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Year 5 > Test interpretation > Flashcards

Test interpretation Flashcards

1
Q

ABPI

A
  • > 1.2: may indicate calcified, stiff arteries. This may be seen with advanced age or PAD
  • 1.0 - 1.2: normal
  • 0.9 - 1.0: acceptable
  • < 0.9: likely PAD. Values < 0.5 indicate severe disease which should be referred urgently
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2
Q

Impaired glucose tolerance

A

fasting plasma glucose less than 7.0 mmol/l and OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l

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3
Q

DM Glucose results

A

If the patient is symptomatic:
•fasting glucose greater than or equal to 7.0 mmol/l
•random glucose greater than or equal to 11.1 mmol/l (or after 75g oral glucose tolerance test)

in asymptomatic people need on 2 occasions

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4
Q

Hba1c

A
  • a HbA1c of greater than or equal to 48 mmol/mol (6.5%) is diagnostic of diabetes mellitus
  • a HbAlc value of less than 48 mmol/mol (6.5%) does not exclude diabetes (i.e. it is not as sensitive as fasting samples for detecting diabetes)
  • in patients without symptoms, the test must be repeated to confirm the diagnosis
  • it should be remembered that misleading HbA1c results can be caused by increased red cell turnover
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5
Q

Impaired fasting glucose

A

fasting glucose greater than or equal to 6.1 but less than 7.0 mmol/l

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6
Q

Cushings syndrome

A
  • overnight dexamethasone suppression test (most sensitive)
  • 24 hr urinary free cortisol

Hypokalaemic metabolic alkalosis

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7
Q

PTH function

A

Encourages increased absorption Ca2+ from gut and release calcium bones. Decreases phosphate

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8
Q

Pseudohypoparathyroidism

A

High PTH but low calcium and high phospate.

E.g. gland working fine but the tissue is not responding to the PTH

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9
Q

Primary Hypoparathyroidiam

A

Low PTH, Low calcium and high phosphate

PTH not being produced by gland

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10
Q

Lights criteria

A

Exudaitive if:

  • Effusion protein/serum protein ratio greater than 0.5
  • Effusion lactate dehydrogenase (LDH)/serum LDH ratio greater than 0.6
  • Effusion LDH level greater than two-thirds the upper limit of the laboratory’s reference range of serum LDH
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11
Q

Target Hba1c in patients with gliclazide

A

53mmol/mol as these drugs can cause hypoglycaemia

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12
Q

GH deficiency in children - Sx

A

Obesity

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13
Q

Anorexia biochemistry results

A

Most things low e.g. potassium

Raised G’s and C’s - growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia

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14
Q

COPD breathless/ exacerbations despite salbutamol

FEV1 dependant management

A

FEV1 > 50%
•long-acting beta2-agonist (LABA), for example salmeterol, or:
•long-acting muscarinic antagonist (LAMA), for example tiotropium

FEV1 < 50%
•LABA + inhaled corticosteroid (ICS) in a combination inhaler, or:
•LAMA

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15
Q

ECg in hypokalaemia

A 
The ECG findings are:
•prominent U-waves, best seen in precordial leads
•T waves have a 'sine wave' appearance
•prolonged QTc > 600ms
•borderline PR interval
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16
Q

Sick Euthyroid expected results

A

low total and free T4 and T3, with a normal or low TSH.

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17
Q

When to BNP

A

History sounds like heart failure and no previous MI

Prev MI - Echo

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18
Q

Low fibrinogen - which blood product to give

A

Cryoprecipitate

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19
Q

Secondary Hyperparathyroism

A

Due to low to calcium
e.g. renal failure –> low Ca2+, high phosphate therefore increased PTH produced to try and counter
or loop diuretic overuse

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20
Q

Primary hyperparathyroidism

A

High PTH, High Calcium,low phosphate

21
Q

Loop diuretic overuse

A

Hypokalaemia, hyponatraemia, hypocalcaemia (therefore increased PTH - secondary hyperparathyroidism)

22
Q

Increased serum ACE levels

A

Sarcoidosis

23
Q

Fractional exhaled nitric oxide (FeNO

A

Adult new diagnosis of Asthma

Levels of NO typically correlate with levels of inflammation.

