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MBChB Finals > Metabolic > Flashcards

Metabolic Flashcards

1
Q

What electrolyte disturbance is seen in type I renal tubular acidosis?

A

Hypokalaemia

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2
Q

What lab results suggest SIADH?

A

Hyponatremia, hypo-osmolar serum and hyper-osmolar urine with increased urinary sodium

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3
Q

What blood tests are performed 3 months after starting a statin?

A

Lipid profile and LFTs

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4
Q

What fluid replacement is indicated in patients with acute, severe, symptomatic hyponatraemia (< 120 mmol/L)?

A

Hypertonic saline (3% NaCL)

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5
Q

What is the first line management of hypercalcaemia secondary to malignancy?

A

Lifestyle advice e.g. maintaining good hydration (drinking 3-4 L of fluid per day), provided there are no contraindications (such as severe renal impairment or heart failure

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6
Q

What are the features of type 2 renal tubular acidosis?

A

Hypokalaemia, osteomalacia

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7
Q

What electrolyte disturbance is seen in type 4 renal tubular acidosis?

A

Hyperkalaemia

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8
Q

What are the causes of a raised ALP?

A
  • Liver: cholestasis, hepatitis, fatty liver, neoplasia
  • Paget’s
  • Osteomalacia
  • Bone metastases
  • Hyperparathyroidism
  • Renal failure
  • Physiological: pregnancy, growing children, healing fractures
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9
Q
A
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10
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11
Q

Describe the management of a patient with deficiencies in both magnesium and potassium, with evidence of clinical and biochemical dehydration

A

Intravenous magnesium replacement first then potassium replacement

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12
Q

What is a potential complication of correcting hyponatraemia too rapidly?

A

Osmotic demyelination syndrome

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13
Q

What is a potential complication of correcting hypernatraemia too rapidly?

A

Cerebral oedema

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14
Q

What are the differentials for hypertension with low potassium?

A

Conn’s, Cushing’s, renal artery stenosis and Liddle’s

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15
Q

What is the most appropriate first line investigation for hypertension with low potassium?

A

Plasma renin and aldosterone levels

Quantifying the renin and angiotensin levels will help to distinguish the cause, before going on to more specialised tests

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16
Q

What pathologies are associated with a low renin and a high aldosterone level?

A

Cushing’s and Conn’s

17
Q

What pathology is associated with a low renin and a high aldosterone level?

A

Renal artery stenosis

18
Q

Marked hyponatremia alongside a low serum osmolality and high urine osmolality

What is the diagnosis?

A

SIADH

19
Q

What is the short-term treatment of SIADH?

A

Fluid restriction

20
Q

What drugs can lead to hypokalaemia?

A

Thiazide and loop diuretics

21
Q

What ABG results are associated with renal tubular acidosis?

A

Hyperchloraemic, normal anion gap metabolic acidosis

22
Q

What ECG results are associated with hyperkalaemia

A

Tall-tented T waves, small P waves, widened QRS leading to a sinusoidal pattern and asystole

23
Q

What are the drug causes of SIADH?

A

Carbamazepine, sulfonylureas, SSRIs, tricyclics

24
Q

Patient with acute severe hyponatramia becomes unconscious.

What complication has occured?

A

Cerebral oedema

25
Q

What findings on ABG are associated with vomiting?

A

Hypokalaemia with alkalosis

26
Q

Raised ALP in the presence of normal LFT’s should raise suspicion of what diagnosis?

A

Malignancy, particularly bone cancer/metastases

27
Q

A 56-year-old presents to the emergency department with a 1-month history of worsening exertional breathlessness, orthopnoea, and ankle swelling. They are hyponatraemic.

What is the most likely underlying cause?

A

Heart failure

28
Q

Management of low phosphate in DKA?

A

Parenteral phosphate replacement therapy

29
Q

Most appropriate fluid replacement in patients with ssuspected hypovolemic hyponatraemia?

A

Isotonic normal saline

30
Q

What blood findings are normal in early pregnancy?

A

Mild anaemia and elevated ALP

31
Q

What electrolyte imbalances is most likely to be found in acute pancreatitis?

A

Hypocalcemia

32
Q

What ABG results are seen in renal tubular acidosis?

A

Hyperchloraemic, normal anion gap metabolic acidosis

33
Q

First line management in euvolemic and hypervolemic hyponatraemic patients who don’t have severe symptoms?

A

Fluid restriction

34
Q

Name one complication of type 1 renal tubular acidosis

A

Renal stones

35
Q

What is the first line management of patients with suspected hypercalcaemia?

A

IV fluids

36
Q

What is the most common ECG change in hypocalcaemia?

A

Prolonged QTc interval

MBChB Finals (18 decks)

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