Metabolic

Question 1

What is SIADH characterised by?

Answer 1

is characterised by hyponatraemia secondary to the dilutional effects of excessive water retention.

Question 2

Two ways to manage SIADH

Answer 2

fluid restriction
Demeclocycline
Vasopressin

Question 3

3 drugs associated with SIADH

Answer 3

SSRI
Carbamazepine
Sulphonureas (glipizide)

Question 4

If urinary sodium is <20 and you have hyponatraemia what are the causes?

Answer 4

Na+ loss secondary to D+V or burns
Water excess by HF, liver disease or nephrotic syndrome

Question 5

If urinary sodium is >20 and you have hyponatraemia what are the causes?

Answer 5

If euvolaemic = SIADH
if hypovolaemic: Addison’s disease, diuretics

Question 6

If euvolaemic and has a high urinary sodium what is the cause?

Answer 6

SIADH

Question 7

3 causes of hypokalaemia with alkalosis

Answer 7

Vomiting
Thiazide diuretics
Conns syndrome

Question 8

Hypokalaemia with acidosis

Answer 8

diarrhoea
renal tubular acidosis
Acetazolamide

Question 9

What is seen on ECG with hypocalcaemia?

Answer 9

prolonged QT interval

Question 10

What is Trousseau’s sign ?

Answer 10

carpal spasm if the brachial artery occluded by inflating the blood pressure cuff and maintaining pressure above systolic
wrist flexion and fingers are drawn together
seen in around 95% of patients with hypocalcaemia and around 1% of normocalcaemic people

Question 11

Name 3 drugs that lead to decreased excretion of uric acid

Answer 11

aspirin diuretics and pyrazinamide

Question 12

3 causes of hypernatraemia

Answer 12

dehydration
osmotic diuresis
diabetes inspidus

Question 13

What dose of statin should you give in secondary prevention?

Answer 13

Atorvastatin 80mg OD

Question 14

What dose of statin should you give in primary prevention?

Answer 14

Atorvastatin 20mg OD

Question 15

How do you assess primary prevention for a statin?

Answer 15

QRISK2 score
score of 10% or higher needs treating

Question 16

What are two special situations when you don’t use the QRISK2 and give statins anyway

Answer 16

CKD
T1DM

Question 17

3 ECG changes with hyperkalaemia

Answer 17

tall tented t waves, small p waves, widened QRS

Question 18

3 causes of hyperkalaemia

Answer 18

AKI
ACE inhibitor, potassium sparing diuretic, spironolactone
Addisons
Rhabdomyolysis

Question 19

What inheritance is familial hypercholesterolaemia?

Answer 19

autosomal dominant

Question 20

When should statins be discontinued in people trying to conceive

Answer 20

3 months before conception.

Question 21

What is second line treatment for high cholesterol?

Answer 21

Ezetimibe

Question 22

what will happen to ALP and calcium in hyperparathyroidism ?

Answer 22

Both will rise

Question 23

what will happen to ALP and calcium in hyperparathyroidism ?

Answer 23

Both will rise