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Y3 DIAGNOSTIC TOOLS > DIAGNOSTIC TOOLS > Flashcards

DIAGNOSTIC TOOLS Flashcards

1
Q

what colour blood bottle would you use to collect blood for a coagulation scree, INR or D-dimer?

A

light blue

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2
Q

what colour blood bottle would you use to collect U+E, CRP, LFTs, amylase, TFTs, lipid profile, troponin, Ca, PO4, Mg?

A

yellow

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3
Q

what colour blood both would you use to collect FBC, blood film, ESR and HBA1c?

A

purple

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4
Q

what colour blood bottle would you use for group and save and crossmatch?

A

pink

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5
Q

what colour blood bottle would you use for glucose or lactate?

A

grey

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6
Q

how is blood in a FBC purple bottle anti coagulated?

A

EDTA

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7
Q

if MCV is low, what type of anaemia does this indicate?

a) microcytic
b) megaloblastic/macrocytic
c) normocytic

A

a) microcytic

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8
Q

if MCV is high, what type of anaemia does this indicate?

a) microcytic
b) megaloblastic/macrocytic
c) normocytic

A

b) megaloblastic/macrocytic

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9
Q

if MCV is normal, what type of anaemia could this indicate?

a) microcytic
b) megaloblastic/macrocytic
c) normocytic

A

c) normocytic

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10
Q

what is the most common cause of normocytic anaemia?

A

chronic disease

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11
Q

high WCC might indicate what?

A

infection

malignancy

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12
Q

low neutrophils might indicate what?

A

malignancy

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13
Q

what 2 things might high neutrophils indicate

A

bacterial infection

inflammation

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14
Q

what type of infection might high lymphocytes indicate?

A

viral

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15
Q

what other type of disease might cause raised lymphocytes?

A

autoimmune

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16
Q

what blood cell might be raised in chronic inflammation and TB infection?

A

monocytes

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17
Q

what blood cell might be raised in allergy and parasitic infection?

A

eosinophils

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18
Q

what blood marker might be raised post-operatively and during infection and inflammation?

A

platelets

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19
Q

give 2 examples of when urea might be raised

A

renal failure

protein load

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20
Q

if raised urea was due to protein load not renal failure, what might you expect creatinine to look like in U+Es?

A

normal

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21
Q

give 4 causes of raised creatinine

A 
renal failure
dehydration
shock
glomerulonephritis
pyelonephritis
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22
Q

give 2 instances when sodium might be low

A

D+V
thiazide diuretics
kidney disease
Addison’s

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23
Q

give 2 instances when sodium might be high

A

hyperaldosteronism
Cushing’s
hypertension

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24
Q

give 2 instances when potassium may be low

A

insulin use
non K-sparing diuretics
D+V

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25
Q

give 2 instances when potassium might be high

A

kidney disease
addison’s
trauma
diabetes

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26
Q

explain why albumin is low in these two situations

a) nephrotic syndrome
b) liver failure

A

a) leaky glomeruli

b) none produced

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27
Q

to what biological molecule does albumin bind?

A

bilirubin

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28
Q

where is ALT made?

A

liver

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29
Q

what is ALT a marker of?

A

liver damage

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30
Q

what 2 things is AST a marker of?

A

liver damage

heart damage

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31
Q

explain the LOVE SAKE pneumonic for the relationship between ALT and AST

A

if ALT higher = viral hepatitis

if AST higher = alcoholic hepatitis

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32
Q

what 2 things is ALP a marker of?

A

paget’s bone disease

biliary damage/obstruction

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33
Q

what clinical sign is elevated bilirubin an indicator of?

A

jaundice

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34
Q

CRP and ESR are both infective markers - what is their different usefulness?

A 
CRP  = more acute marker
ESR = remains high for a few weeks
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35
Q

what three things are measured in TFTs?

A

TSH

free T3, free T4

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36
Q

what clotting pathway is plotted by prothrombin time?

A

extrinsic

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37
Q

what clotting pathway is plotted by activated partial thrombin time?

A

intrinsic pathway

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38
Q

what clotting pathway is plotted by thrombin time?

A

common pathway

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39
Q

what drug is monitored using INR?

A

warfarin

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40
Q

what type of motor neurone damage arises from stroke, tumour or blunt trauma?

A

upper motor neuron

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41
Q

where is the site of an UMN lesion?

A

above anterior horn

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42
Q

what is the effect on the following in an UMN lesion?

a) muscle tone
b) weakness
c) reflexes

A

a) increased - spasticity
b) increased
c) increased - hypereflexia

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43
Q

what 2 reflex signs might you see in an UMN lesion?

