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Year 3 Examination > Blood interpretation > Flashcards

Blood interpretation Flashcards

1
Q

What do iron studies show?

A

TIBC

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2
Q

Low serum ferritin - what is it?

A

Fe deficiency anaemia

Reflection of iron stores

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3
Q

What would you typically

A

Low trans saturation
raised TIBC
High serum transferrin (body’s response)

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4
Q

Causes of iron deficiency anaemia

A

Bleeding e.g.
GI bleeds
Malabsorption e.g. H pylori
Increased demand for iron e.g. pregnancy and growth

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5
Q

What are the three things you look for initially on a FBC?

A

Platelet
WCC
Hb

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6
Q

What thyroid disorder can cause anaemia?

A

Hypothyroidism because it is

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7
Q

Macrocytic anaemia - causes

A

B12 deficiency

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8
Q

What questions would you ask if you suspect B12 deficiency?

A

Pins and needles

Glossitis

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9
Q

Differentiate between megaloblasitc and non megaloblastic anaemia

A

megaloblastic = delay in maturation of dna due to folate problems e.g. b12 deficiencey

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10
Q

Further blood tests if macro anaemia suspected?

A 
B12/folate
Blood film 
U and e
LFT
GGT given alcohol intake
Thyroid function tests 
Reticulocytes
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11
Q

Causes of folate deficiency?

A

Alcohol
Malginancy
Drugs e.g. methotrexate
Increased urinary excretion e.g. heart failure

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12
Q

Mechanisms of normocytic anaemia?

A

Primary bone marrow problem e.g. aplastic anaemia

Secondary to underlying disease e.g. ACD, chronic renal disease

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13
Q

What must you remember when prescribing folate?

A

Always check and replace b12 before replacing folate, so

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14
Q

How much folate would someone need?

A

5mg of folate

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15
Q

If someone’s u and e is deranged, what would you look for on inspection and examination?

A

Dehydration?
Capillary refill, tachycardia

Assess fluid intake/outflow e.g. recent diarrhoea
?????????
Urine dipstick

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16
Q

If someone’s u and e is deranged, what would you look for on inspection and examination?

A

Dehydration?

Capillary refill, tachycardia

17
Q

What blood test would suggest CKD?

A

High albumin to creatinine ratio (leakage into blood)

18
Q

How would you diagnose CKD?

A

You need at least two repeats

19
Q

What markers are used to classify CKD?

A

eGFR
CKD
USED TOGETHER

20
Q

How would you manage CKD, to reduce albuminuria?

A 
ACE inhibitor
Reduce salt intake
More water
Dietary changes 
Atorvastatin
21
Q

What is the risk with CKD?

A

Cardiovascular complications

22
Q

Do you use the QRISK score to offer a statin in someone with CKD? What dose do you prescribe of what drug?

A

No, offer statin immediately

Atorvastatin, 20mg

23
Q

Causes of CKD

A 
HTN
Diabetes 
Medication 
Glomerulonephritis 
SLE
Vasculitis
Myeloma
Nephrotoxic drugs
24
Q

What drugs harm the kidney?

A

Ibuprofen and NSAIDS

Gentamicin

25
Q

What drugs should you be cautious about when someone has CKD?

A 
Bisphosphonates
Antiplatelets
Anticoagulants
Antibiotics 
Radiocontrast dye 
Many other drugs - always check BNF when prescribing
26
Q

Raised ALT what must you ask a pt?

A 
Alcohol history (incl. CAGE)
Blood transfusions
IV drug use / tattoos 
Paracetamol / herbal remedy use 
Risk sexual behaviour?
Recent travel
27
Q

What would you look for on examination if there is a raised ALT?

A 
Ascites 
BMI 
BP 
Abdo examination 
Brief check for stigmata of chronic liver disease
28
Q

Give some stigmata of chronic liver disease

A 
Palmar erythema
Hepatic flap 
Spider naevi
Jaundice
Hepatomegaly
29
Q

Raised BMI and liver derangement, what would you think of?

A

Fatty liver disease

30
Q

What would you do after a repeat of bloods if there is a deranged liver function?

A

Liver screen i.e. ultrasound

31
Q

What other things would you

A 
TSH 
Immunoglobulins (autoimmune)
Hep A IgM
Hep B surface antigen
Hep C antibody
Ceruloplasmin
Anti-mitochondrial Ab
Anti-smooth muscle Ab
Anti-liver kidney micro ab
Iron studies
32
Q

Why do you do iron studies?

A

Haemochromatosis

33
Q

What test do you to do check for fatty liver disease?

A

Enhanced liver fibrosis (ELF) test

34
Q

What scoring system is used to work out how fibrosed the liver is?

A

NAFLD fibrosis score

35
Q

management of Non alcoholic fatty liver disease (NAFLD)?

A

No drugs

Mainly diet, exercise, alcohol changes

36
Q

When do you refer to a hepatologist?

A

If the non-invasive scoring system suggests enhanced liver fibrosis
Uncertainty about diagnosis
Signs of advanced liver disease

37
Q

Complications of NAFLD

A

NASH to cirrhosis

38
Q

What is used to look at the stiffness of the liver?

A

Fibroscan

Year 3 Examination (8 decks)

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