24
Q

conjugated bilirubin percentage

A

> 50% direct bilrubin of total = conjugated

25
Q

Causes paraproteinaemia

A

Multiple Myeloma
Waldestroms macroglobuminaemia
Primary amyloidosis

26
Q

Hodgkins Lympoma characteristic cell

A

Reed Sternberg cells

27
Q

When to transfuse platelets

A

Discuss with haematology when below 50
Definitely if: plts below 10
Haemorrhage (DIC)
Before invasive procedures e.g. LP and biopsy toget count above 50

28
Q

Myeloma Diagnosis Criteria

A

High index suspicion in bone/back pain not improving - do ESR and serum electrophoresis

1) Momoclonal band on electrophoresis
2) increased plasma callson BM biopsy
3) End organ damage - high Ca,Renal damage, anaemia
4) Bone lesions on skeletal survey

29
Q

Myeloma test findings

A 
Normocytic normorchromic aneamia
Blood film - rouleaux formation RBC
IgG paraproteineamia on electrophroesis
Urinary bence jones proteins
punched out lesions on x ray
30
Q

causes of LAD on ECG

A

LVH
Inferior MI
left anterior hemiblock
WPW - some types

31
Q

Causes of RAD on ECG

A

PE
RVH
Anterolateral MI
WPW - sometypes

32
Q

Bifasicular block

A

RBBB and LAD

33
Q

Trifasicular block

A

Pronlonged PR

RBBB and LAD

34
Q

Congenital Adrenal hyperplasia

A

Increased plasma 17-hydroxyprogesterone levels
Increased plasma 21-deoxycortisol levels
Increased urinary adrenocorticosteroid metabolites

Issues biosynthesising cortisol therefore increase in ATCH production and inc Adrenal androgens –> Virilisation females

35
Q

HOCM

A

S4
‘jerky’ or sudden carotid upstroke
ejection systolic murmur/crescendo–decrescendo systolic murmur exacerbated by Valsalva manoeuvres . ECG LVH .
Echocardiography is usually diagnostic, typically showing asymmetrical left ventricular hypertrophy with greater septal thickening compared to the posterior wall.

36
Q

Dehydration

A

inc urea, albumin and PCV

Dec urine output and skin turgor

37
Q

Abnormal kidney function - low GFR

A

inc urea, Creatinine, K+, H+, Urate, phosphate and oilguria

AKI and CKD (if also anaemic and inc PTH)

38
Q

Abnormal kidney function - Tubular dysfunction

A

Dec K+, urate phosphate.
Normal urea and creatinine
Acidotic
Recovery from AKI, Hypercalcaemia, hyperuricaemia, myeloma, pyelo ,hypokalaemia, Wilsons

39
Q

Thiazide and Loop diuretics

A

Hypokalaemia, hyponatraemia,

Inc Bicarb and Inc Urea

40
Q

Hepatocellular disease

A

↑ bili, ↑↑AST, ↑ALP (slightly), ↑ clotting

Dec Albumin

41
Q

Cholestasis

A

↑bili, ↑↑ gamma GT, ↑↑ALP ↑ AST

42
Q

Excess alcohol

A

↑Gamma GT and ↑MCV

Also hepatocellular disease picture

43
Q

MI

A

↑Trop, CK AST and LDH

44
Q

Addisons

A

↑K+, ↑ Urea and hyponatraemia

45
Q

Cushings

A

↑bicarb and Na+, hypokalaemia

46
Q

Conns

A

Hypokalaemia, HTN, ↑bicarb

47
Q

Diabetes insipidus

A

↑Na+, ↑plasma osmolarity, and low urine osmolarity

48
Q

SIADH

A

Low Na+, with high urine osmolarity and ↑urine sodium (>20)

Year 5 (9 decks)

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