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Emergency Medicine > Investigation Results > Flashcards

Investigation Results Flashcards

1
Q

High WCC

A

Infection, leukaemia, steroid use

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2
Q

Low WCC

A

Bone marrow cancer, viral infection

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3
Q

What do lymphocytes change with?

A

Viral infections

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4
Q

High eosinophils

A

Atopy, parasitic infections, vasculitis

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5
Q

High basophils

A

Infections, inflammatory disorders

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6
Q

High Hb

A

Lung disease, bone marrow disease

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7
Q

Low Hb

A

Anaemia

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8
Q

High platelets

A

Inflammation, infection, bleeding

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9
Q

Low platelets

A

Viral infection, autoimmune conditions

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10
Q

High MCV

A 
B12 + folate deficiency 
Liver disease
Hypothyroidism 
Pregnancy 
Alcohol excess
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11
Q

Low MCV

A

Anaemia, thalassemia

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12
Q

High urea

A

AKI, CKD, HF, GI bleed

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13
Q

High sodium

A

Dehydration

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14
Q

Low sodium/ chloride

A

D+V, sweating, CKD, Addisons

Too much water due to HF, cirrhosis

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15
Q

High potassium

A

Kidney disease, Addisons, infection, DM, NSAIDs, B blockers, ACE inhibitors, potassium sparing diuretics

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16
Q

Low potassium

A

D+V

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17
Q

High bicarbonate

A

Vomiting, lung disease, Cushing’s, metabolic alkalosis

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18
Q

Low bicarbonate

A

Addisons, diarrhoea, DKA, metabolic acidosis, kidney disease, aspirin OD

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19
Q

High TSH, normal T3 + T4

A

Subclinical hypothyroidism

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20
Q

High TSH, low T4 + T3

A

Hypothyroidism

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21
Q

Low TSH, normal T4 + T3

A

Subclinical hyperthyroidism

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22
Q

Low TSH, high T4 + T3

A

Hyperthyroidism

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23
Q

Low TSH, low T4 + T3

A

Non-thyroid illness

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24
Q

What is ALT + AST?

A 
ALT = specific to liver
AST = liver, heart, skeletal muscle, kidneys, pancreas
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25
Q

Very high ALT + AST

A

Drug induced hepatitis, viral hepatitis, liver ischaemia

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26
Q

Moderate increase in AST + ALT

A

Chronic/ alcoholic hepatitis, biliary obstruction

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27
Q

Mild increase in AST + ALT

A

Cirrhosis, fatty liver

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28
Q

ALT higher than AST

A

Acute liver damage eg hepatitis

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29
Q

AST higher than ALT

A

Damage due to alcohol

30
Q

High AST

A

Haemolysis after MI

31
Q

High total bilirubin

A

Blockage of hepatic system eg gallstones

32
Q

High conjugated bilirubin

A

Blockage of bile ducts, hepatitis, cirrhosis

33
Q

High unconjugated bilirubin

A

Haemolysis, sickle cell, pernicious anaemia

34
Q

Where is ALP produced?

A

Biliary ducts, bone, small intestines, kidneys

35
Q

Very high ALP

A

Cholestasis (gallstones, pancreatic carcinoma)

36
Q

High ALP

A

Hepatitis, cirrhosis, infiltration (abscess, liver carcinoma)

37
Q

High ALP with calcium + phosphate abnormal

A

Bone disease

38
Q

Low albumin + low protein

A

Cirrhosis
Alcoholism
Chronic inflammation
Kidney disease

39
Q

Low albumin + normal protein

A

Infection

40
Q

Low + increased protein

A

Myeloma

41
Q

High albumin

A

Dehydration

42
Q

Prolonged PT, normal PTT

A

Liver disease, decreased Vit K, decreased factor VII

43
Q

Normal PT, prolonged PTT

A

Decreased VIII, IX, XI, XII, vW disease

44
Q

Prolonged PT + PTT

A

Decreased I, II, V or X, DIC

45
Q

How to interpret blood gases

A

O2 - are they hypoxic
pH
Respiratory - PaCO2
Metabolic - HCO3-

46
Q

What should PaO2 be?

A

10 below inspired O2

47
Q

What does a low pH + high PCO2 mean?

A

Respiratory acidosis

Pneumonia, COPD, over sedation from drugs

48
Q

High pH low PCO2

A

Respiratory alkalosis

Hyperventilation, emotional distress, severe infection

49
Q

Low pH, low bicarbonate

A

Metabolic acidosis

Diabetes, shock, kidney failure

50
Q

High pH, high bicarbonate

A

Metabolic alkalosis

Hypokalaemia, chronic vomiting, sodium bicarb OD

51
Q

High creatine kinase

A

Muscle damage

52
Q

High ESR

A

Infection, inflammation, anaemia, kidney failure

53
Q

Low ESR

A

Polycythaemia, extreme leucocytosis

54
Q

High lactate

A

Decreased O2, metformin, shock, infection

55
Q

High amylase

A

Pancreatitis, cancer of pancreas or gallbladder, perforated ulcer, mumps, ectopic

56
Q

X Ray presentation

A 
Intro - identify patient, type of X ray 
Date + time taken 
RIP: rotation, inspiration, penetration 
Obvious abnormalities 
Systematic approach of anatomical structures
57
Q

Lung x ray structures

A 
Trachea 
Hilar structure 
Zones of lung 
Costophrenic angles + hemidiaphragms 
Heart size + contours 
Bones + soft tissue
58
Q

Sepsis results

A 
Temp <36 or >38 
HR >90
RR >20
WCC <4 or >12 
PaCO2 <4.3 
Lactate >2
59
Q

ECG interpretation: rhythm abnormalities

A

Supraventricular tachycardias:
AF = irregular without P waves
Atrial flutter = regular with sawtooth baseline
Atrial tachycardia = regular with abnormal P waves
VF = no discernible P waves/ QRS complexes
VT = broad complex tachycardia

60
Q

ECG interpretation: perfusion abnormalities

A

Infarction: ST elevation, T wave inversion, pathological Q waves
STEMI: ST elevation
Ischaemia: ST depression, new wave T inversion

61
Q

ECG interpretation: LV hypertrophy

A

R wave >5 big squares in V5/6, T wave inversion

62
Q

ECG interpretation: RV hypertrophy

A

Dominant R wave in V1

T wave inversion in right chest leads

63
Q

ECG interpretation: hypertrophic cardiomyopathy

A

LV hypertrophy signs + dramatic T wave inversion in lateral leads

64
Q

ECG interpretation: hyperkalaemia

A

Low flat P waves, wide bizarre QRS, slurring into ST segment, tall tented T waves

65
Q

ECG interpretation: hypokalaemia

A

Small flattened T waves, prolonged PR, depressed ST, prominent U wave

66
Q

ECG interpretation: hyper/hypocalcaemia

A

Hyper: short QT
Hypo: prolonged QT

67
Q

ECG interpretation: PE signs

A

Tachycardia
RV strain
T wave inversion in right chest lead

68
Q

What does NEWS measure?

A 
RR
O2
Temp
Systolic BP
HR 
LOC
69
Q

What to do with NEWS 1-4?

A

4-6 hr obs

Inform nurse

70
Q

What to do with NEWS >5?

A

1 hrly obs
Inform medical team + urgent assessment
Clinical care in an environment with monitoring

71
Q

What to do with NEWS >7?

A

Continuous monitoring

Immediately inform medical team + seen by reg, transfer to HDU/ ICU

Emergency Medicine (24 decks)

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