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PATASS III > Data Interpretation > Flashcards

Data Interpretation Flashcards

1
Q

When can haematological blood tests be abnormal?

A
  • aneamia
  • cancer
  • sickle cell
  • Haemorrhange - GI/PE bleed
  • trauma
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2
Q

What comes under haematological tests?

A

FBC

  • HB
  • Mean Cell Volume
  • Platelets
    • reduced in - clotting disorders, alcoholics
    • Raised in - lymphoma
  • WCC
    • Raised in = infection, leukaemia
    • low in = recurrent infection, acquired immune suppression (HIV)

D-Dimer (when thrombus breaks down produces d-dimer)
- raised in DVT, cancer

Group + save/crossmatch

Coagulation

  • INR
  • Prothrombin
  • Activated partial thromboplastin time
  • Fibrinogen
  • Thrombin
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3
Q

What comes under biochemical tests?

A

U+Es (kidney function)

  • Na
    • hypernatremia e.g. dehydration
    • hyponatremic e.g. Addisons
  • K
    • hyperkalemia e.g. arrhythmia
    • hypokalaemia e.g. drugs
  • Creatine
    • Raised e.g. kidney failure
  • Urea
    • Raised e.g. not perfused kidneys or being reabsorbed

CRP
- Raised in inflammatory process

Troponin T
- Shows myocardial damage has occurred

LFTs

  • Bilorubin
    • Raised e.g. jaundice
  • always look at pre, intra and post when looking at kidneys + liver
  • Albumin
  • Protein
    • Reduced = oedema as protein is needed to draw fluid back into the capillary bed

Pancreatic enzymes

  • Amylase
  • Lipase
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4
Q

Plain radiograph uses

A
  • bones white as they absorb radiation
  • air is dark
  • if bones overlapping get increased whiteness
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5
Q

CT uses

A

Benefits;

  • Good to look at bones
  • Good for picking up big structure abnormalities
  • Good to see when someone’s bleeding out
  • Good for looking for cancer

Disadvantages;

  • Exposing pt to lot of radiation
  • Not good for looking at small soft tissue changes e.g. brain, spinal cord and nerves because it can’t pick up small details
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6
Q

Ultrasound uses

A
  • No radiation
  • Quick & cheap
  • Good at looking at soft tissue; kidneys, liver, baby’s

Disadvantage;
- Very operational sensitive

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7
Q

MRI uses

A
  • Can see damage in small soft tissue, good for;
    • MS
    • Epilepsy
  • No radiation
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8
Q

What is the tool to view chest x-ray

A

Adequate
- Is it adequate - can you see from bottom of diaphragm to top of clavicle

Bronchial breathing
- Can you see trachea & bronchi & lung fields

Bones
- looking at rib cage for any fractures, dark areas over bone =could be neumothorax

Cardiac

  • what is size of heart - enlarged could be cardiomyopathy
  • Can u see boarders of heart, loss of contours around heart = fluid
  • Pulmonary oedema appears as cotton wool

Diaphragm
- Can you see the diaphragm

Everything else
- scapula, clavicles

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9
Q

What comes under ABGs?

A
  • PH (7.35-7.45)
  • PO2 (10-14 kPa)
  • PCO2 (4.5-6kPa)
  • Base excess (-2 - 2)
  • Bicarbonate (22-26 mmol)
  • Lactate (0.5-1 mmol)
  • HB
  • Electrolytes
  • Glucose (4-7.5)
  • CO/MetHb
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10
Q

Define sepsis

A

Sepsis = Dissregulation of the inflammatory process

  • Organ dissregulation (inflammatory cascade, hypertension, oedema)
  • Cellular dissregulation - abnormal ATP production = lactate production
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11
Q

What is PH?

A
  • concentration of hydrogen ions in a solution
  • When a solution becomes more acidic the concentration of hydrogen ions increases and the pH falls
  • Hydrogen ions are excreted via the kidney and carbon dioxide is excreted via the lungs.
  • If the buffers e.g. plasma proteins and excretion mechanisms are overwhelmed and acid is continually produced, the he pH falls. This creates a metabolic acidosis.
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12
Q

What is base excess?

A
  • This is the amount of strong base which would need to be added or subtracted from a substance in order to return the pH to normal (7.40).
  • A base excess more than +2 mEq/L indicates a metabolic alkalosis.
  • A base excess less than -2 mEq/L indicates a metabolic acidosis.
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13
Q

What is bicarbonate?

A
  • Bicarbonate is produced by the kidneys and acts as a buffer to maintain a normal pH. The normal range for bicarbonate is 22 – 26mmol/l.
  • If there are additional acids in the blood the level of bicarbonate will fall as ions are used to buffer these acids. If there is a chronic acidosis additional bicarbonate is produced by the kidneys to keep the pH in range.
  • raised bicarbonate may be seen in chronic type 2 respiratory failure where the pH remains normal despite a raised CO .
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14
Q

What is electrolytes?

A

venous or arterial blood gas - check potassium + sodium - e.g. for management of cardiac arrhythmias

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15
Q

What is lactate?

A
  • Produced as a by-product of anaerobic respiration.

- good indicator of poor tissue perfusion.

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16
Q

Glucose

A
  • Glucose may also be raised in patients with severe sepsis or other metabolic stress.
17
Q

What is Carbon monoxide?

A

At levels of 10 -20% symptoms such as nausea, headache vomiting and dizziness will be predominant. At higher levels patients may experience arrhythmias, cardiac ischaemia, respiratory failure and seizures.

18
Q

What is methaemoglobin (metHb)?

A

MetHb is an oxidized form of haemoglobin. Levels of >2% are abnormal.

19
Q

Respiratory compensation

A
  • If a metabolic acidosis develops the change is sensed by chemoreceptors centrally
    in the medulla oblongata and peripherally in the carotid bodies.
  • The body responds by increasing depth and rate of respiration therefore increasing the excretion of CO2 to try to keep the pH constant.
20
Q

Metabolic Compensation

A
  • In response to a respiratory acidosis, for example in CO2 retention secondary to COPD, the kidneys will start to retain more HCO3 in order to correct the pH.
  • low normal pH with a high CO2 and high bicarbonate.
21
Q

Respiratory Failure

A

Type 1 Respiratory failure (T1RF)
- PaO2 less than 8 and a PaCO2 which is
low or normal.
- Caused by pathological processes which reduce the ability of the lungs to
exchange oxygen, without changing the ability to excrete CO2.
- E.g. PE, pneumonia, asthma and pulmonary oedema.

Type 2 respiratory failure (T2RF)
- PaO2 of less than 8 and a raised PaCO2.
- You can think of it as being caused by a problem with the lungs or by a problem
with the mechanics or control of respiration.

22
Q

Is a venous blood gas comparable to an arterial blood gas?

A

The values on a VBG and ABG are comparable (arterial and venous values are NOT significantly different for practical purposes) except in the cases of O2 and CO2.

PATASS III (16 decks)

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