Data interpretation Flashcards
What are examples of microcytic anaemia?
- Iron deficiency
- Chronic disease
- Thalassaemia
- Sideroblastic anaemia
What are examples of macrocytic anaemia?
- Vitamin B12 deficiency
- Folate deficiency
- Excessive alcohol consumption
- Multiple myeloma
- Myeloproliferative disorders
What are examples of normocytic anaemia?
- Chronic disease
- Blood loss
- Haemolytic anaemia
- Marrow infiltration
Where is iron absorbed from?
-Duodenum and jejunum
Where is vit b12 absorbed from?
-Terminal ileum
Where is folate absorbed from?
-Small bowel
What are the components of an iron profile?
- Serum iron
- Serum total iron binding capacity
- Serum ferritin
- Transferrin saturation
- Serum soluble transferring receptors
In an iron deficient state, what would an iron study show?
- Serum iron: reduced
- Serum total iron binding capacity: increased
- Serum ferritin: reduced
- Transferrin saturation: reduced
- Serum soluble transferring receptors: Increased
What serum ferritin level suggests iron deficiency?
-<15micrograms/L
What needs to be considered in someone with anaemia when looking at the ferritin level?
-Ferritin is an acute phase reactant, so the level maybe high even in an iron deficient state. It’s levels increase in the presence of inflammation
What would iron studies show for someone who had anaemia of chronic disease?
- Serum iron: normal/slightly reduced
- Serum total binding capacity: reduced
- Serum ferritin: may be raised (as acute phase reactant)
- Transferring saturation: reduced
What is the most common disease that causes vitamin B12 deficiency?
-Pernicious anaemia
>defective instrinsic factor production due to autoantibodies against gastric parietal cells
What cells will be increased on blood film in hameolytic anaemia?
-Reticulocytes
What is Direct antiglobulin test?
-A test to detect an autoimmune haemolytic anaemia.
>antibodies to human immunoglobulin are added to red cells, if they agglutinate = presence of haemolytic anaemia
How can haemolytic anaemias be classified?
- Inherited
- Acquired
What are examples of inherited haemolytic anaemias?
- Spherocytes
- Elliptocytes
- Thalassaemia
- Sickle cell anaemia
- Pyruvate kinase deficiency
- Glucose-6-phosphate dehydrogenase deficiency
What are some examples of acquired immune causes of haemolytic anaemias?
- Autoimmune warm
- Autoimmune cold
- Transfusion reaction
- Haemolytic disease of the newborn
- Adverse drug event
What are some examples of non-immune causes of haemolytic anaemias?
- Malaria
- Microangiopathic anaemia
- Hypersplenism
- Mechanical heart valve
- Burns
How do you detect true polycythaemia?
-Use the red cell mass
>raised. Males >0.51, Females >0.48
What is apparent polycythaemia?
-A reduction in plasma volume rather than an increase in red cell mass
What are causes of apparent polycythaemia?
- Dehydration
- Gaissbock syndrome
What are causes of true primary polycythaemia?
polycythaemia rubra vera
What are causes of true secondary polycycthaemia?
- Hypoxia causes: lung disease, cyanotic cardiac disease, chronic smoking, high altitude
- Excessive erythropoietin: renal cell carcinoma, polycycstic kidney disease, adrenal tumour, hepatocellular carcinoma
What causes a neutrophillia?
- Bacterial infections
- Inflammation
- Necrosis (ie post MI)
- Corticosteroid use
- Malignancy
- Myeloproliferative disorders
- Metabolic disorders is renal failure
What are causes of neutropenia?
- Post chemo/radio
- Adverse drug reaction ie clozapine, carbimazole
- Viral infection
What are causes of lymphocytosis?
- Viral infection
- Chronic infection
- Chronic lymphocytic leukaemia
- Lymphomas
What are causes of eosinophillia?
- Allergic disorders
- Parasitic infection
- Skin diseases ie eczema
- Malignancy ie hodgkins
- Allergic bronchopulmonary aspergiloosis
Causes of thrombocytosis?
- Primary: essential thrombocythaemia, CML
- Reactive: infection, inflammation, malignancy, bleeding, pregnancy, post splenectomy
How can you classify the causes of thrombocytopenia?
- Reduced platelet production due to bone marrow failure
- Increased platelet destruction
What are causes of reduced platelet production due to BM failure?
- Infection
- Drug induced
- Leukaemia
- Aplastic anaemia
- Bone marrow displacement
- Megaloblastic anaemia
What are causes of increased platelet destruction?
