Blood Results - U&E's Flashcards
What is the limit for hypernatraemia?
> 145 mmol/L
What are 5 common CNS symptoms of hypernatraemia?
lethargy weakness confusion irritability myoclonic seizures.
What is the limit for hyponatraemia?
<135 mmol/L
What are some common symptoms of hyponatraemia?
chronic - headaches, nausea, poor balance
What is a more common cause of hyponatraemia - low Na intake OR too much water?
Too much water - overdilution of blood.
What are 3 severe symptoms of hyponatraemia?
vomiting
confusion
seizures
what is the normal range for sodium in the blood?
135-145 mmol/L
What are 3 common drugs that can cause hyponatraemia?
thiazide diuretics
PPI
NSAIDs
What is the normal range for potassium in the blood?
3.5 - 5.5 mmol/L
What is defined as severe hypokalaemia?
<2.5 mmol/L
What are some common symptoms of hypokalaemia?
Muscle - weakness, tiredness, cramping
GIT - N+V and constipation
CVS - palpitations, hypotension.
What are 3 common causes of increased K loss?
GI - n+v diarrhoea
Renal loss - furosemide
Magnesium deficiency - needed to reabsorb K
What are some common causes of decreased K intake?
poor diet/malnutrition
illness
alcohol abuse
Which 2 drugs can cause an intracellular shift of K (from blood to cells)?
insulin - K out of blood into cells.
b-agonists - hypokalaemia.
Which 3 specific drugs can cause a transcellular K shift?
verapamil
pseudoephedrine
theophylline
What 4 drugs can cause increased renal K loss?
loop diuretics
fludrocortisone
gentamicin
penicillin
What are some mild symptoms of hyperkalaemia?
muscle weakness + tingling sensations
tiredness
nausea
Which level of hyperkalaemia can cause ECG changes?
> 6.0 mmol/L
What 4 ways can hyperkalaemia be treated?
- cation exchange resins
- IV glucose and insulin
- nebulised salbutamol
- haemodialysis
What are the 4 main causes of hyperkalaemia?
- drugs
- inadequate excretion
- shifting K from tissue to blood
- excessive intake
What 4 drug groups can cause hyperkalaemia?
K-sparing diuretics
NSAIDs
Trimethiprom
ACE-I/ARBs
What 3 ways can K be shifted from tissue to blood?
- trauma - burns
- haemodialysis
- insulin def
What is the ref range for urea in the blood?
1.7 - 7.1 mmol/L
What 3 parameters does urea help determine?
- hydration status
- renal function
- liver function
What 5 things can contribute to increased urea concentration?
- dehydration
- high protein diet
- increased catabolism
- GI bleed
- renal imp
What 4 things can cause reduced urea concentration?
- over hydration
- hepatic imp
- low protein diet
- pregnancy
What is the eGFR associated with CKD stage 1?
> 90ml/min
What is the eGFR associated with CKD stage 2?
60-89 ml/min
What is the eGFR associated with CKD stage 3A and 3B?
A 45-59 ml/min
B 30-44 ml/min
What is the eGFR associated with CKD stage 4?
15-29
What is the eGFR associated with CKD stage 5?
< 15
What are some characteristics of AKI?
- rise in serum creatinine of 26 micromol/L
- 50% greater rise in serum creatinine
- fall in urine output <0.5ml/kg/hr
- 25% greater fall in eGFR
List some risk factors for developing AKI ?
- previous AKI
- CKD
- Increasing age
- Dehydration
- sepsis
- comorbid conditions eg diabetes.
- nephrotoxic drugs.
List 4 types of nephrotoxic drugs?
- NSAIDs
- ACE-I /ARB
- Gentamicin
- Diuretics
List some common symptoms of an AKI?
reduced/no urine output oedema fatigue tiredness SOB confusion nausea chest pain/pressure
What are the 5 medicines on a Sick Day Rules card?
- metformin
- NSAIDs
- ACE-I
- ARB
- Diuretics
Is a urea level of 0.9 mmol/L normal to see in late pregnancy?
Yes - due to increased blood volume = over-dilution.