A

babinski’s sign

clonus

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44
Q

what is the site of a LMN lesion?

A

inside or distal to anterior horn

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45
Q

what is the effect on the following in an LMN lesion?

a) muscle tone
b) muscle size
c) reflexes

A

a) decreased - hypotonia + fasciculation
b) atrophy of muscles
c) decreased + arreflexia

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46
Q

if there was damage at the point of a spinal cord disc, what would neurone signs look like at that level and below that level?

A

at that level = LMN signs

below that level = UMN signs

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47
Q

what are the 3 types of jaundice?

A

pre hepatic, intra-hepatic, post hepatic

48
Q

what type of jaundice are you most likely to be very yellow during?

A

post hepatic

49
Q

What causes increase breakdown of RBC (haemolysis) leading to excess bilirubin and consequently pre-hepatic jaundice ( unconjugated hyperbilirubinaemia)?

A 
Sickle cell anaemia
Trauma
Thalassemia
Malaria 
hereditary spherocytosis= reduce RBC lifespan 
haemolytic anaemia
50
Q

how does pre-hepatic jaundice increase the risk of gallstones?

A

bilirubin is unconjugated/insoluble at this stage so can for billirubinate calculi

51
Q

give 3 causes of intra-hepatic jaundice

A 
acute viral hepatitis A,B,c
drug induced liver damage= main cause paracetamol overdose and ecstasy
Gilberts syndrome 
alcoholic hepatitis
cirrhosis
Liver cancer
glandular fever =EBV
Primary biliary cirrhosis
52
Q

what occurs to the urine in intra-hepatic jaundice and why?

A

urine is dark

bilirubin is conjugated/soluble at this stage so is excreted

53
Q

Inflammation, obstruction and damage to the bile duct causes the gallbladder not able to move bile to the digestive system causing post hepatic jaundice= V. yellow. What are the causes?

A 
biliary stones
cholecystitis
Pancreatitis acute and chronic
Bile duct cancer
Pancreatic cancer
Gall bladder cancer
54
Q

what occurs to urine and stools in post-hepatic jaundice and why?

A

dark urine
pale stools
biliary drainage is interfered with

55
Q

What are the associated symptoms of jaundice?

A

itch
Tiredness
Abdo pain

56
Q

what is produced in pancreatic alpha cells?

A

glucagon

57
Q

what is produced in pancreatic beta cells?

A

insulin

58
Q

what is produced in pancreatic delta cells?

A

simvastatin

59
Q

what is the main cause of pancreatitic diabetes?

A

alcohol

60
Q

What are the 3 key features of mature onset diabetes of the young?

A

Very strong family link with at least one parent having it, with diabetes in two generations
Occurs before 25
Does not necessarily need insulin

61
Q

what inheritance pattern does mitochondrial diabetes have?

A

autosomal dominant

62
Q

does mitochondrial diabetes need insulin?

A

no

63
Q

give 3 microvascular complications of diabetes

A

neuropathy
nephropathy
retinopathy

64
Q

give 3 macrovascular complications of diabetes

A

stroke
MI
PVD
erectile dysfunction

65
Q

give 2 skin complications of diabetes

A

staph

genital candida

66
Q

what are the 4 A’s of palliative care?

A

analgesia
anti-emetics
anti-muscarinics
anti-anxiety

67
Q

where would you hear the following murmurs?

a) aortic stenosis
b) mitral regurgitation
c) aortic regurgitation
d) mitral stenosis

A

a) aortic valve
b) axilla
c) tricuspid valve
d) mitral valve

68
Q

where in the heart cycle do the following murmurs occur?

a) aortic stenosis
b) mitral regurgitation
c) aortic regurgitation
d) mitral stenosis

A

a) ejection systolic
b) pan systolic
c) diastolic
d) diastolic

69
Q

where do the following murmurs radiate?

a) aortic stenosis
b) mitral regurgitation
c) aortic regurgitation

A

a) carotids
b) axilla
c) tricuspid valve

70
Q

Give 3 examples of drugs when pain is 1-3 or MILD on the analgesic ladder?

A

NSAIDs
ASA= aspirin
Acetaminophen= paracetamol

71
Q

give 3 examples of drugs you might give if pain is 4-6 or MODERATE on the analgesic ladder

A

codeine
dihydrocodeine
tramadol
hydro/oxycodone

72
Q

give 3 examples of drugs you might give if pain is 7-10 or SEVERE on the analgesic ladder

A

morphine
hydromorphine
methadone
fentanyl

73
Q

what is courvoisier’s law?

A

palpable non-tender gallbladder

74
Q

what is murphy’s sign?

