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PSA > Data interpretation > Flashcards

Data interpretation Flashcards

1
Q

What blood result would be concerning in a patient on Clozapine?

A

neutropenia

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2
Q

Give 4 causes of hypernatremia

A

Dehydration
Drips (too much IV saline)
Drugs
Diabetes insipidus

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3
Q

3 causes of microcytic anaemia

A

Iron deficiency anaemia
Thalassaemia
Sideroblastic anaemia

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4
Q

3 causes of normocytic anaemia

A

Anaemia of chronic disease
Acute blood loss
Haemolytic anaemia
Renal failure (chronic)

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5
Q

3 causes of macrocytic anaemia

A

B12/ folate deficiency
Excess alcohol
Liver disease
Hypothyroidism
Multiple myeloma, myeloproliferative/myelodysplastic disease

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6
Q

What is the normal range for sodium?

A

135-145 mmol/L

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7
Q

What is the normal range for potassium?

A

3.5-5 mmol/L

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8
Q

What are some causes of high neutrophils (neutrophilia)?

A

Bacterial infection
tissue damage (inflammation, infarct, malignancy)
Steroids

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9
Q

What are some causes of low neutrophils (neutropenia)?

A

Viral infection
Chemo/radiotherapy
Clozapine
Carbimazole

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10
Q

What are some causes of high lymphocytes (lymphocytosis)?

A

Viral infection
Lymphoma
Chronic lymphocytic leukaemia

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11
Q

What are some causes of low platelets (thrombocytopenia)?

A

Reduced production:
- infection
- Drugs (penicillamine)
- myelodysplasia, myelofibrosis, myeloma
Increased destruction:
- heparin
- hypersplenism
- DIC
- ITP
- haemolytic uraemic syndrome/ thrombotic thrombocytopenic purpura

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12
Q

What are some causes of high platelets (thrombocytosis)?

A
  • bleeding
  • tissue damage
  • post splenectomy
  • myeloproliferative disorders
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13
Q

What are some causes of hyponatraemia?

A

Hypovolaemic
- fluid loss (D+ V)
- Addison’s disease
- Diuretics
Euvolemic:
- SIADH
- psychogenic polydipsia
- hypothyroidism
Hypervolemic
- Heart failure
- Renal failure
- Liver failure
- Nutritional failure

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14
Q

What are some causes of Hypokalaemia? (DIRE)

A
  • Drugs (loop and thiazide diuretics)
  • Inadequate intake or intestinal loss (D+V)
  • Renal tubular acidosis
  • Endocrine (Cushing’s and Conn’s)
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15
Q

What are some causes of Hyperkalaemia? (DREAD)

A
  • Drugs (loop and thiazide)
  • Renal failure
  • Endocrine (Addison’s)
  • Artefact
  • DKA
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16
Q

Raised urea with a normal creatinine in a patient who is not dehydrated may indicate what?

A

Upper GI bleed

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17
Q

What is the biochemical disturbance in prerenal AKI?

A

Urea rise> creatinine rise

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18
Q

What are some causes of prerenal AKI?

A

Dehydration
Renal artery stenosis
Shock

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19
Q

What is the biochemical disturbance in intrinsic renal AKI?

A

Urea rise<creatinine rise

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20
Q

What are some intrinsic causes of AKI? (INTRINSIC)

A
  • Ischaemia (due to prerenal AKI causing acute tubular necrosis)
  • Nephrotoxic antibiotics
  • Tablets (ACEi, NSAIDs)
  • Radiological contrast
  • Injury (rhabdomyolysis)
  • Negatively birefringent crystals (gout)
  • Syndromes (glomerulonephridites)
  • Inflammation (vasculitis)
  • Cholesterol emboli
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21
Q

What is the biochemical disturbance in postrenal AKI (obstructive)

A

Urea rise< creatinine rise (bladder or hydronephrosis may be palpable depending on level of obstruction)

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22
Q

What are postrenal causes of AKI?

A

In lumen: stone or sloughed papilla
In wall: tumour
External pressure: BPH, prostate cancer, lymphadenopathy, aneurysm

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23
Q

What are some common causes of a raised alk phos?

A
  • Any fracture
  • Liver damage
  • K (cancer)
  • Paget’s disease of the bone/Pregnancy
  • Hyperparathyroidism
  • Osteomalacia
  • Surgery
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24
Q

What are some prehepatic causes of a raised bilirubin?

