Blood Results QUIZ Flashcards
(115 cards)
1
Q
High K
Low Na
A
Addisons disease
2
Q
Low Na
High urine Na
High urine osmolality
A
SIADH
3
Q
Low glucose
Low K
A
Excess insulin injection
4
Q
Raised WCC
Leucocytes and nitrites on urine dip
A
UTI
5
Q
High potassium
High sodium
High creatinine
High urea
A
Renal failure
6
Q
cANCA
crescents
casts
A
Wegeners granulomatosis
7
Q
Low potassium High aldosterone Low renin Normal magnesium/calcium High bp
A
Conn’s syndrome
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
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
10
Q
Low serum sodium
Low blood volume
Low urine sodium
A
Vomiting
Diarrhoea
Skin loss
Treat cause, replace volume
11
Q
Low serum sodium
Low blood volume
High urine sodium
A
Adrenocortical deficiency
Renal failure
Diuretics
Cerebral salt wasting
Treat cause, replace volume
12
Q
Low serum sodium
Normal blood volume
Low urine sodium
A
Acute water load
Psychogenic
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
14
Q
Low serum sodium
High blood volume
Low urine sodium
A
CCF
Cirrhosis
Nephrotic syndrome
Treat cause, diuretics
15
Q
Low serum sodium
High blood volume
High urine sodium
A
Renal failure
Treat cause, diuretics
16
Q
High serum sodium
Low blood volume
A
Diabetes insipidus
Iatrogenic
Hyperosmolar hyperglycaemic state
Treat cause
17
Q
High serum sodium
Dilute urine
Water deprivation test - failure to concentrate urine
A
Diabetes Inspidus
Desmopressin
18
Q
High PTH
High Calcium
Low phosphate
High ALP
A
PRIMARY HYPERPARATHYROIDISM
Parathyroid adenoma
19
Q
High PTH
Low calcium
High phosphate
High ALP
A
SECONDARY HYPERPARATHYROIDISM
Hypocalcemia
Vit D deficiency (common in CKD)
20
Q
High PTH
High Calcium
Normal phosphate
Normal ALP
A
TERTIARY HYPERPARATHYROIDISM
Secondary hyperparathyroidism for so long that the gland becomes autonomous
21
Q
High calcium
Low PTH
Low phosphate
High ALP
A
MALIGNANT HYPERCALCEMIA
- paraneoplastic PTHrP secretion from squamous cell lung cancer
- bony mets
22
Q
Low calcium
Low phosphate
Very low vit D
High PTH
A
Osteomalacia (rickets)
23
Q
Huge ALT
A
Paracetamol overdose
AI hepatitis
Viral
(ALT is specific to liver, whereas AST is not)
24
Q
AST:ALT ratio >2.5
A
Alcoholic hepatitis
25
High ALP
High GGT
High bilirubin
```
Cholestatic picture
(gallstones, cholangitis, PBC, PSC, pancreatic cancer)
```
26
High ALP
| Other LFTs normal
Pregnancy
Bone - osteomalacia, pagets, bone mets
Hyperparathyroidism
IBD
27
Very high GGT
| Increased MCV
Alcohol ingestion
28
ALT/AST in 1000s
Acute hepatitis picture
29
ALT/AST in 100s
Chronic hepatitis picture
30
Unconjugated high bilirubin
Haemaolytic anaemia
Gilberts
Physiological neonatal jaundice
31
Conjugated high bilirubin
Liver disease
| Cholestasis
32
Low albumin
| Low protein
Advanced cirrhosis
Alcoholism
Chronic inflammation
33
Low albumin
| Normal protein
Infection (acute phase reactant)
34
Low albumin
| High protein
Multiple myeloma (paraprotein)
35
High INR
```
Liver disease
Vit K deficiency
Consumptive coagulopathy (DIC)
```
36
Raised IgM
| Raised AMA
Primary biliary cirrhosis
37
Raised IgG
| Raised ANA, Anti SM
Autoimmune hepatitis
38
Raised ANCA
Primary sclerosing cholangitis
39
Raised IgA
| On a background of liver dysfunction
