Data interpretation- haematology, biochemistry

Question 1

Drug-related causes of neutropenia? (2)

Answer 1

Clozapine

Carbimazole

Question 2

Drug-related causes of thrombocytopenia?

Answer 2

Penicillamine (used in rheumatoid arthritis- decreases production)
Heparin (increased destruction of platelets)

Question 3

What are the causes of hypernatraemia? (4 Ds)

Answer 3

Dehydration
Drips (too much saline)
Drugs (e.g. effervescent tablets)
Diabetes insipidus

Question 4

Causes of hyponatraemia:

a) hypovolaemic (3)
b) euvolaemic (3)
c) hypervolaemic (2)

Answer 4

a) fluid loss e.g. D&V, addisons disease, diuretics
b) SIADH, psychogenic polydipsia, hypothyroidism
c) heart failure, renal failure

Question 5

What drugs can cause SIADH? (2)

Answer 5

Carbamezapine, antipsychotics

Question 6

Causes of hypokalaemia? (DIRE)

Answer 6

Drugs (loop and thiazide)
Inadequate intake/intestinal loss
Renal tubular acidosis
Endocrine (Cushings, Conn’s)

Question 7

Causes of hyperkalaemia? (DREAD)

Answer 7

Drugs (ACE inhibitors, potassium sparing diuretics)
Renal failure
Endocrine (Addisons)
Artefactual (clotted blood sample)
DKA

Question 8

Raised urea with normal creatinine in a patient who is not dehydrated?

Answer 8

Possible upper GI bleed

Question 9

How can pre-renal and renal causes of AKI be distinguished?

Answer 9

Pre-renal, the urea rise is greater than the creatinine rise

Question 10

What drugs can cause pre-renal AKI?

Answer 10

Drugs which exacerbate renal artery stenosis- NSAIDs, ACE inhibitors

Question 11

Drugs which cause intrinsic renal AKI? (3)

Answer 11

Nephrotoxic antibiotics e.g. gentamicin, vancomycin
ACE inhhibitors
NSAIDs

Question 12

Patterns of LFT derangement:

a) raised bilirubin
b) raised bilirubin and transaminases
c) raised bilirubin and alk phos

Answer 12

a) pre-hepatic
b) intra-hepatic
c) post-hepatic

Question 13

Drugs which cause intrahepatic hyperbilirubinaemia? (3)

Answer 13

Paracetamol in overdose, statins, rifampicin

Question 14

Drugs which cause cholestasis? (5)

Answer 14

Flucloxacillin, co-amoxiclav, nitrofurantoin, steroids, sulphonylureas

Question 15

What is the target range for TSH?

Answer 15

0.5-5mIU/L

Question 16

How should the levothyroxine dose be adjusted (in the PSA) if the patient is hypo/hyperthyroid?

Answer 16

By the smallest increment offered (unless grossly abnormal)