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Final > Data interpretation > Flashcards

Data interpretation Flashcards

1
Q

Causes of hyponatraemia

A

Hypovolaemic: Addison’s (Low Aldosterone = Low Na and H2O reabsorption)

Euvolaemic: SIADH (Inc water retention, Urine high osmolality), H2O toxicity (Urine osmolality under 100 - v dilute)

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2
Q

Potassium (think intake, shift, loss)

Causes hypo

Causes hyper

A

Hypokalaemia

  • Low intake (eating disorder, alcohol)
  • Shift into cells (alkalosis, drug - salbutamol, refuting syndrome)
  • Loss: GI (D&V), Renal (diuretics, hypomagneisa, hyperaldosteronism - Conn’s, Cushings)

Hyperkalaemia

  • IV fluids (Hartmanns)
  • Shift out of cells (acidosis, swapped for H+), Tissue damage
  • Reduced loss: kidney disease, drugs (ACEi/ARB), Addisons
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3
Q

Measures of renal fucntion

A

Creatinine (beware in bodybuilders - Cr prod by muscle)
Urea (from protein)
eGFR (using creatinine/sex/age)

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4
Q

Bone profile

Osteoporosis
Malacia
Pagets
mets
Primary hyperparathyroidism
A

Ca, PO4, ALP

N,N,N
L,L,H
N,N,H
H,H,H
H,L,H
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5
Q

Causes of hypocalcaemia

A

Vit D def
Renal failure (low active Vit D)
Hypopara
Hypomagnesia

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6
Q

Causes of hypercalcemia

A

Primary Hyperparathyroid
Cancer (mets, myeloma)
Sarcoidosis (granuloma cAMP mediated Ca release)
Thiazide diuretics

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7
Q

Useful tests for hypocalcaemia

A

Vit D
U&E
Mg
PTH

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8
Q

Magnesium

  • low
  • link
A

Poor intake/alc/malabsorption

Shifts into cells (treat DKA, referring)

Loss (diarrhoea, diuretics)

Hypomagnesia and Hypokalaemia are linked

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9
Q

LFTs

  • Eg
  • Which are non-specific
  • Raised in hepatocellular damage
  • Billiary outflow block
A

AST, ALT, Bilirubin, GGT, ALP, Albumin

AST - muscle ALP - bone

AST+ALT

ALP+GGT

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10
Q

What is seen in failing liver?

A

Poor synthetic = low albumin, raised INR

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11
Q

Iron studies

A

TIBC (transferrin sats)
Serum Iron
High ferritin

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12
Q

Compensation for metabolic acidosis

A

Inc resp rate

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13
Q

Compensation for respiratory acidosis

A

Inc in bicarbonate

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14
Q

Compensation speeds

A

Resp compensation = quick

Metabolic compensation = days

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15
Q

Causes of:

  • Resp acidosis
  • Resp alkalosis
  • Metabolic acidosis
  • Metabolic alkalosis
A

Pneumonia, oedema, Pulmonary fibrosis, PE, COPD

Hyperventilation always

Calculate anion gap (normal = bicarb loss - diarrhoea or RTA, High excess acid - ketoacidoiss, lactic acidosis, renal failure)

Vomiting, hypercalcemia, hyperaldosteronism

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16
Q

Causes of resp failure

A

T1 things that block O2 = pulmonary oedema, pulmonary fibrosis, pneumonia, PE

T2 affect blow off = COPD, muscle weakness, resp centre depression

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17
Q

Enzymes as markers:

Amylase
Lipase
CK
LDH

A

Amylase: Pancreas and salivary glands
Raised - acute pancreatitis, pancreas Ca, salivary gland disease (mumps, tumour), DKA, morphine.

Lipase
More specific for pancreas

CK
From damaged skeletal muscle
Elevated in:
- Muscle disease (rhabdo, dystrophy, polio, excercise)
- Statins, antipsychotics

LDH
Elevated in haemolysis

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18
Q

Plama Proteins

  • High
  • Low

Acute phase proteins

M Protein

A

Albumin

  • High: dehydration
  • Low: malabsorption, liver fail, nephrotic, burns

CRP and ESR

  • Liver prod in inflam/infect
  • Raised ESR but normal CRP in SLE, Myeloma

M protein:

  • Paraprotein seen in Myeloma
  • Serum free light chains and urinary Bence Jones can be seen
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19
Q