- Immune mediated: AI thrombocytopenia purpura, drug induced
- Hypersplenism
- Thrombotic thrombocytopenic purpura
- DIC
What are common causes of pancytopenia?
- Aplastic anaemia
- Bone marrow infiltration
- Hypersplenism
- Megaloblastic anaemia
- Sepsis
- SLE
What causes hypochromic cells on a blood film?
- Iron deficiency
- Defective Hb synthesis
What cause microcytosis on a blood film?
- Iron deficiency
- Defective Hb synthesis
What causes macrocytosis on a blood film?
- Megaloblastic anaemia
- High alcohol intake
- Liver disease
What causes penil cells on a blood film?
-Iron deficiency
What causes spherocytes on a blood film?
- Hereditary spherocytosis
- Haemolytic anaemia
- Burns
WHat are causes of elliptocytes on a blood film?
- Hereditary elliptocytosis
- Thalassaemia
- Iron deficiency
What are causes of acnathocytes on a blood film?
- Post-splenectomy
- Liver disease
What are causes of target cells on a blood film?
- Thalassaemia
- Iron deficiency
- Post splenectomy
- Liver disease
What are causes of stomatocytes on a blood film?
- Hereditary stomatocytosis
- High alcohol intake
- Liver disease
What are causes of ecchinocytes on a blood film?
- Post splenectomy
- Liver disease
- Uraemia
What are causes of sickle cells on a blood film?
-Sickle cell anaemia
What are cuases of fragmented cells on a blood film?
- DIC
- Mechanical heart valves
- Haemolytic uraemic syndrome
- TTP
What are causes of tear cells on a blood film?
-Myelofibrosis
What are causes of poikolocytosis on a blood film?
-Iron deficiency
What are causes of anisochromia (varying shades of colour) on a blood film?
-Iron deficiency
What are Heinz bodies a sign of?
-Unstable Hb states
What are Howell-Jolly bodies a sign of?
- Post-splenectomy
- Hyposplenism
What are pappenheimer bodies a sign of?
- Post-splenecotmy
- Haemolytic anaemia
- Sideroblastic anaemia
WHat is basophilic stippling a sign of?
- Lead poisoning
- Thalassaemia
- Myelodysplasia
What are cabot rings a sign of?
- Myelodysplasia
- Megaloblastic anaemia
What are auer rods a sign of?
-AML
What are smear cells a sign of?
-CLL
What are the common tests that are included in coagulation?
- Prothrombin time
- International normalised ratio
- Activated partial thromboplastin time
- Bleeding time
What clotting factors is prothrombin time dependent on?
I, II, V, VII and X
What is measuring the PT commonly used for in clinical practice?
-Liver function
What blood test is done to measure the effects of heparin?
-APPT
What clotting factors affect the APPT?
-All except VII
What would the PT, APPT and fibrinogen show for someone on warfarin treatment?
- PT: Increased
- APTT: Normal/increased
- Fibrinogen: normal
What would the PT, APPT and fibrinogen show for someone on heparin treatment?
- PT: Normal or increased
- APPT: increased
- Fibrinogen: normal
What would the PT, APPT and fibrinogen show for someone with haemophillia?
- PT: normal
- APPT: increased
- Fibrinogen: Normal
What would the PT, APPT and fibrinogen show for someone with liver disease show?
- PT: increased
- APPT: increased
- Fibrinogen: normal
What would the PT, APPT and fibrinogen show for someone with DIC show?
- PT: increased
- APPT: increased
- Fibrinogen: decreased
What features may someone show if they have a multiple myeloma?
- Anaemia
- Renal impairment
- Low levels of normal immunoglobulins - resultant infections
- Bone involvement: bony pain, hypercalcaemia, lytic lesions
- Hyperviscosity of blood
How do you investigate hyponatraemia?
- First assess the serum osmolality. Sometimes hyperglycaemia/hyperlipidaemia can cause a pseudohyponatraemia
- Then assess volume status (ie hypovolaemic/euvolaemic/hypervolaemic)
What are causes of hypovolaemic hyponatraemia?
-Extra-renal causes (urine Na <15) >GI-D+V >Fluid shifts -Renal causes >Diuretics >Salt wasting renal disease >Nephropathy (analgesics, PCKD) >Adrenal insufficiency
What are causes of euvolaemic hyponatraeia?
-Urine Na >15 >H20 intoxication >SIADH >Drugs >Renal failure >Hyperthyroidism
What are causes of hypervolaemic hyponatraemia?
