I n t e r n a L medicine questions Bank

Erythropoietin

Erythropoietin is a haematopoietic growth factor that stimulates the production of erythrocytes. The main uses of erythropoietin are to treat the anaemia associated with chronic renal failure and that associated with cytotoxic therapy

Side-effects of erythropoietin

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  accelerated hypertension --> encephalopathy, seizures (blood pressure increases in 25% of patients)
  
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  bone aches
  
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  skin rashes, urticaria, flu-like symptoms
  
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  pure red cell aplasia (due to antibodies against erythropoietin)
  
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  raised PCV increases risk of thrombosis (e.g. fistula)
  
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  iron deficiency 2nd to increased erythropoiesis
  

There are a number of reasons why patients may failure to respond to erythropoietin therapy

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  iron deficiency
  
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  inadequate dose
  
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  concurrent infection/inflammation
  
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  hyperparathyroid bone disease
  
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  aluminium toxicity
  

1 3-A 10-year-old boy is taken to see the GP by his mother. For the past two days he has had a sore throat associated with blood in his urine. There is no significant past medical history. The GP suspects glomerulonephritis and refers the patient to hospital. What would a renal biopsy most likely show?

	A.	Proliferation of endothelial cells
	B.	No change
	C.	Mesangial hypercellularity
	D.	Basement membrane thickening
	E.	Capillary wall necrosis

This boy is likely to have IgA nephropathy. Histological features include mesangial hypercellularity and positive immunofluorescence for IgA & C3