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Data interpretation Flashcards

1
Q

What are examples of microcytic anaemia?

A
  • Iron deficiency
  • Chronic disease
  • Thalassaemia
  • Sideroblastic anaemia
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2
Q

What are examples of macrocytic anaemia?

A
  • Vitamin B12 deficiency
  • Folate deficiency
  • Excessive alcohol consumption
  • Multiple myeloma
  • Myeloproliferative disorders
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3
Q

What are examples of normocytic anaemia?

A
  • Chronic disease
  • Blood loss
  • Haemolytic anaemia
  • Marrow infiltration
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4
Q

Where is iron absorbed from?

A

-Duodenum and jejunum

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5
Q

Where is vit b12 absorbed from?

A

-Terminal ileum

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6
Q

Where is folate absorbed from?

A

-Small bowel

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7
Q

What are the components of an iron profile?

A
  • Serum iron
  • Serum total iron binding capacity
  • Serum ferritin
  • Transferrin saturation
  • Serum soluble transferring receptors
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8
Q

In an iron deficient state, what would an iron study show?

A
  • Serum iron: reduced
  • Serum total iron binding capacity: increased
  • Serum ferritin: reduced
  • Transferrin saturation: reduced
  • Serum soluble transferring receptors: Increased
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9
Q

What serum ferritin level suggests iron deficiency?

A

-<15micrograms/L

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10
Q

What needs to be considered in someone with anaemia when looking at the ferritin level?

A

-Ferritin is an acute phase reactant, so the level maybe high even in an iron deficient state. It’s levels increase in the presence of inflammation

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11
Q

What would iron studies show for someone who had anaemia of chronic disease?

A
  • Serum iron: normal/slightly reduced
  • Serum total binding capacity: reduced
  • Serum ferritin: may be raised (as acute phase reactant)
  • Transferring saturation: reduced
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12
Q

What is the most common disease that causes vitamin B12 deficiency?

A

-Pernicious anaemia

>defective instrinsic factor production due to autoantibodies against gastric parietal cells

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13
Q

What cells will be increased on blood film in hameolytic anaemia?

A

-Reticulocytes

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14
Q

What is Direct antiglobulin test?

A

-A test to detect an autoimmune haemolytic anaemia.

>antibodies to human immunoglobulin are added to red cells, if they agglutinate = presence of haemolytic anaemia

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15
Q

How can haemolytic anaemias be classified?

A
  • Inherited

- Acquired

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16
Q

What are examples of inherited haemolytic anaemias?

A
  • Spherocytes
  • Elliptocytes
  • Thalassaemia
  • Sickle cell anaemia
  • Pyruvate kinase deficiency
  • Glucose-6-phosphate dehydrogenase deficiency
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17
Q

What are some examples of acquired immune causes of haemolytic anaemias?

A
  • Autoimmune warm
  • Autoimmune cold
  • Transfusion reaction
  • Haemolytic disease of the newborn
  • Adverse drug event
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18
Q

What are some examples of non-immune causes of haemolytic anaemias?

A
  • Malaria
  • Microangiopathic anaemia
  • Hypersplenism
  • Mechanical heart valve
  • Burns
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19
Q

How do you detect true polycythaemia?

A

-Use the red cell mass

>raised. Males >0.51, Females >0.48

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20
Q

What is apparent polycythaemia?

A

-A reduction in plasma volume rather than an increase in red cell mass

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21
Q

What are causes of apparent polycythaemia?

A
  • Dehydration

- Gaissbock syndrome

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22
Q

What are causes of true primary polycythaemia?

A

polycythaemia rubra vera

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23
Q

What are causes of true secondary polycycthaemia?

A
  • Hypoxia causes: lung disease, cyanotic cardiac disease, chronic smoking, high altitude
  • Excessive erythropoietin: renal cell carcinoma, polycycstic kidney disease, adrenal tumour, hepatocellular carcinoma
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24
Q

What causes a neutrophillia?