- Liver failure
- CCF
- Renal failure
- Nephrotic syndrome
How do you treat symptomatic and asymptomatic hypovolaemic hyponatraemia?
-1L 0.9% normal saline over 2-4hrs. Repeat Na and continue fluids if Na is still rising
How do you treat isovolaemic hyponatraemia?
- Symptomatic: administration of hypertonic saline and furosemid diuresis
- Asymptomatic: Water restriction
How do you treat hypervolaemic hyponatraemia?
- Treat underlying disorder
- Water and Na restriction
What are the causes of hypernatraemia?
- Diabetes insipidus
- Poor water intake eg frail elderly pts
- Administration of excess sodium in Iv fluids
- Administration of durgs containing high sodium content
Causes of hypokalaemia?
- Drugs: diuretics
- Intestinal losses: excess vomiting and diarrhoea, high stoma output
- Renal tubular disease: (acidosis or drug induced tubular damage)
- Endocrine causes
- Metabolic alkalosis
What are the causes of hyperkalaemia?
- Renal failure
- Drugs: excessive K+ supplementation, K+ sparing diuretic
- Rhabdomyolysis
- Endocrine disease
- DKA
- Haemolysis of blood sample in transit
What factors are used to calculate eGFR?
- Serum creatinine
- Age
- Sex
- Race
How do you work out plasma osmolarity?
= 2x (Na + K) + urea + glucose
Which electrolytes need to be monitored in a patient that has been starved for a long period of time and what are they at risk of?
- Refeeding syndrome
- Phosphate
- Magnesium
- Calcium
In pre-renal AKI what will the URINARY sodium be?
-Low because the kidneys are functioning properly and detect a low blood pressure meaning RAAS is activated and therefore sodium is reabsorbed back into the circulation
In renal AKI, what will the URINARY sodium be?
-High as the normal kidney physiological function will be impaired.
What components form a bone profile?
- Calcium
- Phosphate
- Alk phos
- Albumin
What hormone is released when calcium is low and what does it do?
-PTH
>to Increase calcium reabsorption from bone
>increase renal calcium reabsorption
>increase renal excretion of phosphate
>indirectly increasing absorption of calcium from the gut via vitamin D
What would the bone profile look like for osteoporosis?
- Calcium: Normal
- Phosphate: Normal
- ALP: Normal
What would the bone profile look like for Osteomalacia?
- Calcium: Normal or decreased
- Phos: decreased
- ALP: increased
What would the bone profile look like for Paget disease?
- Ca: normal
- Phos: normal
- AlP:increased
What would the bone profile look like for bony mets?
- Ca: increased/normal
- Phos: normal/increased
- ALP: increased
What would the bone profile look like for primary hyperparathyroidism?
- Ca: increased
- Phos: decreased
- ALP: increased
What would the bone profile look like for secondary hyperparathyroidism?
- Ca: Normal
- Phos: increased
- ALP: increased
What would the bone profile look like for tertiary hyperparathyrodism?
- CA: increased
- Phos: decreased
- ALP: increased
What are causes of hypercalcaemia?
- Bone mets
- Multiple myeloma
- Hyperparathyroidism
- Excessive vit D intake
What makes up the LFT?
- Bilirubin
- Aspartate aminotransferase
- Alanine aminotrasferase
- Alk phos
- GGT
- Albumin
What components of the LFT are not specific to the liver and what else needs to be considered?
- AST = muscle damage (including cardiac)
- ALP = bone disease
Which components of the LFT will be raised in liver damage?
-ALT and AST
WHich components of the LFT will be raised in obstructive/cholestatic liver disease?
-ALP and GGT
What does it mean if all components of the LFT are raised?
-Primarily obstructive cause which has caused back pressure on the liver to cause a hepatocytic picture.
The ALP and GGT will be raised out of proportion compared to the transaminases
What are some causes of hepatitic LFTS?
- Viral hepatitis
- A.I hepatitis
- Drugs and toxins
- Alochol
- Metabolic disorders
- Fatty liver
- Malignancy
- CCF
Causes of cholestatic LFTS?
- Bile duct gallstone
- Bile duct stricture
- Cholangiocarcinoma
- Pancreatic carcinoma
- Nodes at the porta hepatis
- Ampullary carcinoma
Which enzymes will be deranged in a failing liver?
- Low albumin levels
- Raised PT (liver synthesises clotting factors)
Differential diagnoses of a positive sweat test?
