Data Interpretation Flashcards
Give 2 side effects of clozapine that require monitoring
Agranulocytosis
Neutropenia
(Pts require monthly blood tests to monitor)
Give 1 side effect of Carbimazole (antithyroid)
Neutropenia
What 4 causes of Hypokalaemia
DIRE
Drugs - Thiazide/Loop Diuretics
Inadequate intake/Intestinal loss (diarhoea/vomiting)
Renal tubular Acidosis
Endocrine - Cushing’s/Conn’s Syndrome
Give 5 causes of Hyperkalaemia
DREAD
Drugs - ACEi + Aldosterone Antagonists (K+ Sparing diuretics)
Renal Failure
Endocrine - Addison’s
Artefact - Clotted sample
DKA
Give 2 causes of a raised Urea
AKI
Upper GI bleed
A raised urea without an increase in creatinine indicates what?
A non-renal cause
Regarding AKI, if Urea rise is > than creatinine, what type of AKI is it?
Pre-renal AKI
Regarding AKI, if Urea rise is < than creatinine, what type of AKI is it?
Intrinsic or post-renal AKI
What issue usually causes pre-renal AKI?
Perfusion issue
What issues can cause intrinsic AKI? (5)
Ischaemia (causing acute tubular necrosis)
Nephrotoxic antibiotics (gentamicin, vancomycin, doxycycline)
Drugs - ACEi, NSAIDs
Radiological contrast
Injury - Rhabdomyolysis
What issue usually causes post-renal AKI?
Obstruction issue (i.e blocked catheter)
What biomarkers would be raised in pre-hepatic pathology?
Isolated raise in bilirubin
What biomarkers would be raised in intrahepatic pathology?
Increased Bilirubin
Increased ALT/AST
What biomarkers would be increased in post-hepatic pathology?
Increased bilirubin
Increased ALP/gGT
Thyroid Function Tests - High TSH and Low T4 indicates what?
Primary Hypothyroidism
(Hashimoto’s, Drug Induced)
Thyroid Function Tests - Low TSH and High T4 indicates what?
Primary Hyperthyroidism
(Grave’s, Toxic Multinodular Goitre, Drugs)
Thyroid Function Tests - Low TSH and Low T4 indicates what?
Secondary hypothyroidism
(Pituitary Tumour/Damage)
Thyroid Function Tests - High TSH and High T4 indicates what?
Secondary Hyperthyroidism
Pituitary Tumour
Give 6 drugs with a narrow therapeutic range that require monitoring
Digoxin
Theophylline
Lithium
Phenytoin
Gentamicin
Vancomycin
Drug monitoring - If an adequate therapeutic effect is achieved and serum concentration levels are high, what should be done to the dose?
Reduce dose
Drug monitoring - If an adequate therapeutic effect is achieved and serum concentration levels are normal/low, what should be done to the dose?
No dose change
Give 4 features of digoxin toxicity
Confusion
Nausea
Visual Halos
Arrhythmias
Give 5 features of lithium toxicity
Tremor
Tiredness
Seizures
Coma
Diabetes Insipidus
Give 5 features of Phenytoin Toxicity
Gum Hypertrophy
Ataxia
Nystagmus
Peripheral Neuropathy
Teratogenic
Give 2 features of gentamicin/vancomycin toxicity
Ototoxicity
Nephrotoxicity
What liver product is required for paracetamol metaboliosm?
Glutathione (antioxidant)
What happens to Glutathione stores in paracetamol overdose? What effect does this have on the liver? (3)
Stores are quickly depleted.
Leads to accumulation of toxic metabolites - NAPQI
NAPQI causes acute liver damage
What is the treatment for paracetamol overdose? How is this achieved?
N-Acetyl-Cysteine (NAC)
NAC replenishes stores of Glutathione, thus preventing further production of NAPQI and preventing further liver damage.
Reversal of Warfarin - How should major bleeding be managed? (3)
Stop Warfarin
IV Vitamin K 5mg
Prothrombin Complex
Reversal of Warfarin - How should minor bleeding be managed + INR >8 ? (2)
Stop Warfarin
IV Vitamin K 1-3mg
Reversal of Warfarin - How should no bleeding but an INR >8 be managed? (2)
Stop Warfarin
Oral Vitamin K 1-5mg
Reversal of Warfarin - How should minor bleeding + INR 5-8 be managed? (2)
Stop Warfarin
IV vitamin K 1-3mg
Reversal of Warfarin - How should INR 3-5 + no bleeding be managed? (1)
Omit doses of Warfarin until INR <3
What effect do macrolides (erythromycin/clarithromycin) have on Warfarin? What effect does this have on INR?
Macrolides are enzyme inhibitors so increase effects of Warfarin
(Increase INR)
How can Carbamazepine cause hyponatraemia?
Inducing SIADH
In a patient with Addison’s or who is on Long Term Steroids, what should be done during intercurrent illness?
Increase hydrocortisone
What is the mainstay treatment for acute heart failure with signs of fluid overload? (Pulmonary oedema, Raised JVP, Peripheral Oedema)
40mg IV Furosemide
What are the 2 first line drugs for rate control in fast AF? Give 2 contraindications to look out for
Betablockers and Diltiazem
BB - Asthma
CCB - Peripheral oedema/leg swelling
