Data interpretation Flashcards by Reece Weaver

causes of low MCV anaemia

IDA

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Causes of normocytic anaemia

anaemia of chronic disease, acute blood loss, haemolytic anaemia, renal failure

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causes of macrocytic anaemia

B12 deficency
folate deficiency 
excess alcohol;
liver disease 
hypothyroidism 
multiple myeloma

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What antipsychotic causes agranulocytosis

Clozapine

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what causes high neutrophils(neutrophillia)

bacterial infection
tissue damage - inflammation, infraction, malignancy
Steroids

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What causes low neutrophils(neutropenia)

Viral infection
chemotherapy/radiotherapy
clozapine
carbimazole (anti thyroid)

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What causes high lymphocytes(lymphocytosis)

viral infection
lymphoma
CLL

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what causes low platelets (thrombocytopenia)

penicillamine 
heparin
myeloma 
hyperspelnism 
infection 
DIC
ITP
HUS/TTP

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What causes high platelets

bleeding
tissue damage
post-splenectomy

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What causes hypernatraemia

Dehyration
drips - too much IV saline
drugs - anything w/ high sodium content
Diabetes insipidus - not enough ADH

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What causes hypovolaemic hyponatraemia

Fluid loss (diarrhoea, vomiting)
Addisons
Diuretics

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What causes euvolaemic hyponatraemia

SIADH: remember SIADH causes w/ SIADH acronym - Small cell lung tumour, Infection, Abscess, Drugs (esp carbamazepine and antipsychotics), Head injury
psychogenic polydipsia
hypothyroidism

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What causes hypervolaemic hypontraemia

Heart failure
Renal failure
liver failure or nutritional failure - hypoalbuminaemia
thyroid failure/ hypothyroidism

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causes of hypokalaemia

DIRE

Drugs - loop and thiazide diuretics
Inadequate intake or intestinal loss - diarrhoea, vomiting
Renal tubular acidosis - amphoteiicin, lithium, ifosfamide
Endocrine - Cushing’s, Conn’s

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Causes of hyperkalaemia

DREAD

Drugs - spirnonalactone, ACEi
Renal failure
Endocrine - Addison's disease
artefact - clotted blood sample
DKA

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Causes of raised urea, and how to seperate

Renal failure, upper GI bleed

creatinine won’t rise with upper GI bleed

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How to tell if a pre-renal AKI

What are the causes

Urea rise > creatinine rise
Dehydration
Renal artery stenosis - ACEi, NSAIDS

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How to tell if intrinsic AKI

What are the causes

Urea rise < creatinine rise
Bladder or hydronephorsis not palpable 
Remember with INTRINSIC acronym 
Ischaemia - acute tubular necrosis 
Nephrotoxic antibiotics - gent, Vanc, tetracyclines 
Tablets - NSAIDS, ACEi
Radiological contrast
Injury - rhabdomyolysis 
Negatively bifurigent crystals - gout 
Syndromes - GN
Inflammation - vasculitis 
Cholesterol emboli

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How to tell if post renal AKI

Urea < creatinine

bladder or hydronephorsis may be palpable

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how to tell if prehepatic liver problem

causes

Bilirubin raised on its own, no other LFT raised
Haemolysis
Gilbert’s
Crigler- Najjar

How to tell if intrahepatic liver problem

Biliruib and AST/ALT both raised 
Fatty liver 
hepatitis - alcohol, viruses, paracetamol, statins, rifampicin, PBC, PSC, autoimmune
Cirrhosis  - same as hepatitis 
Malignancy
Metabolic - Wilsons, haemochromatosis 
HF

How to tell if post hepatic liver problem

Bilirubin and ALP rise
Stones
Drugs causing cholestasis - flucloxacillin, coamoxiclav, nitrfuratonin, steroids, sulphonylyreas
tumours, PBC, PSC