A
  • Bacterial infections
  • Inflammation
  • Necrosis (ie post MI)
  • Corticosteroid use
  • Malignancy
  • Myeloproliferative disorders
  • Metabolic disorders is renal failure
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25
What are causes of neutropenia?
- Post chemo/radio - Adverse drug reaction ie clozapine, carbimazole - Viral infection
26
What are causes of lymphocytosis?
- Viral infection - Chronic infection - Chronic lymphocytic leukaemia - Lymphomas
27
What are causes of eosinophillia?
- Allergic disorders - Parasitic infection - Skin diseases ie eczema - Malignancy ie hodgkins - Allergic bronchopulmonary aspergiloosis
28
Causes of thrombocytosis?
- Primary: essential thrombocythaemia, CML | - Reactive: infection, inflammation, malignancy, bleeding, pregnancy, post splenectomy
29
How can you classify the causes of thrombocytopenia?
- Reduced platelet production due to bone marrow failure | - Increased platelet destruction
30
What are causes of reduced platelet production due to BM failure?
- Infection - Drug induced - Leukaemia - Aplastic anaemia - Bone marrow displacement - Megaloblastic anaemia
31
What are causes of increased platelet destruction?
- Immune mediated: AI thrombocytopenia purpura, drug induced - Hypersplenism - Thrombotic thrombocytopenic purpura - DIC
32
What are common causes of pancytopenia?
- Aplastic anaemia - Bone marrow infiltration - Hypersplenism - Megaloblastic anaemia - Sepsis - SLE
33
What causes hypochromic cells on a blood film?
- Iron deficiency | - Defective Hb synthesis
34
What cause microcytosis on a blood film?
- Iron deficiency | - Defective Hb synthesis
35
What causes macrocytosis on a blood film?
- Megaloblastic anaemia - High alcohol intake - Liver disease
36
What causes penil cells on a blood film?
-Iron deficiency
37
What causes spherocytes on a blood film?
- Hereditary spherocytosis - Haemolytic anaemia - Burns
38
WHat are causes of elliptocytes on a blood film?
- Hereditary elliptocytosis - Thalassaemia - Iron deficiency
39
What are causes of acnathocytes on a blood film?
- Post-splenectomy | - Liver disease
40
What are causes of target cells on a blood film?
- Thalassaemia - Iron deficiency - Post splenectomy - Liver disease
41
What are causes of stomatocytes on a blood film?
- Hereditary stomatocytosis - High alcohol intake - Liver disease
42
What are causes of ecchinocytes on a blood film?
- Post splenectomy - Liver disease - Uraemia
43
What are causes of sickle cells on a blood film?
-Sickle cell anaemia
44
What are cuases of fragmented cells on a blood film?
- DIC - Mechanical heart valves - Haemolytic uraemic syndrome - TTP
45
What are causes of tear cells on a blood film?
-Myelofibrosis
46
What are causes of poikolocytosis on a blood film?
-Iron deficiency
47
What are causes of anisochromia (varying shades of colour) on a blood film?
-Iron deficiency
48
What are Heinz bodies a sign of?
-Unstable Hb states
49
What are Howell-Jolly bodies a sign of?
- Post-splenectomy | - Hyposplenism
50
What are pappenheimer bodies a sign of?
- Post-splenecotmy - Haemolytic anaemia - Sideroblastic anaemia
51
WHat is basophilic stippling a sign of?
- Lead poisoning - Thalassaemia - Myelodysplasia
52
What are cabot rings a sign of?
- Myelodysplasia | - Megaloblastic anaemia
53
What are auer rods a sign of?
-AML
54
What are smear cells a sign of?
-CLL
55
What are the common tests that are included in coagulation?
- Prothrombin time - International normalised ratio - Activated partial thromboplastin time - Bleeding time
56
What clotting factors is prothrombin time dependent on?
I, II, V, VII and X
57
What is measuring the PT commonly used for in clinical practice?
-Liver function
58
What blood test is done to measure the effects of heparin?
-APPT
59
What clotting factors affect the APPT?