A

palpable painful gallbladder

75
Q

what is cullen’s sign? what does it occur in?

A

umbilical bleeding

pancreatitis

76
Q

what is grey-turner’s sign? what does it occur in?

A

flank bleeding

pancreatitis

77
Q

what is brown-sequhard syndrome? what two pathways does it affect?

A

loss of decussation in the spinal column
affects contralateral spinothalamic pathway (pain, temperature)
ipsilateral dorsal column pathway (light touch)

78
Q

what is budd-chiari syndrome? give 3 symptoms

A

occlusion of hepatic vessels

pain, ascites, enlargement

79
Q

what is a large version of a macule?

A

patch

80
Q

what is a large version of a papule?

A

plaque

81
Q

what is a papule raised more than 1cm?

A

nodule

82
Q

what is the large version of a vesicle?

A

bulla

83
Q

what is a deeper version of an erosion?

A

ulcer

84
Q

what is a sharp sided break in the skin?

A

fissure

85
Q

what causes scale on the skin?

A

keratin

86
Q

what does lichenification mean?

A

thickening

87
Q

what does APACHE stand for?

A

acute physiological and chronic health evaluation

88
Q

what is APACHE score used to determine?

A

severity of disease for adults in ICU

89
Q

what test is determined by PaO2, temp, BP, pH, HR, RR, blood tests and GCS?

A

APACHE score

90
Q

what test must be performed before an ABG can be performed?

A

Allen’s test

91
Q

what would a low pH and low CO2 indicate on an ABG?

A

respiratory acidosis

92
Q

what would a high pH and high HCO3- indicate on an ABG?

A

metabolic alkalosis

93
Q

what would low pH, low CO2 but high HCO3 indicate on ABG?

A

respiratory alkalosis with metabolic compensation

94
Q

what is normal pH on an ABG?

A

7.4

95
Q

what 2 urine markers are raised in infection?

A

nitrates

leukocytes

96
Q

what is the optic disc and optic cup in the view of an eye in fundoscopy?

A

bright disc

97
Q

what is the macula and fovea in the view of an eye in fundoscopy?

A 
fovea = dark patch
macula = just behind
98
Q

how do you distinguish between arteries and veins in fundoscopy?

A

arteries = thinner and paler

99
Q

what type of retinopathy is indicated by micro aneurysms?

A

diabetic

100
Q

what do flame and splinter haemorrhages indicate?

A

hypertensive changes

101
Q

what do dot and blot haemorrhages indicate?

A

diabetic changes

102
Q

what 3 things do vitreous haemorrhages indicate?

A

diabetic changes
trauma
retinal/vitreous detachment

103
Q

what stage retinopathy is indicated by hard and soft (cotton wool) exudates?

A

diabetic/hypertensive grade 3

104
Q

if vasculature is narrowed/nipped, what retinopathy might this indicate?

A

hypertensive

105
Q

if vasculature is more tortuous, what retinopathy might this indicate?

A

hypertensive

106
Q

if new vessels are present in the eye, what retinopathy might this indicate?

A

diabetic

107
Q

if vasculature shows signs of silver/copper wiring, what retinopathy might this indicate?

A

hypertensive

108
Q

what 3 things might be indicated by papilloedema

A

malignant hypertension
hypertension grade 4
raised ICP

109
Q

what is indicated by optic disc cupping?

A

glaucoma

110
Q

what is the difference between a cyst, sinus and fistula?

A 
cyst = inside a structure, walls not compromised
sinus = pouch into a structure, 1 wall compromised
fistula = pouching through a structure, both walls/sides compromised
111
Q

complete the clubbing pneumonic for causes of clubbing

A 
Cyanotic heart disease
Lung pathology
Ulcerative colitis
Billiary cirrhosis
Birth defects
Infective endocarditis
Neoplasm
GI malabsorption
112
Q

what is the ABCDEF pneumonic for lung causes of clubbing

A 
Abscess
Bronchiectasis
Cystic fibrosis
Don't say COPD!!
Empyema
Fibrosis
113
Q

what ratio should optic cup to disc be?

a) 1/30
b) 1/15
c) 1/3
d) 1/5

A

c) 1/3

114
Q

what colour is a healthy optic disc?

A

pale pink/yellow

115
Q

What 3 endocrine conditions can cause diabetes?

A

Untreated cushings
Acromegaly = excess growth hormone producti
Pheochromocytomas = catecholamine secreting hormone

116
Q

What is Rovsing sign?

A

It is for appendicitis

Palpate on the left lumbar area and pain in the right lumbar area

Y3 DIAGNOSTIC TOOLS (1 decks)

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