Data Interpretation Flashcards
1
Q
Causes of microcytic anaemia?
A
- Iron deficiency
- Thalassaemia
- Sideroblastic anaemia
2
Q
Causes of normocytic anaemia?
A
- Anaemia of chronic disease
- Acute blood loss
- Haemolytic anaemia
- Renal failure (chronic)
3
Q
Causes of macrocytic anaemia?
A
- B12/folate deficiency
- Pernicious anaemia
- Excess alcohol
- Liver disease
- Hypothyroidism
- Haematological diseases beginning with ‘M’: Myeloproliferative, myelodysplastic, multiple myeloma
4
Q
Causes of high neutrophils? (Neutrophilia)
A
- Bacterial infection
- Tissue damage (inflammation, infarct, malignancy)
- Steroids
5
Q
Causes of low neutrophils? (Neutropenia)
A
- Viral infection
- CLOZAPINE
- CARBIMAZOLE
- Chemotherapy/ radiotherapy
6
Q
Causes of high lymphocytes? (Lymphocytosis)
A
- Viral infection
- Lymphoma
- Chronic lymphocytic leukaemia
7
Q
How to treat chemo/radio induced neutropenic sepsis?
A
- URGENT IV BROAD-SPEC ANTIBIOTICS
8
Q
Causes of low platelets (thrombocytopenia)
A
- Infection
- Myelodysplasia/myelofibrosis/myeloma
- Hypersplenism
- DIC
- ITP
- Haemolytic uraemic syndrome
DRUGS:
- Penicillamine (RA Tx)
- Heparin
9
Q
Causes of high platelets (thrombocytosis)
A
- Bleeding
- Tissue damage (infection/inflammation/malignancy)
- Post-splenectomy
- Myeloproliferative disorders
10
Q
Causes of hyponatraemia
Hypovolaemic
A
- Fluid loss (D+V)
- Addison’s disease
- Diuretics (any)
11
Q
Causes of hyponatraemia
Euvolaemic
A
- SIADH
- Psychogenic polydipsia
- Hypothyroidism (can also be hypervolaemic)
12
Q
Causes of hyponatraemia
Hypervolaemic
A
- Heart failure
- Renal failure
- Liver failure (hypoalbuminaemia)
- Nutritional failure
- Thyroid failure (can also be euvolaemic)
13
Q
Causes of SIADH
A
SIADH:
- S: Small cell lung tumours
- I: Infection
- A: Abscess
- D: Drugs (carbamazepine, antipsychotics)
- H: Head injury
14
Q
Causes of hypokalaemia
A
DIRE
- D: Drugs (loop/thiazide diuretics)
- I: Inadequate intake or intestinal loss (D+V)
- R: Renal tubular acidosis
- E: Endocrine (Cushing’s/Conn’s)
15
Q
Causes of hyperkalaemia
A
DREAD
- D: Drugs (potassium-sparing diuretics, ACE-inhibitors)
- R: Renal failure
- E: Endocrine (Addison’s)
- A: Artefact (clotted sample)
- D: DKA (before treatment –> then see hypokalaemia requiring monitoring/replacement)
16
Q
Raised urea
Normal creatinine
A
- Upper GI bleed
- Look at Hb
17
Q
Causes
a) raised bilirubin alone?
A
Prehepatic
- Haemolysis
- Gilbert’s and Crigler-Najjar Syndrome
18
Q
Causes
b) raised bilirubin and raised AST/ALT
A
Intrahepatic
- Fatty liver
- Hepatitis
- Cirrhosis
- Malignancy
- Wilson’s/haemochromatosis
- HF (hepatic congestion)
19
Q
Causes
c) raised billirubin and raised ALP
A
Posthepatic:
- Lumen: gallstone, drugs causing cholestasis
- Wall: tumour (cholangiocarcinoma), primary biliary cirrhosis, sclerosing cholangitis
- Extrinsic pressure: pancreatic or gastric cancer, lymph node
20
Q
Causes
d) drugs that cause cholestasis? (raised billi and ALP)
A
- Flucloxacillin
- Co-amoxiclav
- Nitrofurantoin
- Steroids
- Sulphonylureas
21
Q
Causes
e) hepatitis/cirrhosis
A
- Alcohol
- Viruses (Hep A-E, CMV, EBV)
- Drugs (Paracetamol OD, statins, rifampicin)
- Autoimmune
22
Q
Causes
f) Raised ALP alone?