-All except VII
60
What would the PT, APPT and fibrinogen show for someone on warfarin treatment?
- PT: Increased - APTT: Normal/increased - Fibrinogen: normal
61
What would the PT, APPT and fibrinogen show for someone on heparin treatment?
- PT: Normal or increased - APPT: increased - Fibrinogen: normal
62
What would the PT, APPT and fibrinogen show for someone with haemophillia?
- PT: normal - APPT: increased - Fibrinogen: Normal
63
What would the PT, APPT and fibrinogen show for someone with liver disease show?
- PT: increased - APPT: increased - Fibrinogen: normal
64
What would the PT, APPT and fibrinogen show for someone with DIC show?
- PT: increased - APPT: increased - Fibrinogen: decreased
65
What features may someone show if they have a multiple myeloma?
- Anaemia - Renal impairment - Low levels of normal immunoglobulins - resultant infections - Bone involvement: bony pain, hypercalcaemia, lytic lesions - Hyperviscosity of blood
66
How do you investigate hyponatraemia?
- First assess the serum osmolality. Sometimes hyperglycaemia/hyperlipidaemia can cause a pseudohyponatraemia - Then assess volume status (ie hypovolaemic/euvolaemic/hypervolaemic)
67
What are causes of hypovolaemic hyponatraemia?
``` -Extra-renal causes (urine Na <15) >GI-D+V >Fluid shifts -Renal causes >Diuretics >Salt wasting renal disease >Nephropathy (analgesics, PCKD) >Adrenal insufficiency ```
68
What are causes of euvolaemic hyponatraeia?
``` -Urine Na >15 >H20 intoxication >SIADH >Drugs >Renal failure >Hyperthyroidism ```
69
What are causes of hypervolaemic hyponatraemia?
- Liver failure - CCF - Renal failure - Nephrotic syndrome
70
How do you treat symptomatic and asymptomatic hypovolaemic hyponatraemia?
-1L 0.9% normal saline over 2-4hrs. Repeat Na and continue fluids if Na is still rising
71
How do you treat isovolaemic hyponatraemia?
- Symptomatic: administration of hypertonic saline and furosemid diuresis - Asymptomatic: Water restriction
72
How do you treat hypervolaemic hyponatraemia?
- Treat underlying disorder | - Water and Na restriction
73
What are the causes of hypernatraemia?
- Diabetes insipidus - Poor water intake eg frail elderly pts - Administration of excess sodium in Iv fluids - Administration of durgs containing high sodium content
74
Causes of hypokalaemia?
- Drugs: diuretics - Intestinal losses: excess vomiting and diarrhoea, high stoma output - Renal tubular disease: (acidosis or drug induced tubular damage) - Endocrine causes - Metabolic alkalosis
75
What are the causes of hyperkalaemia?
- Renal failure - Drugs: excessive K+ supplementation, K+ sparing diuretic - Rhabdomyolysis - Endocrine disease - DKA - Haemolysis of blood sample in transit
76
What factors are used to calculate eGFR?
- Serum creatinine - Age - Sex - Race
77
How do you work out plasma osmolarity?
= 2x (Na + K) + urea + glucose
78
Which electrolytes need to be monitored in a patient that has been starved for a long period of time and what are they at risk of?
- Refeeding syndrome - Phosphate - Magnesium - Calcium
79
In pre-renal AKI what will the URINARY sodium be?
-Low because the kidneys are functioning properly and detect a low blood pressure meaning RAAS is activated and therefore sodium is reabsorbed back into the circulation
80
In renal AKI, what will the URINARY sodium be?
-High as the normal kidney physiological function will be impaired.
81
What components form a bone profile?
- Calcium - Phosphate - Alk phos - Albumin
82
What hormone is released when calcium is low and what does it do?
-PTH >to Increase calcium reabsorption from bone >increase renal calcium reabsorption >increase renal excretion of phosphate >indirectly increasing absorption of calcium from the gut via vitamin D
83
What would the bone profile look like for osteoporosis?
