GPhC Exam: Nutrition & Blood

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What are the key topics in the nutrition & blood section?

As a chapter in the British National Formulary this is a fairly small section which covers some of the following areas: different types of anaemia and blood disorders, fluids and electrolytes, vitamins and minerals, health supplements and enteral and intravenous nutrition.

An important aspect to bear in mind is that many drugs/drug classes that you will come across will relate back to this topic of blood and nutrition. This is the case a lot of the times due to side effects and monitoring requirements of specific parameters. As a result, you need to recognise and understand the links between different topics.

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Top tips on the nutrition & blood GPhC exam questions

  • You can devise simple scenarios or patients with specific medicinal/supplement requirements. For example, a pregnant woman is advised the following: take folic acid 400mcg daily up to week 12 of pregnancy to prevent neural tube defects in a baby; take vitamin D 10mcg throughout the duration of pregnancy; avoid vitamin A supplements and foods such as liver that have large amounts of vitamin A. A second example would be an individual on alcohol withdrawal usually needs to take thiamine).
  • In some cases, an individual will not be able to have anything administered orally thus, the gastrointestinal activity is bypassed. When a person receives vitamins, minerals, salts, and glucose via an intravenous line, it is referred to as total parenteral nutrition (TPN). It is possible to be examined on this topic, hence ensure you understand terms such as “central line” and “peripheral parenteral nutrition”. You may come across calculation questions in the exam that are related to TPN and/or you will possibly have to calculate intravenous infusion rates of certain drugs.
  • Calcium and vitamin D supplements are commonly prescribed to patients (alternatively, many people will be advised to purchase these and told to get a certain strength) – do you know how to convert units i.e. micrograms to international units? These can be fairly straightforward calculations, so it would be ideal to put it into practice.
  • With regards to vitamin deficiencies, ensure you are aware of the signs/symptoms of specific vitamin deficiencies i.e. you may know that scurvy is caused by a lack of vitamin C however, did you know that couple of signs of this could be bleeding/ulceration of the gums and leg pain?
  • If you think back to your MPharm studies, you may recall that there are different types of anaemia (and is not always due to a deficiency of iron). Learn the differences between them in terms of presentation of the condition and the appropriate treatment for each clinical situation.
  • As you are studying for the exam, you will come across various drugs that are associated with side effects that cause imbalances in bodily electrolytes. Hence, it is important to know the signs that are related to these imbalances. For example, write down the signs and symptoms that are linked to the following terms: hypernatremia, hypokalaemia, hypercalcemia. Alternatively, you could create a “match the symptom” revision aid which you can complete at a later stage to test your revision and knowledge – testing yourself could be far more efficient that regurgitating long sentences or bullet points of information.
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Example GPhC Exam Blood & Nutrition Questions

1) Mr Y was suffering from and eating disorder and has recently been prescribed nutritional supplements to support his weight gain as part of his therapy plan. Mr Y has a BMI of 16.5kg/m2 and is 180cm tall. Using the following information, calculate his body weight in kilograms and round to one decimal place.

BMI = weight(kg) / height(m)2

2) You have received a prescription for Menadiol Sodium Phosphate 10mg tablets at a dose of 30mg to be taken daily. Menadiol sodium phosphate is a water-soluble synthetic vitamin derivative of which of the following vitamins?

A. Vitamin A

B. Vitamin B1

C. Vitamin B12

D. Vitamin D

E. Vitamin K

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