Alcoholic liver disease
40
Liver dysfunction
High TTG
Low ferritin
Coeliac disease
41
Hepatitis IgM
Acute infection
42
Hepatitis IgG
Chronic/past infection/vaccination
43
HbsAg
Anti-hbC
IgM
Acute infection
44
Hbe antigen
Highly infectious state
45
Anti Hb s antigen
Vaccination
46
Increased APTT
```
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
```
47
Increased PT
Warfarin/vit K deficiency
Liver disease
DIC
48
High D dimer
PE/DVT
Aortic dissection
ACS
49
```
Very high D dimer
Low platelets
Low clotting factors
High PT/APTT/INR
High fibrin degradation products
```
DIC
50
FEV1>80% predicted
Normal
51
FEV1/FVC<70%
| FEV1 50-80%
MILD obstructive lung disease
52
FEV1/FVC<70%
| FEV1 30-50%
MODERATE obstructive lung disease
53
FEV1/FVC<70%
| FEV1 <30%
SEVERE obstructive lung disease
54
TLCO decreasesd
| KCO normal
Reduced alveolar volume (pneumonectomy)
| Incomplete alveolar expansion (restrictive disorder)
55
TLCO decreased
| KCO decreased
```
Pulomonary vascular bed abnormalities (PE, HTN)
Alveolar destruction (emphysema, ILD)
```
56
TLCO decreased
| KCO increased
Extra-pulmonary problem
57
Reduced TLC
Restrictive disease of the lung
58
Hamburger shape on flow volume curve
Problem with large airways
59
Church shape on flow volume loop
Problem with small airways
60
Haematuria?
```
ONNIT
Obstruction
Neoplasm
Nephritic syndrome
Inflammation
Trauma
```
Most common cause is glomerular disease
61
Proteinuria?
Nephrotic syndrome
Fever, orthostatic, exercise
Glomerular disease
Myeloma (bence jones proteins)
62
Leucocytes + nitrites in urine?
UTI
63
Ketones in urine?
DKA, starvation
64
Glucose in urine?
DM
Cushings
Pregnancy
Renal tubular disease
65
White cell casts in urine?
Acute interstitial nephritis
66
Red cell casts in urine?
Glomerulonephritis
67
Eosinophils in urine?
Acute allergic interstitial nephritis
68
Epithelial cells in urine?
Acute tubular necrosis
69
Pleural fluid
High protein (>30)
Protein ratio >0.5
LDH ratio >0.6
Exudate (infection, inflammation, infarction, malignancy?
70
Pleural fluid
Low protein (<30)
Protein ratio <0.5
LDH ratio <0.6
Transudate (failure)
71
Pleural fluid
High protein (>30)
Low glucose
Empyema
72
Ascitic Fluid
SAAG >11g
(SAAG = serum album - ascitic albumin)
Portal hypertension
- portal vein thrombosis
- cirrhosis
- chronic hepatitis
- post-hepatic
73
Ascitic Fluid
| SAAC <11g
Peritoneal disease - SBP, malignancy
Hypoalbuminaemia - nephrotic syndrome, malnutrition
Pancreatitis
74
Ascitic fluid
| Neutrophils >0.25x10^9/L
Spontaneous Bacterial Peritonitis
75
High CK
Statins
Rhabdomyolysis
Polymyositis/dermatomyositis
High muscle mass
76
```
ABG
High pH
Low CO2
Normal bicarb
High Oxygen
```
Respiratory alkalosis
eg. hyperventilation
77
```
ABG
Normal pH
High Co2
High bicarb
Low oxygen
```
Fully compensated respiratory acidosis + type 2 respiratory failure
eg. chronic COPD
78
```
ABG
Low pH
High C02
High bicarb
Very low Oxygen
```
Partially compensated respiratory acidosis + type 2 respiratory failure
eg. acute COPD exacerbation
79
Normal ABG
Asthma
80
```
ABG
Low pH
High C02
Normal bicarb
Low oxygen
```
Respiratory acidosis + type 2 resp failreu, no compensation
eg. life threatening asthma, opiate overdose
81