- Calcium: Normal - Phosphate: Normal - ALP: Normal
84
What would the bone profile look like for Osteomalacia?
- Calcium: Normal or decreased - Phos: decreased - ALP: increased
85
What would the bone profile look like for Paget disease?
- Ca: normal - Phos: normal - AlP:increased
86
What would the bone profile look like for bony mets?
- Ca: increased/normal - Phos: normal/increased - ALP: increased
87
What would the bone profile look like for primary hyperparathyroidism?
- Ca: increased - Phos: decreased - ALP: increased
88
What would the bone profile look like for secondary hyperparathyroidism?
- Ca: Normal - Phos: increased - ALP: increased
89
What would the bone profile look like for tertiary hyperparathyrodism?
- CA: increased - Phos: decreased - ALP: increased
90
What are causes of hypercalcaemia?
- Bone mets - Multiple myeloma - Hyperparathyroidism - Excessive vit D intake
91
What makes up the LFT?
- Bilirubin - Aspartate aminotransferase - Alanine aminotrasferase - Alk phos - GGT - Albumin
92
What components of the LFT are not specific to the liver and what else needs to be considered?
- AST = muscle damage (including cardiac) | - ALP = bone disease
93
Which components of the LFT will be raised in liver damage?
-ALT and AST
94
WHich components of the LFT will be raised in obstructive/cholestatic liver disease?
-ALP and GGT
95
What does it mean if all components of the LFT are raised?
-Primarily obstructive cause which has caused back pressure on the liver to cause a hepatocytic picture. The ALP and GGT will be raised out of proportion compared to the transaminases
96
What are some causes of hepatitic LFTS?
- Viral hepatitis - A.I hepatitis - Drugs and toxins - Alochol - Metabolic disorders - Fatty liver - Malignancy - CCF
97
Causes of cholestatic LFTS?
- Bile duct gallstone - Bile duct stricture - Cholangiocarcinoma - Pancreatic carcinoma - Nodes at the porta hepatis - Ampullary carcinoma
98
Which enzymes will be deranged in a failing liver?
- Low albumin levels | - Raised PT (liver synthesises clotting factors)
99
Differential diagnoses of a positive sweat test?
- CF - Adrenal insufficiency - Anorexia nervosa - Coeliac disease - Hypothyroidism
100
What are endogenous causes of cushing's syndrome?
- Primary adrenal disease: adrenal tumour | - ACTH excess: from the pituitary gland or from an ACTH-producing tumour
101
What are some common causes of SIADH?
- Intrathoracic causes: infection, tumour - Intracranial causes: infection, tumour, head injury - Medications: Carbamazepine, antipsychotics
102
Which liver enzymes will rise in a paracetamol overdose?
- ALT - AST - Bilirubin - PT will also increase as there will be impaired synthesis of liver enzymes
103
What ECG changes will you see in someone who has overdosed on TCAs?
- QRS broadening | - Abnormally tall t wave in aVR
104
Why can salicylate poisoning give a mixed abg picture?
- Respiratory centre of brain is stimulated = hyperventilation = resp. alkalosis - Metabolic acidosis also occurs due to variety of production of acids
105
How should TCA over dose be treated?
-Sodium bicarbonate (overdose causes a metabolic acidosis)
106
What ECG change may you see in digoxin toxicity?
- Downsloping of the ST segment depression. | - Arrhythmias
107
How can you tell the difference between an exudative and transudative pleural effusion?
- Exudate >30g/L of protein | - Transudate <30g/L of protein
108
What is light's criteria for determining the type of pleural effusion?
- Pleural fluid: serum protein ratio >0.5 - Pleural fluid LDH >200IU/I - Pleural fluid: serum LDH ratio >0.6
109
What parameters are analysed in pleural fluid?
- Total protein - Lactate dehydrogenase - Microbiology: microscopy, cell count, gram stain and culture) - pH (low in empyema) - Cytological examination - Glucose - Rheumatoid factor - Amylase - Ziehl-Neelson stain and culture - Haematocrit
