Data interpretation Flashcards
What are the key info you gain from U+Es?
- Electrolyte levels
- Presence and type of kidney injury
What are causes of hypernatraemia?
- Dehydration
- Drips
- Drugs
- Diabetes insipidus
What are the causes of hypokalaemia?
DIRE
- Drugs (loop/thiazide diuretics)
- Inadequate intake/intestinal losses
- Renal tubular acidosis
- Endocrine (cushings/conns)
What are the causes of hyperkalaemia?
DREAD
- Drugs (potassium sparing diuretics/ACE-In)
- Renal failure
- Endocrine (addisons)
- Artefact (clotted sample)
- DKA
What drugs cause hypokalaemia?
- Loop diuretics
- Thiazide diuretics
What drugs cause hyperkalaemia?
- ACE-In
- Potassium sparing diuretics
What are the main causes of megaloblastic anaemia?
- B12/folate deficiency
- Excess alcohol
- Liver disease (inc non alcoholic)
What causes high neutrophils?
- Bacterial infection
- Steriods
What causes low neutrophils?
- Viral infection
- Clozapine
- Carbimazole (antithyroid)
What drugs can cause SIADH?
- Carbamazepine
- Antipsychotics
What drugs can cause intrinsic AKI?
- ACE-In
- NSAIDs
- Gentamicin
- Vancomycin
- Tetracyclines
What does an isolated rise in bilirubin indicate?
Haemolysis
What does an isolated rise in urea indicate?
Upper GI haemorrhage
What is the target range for TSH in patients on levothyroxine for hypothyroidism?
- 0.5-5 mIU/L
- If <0.5 - decrease dose
- If >5 - increase dose
What are the most likely CXR in the PSA?
- Pneumonia
- Pleural effusion
How do you assess the quality of a CXR?
PRIM
- Projection
- Rotation
- Inspiration
- Markings
What indicates adequate inspiration on a CXR?
If the 7th anterior (down sloping) rib transects the diaphragm
What indicates effusion on CXR?
- Unilateral
- Solid
What indicates pneumonia on CXR?
- Unilateral
- Fluffy
What indicates oedema on CXR?
- Bilateral
- Fluffy
What indicates fibrosis on CXR?
- Bilateral
- Honeycomb
What are the different dose options (+ indications) for gentamicin?
- 5-7mg/kg OD (most people)
- Divided daily dosing (1mg/kg)
- 12 hourly in renal failure
- 8 hourly in infective endocarditis
Why is gentamicin monitoring important?
Risk of ototoxicity and nephrotoxicity
How do you manage a major bleed in a patient on warfarin?
- Stop warfarin
- 5-10 mg IV vitamin K
- Prothrombin complex
How do you manage a minor bleed in a patient on warfarin?
- Stop warfarin
- 5-10 mg IV vitamin K
How do you manage a patient on warfarin with an INR >8 (no bleeding)?
- Stop warfarin
- 5-10 mg PO vitamin K
How do you manage a patient on warfarin with an INR 5-8 (no bleeding)?
- Stop warfarin for 2 days
- Then reduce dose
When are blood transfusions indicated in iron deficiency anaemia?
- Severely symptomatic and cannot tolerate or wait for the effect of iron-replacement
- Hb <70g/L
Can 5% dextrose (maintenance fluids) be given to diabetic patients
Yes - unless significantly hyperglycaemic
