Data Interpretation Flashcards

1
Q

Why do panic attacks cause paraesthesias

A

Panic attacks cause numbness because the alkalosis from the hyperventilation drives calcium binding to albumin in the blood. Hypocalcaemia ensues and leads to parasthesiaes.

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2
Q

What is respiratory acidosis also known as

A

T2RF

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3
Q

What is T2RF also known as

A

Respiratory acidosis

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4
Q

What can cause metabolic alkalosis (2)

A

Vomiting (loss of hydrochloric acid leads to effective loss of hydrogen ions)
Bicarbonate drugs mop up hydrogen ions leading to an effective decrease in H+ concentration and alkalosis

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5
Q

Normal anion gap causes of metabolic acidosis (2)

A

Loss of bicarbonate in diarrhoeal illnesses

Renal tubular acidosis

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6
Q

Causes of a wide anion gap metabolic acidosis

A
KULT
Ketones 
Uraemia
Lactate
Toxins (paracetamol, aspirin, ethylene glycol (anti-freeze) and isoniazid)
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7
Q

Which toxins can cause a wide- anion gap metabolic acidosis (4)

A

paracetamol, aspirin, ethylene glycol (anti-freeze) and isoniazid

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8
Q

Triggers for ADH release (2)

A

Reduced blood volume sensed via baroreceptors at the Carotid sinus
Decreased sodium concentration sensed via chemoreceptors at the hypothalamus

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9
Q

Does aldosterone affect Na concentration and why

A

Aldosterone does not change [Na]+ as water will follow when it is absorbed

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10
Q

What does ANP and BNP do and how

A

prevents the overloading of the heart due to excess water retention. It decreases water retention by promoting sodium loss at the kidney. It does this by increasing the kidney’s GFR and also by switching off the RAAS.

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11
Q

Causes of hypovolaemic hyponatraemia (7)

A
Vomiting
Diarrhoea (particularly cholera)
Diuretics
Addisons 
Renal failure 
Cutaneous loss
Third space loss (pancreatitis, small bowel obstruction)
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12
Q

Causes of euvolaemic hyponatraemia (3)

A

SIADH
Hypothyroidism
Psychogenic/iatrogenic DI

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13
Q

Causes of SIADH (5)

A

Surgery
Lung pathology (pneumonia)
Tumours (small cell lung carcinoma)
Drugs (SSRIs, TCAs, opiates, PPIs, carbamazepine)
CNS pathology (meningitis, encephalitis, SAH)

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14
Q

Which drugs can cause hyponatraemia (5)

A

SSRIs, TCAs, opiates, PPIs, carbamazepine

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15
Q

How come SIADH does not cause hypervolaemia

A

Due to the RAAS being activated so salt is reabsorbed with water (so we are still hyponatraemic) and BNP and ANP

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16
Q

How does hypothyroidism cause euvolaemic hyponatraemia

A

Hypothyroidism causes reduced CO, so ADH is released and RAAS tries to raise your fluid volume.

17
Q

How does adrenal insufficiency cause hypovalaemic hyponatraemia

A

Natriuresis and water loss from lack of sodium reabsorption through aldosterone insufficiency

18
Q

Causes of hypervolaemic hyponatraemia

A

‘Failures’
Heart failure
Liver failure
+ Nephrotic syndrome

19
Q

How does liver failure cause hypervolaemic hypernatraemia

A

Causes release of NOS which vasodilates systemically causing pooling of blood.
Also hypoalbuminaemia occurs in cirrhosis which disrupts the oncotic pressure of the blood and promotes leaking

20
Q

How does nephrotic syndrome cause hypervolaemic hyponatraemia

A

Causes hypoalbuminaemia which disrupts oncotic pressure of blood causing leaking into third space

21
Q

What effect does nephrogenic/central DI have on blood sodium?

A

Hypernatraemia

22
Q

What does an isolated raised bilirubin suggest

A

Haemolytic anaemia, Gilbert’s

23
Q

What does AST > 2x ALT suggest

A

Alcoholic Liver Disease

24
Q

What does ALP & GGT raised suggest

A

Biliary pathology

25
Q

What does ALT & AST in 1000s suggest

A

Hepatitis: toxic, ischaemic, viral

26
Q

What does α-fetoprotein (AFP) raised suggest

A

Hepatocellular carcinoma

27
Q

What does hypoalbuminaemia suggest

A

Liver failure,

Nephrotic syndrome

28
Q

What LFT pattern suggests:

Haemolytic anaemia

A

Isolated raised Bilirubin

29
Q

What LFT pattern suggests: Gilbert’s

A

Isolated raised Bilirubin

30
Q

What LFT pattern suggests:

Alcoholic Liver Disease

A

AST > 2x ALT

31
Q

What LFT pattern suggests:

Biliary pathology

A

ALP & GGT raised

32
Q

What LFT pattern suggests:

Hepatocellular carcinoma

A

α-fetoprotein (AFP) raised

33
Q

What LFT pattern suggests:

Liver failure

A

Hypoalbuminaemia

34
Q

What LFT pattern suggests:

Nephrotic syndrome

A

Hypoalbuminaemia

35
Q

What LFT pattern suggests:

Hepatitis: toxic, ischaemic, viral

A

ALT & AST in 1000s

36
Q

How do we measure synthetic liver function

A
Clotting factors (prolonged PT)
Also albumin but its half life is 20 days so not useful in acute medicine