Basic Medicine

Question 1

State 4 causes of hypernatraemia

Answer 1

Dehydration, IV saline, drugs, diabetes insipidus

Question 2

State 3 causes of microcytic anaemia

Answer 2

Iron deficiency, thalassaemia, sideroblastic anaemia

Question 3

State 4 causes of normocytic anaemia

Answer 3

Chronic disease. acute blood loss, haemolytic anaemia, chronic renal failure

Question 4

State at least 5 causes of macrocytic anaemia

Answer 4

B12 deficiency, folate deficiency, excess EtOH, liver disease, hypothyroidism, myelodysplastic syndrome, myeloproliferation, multiple myeloma

Question 5

State at least 4 causes of hypokalaemia

Answer 5

Thiazide and loop diuretics, diarrhoea and vomiting, renal tubular acidosis, Cushing’s syndrome, Conn’s syndrome

Question 6

State at least 4 causes of hyperkalaemia

Answer 6

ACE inhibitors, potassium-sparing diuretucs, renal failure, Addisons disease, DKA, artefact (clotted sample)

Question 7

State at least 4 causes of neutropaenia

Answer 7

Viral infection, chemotherapy, radiotherapy, clozapine, carbimazole

Question 8

State at least 4 causes of neutrophilia

Answer 8

Bacterial infection, steroids, inflammation, malignancy, infarct

Question 9

State at least 3 causes of thrombocytopaenia due to reduced platelet production

Answer 9

Viral infection, penicillamine, myelodysplasia, myelofibrosis, multiple myeloma

Question 10

State at least 4 causes of thrombocytopaenia due to increased platelet destruction

Answer 10

Heparin, hypersplenism, DIC, ITP, HUS, TTP

Question 11

State 4 causes of thrombocytosis

Answer 11

Bleeding, tissue damage, post-splenectomy, myeloproliferation

Question 12

State 3 causes of hypovolaemic hyponatraemia

Answer 12

Fluid loss (e.g. D&V), Addison’s disease, diuretics

Question 13

State 3 causes of euvolaemic hyponatraemia

Answer 13

SIADH, psychogenic polydipsia, hypothyroidism

Question 14

State 4 causes of hypervolaemia hyponatraemia

Answer 14

Heart failure, renal failure, kidney failure, hypoalbuminaemia, hypothyroidism

Question 15

Describe the biochemistry of prerenal AKI

Answer 15

Urea rise greater than creatinine rise

Question 16

State 3 causes of prerenal AKI

Answer 16

Shock, dehydration, renal artery stenosis

Question 17

Describe the biochemistry of intrinsic and post-renal AKI

Answer 17

Creatinine rise greater than urea rise

Question 18

State at least 5 causes of intrinsic AKI

Answer 18

Ischaemia (acute tubular necrosis from prerenal AKI), nephrotoxic antibiotics, ACE inhibitors, NSAIDs, radiological contrast, rhabdomyolysis, gout, cholesterol emboli

Question 19

State at least 5 causes of post-renal AKI

Answer 19

Stones, renal tumours, transitional cell carcinoma, renal wall fibrosis, BPH, prostate cancer, lymphadenopathy, aneurysm

Question 20

State at least 5 causes of a raised alkaline phosphatase

Answer 20

Fracture, post-hepatic liver damage, cancer, Paget’s disease of bone, pregnancy, hyperparathyroidism, osteomalacia, surgery

Question 21

State 3 pre-hepatic causes of a raised bilirubin

Answer 21

Haemolysis, Gilbert’s syndrome, Crigler-Najjar syndrome

Question 22

Describe the biochemistry of an intrinsic hepatic cause of raised bilirubin

Answer 22

Raised bilirubin, AST, ALT (transamininitis)

Question 23

State at least 5 intrinsic hepatic causes of a raised bilirubin

Answer 23

Fatty liver, hepatitis, cirrhosis, malignancy, Wilson’s disease, haemochromatosis, heart failure

Question 24

Describe the biochemistry of a post-hepatic cause of a raised bilirubin

Answer 24

Raised bilirubin and ALP

Question 25

State at least 5 post-hepatic causes of a raised bilirubin

Answer 25

Gallstones, cholangiocarcinoma, pancreatic cancer, PBC, PSC, steroids, penicillins, sulphonylureas

Question 26

Describe the signs of heart failure on a CXR

Answer 26

Alveolar oedema (bat wing shadowing), interstitial oedema (Kerley B lines), cardiomegaly, diversion of blood to upper lobes, pleural effusions

Question 27

State 3 causes of respiratory acidosis

Answer 27

COPD, neuromuscular failure, restrictive chest wall abnormalities

Question 28

State 3 causes of metabolic alkalosis

Answer 28

Vomiting, diuretics, Conn’s syndrome

Question 29

Name 5 drugs with a narrow therapeutic index

Answer 29

Digoxin, theophylline, lithium, phenytoin, gentamicin, vancomycin