Chronic diseases Flashcards
1
Q
3 things to remember for data interpretation
A
- Questions to assess control (e.g. changes in life like mood, accommodation, relationships)
- Assess impact of disease on life (e.g. ability to work)
- Questions to assess adherence
2
Q
INR: DHx questions
A
- Do you know why you are on warfarin?
- Do you remember to take your warfarin?
- Do you ever double dose?
- Do you take your warfarin at the same time every day?
- Are you taking any other medications? (e.g. NSAIDs, Abx, amiodarone, antifungals, anti-medicines)
3
Q
INR: SHx questions
A
- Recent life changes?
- Problems with family, relationships, housing, finance, work, etc.?
- How are you coping with diagnosis?
- Are you still smoking?
- Are you still drinking? How much? Do you binge drink?
- Do you play contact sports?
- Have you changed your diet recently? (e.g. high vit.K foods or cranberry juice)
4
Q
How does liver function affect INR?
A
Chronic liver disease results in a decreased synthesis of clotting factors II, VII, IX, and X, meaning INR rises
5
Q
Focussed history questions for deranged LFTs?
A
- How are you currently feeling?
- Leukonychia?
- Red spots on hands or chest? Palmar erythema?
- Abnormal bruising?
- Swollen ankles?
- Confusion?
- Swollen tummy?
- Vomiting blood?
- Recent infections (e.g. sepsis) due to decreased WCC?
- Jaundice? Pruritus?
6
Q
PMH questions to ask for deranged LFTs?
A
- Alcoholism
- Hepatitis
- Cirrhosis
- Vascular problems
