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Blood tests Flashcards

1
Q

what is the minimum daily water intake to maintain fluid balance

A

1100ml

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2
Q

Around 500ml water required for normal excretion of waste products in urine, with remaining losses coming from where?

A

insensible losses via skin in sweat, lungs in expired air and in faeces

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3
Q

The kidneys regulate water balance, with water being filtered, then resorbed in variable amounts depending primarily on

A

ADH

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4
Q

what is the normal reference range for sodium?

A

135-145 mmol/l

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5
Q

is inadequate oral intake of Na a cause for hyponatremia?

A

rarely

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6
Q

hypOnatraemia can present asymptomatically but name some possible symptoms

A

vomiting
drowsiness
headaches
seizures

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7
Q

what does hyponatremia go alongside?

A

volume depletion due to water loss/dehydration

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8
Q

what are 4 drug causes of low sodium?

A

antidepressants
diuretics
nsaids
carbamazepine

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9
Q

what is the most common reason for hypernatremia

A

impaired excretion

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10
Q

what symptoms do patients with high sodium present with that are shared with diabetes inspidus

A

polyuria
polydipsia
dehydration

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11
Q

drug causes are less common for hypernatremia but list some that may increase sodium levels

A

lithium
demeclocycline phenytoin

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12
Q

reference range for K?

A

3.4-5.0 mmol/k

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13
Q

list some non drug causes for hypokalemia

A

transcellular movement into cells
losses from GIT
losses from kidney

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14
Q

px with moderate hypokalemia are often asymptomatic but how might severe cases present

A

muscle weakness
depression
confusion
ecg changes

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15
Q

what ecg changes may be seen in hypokalemia

A

st or t wave depression

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16
Q

list some drug causes for hypokalemia

A

diuretics
insulin
corticosteroids
laxatives
salbutamol

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17
Q

hyperkalemia can be asymptomatic but fatal due effects on the heart, in what ways can it affect the heart

A

lowers membrane resting potential thus lowering action potential -> ventricular fibrillation and cardiac arrest

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18
Q

non-drug causes of hyperkalaemia

A

K goes from cells to ECF, CKD as cannot excrete K,

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19
Q

drugs causing hyperkalaemia

A

ACE/ARB i
spironolactone
K sparing diuretics

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20
Q

Urea reference range

A

3.1-7.9 mmol/l

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21
Q

urea levels vary with diet, rate of protein metab and what else?

A

GFR

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22
Q

low urea levels are uncommon and not cause for concern.
they are normal for what group?

A

normal pregnancy

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23
Q

why is urea monitoring esp required for highly protein bound drugs such with ntr such as digoxin or phenytoin?

A

toxcity can occur

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24
Q

when might urea monitoring be important?

A

when monitoring NTR drugs for toxicity

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25
Q

what are high urea levels >10 caused by

A

renal disease or decreased renal blood flow following shock or dehydration

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26
Q

normal creatinine range

A

75-155mol/l

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27
Q

what does creatinine show?

A

how the kidney is excreting as it is excreted unchanged and not reabsorbed by tubules

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28
Q

why is creatinine clearance a good indicator of gfr and therefore kidney function

A

creatinine undergoes complete glomerular filtration with little reabs from renal tubules

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29
Q

what does a doubled creatinine show?

A

GFR halved

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30
Q

a decline in eGFR represents decline in what?

A

renal function

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31
Q

an egfr above x means good clearance and therefore kidney function

A

90

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32
Q

what is the reference range for men for Hb?

A

115-165g/L

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33
Q

what is the reference range for women for Hb

A

112-160g/L

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34
Q

what is the primary role of hb

A

transport oxygen
good marker for anaemia

35
Q

give one reason why women may have lower hb compared to men

A

menstrual losses

36
Q

why might Hb be higher?

A

cancer or dehydration

37
Q

what is the normal range for platelets?

