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4TH YEAR - CSIM2 > Blood Results QUIZ > Flashcards

Blood Results QUIZ Flashcards

1
Q

High K

Low Na

A

Addisons disease

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2
Q

Low Na
High urine Na
High urine osmolality

A

SIADH

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3
Q

Low glucose

Low K

A

Excess insulin injection

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4
Q

Raised WCC

Leucocytes and nitrites on urine dip

A

UTI

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5
Q

High potassium
High sodium
High creatinine
High urea

A

Renal failure

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6
Q

cANCA
crescents
casts

A

Wegeners granulomatosis

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7
Q 
Low potassium
High aldosterone
Low renin
Normal magnesium/calcium
High bp
A

Conn’s syndrome

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8
Q 
Low potassium
High aldosterone
High renin
High calcium
Low bp
A 
Barrters syndrome
(defect in Na+k+Cl- transporter in TALH)

Bart is hyper-active, but NO pressure

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9
Q 
Low potassium 
High aldosterone
High renin
Low calcium
Low magnesium
Normal bp
A 
Gitlemans syndrome
(defect in Na+cl- symporter)

Little man - not much calcium/or magnesium

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10
Q

Low serum sodium
Low blood volume
Low urine sodium

A

Vomiting
Diarrhoea
Skin loss

Treat cause, replace volume

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11
Q

Low serum sodium
Low blood volume
High urine sodium

A

Adrenocortical deficiency
Renal failure
Diuretics
Cerebral salt wasting

Treat cause, replace volume

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12
Q

Low serum sodium
Normal blood volume
Low urine sodium

A

Acute water load

Psychogenic

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13
Q

Low serum sodium
Normal blood volume
High urine sodium

A

SIADH - also look at plasma/urine osmolality
Severe hypothyroidism
Addisons

NEEDS INVESTIGATIONS SIADH - fluid restrict

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14
Q

Low serum sodium
High blood volume
Low urine sodium

A

CCF
Cirrhosis
Nephrotic syndrome

Treat cause, diuretics

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15
Q

Low serum sodium
High blood volume
High urine sodium

A

Renal failure

Treat cause, diuretics

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16
Q

High serum sodium

Low blood volume

A

Diabetes insipidus
Iatrogenic
Hyperosmolar hyperglycaemic state

Treat cause

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17
Q

High serum sodium
Dilute urine
Water deprivation test - failure to concentrate urine

A

Diabetes Inspidus

Desmopressin

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18
Q

High PTH
High Calcium
Low phosphate
High ALP

A

PRIMARY HYPERPARATHYROIDISM

Parathyroid adenoma

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19
Q

High PTH
Low calcium
High phosphate
High ALP

A

SECONDARY HYPERPARATHYROIDISM
Hypocalcemia
Vit D deficiency (common in CKD)

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20
Q

High PTH
High Calcium
Normal phosphate
Normal ALP

A

TERTIARY HYPERPARATHYROIDISM

Secondary hyperparathyroidism for so long that the gland becomes autonomous

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21
Q

High calcium
Low PTH
Low phosphate
High ALP

A

MALIGNANT HYPERCALCEMIA

  • paraneoplastic PTHrP secretion from squamous cell lung cancer
  • bony mets
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22
Q

Low calcium
Low phosphate
Very low vit D
High PTH

A

Osteomalacia (rickets)

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23
Q

Huge ALT

A

Paracetamol overdose
AI hepatitis
Viral

(ALT is specific to liver, whereas AST is not)

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24
Q

AST:ALT ratio >2.5

A

Alcoholic hepatitis

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25
Q

High ALP
High GGT
High bilirubin

A 
Cholestatic picture
(gallstones, cholangitis, PBC, PSC, pancreatic cancer)
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26
Q

High ALP

Other LFTs normal

A

Pregnancy
Bone - osteomalacia, pagets, bone mets
Hyperparathyroidism
IBD

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27
Q

Very high GGT

Increased MCV

A

Alcohol ingestion

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28
Q

ALT/AST in 1000s

A

Acute hepatitis picture

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29
Q

ALT/AST in 100s

A

Chronic hepatitis picture

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30
Q

Unconjugated high bilirubin

A

Haemaolytic anaemia
Gilberts
Physiological neonatal jaundice

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31
Q

Conjugated high bilirubin

A

Liver disease

Cholestasis

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32
Q

Low albumin

Low protein

A

Advanced cirrhosis
Alcoholism
Chronic inflammation

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33
Q

Low albumin

Normal protein

A

Infection (acute phase reactant)

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34
Q

Low albumin

High protein

A

Multiple myeloma (paraprotein)

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35
Q

High INR

A 
Liver disease
Vit K deficiency
Consumptive coagulopathy (DIC)
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36
Q

