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Data Interpretation > Biochemistry results > Flashcards

Biochemistry results Flashcards

1
Q

What test can be done to determine if hyponatraemia is a true finding?
And what will the result be if it is a true hyponatraemia?

A

Serum osmolality

It will be low

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2
Q

After determining a true hyponatraemia, what is the next assessment?

A

Determining the patients volume status, eg dehydrated (hypovolaemic), fluid overloaded (hypervolaemic) or normally hydrated (isovolaemic)

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3
Q

What are common causes of hypovolaemic hyponatraemia?

A

Extra-renal causes: GI-vomiting or diarrhoea

Renal causes: diuretics, salt-wasting renal disease, nephropathy, adrenal insufficiency

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4
Q

What are the common causes of isovolaemic hyponatraemia?

A

Water intoxication (urine osmolality 100mosmol)
Drugs
Renal failure
Hyperthyroidism

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5
Q

What are the common causes of hypervolaemic hyponatraemia?

A

Liver failure
Congestive cardiac failure
Renal failure
Nephrotic syndrome

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6
Q

What are causes of hypernatraemia?

A

Diabetes insipidus
Poor water intake
Administration of excess sodium in IV fluids
Administration of drugs containing high concn of Na

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7
Q

What are common causes of hypokalaemia?

A

Drugs: diuretic therapy
Intestinal losses: excess vomiting, profuse diarrhoea, high stoma or fistula output
Renal tubular disease: renal tubular acidosis
Endocrine causes
Metabolic alkalosis

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8
Q

What are common causes of hyperkalaemia?

A 
Renal failure
Drugs: excess potassium supplementation, potassium-sparing diuretics, 
Rhabdomyolysis
Endocrine disease (hypoadrenalism)
DKA
Haemolysis of blood sample
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9
Q

At what levels does hyperkalaemia need immediate attention?

A

> 6.5mmol/l or between 4.5-6.5mmol/l with ECG changes

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10
Q

What is considered to be a normal GFR?

A

Approx 100ml/min per 1.73m(2)

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11
Q

What is measured in a nutritional profile?

A

Magnesium
Calcium
Phosphate
Albumin

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12
Q

What are the common causes of a poor nutritional profile?

A

Poor oral diet (eg alcoholic, hunger strike)

Malabsorption

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13
Q

What happens to the biochemistry in re-feeding syndrome?

A

Dangerous shifts in electrolytes (eg magnesium, phosphate, calcium)

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14
Q

What would the urinary sodium result be in a prerenal uraemia?

A

Low urinary sodium

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15
Q

What would the urinary sodium result be in an acute tubular necrosis?

A

High urinary sodium

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16
Q

What are the components of a bone profile?

A

Calcium
Phosphate
Alkaline phosphatase
Albumin

17
Q

What would the results of a bone profile be in osteoporosis?

A

All normal

18
Q

What would bone profile show in Paget’s disease?

A

Normal calcium and phosphate

Increased ALP

19
Q

What would bone profile show in primary hyperparathyroidism?

A

Increased calcium
Decreased phosphate
Increased ALP

20
Q

What would bone profile show in osteomalacia?

A

Normal/decreased calcium
Decreased phosphate
Increased ALP

21
Q

What would a bone profile show in the presence of bony metastases?

A

Increased/normal calcium
Normal/increased phosphate
Increased ALP

22
Q

What are causes of hypercalcaemia?

A

Bony mets
Multiple myeloma
Hyperparathyroidism
Excess vitamin D intake

23
Q

What are the three classifications of deranged LFTs?

A

Hepatitic
Cholestatic
Mixed

24
Q

Which LFTs will be abnormal in a hepatitic pattern?

A

Raised AST

Raised ALT

25
Q

Which LFTs will be abnormal in a cholestatic pattern?

A

Raised ALP

Raised GGT

26
Q

What are the causes of a hepatitic pattern of LFTs?

A 
Viral hepatitis
Autoimmune hepatitis
Drugs/toxins
Alcohol
Metabolic disorders (eg Wilson's disease)
Fatty liver
Malignancy
CCF
27
Q

What are the causes of a cholestatic pattern of LFTs?

A

Bile duct obstruction: gallstone
Abnormal bile duct wall: bile duct stricture, cholangiocarcinoma
Compression of bile duct by external lesion: pancreatic carcinoma, nodes of porta hepatis, ampullary carcinoma

28
Q

What are the causes of a raised ESR with a normal CRP?

A

SLE

Multiple myeloma

29
Q

What can cause hyperuricaemia?

A

Increased purine consumption or uric acid production

Impaired excretion of uric acid

30
Q

What tumours are associated with raised alpha-fetoprotein?

A

Hepatocellular carcinoma

Testicular carcinoma

31
Q

The sweat test is used to detect CF. What are common causes of a false-positive sweat test?

A

Adrenal insufficiency
Anorexia nervosa
Coeliac disease
Hypothyroidism

32
Q

What test will represent how well the liver is functioning?

A

Prothrombin time

Data Interpretation (6 decks)

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