A

Haemolysis
Gilbert’s and Crigler-Najjar

25
Q

What are some causes of a raised bilirubin and AST/ALT

A

fatty liver
hepatitis
cirrhosis
Malignancy
metabolic (Wilsons/haemochromatosis)
Heart failure (causing hepatic congestion)

26
Q

what are some causes of a raised bilirubin and ALP?

A

Gallstone
drugs causing cholestasis
tumour
primary biliary cirrhosis
sclerosing cholangitis
pancreatic or gastric cancer

27
Q

What drugs can cause cholestasis?

A

Flucloxacillin
Co-amoxiclav
Nitrofurantoin
Steroids
Sulphonylurea’s

28
Q

How should you adjust levothyroxine dose based of TSH?

A

<0.5 = decrease dose
0.5-5 = no action
>5 = increase dose

29
Q

What would TFT’s be in primary hypothyroidism?

A

T4 = low
TSH = high

30
Q

What are some causes of primary hypothyroidism?

A

Hashimoto’s thyroiditis
Drug induced

31
Q

What would TFT’s be in secondary hypothyroidism?

A

T4 = low
TSH = low

32
Q

What is a cause of secondary hypothyroidism?

A

pituitary tumour or damage

33
Q

What would TFT’s be in primary hyperthyroidism?

A

T4 = high
TSH = low

34
Q

What are some causes of primary hyperthyroidism?

A

Grave’s disease
toxic nodular goitre
Drug induced

35
Q

What would TFT’s be in secondary hyperthyroidism?

A

T4 = high
TSH = high

36
Q

What is the main cause of secondary hyperthyroidism?

A

pituitary tumour

37
Q

How do you assess the quality of a chest x-ray film? (PRIM)

A
  • Projection
  • Rotation
  • Inspiration
  • Markings
38
Q

What on a blood gas indicates a respiratory problem

A

PaCO2 abnormality

39
Q

What on a blood gas indicates a metabolic problem

A

HCO3 abnormality

40
Q

What on a blood gas is the difference between T1 and 2 respiratory failure

A

type 2 has a high PCO2

41
Q

What does 1st degree heart block look like on an ECG

A

PR interval constant but >1 large square

42
Q

What does 2nd degree heart block look like in ECG?

A
  • increasing PR interval then missing QRS then increasing again
  • 2/3 p waves for every QRS
43
Q

What does 3rd degree heart block look like on ECG?

A

no relationship between p and QRS

44
Q

What does atrial fibrillation look like on ECG

A
  • no P waves
  • Irregular QRS
45
Q

What does Left BBB look like on ECG?

A

V1 = W
V6 = M

45
Q

What on ECG indicated Bundle branch block?

A

QRS width >3 small squares

46
Q

What does Right BBB look like on ECG?

A

V1 = M
V6 = W

47
Q

How do you calculate if someone has left ventricular hypertrophy?

A

add largest deflection of QRS in V1 to that in V6, if above 3.5 large squares then LVH

48
Q

How do you know if a patient on oxygen is hypoxic from an ABG?

A

take away 10 from oxygen requirement, PaO2 should be this of higher

49
Q

Name 2 causes of elevated ST segment

A
  1. Infarction
  2. pericarditis
50
Q

Name 2 causes of depressed ST segment

A
  1. Ischaemia or infarction
  2. digoxin
51
Q

What does T waves >2/3rds height of QRS indicate?

A

hyperkalaemia

52
Q

In what leads is T wave inversion normal

A

aVR and I

53
Q

What can T wave inversion indicate?

A

old infarction/LVH

54
Q

Features of Digoxin toxicity

A

confusion
Nausea
visual halos
arrhythmias

55
Q

Features of late lithium toxicity

A

arrhythmias
seizures
coma
renal failure
diabetes insipidus

56
Q

Features of Phenytoin toxicity

A

Gum hypertrophy
Ataxia
Nystagmus
Peripheral neuropathy
Teratogenicity

57
Q

Features of Gentamycin and vancomycin toxicity

A

Ototoxicity and nephrotoxicity

58
Q

What action should you take if INR is increased and there is minor bleeding

A

Omit warfarin and give 1-5mg IV vitamin K

PSA (3 decks)

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