Raised IgM

Raised AMA

A

Primary biliary cirrhosis

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37
Q

Raised IgG

Raised ANA, Anti SM

A

Autoimmune hepatitis

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38
Q

Raised ANCA

A

Primary sclerosing cholangitis

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39
Q

Raised IgA

On a background of liver dysfunction

A

Alcoholic liver disease

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40
Q

Liver dysfunction
High TTG
Low ferritin

A

Coeliac disease

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41
Q

Hepatitis IgM

A

Acute infection

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42
Q

Hepatitis IgG

A

Chronic/past infection/vaccination

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43
Q

HbsAg
Anti-hbC
IgM

A

Acute infection

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44
Q

Hbe antigen

A

Highly infectious state

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45
Q

Anti Hb s antigen

A

Vaccination

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46
Q

Increased APTT

A 
Deficiency of factor 8,9,11, 12
Antiphospholipid syndrome (doesn't correct on mixed study)
Haemophilia A/B
Von Willebrand disease
Warfarin/vit K deficiency
Liver disease
DIC
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47
Q

Increased PT

A

Warfarin/vit K deficiency
Liver disease
DIC

48
Q

High D dimer

A

PE/DVT
Aortic dissection
ACS

49
Q 
Very high D dimer
Low platelets
Low clotting factors
High PT/APTT/INR
High fibrin degradation products
A

DIC

50
Q

FEV1>80% predicted

A

Normal

51
Q

FEV1/FVC<70%

FEV1 50-80%

A

MILD obstructive lung disease

52
Q

FEV1/FVC<70%

FEV1 30-50%

A

MODERATE obstructive lung disease

53
Q

FEV1/FVC<70%

FEV1 <30%

A

SEVERE obstructive lung disease

54
Q

TLCO decreasesd

KCO normal

A

Reduced alveolar volume (pneumonectomy)

Incomplete alveolar expansion (restrictive disorder)

55
Q

TLCO decreased

KCO decreased

A 
Pulomonary vascular bed abnormalities (PE, HTN)
Alveolar destruction (emphysema, ILD)
56
Q

TLCO decreased

KCO increased

A

Extra-pulmonary problem

57
Q

Reduced TLC

A

Restrictive disease of the lung

58
Q

Hamburger shape on flow volume curve

A

Problem with large airways

59
Q

Church shape on flow volume loop

A

Problem with small airways

60
Q

Haematuria?

A 
ONNIT
Obstruction
Neoplasm
Nephritic syndrome
Inflammation
Trauma

Most common cause is glomerular disease

61
Q

Proteinuria?

A

Nephrotic syndrome
Fever, orthostatic, exercise
Glomerular disease
Myeloma (bence jones proteins)

62
Q

Leucocytes + nitrites in urine?

A

UTI

63
Q

Ketones in urine?

A

DKA, starvation

64
Q

Glucose in urine?

A

DM
Cushings
Pregnancy
Renal tubular disease

65
Q

White cell casts in urine?

A

Acute interstitial nephritis

66
Q

Red cell casts in urine?

A

Glomerulonephritis

67
Q

Eosinophils in urine?

A

Acute allergic interstitial nephritis

68
Q

Epithelial cells in urine?

A

Acute tubular necrosis

69
Q

Pleural fluid
High protein (>30)
Protein ratio >0.5
LDH ratio >0.6

A

Exudate (infection, inflammation, infarction, malignancy?

70
Q

Pleural fluid
Low protein (<30)
Protein ratio <0.5
LDH ratio <0.6

A

Transudate (failure)

71
Q

Pleural fluid
High protein (>30)
Low glucose

A

Empyema

72
Q

Ascitic Fluid
SAAG >11g

(SAAG = serum album - ascitic albumin)

A

Portal hypertension

  • portal vein thrombosis
  • cirrhosis
  • chronic hepatitis
  • post-hepatic
73
Q

Ascitic Fluid

SAAC <11g

A

Peritoneal disease - SBP, malignancy
Hypoalbuminaemia - nephrotic syndrome, malnutrition
Pancreatitis

74
Q

Ascitic fluid

Neutrophils >0.25x10^9/L

A

Spontaneous Bacterial Peritonitis

75
Q

High CK

A

Statins
Rhabdomyolysis
Polymyositis/dermatomyositis
High muscle mass

76
Q 
ABG
High pH
Low CO2
Normal bicarb
High Oxygen
A

Respiratory alkalosis

eg. hyperventilation

77
Q 
ABG
Normal pH
High Co2
High bicarb
Low oxygen
A

Fully compensated respiratory acidosis + type 2 respiratory failure

eg. chronic COPD

78
Q 
ABG
Low pH
High C02
High bicarb 
Very low Oxygen
A

Partially compensated respiratory acidosis + type 2 respiratory failure

eg. acute COPD exacerbation

79
Q

Normal ABG

A

Asthma

80
Q 
ABG
Low pH
High C02
Normal bicarb
Low oxygen
A

Respiratory acidosis + type 2 resp failreu, no compensation

eg. life threatening asthma, opiate overdose

81
Q

ABG
Everything normal
Low 0xygen

A

Isolated type 1 resp failure

eg. pulmonary fibrosis

82
Q 
ABG
High pH
Low CO2
Normal bicarb
Low oxygen
A

Respiratory alkalosis + type 1 reps failure

eg. pulmonary embolism

83
Q 
Anaemia 
Anti dsDNA
Anti-Sm
Homogenous ANA
Low C3/C4
Raised ESR but normal CRP

(+Bchrom)