Lipid profile

A

Total cholesterol
HDL
Triglycerides

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20
Q

Common causes of dyslipidaemia

High total cholesterol, high LDL

A 
FH (hypercholesterol)
Alcohol
DM
Hypothyroid
Liver disease
Obestiy
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21
Q

Troponin
- Time frame
- Causes
bHCG

A

Can be seen from 2h -> 7 days

MI, Congestive HF, PE, Sepsis, Myocarditis

(CK, ASR and Lactate dehydrogenase also high following MI)

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22
Q

Tumour markers

  • Panc
  • Ovarian
  • Prostate
  • Medullary thyroid
  • Liver/Testicular (teratoma)
  • Testes - Seminoma
A

Ca19-9

Ca-125, bHCG

PSA

Calcitonin

AFP

bHCG

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23
Q

Albumin Creatinine Ratio. What does this show if high?

A

Proteinuria

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24
Q

How to differentiate Pre-renal AKI from ATN

A

Pre-renal has Low urinary Na and urine concentrated (due to RAAS activation)

in ATN there is high urinary NA and dilute urine

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25
Q

Pleural Fluid analysis

  • Unilateral Vs Bilateral
  • When is pH low
  • Causes of transudates
  • Causes of exudates
A

Uni - exudate
Bi - Transudate

pH low in Empyema

Trans:Congestive HF, Liver fail, nephrotic, hypoalbuminaemia (nutritional)

Exudates: Pneumonia, PE, pancreatitis, infection, malignancy, TB, sarcoid

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26
Q

Peritoneal fluid

  • Causes of transudates
  • Causes of exudates
  • High WCC?
A

Trans: cirrhosis (portal HTN, Congestive HF, hypoalb, nephrotic

Ex: Male, pancreatitis

SBP

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27
Q

Abnormalities seen in Para OD

A

Elevated liver enzymes (AST/ALT)
Elevated Prothombin time (impaired synthesis)
Impaired Kidneys (high Urea, Cr)
High anion gap acidosis

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28
Q

Para OD Tx

A

N-acetylcysteine

May cause anaphylaxis

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29
Q

Salicylate OD

  • Pres
  • Ix
  • Tx
A

Stim resp centre
Resp alkalosis + metabolic acidosis (salicylic acid)

ABG

Sodium bicarbonate

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30
Q

TCA OD

  • Ix
  • Tx
A

ECG: Broad QRS, Tall R

Sodium bicarb for arrhythmia Benzo for seizures

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31
Q

Surgical Sieve

VITAMIN DIC

A 
Vascular
Inflammatory
Trauma
Autoimmune
Metabolic
Infection
Neoplastic

Degenerative
Idiopathic
Congenital

32
Q

Causes of high prolactin

A

Physiological: preg

Pituitary tumour

Antipsychotics/antiemetics (D2 block)

Hypothyroidsim

PCOS

33
Q

Conns Signs

A

HTN
HypoK
HyperNa

34
Q

RBC: Microcytic

A

IDA, sideroblastic, thalassaemia (rhymes with anaemia), chronic disease

35
Q

RBC: Macrocytic

A

B12, folate, alcohol, reticulocytosis, aplastic anaemia, myeloproliferative disorders

36
Q

Normocytic anemia causes

A

Blood loss, marrow infiltration, chronic disease, haemolytic

37
Q

Evidence of Haemolysis

A

High LDH, high bilirubin, low haptoglobin, high reticulocytes, anaemia

38
Q

Causes of Neutrophilia

Neutropeni

A

Bacterial infection, Malignancy

Chemo/Radio, Felty’s

39
Q

Causes of pancytopenia

A

Aplastic anaemia, BM infiltration, hypersplenism, Sepsis, SLE

40
Q

Auer rods in blood assoc

A

CML, ALL

41
Q

Coal tests

A

PT (1972 - VitK/Liver),
INR (Comparison of PT between labs),
APTT (Intrinsic = factors except VII)

Target INR = 2.5 for all, recurrent DVT/Mechanical valve - 3.5

42
Q

PT, APTT, Fibrinogen

Warfarin

Heparin

Haemophilia

Liver disease

DIC

A

PT, APTT, Fibrinogen

Warfarin
- HNN
Heparin
- NHN
Haemophilia
- NHN
Liver disease
- HHN (synthetic of all factors)
DIC
- HHL
43
Q

