Blood Results - U&E's

Question 1

What is the limit for hypernatraemia?

Answer 1

> 145 mmol/L

Question 2

What are 5 common CNS symptoms of hypernatraemia?

Answer 2

lethargy 
weakness
confusion
irritability 
myoclonic seizures.

Question 3

What is the limit for hyponatraemia?

Answer 3

<135 mmol/L

Question 4

What are some common symptoms of hyponatraemia?

Answer 4

chronic - headaches, nausea, poor balance

Question 5

What is a more common cause of hyponatraemia - low Na intake OR too much water?

Answer 5

Too much water - overdilution of blood.

Question 6

What are 3 severe symptoms of hyponatraemia?

Answer 6

vomiting
confusion
seizures

Question 7

what is the normal range for sodium in the blood?

Answer 7

135-145 mmol/L

Question 8

What are 3 common drugs that can cause hyponatraemia?

Answer 8

thiazide diuretics
PPI
NSAIDs

Question 9

What is the normal range for potassium in the blood?

Answer 9

3.5 - 5.5 mmol/L

Question 10

What is defined as severe hypokalaemia?

Answer 10

<2.5 mmol/L

Question 11

What are some common symptoms of hypokalaemia?

Answer 11

Muscle - weakness, tiredness, cramping
GIT - N+V and constipation
CVS - palpitations, hypotension.

Question 12

What are 3 common causes of increased K loss?

Answer 12

GI - n+v diarrhoea

Renal loss - furosemide

Magnesium deficiency - needed to reabsorb K

Question 13

What are some common causes of decreased K intake?

Answer 13

poor diet/malnutrition
illness
alcohol abuse

Question 14

Which 2 drugs can cause an intracellular shift of K (from blood to cells)?

Answer 14

insulin - K out of blood into cells.

b-agonists - hypokalaemia.

Question 15

Which 3 specific drugs can cause a transcellular K shift?

Answer 15

verapamil

pseudoephedrine

theophylline

Question 16

What 4 drugs can cause increased renal K loss?

Answer 16

loop diuretics
fludrocortisone
gentamicin
penicillin

Question 17

What are some mild symptoms of hyperkalaemia?

Answer 17

muscle weakness + tingling sensations
tiredness
nausea

Question 18

Which level of hyperkalaemia can cause ECG changes?

Answer 18

> 6.0 mmol/L

Question 19

What 4 ways can hyperkalaemia be treated?

Answer 19

• cation exchange resins
• IV glucose and insulin
• nebulised salbutamol
• haemodialysis

Question 20

What are the 4 main causes of hyperkalaemia?

Answer 20

• drugs
• inadequate excretion
• shifting K from tissue to blood
• excessive intake

Question 21

What 4 drug groups can cause hyperkalaemia?

Answer 21

K-sparing diuretics
NSAIDs
Trimethiprom
ACE-I/ARBs

Question 22

What 3 ways can K be shifted from tissue to blood?

Answer 22

• trauma - burns
• haemodialysis
• insulin def

Question 23

What is the ref range for urea in the blood?

Answer 23

1.7 - 7.1 mmol/L

Question 24

What 3 parameters does urea help determine?

Answer 24

• hydration status
• renal function
• liver function

Question 25

What 5 things can contribute to increased urea concentration?

Answer 25

- dehydration - high protein diet - increased catabolism - GI bleed - renal imp

Question 26

What 4 things can cause reduced urea concentration?

Answer 26

- over hydration - hepatic imp - low protein diet - pregnancy

Question 27

What is the eGFR associated with CKD stage 1?

Answer 27

> 90ml/min

Question 28

What is the eGFR associated with CKD stage 2?

Answer 28

60-89 ml/min

Question 29

What is the eGFR associated with CKD stage 3A and 3B?

Answer 29

A 45-59 ml/min B 30-44 ml/min

Question 30

What is the eGFR associated with CKD stage 4?

Answer 30

15-29

Question 31

What is the eGFR associated with CKD stage 5?

Answer 31

< 15

Question 32

What are some characteristics of AKI?

Answer 32

- 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

Question 33

List some risk factors for developing AKI ?

Answer 33

- previous AKI - CKD - Increasing age - Dehydration - sepsis - comorbid conditions eg diabetes. - nephrotoxic drugs.

Question 34

List 4 types of nephrotoxic drugs?

Answer 34

- NSAIDs - ACE-I /ARB - Gentamicin - Diuretics

Question 35

List some common symptoms of an AKI?

Answer 35

``` reduced/no urine output oedema fatigue tiredness SOB confusion nausea chest pain/pressure ```

Question 36

What are the 5 medicines on a Sick Day Rules card?

Answer 36

- metformin - NSAIDs - ACE-I - ARB - Diuretics

Question 37

Is a urea level of 0.9 mmol/L normal to see in late pregnancy?

Answer 37

Yes - due to increased blood volume = over-dilution.