Data Interpretation

Question 1

Causes of hyponatraemia

Answer 1

Hypovolaemic - fluid loss, diarrhoea, vomiting, Addison’s, diuretics

Euvolaemic - SIADH, psychogenic, hypothyroidism

Hypervolaemic - heart failure, renal failure, liver failure, thyroid failure

Question 2

Causes of SIADH

Answer 2

S - small cell lung tumours
I - infection
A - abscesses
D - drugs - carbamazepine, antipsychotics
H - head injury

Question 3

Causes of hypernatraemia

Answer 3

Causes all begin with a D

Dehydration
Drips i.e. too much saline
Drugs
Diabetes insipidus

Question 4

Causes of thrombocytopenia

Answer 4

Drugs - penicillamine e.g. in RA treatment - reduced production
Heparin - increased destruction

Question 5

Causes of thrombocytosis

Answer 5

Bleeding, tissue damage, inflammation
Myeloproliferative disorders

Question 6

Causes of hypokalaemia

Answer 6

DIRE
Drugs - loop and thiazide diuretics
Inadequate intake, intestinal loss
Renal tubular acidosis
Endocrine - cushing’s/conn’s

Question 7

Causes of hyperkalaemia

Answer 7

Drugs - potassium sparing diuretics and ACE inhibitors
Renal failure
Endocrine - Addison’s
Artefact - clotted sample
DKA

Question 8

Causes of AKI
Prerenal, intrinsic renal, postrenal

Answer 8

Prerenal - dehydration, renal artery stenosis
Renal - INTRINSIC
Ischaemia, nephrotoxic abx, tablets (NSAIDs, ACEi), radiological contract, injury, negatively birefringent crystals, syndromes, inflammation, cholesterol
Postrenal - stone, tumour, BPH, prostate cancer, aneurysm

Question 9

Common causes of a raised ALKPHOS

Answer 9

ALKPHOS
Any fracture
Liver damage
K for kancer
Paget’s disease of bone, pregnancy
Hyperparathyroidism
Osteomalacia
Surgery

Question 10

What are the common doses of gentamicin?

Answer 10

High dose regimen - 5-7mg/kg once daily

With severe renal failure or endocarditis - divided daily dosing 1mg/kg 12hrly or 8 hrly

Question 11

What are the features of digoxin toxicity

Answer 11

Confusion, nausea, visual halos, arrhythmias

Question 12

Features of lithium toxicity

Answer 12

Tremor
Tiredness
Arrhythmias, seizures, coma, renal failure, diabetes insipidus

Question 13

Features of phenytoin toxicity

Answer 13

Gum hypertrophy, ataxia, nystagmus, peripheral neuropathy, teratogenicity

Question 14

Features of gentamicin toxicity

Answer 14

Ototoxicity and nephrotoxicity

Question 15

Features of vancomycin toxicity

Answer 15

Ototoxicity and nephrotoxicity

Question 16

How is warfarin adjusted if there is a major bleed?

Answer 16

Stop warfarin
Give 5-10mg IV Vit K
Give prothrombin complex

Question 17

How should warfarin be adjusted with an INR of 5-8?

Answer 17

No bleeding - omit warfarin for 2 days then reduce the dose
Minor bleeding - omit and give 1-5mg IV Vit K

Question 18

How should warfarin be adjusted with an INR of >8

Answer 18

No bleeding - omit, give 1-5mg PO Vit K
Minor bleeding - omit warfarin and give 1-5mg IV Vit K