- CF
- Adrenal insufficiency
- Anorexia nervosa
- Coeliac disease
- Hypothyroidism
What are endogenous causes of cushing’s syndrome?
- Primary adrenal disease: adrenal tumour
- ACTH excess: from the pituitary gland or from an ACTH-producing tumour
What are some common causes of SIADH?
- Intrathoracic causes: infection, tumour
- Intracranial causes: infection, tumour, head injury
- Medications: Carbamazepine, antipsychotics
Which liver enzymes will rise in a paracetamol overdose?
- ALT
- AST
- Bilirubin
- PT will also increase as there will be impaired synthesis of liver enzymes
What ECG changes will you see in someone who has overdosed on TCAs?
- QRS broadening
- Abnormally tall t wave in aVR
Why can salicylate poisoning give a mixed abg picture?
- Respiratory centre of brain is stimulated = hyperventilation = resp. alkalosis
- Metabolic acidosis also occurs due to variety of production of acids
How should TCA over dose be treated?
-Sodium bicarbonate (overdose causes a metabolic acidosis)
What ECG change may you see in digoxin toxicity?
- Downsloping of the ST segment depression.
- Arrhythmias
How can you tell the difference between an exudative and transudative pleural effusion?
- Exudate >30g/L of protein
- Transudate <30g/L of protein
What is light’s criteria for determining the type of pleural effusion?
- Pleural fluid: serum protein ratio >0.5
- Pleural fluid LDH >200IU/I
- Pleural fluid: serum LDH ratio >0.6
What parameters are analysed in pleural fluid?
- Total protein
- Lactate dehydrogenase
- Microbiology: microscopy, cell count, gram stain and culture)
- pH (low in empyema)
- Cytological examination
- Glucose
- Rheumatoid factor
- Amylase
- Ziehl-Neelson stain and culture
- Haematocrit
What are some common causes of transudative plerual effusion?
- Cardiac failure
- Liver failure
- Nephrotic syndrome
- Hypoalbuminaemia
- Hypothyroidism
What are some common causes of exudative pleural effusion?
- Cancer
- Pneumonia
- PE/infarction
- TB
- Connective tissue disease
- Acute pancreatitis
What causes transudate ascites?
- Cirrhosis
- Cardiac failure
- Hypoalbuminaemia
- Nephrotic syndrome
What causes exudate ascites?
- Intraperitoneal malignancy
- Intraperitoneal infection inc. TB
- Pancreatitis
- Hypothyroidism
- Chylous ascites
What is the SAAG and what level indicates what?
- Serum-ascites albumin gradient.
- Level <11g/L indicates an exudative cause ie cancer
- Level >11g/L indicates a transudative cause ie cirrhosis and portal hypertension
When should infective ascites be suspected?
-Increased WCC (indicates peritonitis)
>when associated with cirrhosis, suggests spontaneous bacterial peritonitis
-Multiple organisms on gram staining indicates perforated bowel
What antibiotic should be given to treat SBP?
-3rd gen cephalosporin IV for a min of 5 days
What are some examples of aerobic gram-positive cocci?
- S. aureus
- S. pyogenes
- S. pneumoniae
- Enterococcus faecalis
What are some examples of aerobic gram-positive bacilli?
- Listeria monocytogenes
- Bacillus anthracis
What are some examples of aerobic gram-negative cocci?
- Moraxella catarrhalis
- Neisseria meningitidis
What are some examples of aerobic gram-negative bacilli?
- E.coli
- Pseudomonas aeruginosa
What are some examples of anaerobic cocci?
- Peptococci
- Peptostreptococci
What are some examples of anaerobic bacilli?
- Bacteroides fragilis
- C. diff
What are some causes of abnormally low CSF opening pressure during LP?
- CSF leak
- Recent lumbar puncture
What are some causes of abnormally high CSF opening pressure during LP?
- Meningitis
- Tumour
- Intracranial haemorrhage
- Idiopathic intracranial hypertension
What are some causes of raised CSF protein?
- Meningitis
- Brain abscess
- Intracerebral haemorrhage
- Neoplastic diseaes
- Guillain-Barre syndrome
- MS
What does a low CSF glucose indicate?
-Infection likely due to bacterial, fungal or TB
What are nerve conduction studies?
-Measurement of how well the individual nerves transmit electrical signals. An electrode stimulates a nerve and other electrodes detect the resulting activity and the time it takes for the activity to be detected
>commonly requested for suspected carpal tunnel syndrome
What is electromyography?