Churg strauss small vessel vasculitis antibodies

A

pANCA

MPO

44
Q

Wegners antibodies

A

cANCA

Proteinase 3

45
Q

Genetic disease E.g’s

  • AD
  • AR
  • XR
A
  • AD: ADPKD, huntingtons, Marfans, NF, tuberous sclerosis (tumours in vital organs)
  • AR: CF (CFTR), Haemochromatosis (HFE), Wilsons, Thalassaemia
  • XR: Duchenne/Becker Muscular dystrophy, Haemophilia A/B, G6PDD
46
Q

Coombs test

A

Antibodies against RBC

47
Q

CXR:

  • White
  • Black
  • Grey
A

Bone
Gas
Soft tissue

48
Q

AXR: Indication

A

Obstruction to bowel

Renal calculi

49
Q

CT head indication

A

Decreased GCS
Suspected skull fracture (CSF leak)
Focal neurology
Seizure

50
Q

When is Contrast CI

A

Renal impairment

51
Q

Predisposing factors to pneumothorax

A

Asthma
COPD
CF
Pulmonary Fibrosis

52
Q

Lines and dots on CXR (Reticulonodular shadowing)

A

Pulmonary fibrosis

53
Q

Upper lobe fibrosis causes:

ESCHART

A 
EAA
Sarcoid
Coal
Histiocytosis
Ank Spond
Radiation
TB
54
Q

Lower lobe fibrosis:

RASCO

A 
RA
Asbestosis
Sclerodera
Sryptogenic
Other: drug (amiodarone
55
Q

Unilateral pleural effusion

A

Exudates

Malig, PE, Pneumonia, RA

56
Q

Pulmonary oedema causes

A 
HF
Acute MI
ARDS
Renal failure
Aggressive fluids
57
Q

Bat Wing cause on CXR

A

Perihilar consolidation e.g. in acute pulmonary oedema due to HF

58
Q

HF CXR (ABCDE

A

Alveolar oedema

Kerley B line/ Batwing

Cardiomegaly

Distension of venous system

Effusion

59
Q

What is bright on diffusion weight MRI

A

Stroke (diffusion restriction)

60
Q

CXR Mitral valve disease

A

Prominent L atrial appendage

LA enlargement

Cardiomegaly

61
Q

CXR bronchial Ca

A 
Pulmonary mets
Effusion
Consolidation/pneumonia
Lung collapse
Boney mets
HIlar LN
62
Q

Caveatting lung lesion DDx

A 
TB
Pneumonia
Squam cell ca
Abscess
Vascular (Wegner's - cANCA)
Rheumatoid nodule
63
Q

Hetrogenous ring enhancing cerebral mass

A

Glioma

  • astrocytoma
  • glioblastoma multiforme
64
Q

Ischaemic bowel AXR

A

Free pass in abdo, gas in bowel wall

65
Q

Perforation AXR

A

Gas in peritoneal space (always pathological

66
Q

What is P-mitrale and when is it seen

A

Mitral stenosis

Bifid P-wave

67
Q

Normal length QRS

A

0.12-0.3 (3-5 small sq)

68
Q

FEV1 in obstructive Vs Restrictive

A

Obs: under 0.7

Restrict: over 0.8

69
Q

Urinalysis:

Bilirubin
Blood
Glucose
Ketones
Leukocytes
Nitrites
pH
Protein
Specific gravity
Urobilinogen
A 
Bilirubin: liver disease
Blood: Glomerular damage, menstruation (contamination)
Glucose: DM
Leukocytes: UTI
Nitrites: UTI
pH: RTA
Protein: Glomerular damage, Bence Jones
Urobilinogen: Liver disease, haemolysis
70
Q

LP

  • bacterial
  • viral
  • SAH
A

Bacterial:

  • high protein and WCC
  • Low glucose
  • Turbid

Viral

  • normal protein,
  • leukocytosis
  • Glucose low/normal
  • Clear

Xanthochromia

71
Q

QRisk3

A

Risk MI/Stroke in next 10 years

  • Age
  • Ethnic group
  • Postcode
  • Other Hx (smoking, RA, Angina etc)
72
Q

FRAX

A

Fracture risk

73
Q

When to secure airway according to GCS

A

under 8

74
Q

Causes of postural hypotension

A 
Idiopathic
Dehydration
Drug (diuretics/vasodilation)
Autonomic neuropathy (DM)
MS
75
Q

SIADH Na, Serum Osmolality, urine osmolality,

A

Low serum Na
Low serum osmolality
High urine osmolality

76
Q

Low sodium in urine + AKI =

A

Prerenal cause

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