A
ALK PHOS
- A: Any fracture
- L: Liver damage (post hepatic)
- K: K for cancer
- P: Paget’s disease of bone
- H: Hyperparathyroidism
- O: Osteomalacia
- S: Surgery
23
Q
TSH ranges and Levothyroxine doses
A
< 0.5: Decrease dose
0.5-5: Nil action, same dose
> 0.5: Increase dose
If need to change, change my smallest increment possible if not grossly hypo/hyper
24
Q
Non-drug causes of primary hypothyroidism
A
- Hashimoto’s thyroiditis
25
Non-drug causes of secondary hypothyroidism
- Pituitary tumour or damage
26
Non-drug causes of primary hyperthyroidism
- Grave's disease
| - Toxic nodular goiter
27
Non-drug causes of secondary hyperthyroidism
- Pituitary tumours
28
Drug causes of hypothyroidism
- Amiodarone
- Sulfonylureas
- Lithium
- Iodine
29
Drug causes of hyperthyroidism
- Amiodarone
30
CXR
| White lung marking differentials (4)
- Effusion: unilateral, solid
- Pneumonia: unilateral, fluffy
- Oedema: bilateral, fluffy
- Fibrosis: bilateral and honeycomb
31
CXR
| Deviated trachea differentials
- Collapse (towards affected side)
| - Pneumothorax (away from affected side)
32
ABCDE of pulmonary oedema
- Alveolar oedema
- Kerley B lines
- Cardiomegaly
- Diversion of blood to upper lobes (dilated upper lobe vessels)
- Pleural effusions
33
4 other things to look for and indications
- Costophrenic angles sharp? If not, pleural effusion
- Air under R hemidiaphragm? Bowel perforation or recent surgery
- Triangle behind heart? Lower lobe collapse
- Apices clear? Consider TB or apical tumour
34
Quick way to check if patient on oxygen is hypoxic
Subtract 10 from FiO2 (% of oxygen)
| - If PaO2 exceeds this, they are not hypoxic
35
Causes of resp alkalosis
- Rapid breathing (disease or anxiety)
36
Causes of resp acidosis
- Type 2 resp failure causes
37
Causes of metabolic alkalosis
- Vomiting
- Diuretics
- Conn's
38
Causes of metabolic acidosis
- DKA
- Lactic acidosis
- Renal failure
- Ethanol intoxication
39
Bundle branch block mnemonic and meanings
WiLLiaM MaRRoW
LBBB: first QRS in V1 looks like W, first QRS in V6 looks like M
RBBB: first QRS in V1 looks like M, first QRS in V6 looks like 6
40
How to calculate ecg rate
divide 300 by large squares between QRS complexes
41
P-waves differentials
- Normal p waves < 1 large square apart = sinus tachy
- Constant but > 1 large square = 1st degree HB
- Increasing then missing = 2nd degree HB (type 1)
- Two or three for each QRS = 2nd degree HB (type 2)
- Random (no relationship) = 3rd degree HB/complete HB
- No p waves = AF
42
How to work out QRS height
- Add largest deflection of QRS in V1 to that in V6
- If sum > 3.5 large squares --> LVH
- Small complexes throughout --> consider pericardial effusion
43
ST segment differentials? (4)
Raised:
- Infarction: ST segment flat and raised in some leads
- Pericarditis: ST segment convex and raised in all leads
Depressed:
- Ischaemia: ST segment flat and depressed in some leads
- Digoxin Tx: ST segment down-sloping in all leads
44
T wave height
- High: hyperkalaemia
| - Inversion: normal in aVR and I, but abnormal in other leads --> old infarction/LVH
45
TSH and T4 levels
Primary hypothyroidism:
- Low T4, Raised TSH
Secondary hypothyroidism:
- Low T4, Low TSH
Primary hyperthyroidism:
- High T4, Low TSH
Secondary hyperthyroidism:
- High T4, High TSH