-Surface of needle electrodes are used to detect muscle action potentials following controlled electrical stimulation. This then provokes action potentials within the nerves which in turn stimulates a magnified response in the muscles
>used for myasthenia gravis
What are the classic CSF findings of bacterial meningitis?
- Cloudy appearance
- Organisms seen in CSF
- Raised WCC
- RCC normal
- Raised total protein
- Reduced CSF glucose
- Reduced CSF:plasma glucose ratio
What are causes of oligoclonal bands in CSF?
- MS
- Subacute sclerosing panencephalitis
- GBS
- Neurosyphilis
- Lyme disease
- Neurosarcoidosis
What autoantibody may be present in someone with Addison’s disease?
-Anti-21-hydroxylase
What autoantibody may be present in anti-phospholipid syndrome?
- Anti-cardolipin
- Lupus anticoagulant antibody
What autoantibody may be present in autoimmune haemolytic anaemia?
-Red blood cell autoantibodies
What autoantibody may be present in autoimmune hepatitis?
- Anti-nuclear
- Anti-smooth muscle
What autoantibody may be present in in Churg strauss syndrome?
-MPO-ANCA
What autoantibody may be present in Coeliac disease?
- Anti-endomysial
- Anti-tissue transglutimase
- Anti-Reticulin
- Anti-gliadin
What autoantibody may be present in diffuse cutaneous scleroderma?
- RF
- Anti-nuclear
- Anti SCL-20
What autoantibody may be present in goodpasture syndrome?
-Anti-glomerular basement membrane
What autoantibody may be present in Grave’s disease?
- Anti-TSH receptor
- Anti-peroxidase
What autoantibody may be present in Hashimoto’s thyroiditis?
- TSH receptor blocking antibodies
- Antiperoxidase
What autoantibody may be present in limitated cutaenous syndrome?
- RF
- Anti-nuclear
- Anti-centromere
What autoantibody may be present in Myasthenia gravis
- Anti-nuclear
- Anti-acetylcholine receptor antibodies
What autoantibody may be present in pernicious anaemia?
- Anti-parietal cell
- Anti-intrinsic factor
What autoantibody may be present in polyarteritis nodosa
-ANCA
What autoantibody may be present in primary biliary cirrhosis?
-Anti mitochondrial
What autoantibody may be present in rheumatoid disease?
- Rheumatoid factor
- Anti-nuclear
What autoantibody may be present in Sjogren syndrome
- RF
- Antinuclear
- Anti-Ro
- Anti-La
What autoantibody may be present in SLE?
- Double stranded DNA
- RF
- Anti nuclear
- Anti Ro
- Anti Sm
What autoantibody may be present in Wegener’s syndrome?
-cANCA
What are indications of a head CT following trauma?
- GCS of <13 when first assessed or GCS <15 2 hours after injury
- Suspected open or depressed skull fracture
- Signs of base of skull fracture
- Post-traumatic seizure
- Focal neurological defecit
- > 1 episode of vomiting
- Coagulopathy + any amneisa or loss of conciousness since injury
- > 30 mins of amnesia of events before impact
5 conditions that may predispose someone to a pneumothorax?
- Chronic disease: COPD, asthma, IPF, CF
- Other: trauma, congenital pulmonary blebs, spontaneous in Marfan’s, idiopathic ie central venous line insertion
What are the causes of upper lobe fibrosis?
-Mneumonic: BREAST >Berylliosis (uncommon) >Radiation fibrosis >Extrinsic allergic alvelolitis >Ank. Spond >Sarcoidosis >TB
What are the causes of lower lobe fibrosis?
- Asbestosis
- Connective tissue disease
- Drug induced: amiodarone, methotrexate
What are some differentials causing pulmonary odema?
- CCF
- Acute renal failure
- Adult respiratoyr distress syndrome
- After aggressive fluid resus
- With a massive acute myocardial infarction/valve rupture
- In association with SAH
What are the 5 cxr signs visible in CCF?
- Alveolar oedema (perihilar consolidation)
- Interlobular septal lines (Kerley B lines)
- Cardiomegaly
- Dilation of veins in the upper lobe
- Pleural effusion
What other cxr findings may there be in soemone with a bronchial carcinoma?
- Pleural effusion
- Lung collapse (due to endobronchial tumour)
- Pulmonary mets
- Bony mets - pathological fractures
- Secondary pneumonia
- Enlarged hilar and paratracheal lymph nodes
What are the differential diagnosis for unilateral hilar enlargement?
