Answer 23

Neuropathy if over 200mg daily

Question 24

Which TB drug reduces Pyridoxine levels?

Answer 24

Isoniazid

Question 25

What does a Vitamin B12 deficiency lead to?

Answer 25

Megaloblastic anaemia

Question 26

What is the folic acid dose for pregnancy planning?

Answer 26

400 mcg daily up to 3 months of pregnancy

Question 27

When is a higher folic acid dose (5mg+) required?

Answer 27

Patients on antiepileptics, diabetics, sickle cell, methotrexate users, neural tube defect history

Question 28

When do neural tube defects occur?

Answer 28

Within the first 28 days of pregnancy

Question 29

What are causes of neural tube defects?

Answer 29

Folic acid deficiency, smoking, diabetes, obesity, antiepileptics, B12 deficiency

Question 30

Why shouldn't folic acid be used alone in undiagnosed megaloblastic anaemia?

Answer 30

It may precipitate neuropathy unless B12 is given

Question 31

Why do people with dark skin need more sun exposure for Vitamin D?

Answer 31

Melanin absorbs UVB, reducing Vitamin D synthesis

Question 32

Do clothes covering the body reduce Vitamin D synthesis?

Answer 32

Yes

Question 33

Does sunscreen prevent Vitamin D synthesis?

Answer 33

Not significantly in real-world use

Question 34

What causes iron overdose?

Answer 34

Inappropriate transfusion or excess gut absorption

Question 35

What worsens iron toxicity?

Answer 35

Vitamin C

Question 36

What treats iron overdose?

Answer 36

Desferrioxamine mesilate (teratogenic)

Question 37

What can trigger haemolytic anaemia in G6PD deficiency?

Answer 37

Certain drugs or ingestion of fava/broad beans

Question 38

Is G6PD deficiency risk uniform?

Answer 38

No — it is heterogeneous and dose-related

Question 39

Name drugs with definite haemolysis risk in G6PD deficiency.

Answer 39

Dapsone, Methylene blue, Nitrofurantoin, Primaquine, Quinolones, Sulphonamides

Question 40

Name drugs with possible haemolysis risk in G6PD deficiency.

Answer 40

Aspirin, Chloroquine, Menadione, Quinine

Question 41

What are acute porphyrias?

Answer 41

Hereditary disorders of haem biosynthesis

Question 42

Why must caution be taken with drugs in porphyria?

Answer 42

Some drugs can induce acute porphyric crises

Question 43

Who should be screened for porphyria?

Answer 43

Relatives of affected individuals

Question 44

Name common drugs that can cause haemolysis.

Answer 44

Antidepressants, amiodarone, nitrofurantoin, carbamazepine, erythromycin

Question 45

What is the normal sodium range?

Answer 45

135–145 mmol/L

Question 46

What is the normal potassium range?

Answer 46

3.5–5.0 mmol/L

Question 47

What is the normal calcium range?

Answer 47

2.1–2.6 mmol/L

Question 48

What is the normal magnesium range?

Answer 48

0.7–1.0 mmol/L

Question 49

What is the normal urea range?

Answer 49

2.5–7.8 mmol/L

Question 50

Mnemonic for hyponatraemia drugs?

Answer 50

Certain Drugs Ditch Salt: Carbamazepine, Desmopressin, Diuretics, SSRIs

Question 51

Mnemonic for hypernatremia drugs?

Answer 51

SALT CAO: Sodium bicarbonate, Antacids, Carbamazepine, Oestrogen

Question 52

Mnemonic for hypokalaemia causes?

Answer 52

Learn ABCDE: Laxatives, Aminophylline, Beta agonists, Corticosteroids, Diuretics, External Insulin

Question 53

Mnemonic for hyperkalaemia drugs?

Answer 53

THANKS BETAC: Trimethoprim, Heparin, ACEi/ARBs, NSAIDs, Potassium sparing, Beta blockers, Ciclosporin

Question 54

Mnemonic for hypocalcaemia causes?

Answer 54

CBD low Vit D: Cinacalcet, Calcitonin, Bisphosphonates, Denosumab, Vitamin D deficiency

Question 55

Mnemonic for hypercalcaemia causes?

Answer 55

High Vit D, calcium supplements, Tamoxifen, Teriparatide

Question 56

Mnemonic for hypomagnesemia causes?

Answer 56

PPIs, Ciclosporin