Clinical skills workshop

Question 1

Common renal fx tests

Answer 1

sodium, potassium, urea, creatinine

Question 2

liver function

Answer 2

total protein, albumin, bilirubin, alkaline phosphatase (ALP), alanine transaminase (ALT)

Question 3

bone profile

Answer 3

total protein, albumin, calcium, phosphate, alkaline phosphatase

Question 4

thyroid function

Answer 4

TSH, (free, thyroid stimulating hormone) thyroxine (T4,)

Question 5

lipid (blood fats) profile

Answer 5

total cholesterol, LDL and HDL-cholesterol, triglycerides

Question 6

Is LDL or HDL good/bad

Answer 6

HDL helps rid your body of excess cholesterol so it’s less likely to end up in your arteries. LDL is called “bad cholesterol” because it takes cholesterol to your arteries, where it may collect in artery walls. Too much cholesterol in your arteries may lead to a buildup of plaque known as atherosclerosis

Question 7

What is a reference range?

Answer 7

95% of results are within the reference range

• does not necessarily exclude disease
  2. 5% of results are BELOW the reference range, 2.5.% ABOVE
• may be a chance finding in a healthy individual
• the more extreme the result, the more likely to indicate disease

Question 8

What’s ALP?

Answer 8

Alkaline phosphatase - liver enzyme AND elevated in bone break down

Question 9

What can cause variation in reference range?
5 examples

Answer 9

Age
eg creatinine levels (depends on muscle mass, lower in children)
Gender
eg testosterone levels
Ethnicity
eg creatinine levels vs eGFR
Pregnancy
eg thyroid function
From lab to lab

Question 10

What’s T4?

Answer 10

Thyroxine
Thyroxine, also known as T4, is a type of thyroid hormone. This test measures the level of T4 in your blood. Too much or too little T4 can indicate thyroid disease

Question 11

What’s TSH?

Answer 11

Thyroid stimulating hormone: is made in the pituitary and the blood levels reflect how your own body is responding to the amount of thyroxine in your blood. When thyroid hormone levels are low, the pituitary gland increases secretion of TSH and indicates that your thyroxine dose should be increased.

Question 12

Schematic of thyroid T4, TSH -ve feedback

Answer 12

PICTURE

Question 13

What lab results indicate thyroid function? High or low?

Answer 13

Hypothyroid (underactive)
High TSH
Free T4 may be low
Free T4 may be NORMAL if subclinical
Hyperthyroid (overactive)
Low TSH
Free T4 may be high
Free T4 may be NORMAL if subclinical