A

150-450x10^9 /L

38
Q

why are platelets good to measure

A

damage to vasculature is fixed by the aggregation of platelets to form plus and they act in initiation of coag process

39
Q

rbc are produced in bone marrow under the control of

A

erythropoetin

40
Q

what is erythropoetin released in response to

A

decrease in oxygen delivery

41
Q

what does a high rbc mean

A

increased production in bone marrow due to hypoxia in eg chronic airway disease

42
Q

what are reticulocytes?

A

immature RBCs

43
Q

lifespan of normal rbcs

A

120 days

44
Q

when will anaemia occur?

A

decreased production or increased removal of rbc

45
Q

why might increased loss of RBCs occur?

A

haemolysis/ severe bleeding/haemorrhage

46
Q

what do the reticulocytes do in response to low RBCs?

A

increases production

47
Q

what is the mean cell volume

A

average volume of single RBC

48
Q

3 ways that rbc can be characterised based on their size (anaemias)

A

microcytic
normocytic
macrocytic

49
Q

what is macrocytic anaemia?

A

folate/b12 deficiency

50
Q

what is microcytic anaemia

A

iron deficiency

51
Q

what is the term given to an elevated number of white cells

A

leucocytosis

52
Q

why can white blood cell counts be raised

A

infection, inflammation, leukaemia

53
Q

A decreased WCC is called what?

A

leucopenia

54
Q

give some different causes for leucopenia

A

chemo
bone marrow disorders
b12 or folate deficiency
liver disease
IS disease

55
Q

life span and basic function of neutrophils

A

7 hrs and immune defences

56
Q

life span and basic functions of eosinophils

A

8-12 days and parasitic defence

57
Q

life span and basic function of basophil

A

few hrs to days and inflammatory response

58
Q

life span and basic function of monocytes

A

3 days and immune surveillance

59
Q

life span and basic function of b cells

A

years as memory cells and antibody production

60
Q

life span and basic function of t cells

A

years as memory cells and cellular immune response

61
Q

true or false, there isnt a single test that will give a good estimate of liver function

A

true

62
Q

the range for albumin is 34-50g/l and gives an indication of the synthesis of

A

hepatic proteins

63
Q

albumin plays a role in maintaining X pressure of blood…

A

oncotic

64
Q

what do chronically low albumin levels lead to?

A

in severe hepatic dysfunction can contribute to ascites

65
Q

the range for bilirubin should be below 19mmol/l and is formed from the natural breakdown of what?

A

RBCs at end of their lifespan

66
Q

what does increased bilirubin show

A

liver dysfunction

67
Q

what can the prescence of increased bilirubin be seen as clinically

A

jaundice

68
Q

ALT and AST are liver transaminases, what might raised levels indicate?

A

hepatocellular injury
death

69
Q

what is ALP?

A

enzyme that transports metabolites across cell walls

70
Q

where is ALP found?

A

liver, bile, kidney, intestinal wall

71
Q

why can ALP be raised

A

cholestasis (reduced bile flow)

72
Q

if alp is raised it is important to monitor the levels of gamma gt, what can a raised gamma gt be caused by

A

biliary epithelial damage
bile flow obstruction
alcohol
drugs

73
Q

name one drug that might raise gamma gt levels

A

phenytoin

74
Q

what is the primary site of synthesis for clotting factors

A

liver

75
Q

a rise in which parameter would indicate that liver function is impaired and unable to make enough clotting factors

A

INR

76
Q

what is the normal range for inr

A

0.8-1

77
Q

lifespan of platelets

A

5-10 days

78
Q

platelets made in bone marrow and released into blood where they play role in what?

A

coagulation, helping to stop bleeding when blood vessels are injured.
clump togetehr and aggregate = blood clot

79
Q

where there is infection there will be inflammation but the same isnt true vice versa such as in the case of RA. What is the name of the test that can check for inflammation

A

CRP

80
Q

what is CRP made by

A

liver

81
Q

when can CRP be raised

A

after MI, inflammation, infection, after surgery, in sepsis

82
Q

3 drugs that cause high potassium

A

ACEi, ARB, potassium sparing diuretics, heparin

83
Q

3 drugs that cause low sodium

A

SSRI, diuretic, carbamazepine, NSAIDS

84
Q
A

Refreshers (10 decks)

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