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TPN, syringe drivers, Lab Results > LAB DATA > Flashcards

LAB DATA Flashcards

1
Q

What is osmolality?

A

No. osmotic ions per unit solution mmol/kg

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2
Q

Hyponatraemia - symptoms and causes?

A

Symptoms- weakness <120mmol,
headache, nausea, cramps, confusion ( 90-105 )
then convulsions

Caused by water retention- CCF, renal disease, cirrhosis, ascites or certain drugs (SIADH)- carbamazepine, bendroflumethiazide, SSRIs

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3
Q

Hypernatraemia - symptoms and causes?

A

stupor, coma, lethargy
Insufficient water intake - elderly, young, sick
Sodium retention e.g. steroid use
Thirst is primary defence

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4
Q

Potassium importance?

A

Cation involved in resting membrane potential. Important in carbohydrate/protein, enzyme metabolism.

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5
Q

Hypokalaemia

A

muscle weakness, hypotonia, arrhythmias, muscle weakness in lower extremities
Cause- inadequate intake, N+V, diarroea, diuretics

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6
Q

Hyperkalaemia

A

muscle weakness, cardiac conduction abnormalities (VF if sudden increase, asystole if slow)
Cause - renal disease, tissue breakdown, k sparing diuretics, diabetic acidosis

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7
Q

Blood urea - organ failure it is involved in?

A

Endpoint of protein metabolism formed in liver, filtered in glomeruli. Hydration indicator.
Increased in RENAL failure, high protein intake, GI bleeding, dehydration, starvation.
Decreased in LIVER failure, poor protein diet, overhydration, pregnancy

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8
Q

Creatinine

A

eliminated by glomerular filtration, endpoint of muscle metabolism

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9
Q

Calcium- function, regulation, measurement

A

Most abundant mineral - 99% in bone as hydroxyapatite
Maintains cellular membrane, nervous cell excitability, muscle contractility.
Increased levels by PTH. 1,25-hydroxycholecalciferol controlling absorption, secretion, bone deposition/resorption.
Use corrected calcium - 1/3 is protein bound

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10
Q

Hypocalcaemia

A

Deficiency in Vit D or calcium, hypoparathyroidism, osteoporosis, chronic renal failure.
Numbness of fingers, tingling in lower extremities, thinning and loss of body hair, affects heart (ECG)

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11
Q

Hypercalcaemia

A

hyperparathyroidism, vit D OD, bone diseases

Signs - psychosis, fatigue, depression, GI disturbance, headache, weakness

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12
Q

Bilirubin

Signs of increased bilirubin

A

breakdown product of haemoglobin, almost completely bound to serum albumin. Taken up by liver cells where it is conjugated and excreted in bile

Cause increased -haemolyisis (drugs, infection, enzyme deficiency)
- hepatocellular damage
- cholestasis (obstruction to bile flow)
Build up leads to jaundice

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13
Q

ALP

A

occurs in liver, bone, gut, placenta

excreted in bile and markedly raised in obstructive jaundice

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14
Q

GGT

A

Microsomal enzyme, raised with ALP in cholestasis. Enzyme inducers cause increase (e.g. alcohol)

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15
Q

AST - organ cells?

ALT - organ cells?

A

liver, heart, skeletal muscle
ALT is liver specific
Increased- acute damage

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16
Q

Albumin - synthesised by and utility as a marker of function?

A

synthesised by liver

Not a good marker as influenced by nutritional status and capillary leakage. Long half life

17
Q

Clotting factors (10-14s) - synthesis? and reduced in?

A

Synthesised by liver, short half life so good measurement

Vit K deficiency in cholestasis can reduce factor production

18
Q

Drug induced liver disease- type 1/2

A

Type 1 - usually dose dependent, oestrogen causes cholestasis, methotrexate causes hepatocyte damage

Type 2 - not dose dependent and immune mediated.

19
Q

RBCs function, removal, increased and decreased by?

A

Carry O2 bound to Hb
Require B12/folate and iron
Removed by spleen
increased in polycythaemia and stress. Decreased in anaemia

20
Q

Morphological anaemias - low, normal, high volume

A 
normocytic, normochromic - anaemia of chronic disease
microcytic, hypochromic (low MCV) 
- iron deficiency, sickle cell
macrocytic (high MCV)
- B12 or folate deficiency
21
Q

Causes of anaemia

A
  • iron deficiency (inadequate intake, excessive bleeding, malabsorption disorders, pregnancy
  • B12 or folate deficiency (inadequate intake, malabsorption -coeliac disease or pernicious anaemia)
22
Q

How is haematocrit measured?
MCV?
MCHC?

A

haemoglobin expressed as % of whole blood
Mean corposcular volume (average volume of RBCs)
Mean corposcular haemoglobin volume (haem in RBC as %)

23
Q

PMN granulocytes and mononuclear cells

A

POLYMORPHONUCLEAR (PMN) granulocytes
Neutrophils – phagocytosis of bacteria and cell debris
Eosinophils – involved in allergy/inflammation
Basophils – involved in hypersensitivity reactions
MONONUCLEAR CELLS
Monocytes – macrophage precursors
Lymphocytes – cellular immunity and antibodies

24
Q

WBC increase and decrease?

A

Increased in infection, malignancy (AML/CML),acute inflammation
Decreased in malignancy (leukaemia), chemotherapy, drug interactions
Neutropaenia
-makes up 50-70% of WBCs
Drugs:chemo, phenytoin, propylthiouracil, co-trimoxazole, clozapine

25
Q

Platelets (thrombocytes) role, increased and decreased?

A

integral in clotting cascade, lifespan 8-14 days.
Increased:post splenectomy, myeloploriferative disorders(thrombocythaemia), inflammatory disorders

Decreased: bone marrow suppression - AIDS, SLE, drugs - gold, heparin

26
Q

Thrombocytopenia - cause, symptoms, treatment

A

bone marrow failure, heparin-induced, drugs - valproate, MTX, H2 blockers
Symptoms - bleeding, bruising.
Treatment - support with platelets, tranexamic acid. Steroids, splenectomy, azathioprine

27
Q

ESR - carried out

A

Measures the rate of fall of erythrocytes in a thin tube

28
Q

RBC volume change in B12 deficiency?

A

RBC increases

29
Q

Grave’s Disease?

A

cause of hyperthyroidism

30
Q

Carbimazole effect on neutrophils?

A

reduce causing agranulocytosis

31
Q

RBC volume in iron deficiency

A

RBC decreases

32
Q

What causes numbness of fingers and tingling and burning in feet?

A

hypocalcaemia
potentially caused by diuretic and lansoprazole
treat with Adcal D3 bd

33
Q

What drug combo (COPD) can cause hypokalaemia?
symptoms and treatment?
change bendro?

A

salbutamol (nebulised) + high dose prednisolone
symptoms - muscle cramps
treatment - oral Sando-K
change bendro to amlodipine

34
Q

Post MI + Stroke?

A 
Aspirin + clopidogrel
Clopidogrel preferred
If AF - warfarin after 2 weeks in STROKE
Blood Pressure
Cholesterol - BE AGGRESSIVE

TPN, syringe drivers, Lab Results (13 decks)

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