Placement Flashcards
What are the three main functions of the liver?
Synthesis
Excretion
Storage
What liver function tests relate to hepatocytes?
ALT (alanine aminotransferase)
AST (aspartate aminotransferase)
Where are Alkaline phosphatase (ALP) and y-Glutamyltransferase (GGT) usually found?
In the bile ducts of the liver
What might raised ALP and GGT levels be indicative of?
Obstructive liver disease
GGT levels are also a potential indicator of how much alcohol a patient drinks
What are the Vitamin K dependent clotting factors?
2
7
9
10
What can increased ESR suggest?
Pregnancy TB Rheumatoid arthritis Anaemia Some malignancies
What can increased neutrophils be caused by?
Infection Ischaemic Necrosis (e.g. MI) Metabolic disorders (e.g. diabetic acidosis) Stress response (e.g. due to acute haemorrhage) Inflammatory disease (e.g. rheumatic fever)
Why might creatine be low?
It is proportional to muscle mass in the body and if the person has low muscle mass they might have low creatine
What is refeeding?
It is the process of reintroducing food after starvation or malnourishment
What is refeeding caused by?
Sudden shifts in the electrolytes that help your body metabolise food
Why does refeeding syndrome occur?
When carb consumption is reduced, insulin secretion slows
The body changes to fats and proteins as sources of energy
This can deplete electrolyes levels
When food is reintroduced, there’’s an abrupt shift from fat metabolism back to carbohydrate metabolism
This causes insulin secretion to increase
What are some of the effects of refeeding syndrome?
Hypophosphataemia
Hypomagnesaemia
Hypokalaemia
Thiamine deficiency
Why does hypophosphataemia occur in refeeding syndrome?
Cells need electrolytes like phosphate to convert glucose to energy but phosphate is in short supply
What is Courvoisier’s Law?
Presence of a palpably enlarged gallbladder and accompanied with mild jaundice, the cause is unlikely to be gallstones
What is the typical presentation of pancreatic cancer?
Painless jaundice
What type of drug is Flucloxacillin?
Antibiotic
What are the indications of Flucloxacillin?
Infections due to beta-lactamase-producing staphylcocci
Cellulitis
Leg ulcer infection
Endocarditis
What are the side effects for all penicillins?
Diarrhoea
Hypersensitivity
Nausea
Vomiting
What are the side effects for Flucoxacillin other than the general side effects for penicillin?
Arthralgia
Fever
Neutropenia
What are the side effects of Paracetamol?
Thrombocytopaenia
Rash
Paracetamol Overdose
What type of drug is Amlodopine?
Calcium Channel Blocker
What are the indications for Amlodipine?
Prophylaxis of angina
Hypertension
What are the general side effects for all CCBs?
Abdominal Pain Dizziness Fatigue Nausea Headache Palpitations
What are the specific side effects for Amlodipine?
Constipation Muscle cramps Dyspepsia Alopecia Oedema
What type of drug is Apixaban?
Anticoagulant
How does Apixaban work?
Direct inhibitor of activated factor X (factor Xa)
What are the indications of Apixaban?
Prophylaxis of VTE
Treatment of DVT