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Rahul's Basics > DPD Deck - MISC > Flashcards

DPD Deck - MISC Flashcards

1
Q

How do you identify Microangiopathic hemolytic anemia?

A

The presence of schistocytes on the blood film

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2
Q

What occurs during DIC?

A

In disseminated intravascular coagulation
Systemic activation of the coagulation pathway
This leads to widespread generation of fibrin and deposition in blood vessels
This leads to thrombosis and multiorgan failure
As a result, platelets and coagulation factors are used up
Fibrin degradation produced and D-dimer are produced to break up the clots

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3
Q

What are the lab findings in DIC?

A

DECREASED Platelets and Fibrinogen
INCREASED Fibrin degradation products and D-dimer
PROLONGER Prothrombin time and Activated partial thromboplastin time

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4
Q

Name the 3 features of HUS

A

Haemolysis occurs results in decreased haemoglobin and increased bilirubin
Decreased platelets
Uraemia

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5
Q

What is the classic traid of HUS?

A

Microangiopathic hemolytic anemia
AKI
Thrombocytopenia

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6
Q

What are the features of Thrombotic Thrombocytic Purpura

A 
Purpura
Fever
Fluctuating cerebral dysfunction 
AKI 
Microangiopathic haemolytic anemia
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7
Q

In a patient who had microangiopathic haemolytic anaemia what would you expect to see in a blood test?

A

High bilirubin
Low haemoglobin
High creatinine

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8
Q

What are the two types causes of haemolytic anemia?

A

Hereditary and Acquired

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9
Q

List the hereditary causes of haemolytic anemia?

A
  1. RBC membrane problems: HEREDITARY SPHEROCYTOSIS
  2. Enzyme deficiency: G6PD deficiency
  3. Haemoglobinopathies: Sickle cell, thalassemia
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10
Q

List the acquired causes of haemolytic anemia?

A

MAID:

Microangiopathic haemolytic anemia
Autoimmune
Infection
Drugs

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11
Q

What is the framework one must use when dealing with a patient who is HYPONATRAEMIC?

A

Think about blood volume, a hyponatraemic patient will be either:

HYPOVOLAEMIC
EUVOLAEMIC
HYPERVOLAEMIC

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12
Q

What do all patients with Hyponatraemia have in common?

A

They have excess water due to EXCESS ADH

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13
Q

What are the HYPOVOAEMIC causes of hyponatraemia and how would you test for it?

A

Diarrhoea
Vomitting
Diuretics

DETECT BY: Clinically hypovolaemic, low urine sodium (because kidneys hold onto salt)

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14
Q

What are the EUVOLAEMIC causes of hyponatraemia and how would you test for it?

A

E for Endocrine causes

Hypothyroidsim - Thyroid Function Tests
Adrenal insufficiency (Addison’s) - Short Synacthen test
SIADH - LOW plasma osmolality, HIGH urine osmolality

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15
Q

What are the HYPERVOLAEMIC causes of hyponatraemia and how would you test for it?

A

Cardiac failure
Cirrhosis
Nephrotic Syndrome

Signs of fluid overload
Low urine sodium?

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16
Q

List two reasons other than increased ADH that would lead to hyponatraemia?

A

Excess water intake

Sodium-free irrigation solutions (Used in TURP)

17
Q

List the causes of SIADH

A

CNS Pathology
Lung Pathology
Tumours

Drugs - SSRI, TCA, Opiates, PPI, Carbamazepine

18
Q

What is Onycholysis?

A

Seperation of the nail bed

19
Q

What are some of the causes of onycholysis?

A

Trauma
Thyrotoxicosis
Fungal infection
Psoriasis

20
Q

List the MICROvascular complications of diabetes

A

Retinopathy
Nephropathy
Neuropathy

21
Q

List the MACROvascular comlpications of diabetes

A

Myocardial Infarction
Stroke
Peripheral vascular disease

22
Q

List the METABOLIC complications of diabetes

A

DKA
Hyperosmolar hyperglycaemic state
Hypoglycaemia

23
Q

What is the treatment of a patient with DKA or Hyperosmolar hyperglycaemic state?

A

Fluids
Potassium
Insulin

24
Q

What is the treatment of a patient who is Hypoglycaemic

A

First we must decide on their level of conscioussness and thus their severity

Consciouss - Glucose
Slightly confused - Buccal dextrogel
Very confused/Comatose - IV 10-20% glucose or IM glucagon

25
Q

What changes would you see in an INFERIOR MI?

A

Posterior MI - ST depression in V1, V2, V3 with a dominant R wave and ST elevation in leads V5 and V6

26
Q

In an acute episode of pain where there is blood in the urine what kind of investigation do you want to do?

A

Non-contrast CT Kidney Ureter Bladder

27
Q

What are the two sources of Alkaline Phosphatase?

A

The Liver

Bones

28
Q

Which conditions cause a rise in Alkaline Phosphatase?

A

Obstructive liver disease
Fracture
Malignancy
Paget’s disease

29
Q

Which cells in bones produce ALP?

A

OsteoBlasts

Plasma cells suppress osteoblasts

30
Q

What happens to ALP in patients with myeloma?

A

ALP will be normal

31
Q

What does CRAB stand for and which condition does it relate to?

A

Calcium
Renal impairment
Anaemia
Bone

It is used to describe Multiple Myeloma

32
Q

What would PTH, Calcium and phosphate levels be like in Primary Hyperparathyroidism

A

High PTH
High Calcium
Low Phosphte

Because PTH is phosphate thrashing hormone

33
Q

What would PTH, Calcium and phosphate levels be like in Secondary Hyperparathyroidism due to Vitamin D deficiency

A

High PTH
Low Calcium
Low phosphate

34
Q

What would PTH, Calcium and phosphate levels be like in Secondary Hyperparathyroidism with kidney failure

A

High PTH
Low Calcium
High phosphate

Because the kidneys cannot excrete out the phosphate

35
Q

What would PTH, Calcium and phosphate levels be like in Tertiary Hyperparathyroidism

A

High PTH
High Calcium
High Phosphate

Due to chronic kidney disease

36
Q

What are the features of Nephrotic syndrome?

A

There is increased permeability to the glomerular basement membrane to proteins

As a result proteinuria occurs. Specific features of Nephrotic syndrome include:

  1. Proteinuria > 3.5 g/day
  2. Hypoalbuminaemia
  3. Oedema
  4. DYSLIPIDAEMIA (as the liver tries to compensate for the decreased albumin production and produced lipids as well)
37
Q

List the features of HEREDITARY HAEMORRHAGIC TELANGIECTASIA

A

Autosomal dominant condition
Abnormal blood vessels will be seen in:

Skin
Mucous membranes
Lungs
Liver
Brain

Rahul's Basics (11 decks)

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