- Bronchial carcinoma
- TB
- Lymphoma
- Metastatic mediastinal lymph node disease
- Atypical sarcoidosis
- Vascular anomaly
What are the differential diagnoses for a cavitation lung lesion?
- Bronchial carcinoma
- Pulmonary mets
- TB
- Cavitating pneumonia
- Lung abscess
- Vasculitic disease
- Lung infarction
- Rheumatoid nodule
What are indications for valve replacement?
- Endocarditiscompet
- Rheumatic heart disease (mitral valve)
- Congenital valve disease (bicuspid aortic valve)
- Severe acquired valve incompetence or stenosis
- Acute valvular rupture
What are the ECG findings in hyperkalaemia?
- Tall tented T waves
- Loss of p waves
- Broad QRS
- Sine wave shaped ECG
- Cardiac arrest rhythms
What are the ECG findings in hypokalaemia?
- Flat, broad t waves
- ST depression
- Long QT interval
- Ventricular dysrhythmias
What are some causes of a raised troponin?
- MI
- HF
- Myocarditis
- PE
- Renal failure
- Severe sepsis
- Supraventricular tachycardia
What are some common autosomal dominant inherited diseases?
- Adult polycystic kidney disease
- Dystrophia myotonica
- Familial hypercholesterolaemia
- Huntington disease
- Marfan syndrome
- Neurofibromatosis
- TS
What are some autosomal recessively inherited diseases?
- Cystic fibrosis
- Herediatary haemochromatosis
- Sickle cell disease
What are some X-linked recessive inherited conditions?
- Duchenne muscular dystrophy
- Fragile X syndrome
- Haemophillia A
- Haemophillia B
What disease is caused by trisomy 21?
-Down syndrome
What disease is caused by trisomy 18?
-Edward syndrome
What disease is caused by trisomy 13?
-Patau syndrome
What disease is caused by 45XO?
-Turner syndrome
What disease is caused by 47 XXY?
- Klinefelter syndrome
ass. with behavioural problems and learning disibilities
What disease is caused by 47 XXX?
-Triple X syndrome
Which chromosome is affected in cystic fibrosis?
-Chromosome 7 - F508 codes for the cystic fibrosis transmembrane conductance regulator.
What are some common causes of type 1 resp failure?
- Pulmonary oedema
- Pneumonia
- Pulmonary embolism
- Pulmonary fibrosis
What are some common causes of type 2 resp failure?
- COPD
- Respiratory centre depression
- Respiratory muscle weakness
- Abnormal chest wall architecture
Why should you calculate an anion gap when interpreting a blood gas showing a metabolic acidosis?
-Determines whether the acidosis is caused by acid loss or excess acids
=(Na+K) - (CL+HCO3)
-Norma anion gap: <16
What are the causes of a normal anion gap?
- HCO3 loss from gut ie diarrhoea
- Renal tubular acidosis
What are causes of a raised anion gap?
- Ketoacidosis
- Renal failure
- Lactic acidosis
- Salicylate toxicity
- Methanol ingestion
- Ethylene glycol (anti-freeze) ingestion
What are causes for a metabolic alkalosis?
- Losses from gut ie vomiting
- Primary or secondary hyperaldosteronism
- Hypercalcaemia
- Diuretic use
- Bicarbonate ingestion
What are some causes of postural hypotension?
- Idiopathic
- Dehydration
- Drug induced: diuretics, vasodilators, anti-parkinsonian meds)
- Addison’s disease
- Autonomic neuropathy
- Mutlisystem atrophy
What are some causes of a large sudden drop in GCS?
- Intracerebral bleed
- Cerebral oedema
- Drugs and alcohol
- Trauma
- Metabolic causes ie hypoglycaemia
What are the findings on synovial fluid analysis using light microscopy in gout?
- Negatively birefringent needle-shaped crystals
- Weakly positively birefringent rhomboidal shaped crystals of sodium urate
What are the findings on synovial fluid analysis using light microscopy in pseudogout?
-Weakly positively birefringent rhomboidal shaped crystals of sodium pyrophosphate
What is involved within the HASBLED criteria?
Hypertension
- Abnormal hepatic and/or renal function
- Stroke (hx)
- Bleeding (hx)
- Labile INR
- Elderly (>65)
- Drugs Predisposing to Bleeding (Antiplatelet agents, NSAIDs) Or Alcohol Use (>8 drinks/week)