Data interpretation Flashcards
Criteria definition for AKI?
AKI defined as a rise in serum creatinine level of >1.5 times the baseline which is known or presumed to have occurred within the prior 7 days.
OR
Urine volume <0.5ml/kg/h for 6 hours
What are the components of Hartmann’s solution?
Sodium Chloride Potassium Calcium Lactate
What does ALT: ALP >5 suggest?
Significantly raised ALT, noral ALP suggests a hepatocellular injury picture.
If deranged LFT having started new medication think of drug induced liver injury.
Common causative agent for hepatocellular picture include PCM, NSAIDs, statins and amiodarone.
What is the treatment for CKD patients who have high serum phosphate despite dietary phosphate restrictions?
Hyperphosphataemia is commonly seen in CKD patients due to reduction in amount of filtered phosphate.
Use of phosphate binders. In hypocalcaemia patients, calcium containing phosphate binders are used (calcium carbonate or calcium acetate).
Most likely cause of CKD patient being breathless and fatigued?
Patient would be anaemia, common in CKD patients and picture is usually normocytic and normochromic. Cause is due to reduced erythropoeitin. EPO is usually given subcutaneously every 2 weeks initially.
What is the CHA₂DS₂-VASc score used for?
Calculates annual stroke risk for patients with atrial fibrillation.
A score of 2 or more is considered moderate to high risk and warrants anticoagulation.
Treatment regime for TB?
The treatment of active TB occurs over six months and consists of two phases:
- Rifampicin, isoniazid, pyrazinamide and ethambutol are given for the first two months.
- Rifampicin and isoniazid are continued for an additional four months
“4 drugs for two months, 2 drugs for 4 months”.
What are the drugs that can decrease serum potassium?
- Thiazide diuretics
- Loop diuretics
- Acetazolamide
What are the drugs that can increase serum potassium?
- ACE inhibitors
- Angiotensin-2 receptor blockers
- Spironolactone
- Potassium sparing diuretics (amiloride, triamterene)
- Potassium supplements (Sando-K, Slow-K)
Why is dextrose for maintenance fluids avoided in patients who have just had a stroke?
5% glucose should be avoided in patients who have had a stroke due to the increased risk of cerebral oedema.
In what conditions does a course of systemic steroids need to be tapered?
The BNF suggests gradual withdrawal of systemic corticosteroids if patients have:
- Received more than 40mg prednisolone daily for more than one week
- Received more than 3 weeks treatment
- Recently received repeated courses
Post op patient develops AKI and subsequent opiate toxicity symptoms, what can we consider changing the morphine sulfate to?
Substitute to oxycodone. Oxycodone is metabolised in the liver to inactive metabolites making it an appropriate option where strong analgesia is required in the setting of renal impairment. Morphine metabolite is renally excreted and will accumulate in renal impairment.
