Monitering

Question 1

Monitering req Statins

Answer 1

LFTs

Question 2

Monitering req Ace inhibitors

Answer 2

U&E

Question 3

Monitering req Amiodarone

Answer 3

LFTs &TFTs

Question 4

Monitering req Methotrexate

Answer 4

FBC, LFT, U&E

Question 5

Monitering req Azathioprine

Answer 5

FBC LFT

Question 6

Monitering req Lithium

Answer 6

lithium level
TFT
U&E

Before starting - FBC TFT U&E and BMI (ECG if cvd disease) then every 6 months
Check lithium level 12 hrs (0.4-1mmol/l) after starting and weekly after starting/changed dose until stable

Then 3monthly for first year then 6monthly after that

Question 7

Monitering reqSodium Valp

Answer 7

LFT

Question 8

Monitering req Glitazones

Answer 8

LFTs

Question 9

Changing levothyroxine dose use what and how

Answer 9

Use TSH

<0.5 decrease dose
0.5-5 carry on
>5 increase dose

Question 10

LFT pattern in Prehepatic disease
Causes

Answer 10

Bilirubin up

haemolysis
Gilberts

Question 11

LFT pattern in intrahepatic disease

causes

Answer 11

Bilirubin up
AST & ALT up

Fatty liver
Hepatitis
Cirrhosis
primary n secondary malig
Wilsons/haemochromatosis
Heart failure (hepatic congestion)

Question 12

causes of hepatitis and cirhosis

Answer 12

Alcohol
Viruses (hep A-E, CMV,EBV)
Drugs (Paracet OD, Statins, rifampicin)
Autoimmune

Question 13

LFT pattern in posthepatic (obstructive) disease

Causes

Answer 13

Bilirubin up
ALP up

Lumen:
gallstone, cholestasis causing drugs

Wall:
Cholangiocarcinoma
Primary biliary cirrhosis
sclerosing cholangitis

Extrinsic pressure:
Panc/gastric Ca
Lymph node

Question 14

drugs that cause cholestasis
(= risking posthepatic LFT derangement)

Answer 14

Flucloxacillin
Co-amox
nitrofurantoin
steroids
sulphonureas

Question 15

Ciclosporin monitoring b4 and during

Answer 15

Baseline renal fxn & every two weeks until stable results

Regular BP

Question 16

Statins monitoring n why

what to do if deranged

Answer 16

Myopathy
Cr > 5x upper limit of normal

Stop statin, if sx resolve & Cr normal = reintroduce statin at a lower dose

Question 17

what to do with amiodarone caused hypothyroid

Answer 17

continue amiodarone and start levothyroxine

Question 18

ACEi when starting tx

and what to do

Answer 18

<20% increase in Cr expected

dont change dose - repeat U&Es after a week

Question 19

what to monitor if on UFH

Answer 19

aPTT

and plts

Question 20

What to monitor if on LMWH

Answer 20

Anti factor Xa

Question 21

measuring beneficial effects of ACEi

Answer 21

exercise tolerance

Question 22

monitor on sodium calp

Answer 22

LFTs