A

SLE

B chrom - drug induced

84
Q

LE cell on biopsy

A

SLE

85
Q

Raised ESR, CRP
Normocytic anaemia
Raised neutrophila/thrombo

A

Giant cell arteritis

86
Q

Anti-Scl 70, RNA polymerase III

A

Diffuse systemic sclerosis

87
Q

Anti-centromere

A

Limited systemic sclerosis

88
Q

Anti-Ro/La
Low complement
High ESR

A

Sjorgens syndrome

89
Q

Hep B virology

ANCA negative

A

Polyarteritis nodosa

90
Q

Normal calcium
Normal phosphate
High ALP

A

Paget’s disease of the bone

91
Q

Isolated rise in platelets

A

Essential thrombocythemia
(JAK2 myeloproliferative disorder)

Give aspirin and hydroxycarbamide

92
Q

Isolated fall in platelets

A

ITP

93
Q

Phil chromosome t(9:22)

Increased myeloid cells and myeloblasts

A

Chronic Myeloid Leukemia

Give imatinib (tyrosine kinase inhibitor)

94
Q

All cell lines increased
Low epo
JAK2 mutation

A

Polycythemia vera

Give aspirin and hydroxycarbamide

95
Q

Low FBC
Lots of monoclonal antibodies
Blood film rouleax
JAK2 mutation

A

Multiple myeloma

Give chemo and bisphosphonates

96
Q

Pancytopenia OR pancythemia
Tear drop poikilocytes
Nucleated RBCs

A

Myelofibrosis

JAK2

97
Q

High ALP/GGT
Low FBC
High MCV
High reticulocyte

A

Hereditary spherocytosis
- haemolytic anaemia with cholescystitis

Do splenectomy

98
Q

Macrocytic anaemia

Pancytopenia

A

B12/folate deficiency

99
Q

High APTT that corrects

A

Haemophilia A, B

Recombinant factor, rest, desmopressin

100
Q

High APTT that corrects
Reduced ristocetin cofactor activity
Gp61 assay

Often nothing on bloods

A

vWF disease

101
Q

High ESR
Low hb
Norma bloods otherwise
EBV positive

Generalised lymphadenopathy

A

Lymphoma

102
Q

Pancytopenia

A

BONE MARROW FAILURE

103
Q 
Anaemia
Pancytopenia
Lots of blast cells
Auer rods
Trisomy 21
A

Acute myeloid leukemia

104
Q

Anaemia
Pancytopenia
Lots of blast cells
LP shows blasts in CNS

A

Acute lymphocytic leukemia

105
Q

Anaemia

High lymphocyte count

A

CLL

106
Q

Anaemia

High WCC

A

CML

107
Q

Normocytic anaemia
Normal platelets
Increased ferritin
Reduced total iron binding capacity

A

Anaemia of chronic disease

108
Q

Grossly elevated APTT

No correction with mixed study

A 
Acquired Haemophilia
(often there is an occult malignancy so do tumour markers)

Do anti-TTG test

109
Q 
Fracture
Low ca
Low vit D
Low phosphate
High PTH
High ALP
A

Osteomalacia (adults)

Rickets (kids)

110
Q

Low FBC
High MCV
Low magnesium

A

Alcoholism

111
Q

Elevated LDLc
Elevated total cholesterol
Low/normal TGs

Tendon xanthoma
Corneal arcus

A

Heterozygous familial hypercholesterolaemia

112
Q

Elevated LDLc
Elevated total cholesterol
Low/normal TGs

Cutaneous xanthoma
Aortic stenosis

A

Homozygous familial hypercholesterolaemia

113
Q

Elevated TG
Normal ApoB
Low HDLc

Eruptive xanthomas

A

Familial hypertriglyceridaemia

114
Q 
Elevated ApoB 
Elevated total cholesterol
Elevated LDLc
Elevated TG
Low HDLc

Xanthelasma

A

Familial combined hyperlipidaemia

115
Q

Low ApoB (pathopneumonic)
Elevated total cholesterol
Elevated TG
Presence of remnants of VLDL

Striate palmar xanthomas

A

Remnant (type 3) hyperlipidemia

4TH YEAR - CSIM2 (20 decks)

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