Causes of raised Alk Phos - ALK PPHOS

Any fracture
Liver damage
Kancer
Paget's diseases of pone 
Pregnancy 
Hyperparathyrodism
osteomalacia
Surgery

TSH and Thyroxine dose

TSH <0.5 - reduce dose
TSH 0.5-5 keep same dose
TSH >5 - Increase dose

Signs of pulmonary oedema on CXR

bilateral, fluffy white areas ABCDE signs Alveolar oedema - batwing Kerley B lines Cardiomegaly Diversion of blood to upper lobes - vessels become bigger pleural effusion - unilateral, blunted costophrenic angle

Signs of pneumonia on CXR

Unilateral fluffy consolidation

Signs of fibrosis on CXR

Bilateral, honeycomb

rough check for seeing if someone is hypoxic on O2

FIO2 - 10 should be bigger than PaO2

Signs of type 1 resp faulure

``` Hypoxia Low or normal PaCO2 caused by VQ mismatch Normal or fast breathing anything damaging heart and lungs causing SOB ```

Signs of type 2 resp failure

Hypercapnic high PaCO2 - caused by inadequate ventilation Slow/shallow breathing blue bloater COPD, neuromuscular failure, restrictive chest wall abnormalities

what causes respiratory alkalosis

Rapid breathing - due to disease or anxiety

what causes respiratory acidosis

T2RF

What causes metabolic alkalosis

vomtiing diuretics conn's syndrome

What causes metabolic acidosis

lactic acidosis DKA renal failure Methanol/ethylene glycol intoxication

what causes elevated ST waves on ECG

STEMI | Pericariditis - widespread

what causes ST depression on ECG

Ischaemia - flat, only depressed in some leads | Digoxin - down sloping in all leads

what causes high T waves on ECG

hyperkalaemia

what common drugs require monitoring

``` digoxin theophylline lithium pheytoin gentamicin vancomycin ```

S/E of digoxin

Confusion Nausea visual halos arrytnmias

S/E of lithium

Early - tremor Intermediate - tiredness Late - arrhythmia, seizures, coma, renal failure, diabetes insipidus

S/E of phenytoin

``` Gum hypertrophy Ataxia Nystagmus Peripheral neuropathy Teratogenicity ```

S/E of gentamicin

Ototoxciity | nephrotoxicity

S/E of vancomycin

Ototoxicity | Nephrotoxicity

Gentamicin monitoring - normal people

Usually given 5-7mg/kg once daily measure gentamicin level at particular time e.g 6 hours after infusion started use monogram to look at level each level has an area, e.g if it falls in the 36 hour area, then change to 5-7mg/kg every 36 hours instead of 24 reduce dosing frequency by 12 hours If above 48hr level, repeats level and only redone when <1mg/L

Gentamicin monitoring - renal failure and endocarditis | what is the peak and trough ranges in IE

Give 1mg/kg every 8 hours for endocarditis, every 12 hours for renal failure = divided daily dosing Peak (1hr after dose) should be 3-5mg --> adjust if not Trought (just before next dose) should be <1

Normal range of gentamicin in divided daily dosing regimes not for IE - peak and trough what do if high/low

``` Peak (1h after dose) - 5-10 - adjust dose if outside this Normal trough (just before next dose) is <2 - adjust schedule if outside this ```

Paracetamol OD nonogram

Look at line If at the time taken, their paracetamol conc is below the line, don't require N-acetly cysteine (unless staggered dose or time of ingestion unknown)

Warfarin INR - what's the target, how to interpret, when to stop

INR should be 2.5, unless recurrent thromboembolism or metal replacement valve = 3.5 INR <6 = reduce dose INR 6-8 = omit warfarin for 2d then reduce dose INR >8 = omit warfarin and give 1-5mg oral Vit K If minor bleeding and INR > 5, give IV vit K instead of oral If there is a major bleed, stop warfarin, give 5-10mg Vit K and prothrombin complex