U&E FBC and red flags

Question 1

What are the key learning outcomes of the U&Es, FBC and red flags lecture?

Answer 1

1. Understand physiology of major body systems and impact of pharmacokinetics/dynamics.
2. Recognise psychosocial health influences.
3. Describe healthcare delivery, professionalism, public health, and clinical care.

Question 2

List five reasons why blood tests are important.

Answer 2

1. Aid diagnosis of illness
2. Monitor progression
3. Assess medication side effects
4. Evaluate treatment efficacy
5. Guide clinical decision-making

Question 3

What is the normal sodium range in blood?

Answer 3

135–145 mmol/L

Question 4

List causes of hyponatraemia.

Answer 4

Hypovolaemia, hypervolaemia, euvolaemia (e.g., SIADH), medications like SSRIs and PPIs.

Question 5

What are the symptoms of hyponatraemia?

Answer 5

Headache, nausea, cramps, irritability, confusion, fatigue, muscle weakness, convulsions.

Question 6

How is hyponatraemia treated?

Answer 6

Treat the cause, restrict fluids, stop offending drugs, avoid rapid sodium correction (risk of central pontine myelinolysis).

Question 7

List causes of hypernatraemia.

Answer 7

Increased sodium intake, diabetes insipidus, water loss.

Question 8

What are treatments for hypernatraemia?

Answer 8

Treat cause, IV fluids to rehydrate.

Question 9

What is the normal potassium range in blood?

Answer 9

3.5–5.3 mmol/L

Question 10

List causes of hypokalaemia.

Answer 10

Decreased intake, GI losses (e.g. chronic diarrhea), insulin therapy (intracellular shift).

Question 11

What are symptoms of hypokalaemia?

Answer 11

Muscle weakness, confusion, arrhythmias.

Question 12

How is hypokalaemia treated?

Answer 12

Treat cause, oral/IV supplementation.

Question 13

List causes of hyperkalaemia.

Answer 13

Drugs (e.g. ACEIs, ARBs, amiloride), renal failure, excess intake, extracellular shift.

Question 14

What are the ECG changes in hypokalaemia and hyperkalaemia?

Answer 14

Hypokalaemia: ST depression, U-waves with T-wave inversion.
Hyperkalaemia: Tall peaked T-waves, widened QRS.

Question 15

Why is hyperkalaemia a red flag?

Answer 15

It can lead to VF and cardiac arrest due to lowered resting membrane potential and widened action potential.

Question 16

How is hyperkalaemia treated?

Answer 16

Treat cause, IV fluids, insulin/glucose, ECG monitoring.

Question 17

What is the normal calcium range?

Answer 17

2.2–2.62 mmol/L

Question 18

List causes of hypocalcaemia.

Answer 18

Vitamin D deficiency, hypoparathyroidism, magnesium deficiency, hyperphosphataemia, loop diuretics.

Question 19

What are symptoms of hypocalcaemia?

Answer 19

Muscle spasms, numbness, osteoporosis, behavioural changes, convulsions.

Question 20

List causes of hypercalcaemia.

Answer 20

Malignancy, hyperparathyroidism, vitamin D/calcium overdose, lithium, thiazides.

Question 21

What are symptoms of hypercalcaemia?

Answer 21

Malaise, GI disturbance, renal failure, polyuria, cardiac arrest.

Question 22

What is the normal creatinine range?

Answer 22

60–120 µmol/L

Question 23

What does creatinine clearance indicate?

Answer 23

Glomerular filtration rate (GFR); renal function.

Question 24

What equation is used to estimate creatinine clearance?

Answer 24

Cockcroft and Gault equation.

Question 25

Name the 5 stages of Chronic Kidney Disease (CKD).

Answer 25

Stage 1: >90 mL/min Stage 2: 60–89 Stage 3A: 45–59 Stage 3B: 30–44 Stage 4: 15–29 Stage 5: <15 (renal failure)

Question 26

What is the normal urea range?

Answer 26

2.5–6.5 mmol/L

Question 27

What affects serum urea levels?

Answer 27

Protein intake, breakdown, GI bleeding, dehydration, infection, burns, drugs like tetracycline and glucocorticosteroids.

Question 28

What are key liver function test components?

Answer 28

Albumin, clotting factors (PT/INR), bilirubin, AST, ALT, GGT.

Question 29

What is the normal arterial blood pH range?

Answer 29

7.35–7.45

Question 30

What does a pH <7.35 indicate? >7.45?

Answer 30

<7.35 = acidosis >7.45 = alkalosis

Question 31

What do primary changes in CO2 and HCO3 indicate?

Answer 31

CO2 = respiratory problem; HCO3 = metabolic problem.

Question 32

What are key components of a full blood count (FBC)?

Answer 32

RCC, Hb, PCV, MCV, MCHC, platelets, reticulocytes, WCC (neutrophils, lymphocytes, monocytes, eosinophils, basophils).

Question 33

What does low Hb indicate?

Answer 33

Anaemia.

Question 34

What does raised reticulocyte count indicate?

Answer 34

Haemorrhage or haemolysis.

Question 35

What does low reticulocyte count with anaemia suggest?

Answer 35

Bone marrow failure.

Question 36

What are red flags in clinical practice?

Answer 36

Warning signs of serious pathology. General (e.g. fatigue) or specific (e.g. haemoptysis).

Question 37

Why might red flags be missed?

Answer 37

Time pressure, previous case bias, lack of knowledge, pattern recognition errors.

Question 38

Why must pharmacists recognise red flags?

Answer 38

To make appropriate referrals and reduce patient harm.