Chronic Disease

Question 1

What does low albumin indicate?

Answer 1

• malnutrition
• coeliac disease
• kidney disease

Question 2

What does high albumin indicate?

Answer 2

• severe infection
• dehydration
• chronic inflammation

Question 3

What does high bilirubin indicate?

Answer 3

High conjugates: liver/bile duct disease
High unconjugated: Gilbert’s/haemolytic anemia

Question 4

What is GGT a marker of?

Answer 4

Marker of liver disease from drugs/alcohol.

Question 5

What are AST/ALT markers of?

Answer 5

Liver disease markers of drugs, toxins
and alcohol.

Question 6

What is ALP a marker of?

Answer 6

High in obstructive liver disease.
(bile duct destruction stimulates ALP)

• Can have a non-hepatic origin (high osteoclast activity- Paget’s, osteomalacia)

Question 7

What does a high CRP/ESR mean?

Answer 7

CRP/ESR are markers that show if there is any inflammation in the body, it can be raised if you have any burns, infections and in other scenarios

Question 8

What does a high INR mean?

Answer 8

High susceptibility to bleeding

Question 9

What does a low INR mean?

Answer 9

Clot susceptibile

Question 10

What are some symptoms of a raised INR?

Answer 10

headache
stomach ache
bleeding
bruising
gum bleeding
blood in urine

Question 11

What are some symptoms of a low INR?

Answer 11

weakness
numbness
vision changes
new pain/swelling/redness in calf/ chest pain (DVT/PE)

Question 12

How does an increased consumption of green fruit/veg effect your INR?

Answer 12

Lowers INR

-Vit K increased blood thickness “clot”
-Vit K is antagonist to warfarin

Question 13

What is the HBA1C range for pre diabetes?

Answer 13

42-47

Question 14

What HBA1C is diagnostic for diabetes?

Answer 14

> 48

Question 15

What is HBA1C? (in patient friendly language)

Answer 15

“HBA1c is a test that measures your average blood sugar levels over the previous 2-3 months as the sugar sticks to cells in the blood”

Question 16

What are some important questions to ask in a diabetes history?

Answer 16

• Are you alternating injection sites?
• Have you ever had a hospital admission?
• How often do you monitor glucose levels

Question 17

If a patient with diabetes is unwell, what advice do you give them?

Answer 17

SICK RULES: when sick check blood sugar more regularly (4 hourly), contact diabetes team, check ketones.

Question 18

What’s the difference between peak flow and spirometry?

Answer 18

PF: “A measure of how fast you can breathe out so we can assess how well your lungs are working”

SPIRO: “measures lung function, specifically the amount and speed of air in/out.”

Question 19

What are some important questions to ask in an asthma/COPD history?

Answer 19

• What medications and inhalers? How often?
• Technique!!! And check a nurse has assessed it.
• Spacer?
• Any Beta blockers?
• Any new pets?
• Recent travel?
• Housing- damp/new house?
• Hay Fever?
• Smoking?

Question 20

What are the 5 main tumour markers?

Answer 20

• ALP: hepatocellular cancer
• CEA: bowel cancer
• PSA: prostate cancer
• CA125: ovarian cancer
• CA 19-9: pancreatic