ABG
Everything normal
Low 0xygen
Isolated type 1 resp failure
eg. pulmonary fibrosis
82
```
ABG
High pH
Low CO2
Normal bicarb
Low oxygen
```
Respiratory alkalosis + type 1 reps failure
eg. pulmonary embolism
83
```
Anaemia
Anti dsDNA
Anti-Sm
Homogenous ANA
Low C3/C4
Raised ESR but normal CRP
```
(+Bchrom)
SLE
| B chrom - drug induced
84
LE cell on biopsy
SLE
85
Raised ESR, CRP
Normocytic anaemia
Raised neutrophila/thrombo
Giant cell arteritis
86
Anti-Scl 70, RNA polymerase III
Diffuse systemic sclerosis
87
Anti-centromere
Limited systemic sclerosis
88
Anti-Ro/La
Low complement
High ESR
Sjorgens syndrome
89
Hep B virology
| ANCA negative
Polyarteritis nodosa
90
Normal calcium
Normal phosphate
High ALP
Paget's disease of the bone
91
Isolated rise in platelets
Essential thrombocythemia
(JAK2 myeloproliferative disorder)
Give aspirin and hydroxycarbamide
92
Isolated fall in platelets
ITP
93
Phil chromosome t(9:22)
| Increased myeloid cells and myeloblasts
Chronic Myeloid Leukemia
Give imatinib (tyrosine kinase inhibitor)
94
All cell lines increased
Low epo
JAK2 mutation
Polycythemia vera
Give aspirin and hydroxycarbamide
95
Low FBC
Lots of monoclonal antibodies
Blood film rouleax
JAK2 mutation
Multiple myeloma
Give chemo and bisphosphonates
96
Pancytopenia OR pancythemia
Tear drop poikilocytes
Nucleated RBCs
Myelofibrosis
| JAK2
97
High ALP/GGT
Low FBC
High MCV
High reticulocyte
Hereditary spherocytosis
- haemolytic anaemia with cholescystitis
Do splenectomy
98
Macrocytic anaemia
| Pancytopenia
B12/folate deficiency
99
High APTT that corrects
Haemophilia A, B
Recombinant factor, rest, desmopressin
100
High APTT that corrects
Reduced ristocetin cofactor activity
Gp61 assay
Often nothing on bloods
vWF disease
101
High ESR
Low hb
Norma bloods otherwise
EBV positive
Generalised lymphadenopathy
Lymphoma
102
Pancytopenia
BONE MARROW FAILURE
103
```
Anaemia
Pancytopenia
Lots of blast cells
Auer rods
Trisomy 21
```
Acute myeloid leukemia
104
Anaemia
Pancytopenia
Lots of blast cells
LP shows blasts in CNS
Acute lymphocytic leukemia
105
Anaemia
| High lymphocyte count
CLL
106
Anaemia
| High WCC
CML
107
Normocytic anaemia
Normal platelets
Increased ferritin
Reduced total iron binding capacity
Anaemia of chronic disease
108
Grossly elevated APTT
| No correction with mixed study
```
Acquired Haemophilia
(often there is an occult malignancy so do tumour markers)
```
Do anti-TTG test
109
```
Fracture
Low ca
Low vit D
Low phosphate
High PTH
High ALP
```
Osteomalacia (adults)
| Rickets (kids)
110
Low FBC
High MCV
Low magnesium
Alcoholism
111
Elevated LDLc
Elevated total cholesterol
Low/normal TGs
Tendon xanthoma
Corneal arcus
Heterozygous familial hypercholesterolaemia
112
Elevated LDLc
Elevated total cholesterol
Low/normal TGs
Cutaneous xanthoma
Aortic stenosis
Homozygous familial hypercholesterolaemia
113
Elevated TG
Normal ApoB
Low HDLc
Eruptive xanthomas
Familial hypertriglyceridaemia
114
```
Elevated ApoB
Elevated total cholesterol
Elevated LDLc
Elevated TG
Low HDLc
```
Xanthelasma
Familial combined hyperlipidaemia
115
Low ApoB (pathopneumonic)
Elevated total cholesterol
Elevated TG
Presence of remnants of VLDL
Striate palmar xanthomas
Remnant (type 3) hyperlipidemia