110
What are some common causes of transudative plerual effusion?
- Cardiac failure - Liver failure - Nephrotic syndrome - Hypoalbuminaemia - Hypothyroidism
111
What are some common causes of exudative pleural effusion?
- Cancer - Pneumonia - PE/infarction - TB - Connective tissue disease - Acute pancreatitis
112
What causes transudate ascites?
- Cirrhosis - Cardiac failure - Hypoalbuminaemia - Nephrotic syndrome
113
What causes exudate ascites?
- Intraperitoneal malignancy - Intraperitoneal infection inc. TB - Pancreatitis - Hypothyroidism - Chylous ascites
114
What is the SAAG and what level indicates what?
- Serum-ascites albumin gradient. - Level <11g/L indicates an exudative cause ie cancer - Level >11g/L indicates a transudative cause ie cirrhosis and portal hypertension
115
When should infective ascites be suspected?
-Increased WCC (indicates peritonitis) >when associated with cirrhosis, suggests spontaneous bacterial peritonitis -Multiple organisms on gram staining indicates perforated bowel
116
What antibiotic should be given to treat SBP?
-3rd gen cephalosporin IV for a min of 5 days
117
What are some examples of aerobic gram-positive cocci?
- S. aureus - S. pyogenes - S. pneumoniae - Enterococcus faecalis
118
What are some examples of aerobic gram-positive bacilli?
- Listeria monocytogenes | - Bacillus anthracis
119
What are some examples of aerobic gram-negative cocci?
- Moraxella catarrhalis | - Neisseria meningitidis
120
What are some examples of aerobic gram-negative bacilli?
- E.coli | - Pseudomonas aeruginosa
121
What are some examples of anaerobic cocci?
- Peptococci | - Peptostreptococci
122
What are some examples of anaerobic bacilli?
- Bacteroides fragilis | - C. diff
123
What are some causes of abnormally low CSF opening pressure during LP?
- CSF leak | - Recent lumbar puncture
124
What are some causes of abnormally high CSF opening pressure during LP?
- Meningitis - Tumour - Intracranial haemorrhage - Idiopathic intracranial hypertension
125
What are some causes of raised CSF protein?
- Meningitis - Brain abscess - Intracerebral haemorrhage - Neoplastic diseaes - Guillain-Barre syndrome - MS
126
What does a low CSF glucose indicate?
-Infection likely due to bacterial, fungal or TB
127
What are nerve conduction studies?
-Measurement of how well the individual nerves transmit electrical signals. An electrode stimulates a nerve and other electrodes detect the resulting activity and the time it takes for the activity to be detected >commonly requested for suspected carpal tunnel syndrome
128
What is electromyography?
-Surface of needle electrodes are used to detect muscle action potentials following controlled electrical stimulation. This then provokes action potentials within the nerves which in turn stimulates a magnified response in the muscles >used for myasthenia gravis
129
What are the classic CSF findings of bacterial meningitis?
- Cloudy appearance - Organisms seen in CSF - Raised WCC - RCC normal - Raised total protein - Reduced CSF glucose - Reduced CSF:plasma glucose ratio
130
What are causes of oligoclonal bands in CSF?
- MS - Subacute sclerosing panencephalitis - GBS - Neurosyphilis - Lyme disease - Neurosarcoidosis
131
What autoantibody may be present in someone with Addison's disease?
-Anti-21-hydroxylase
132
What autoantibody may be present in anti-phospholipid syndrome?
- Anti-cardolipin | - Lupus anticoagulant antibody
133
What autoantibody may be present in autoimmune haemolytic anaemia?
-Red blood cell autoantibodies
134
What autoantibody may be present in autoimmune hepatitis?
- Anti-nuclear | - Anti-smooth muscle
135
What autoantibody may be present in in Churg strauss syndrome?
-MPO-ANCA
136
What autoantibody may be present in Coeliac disease?
- Anti-endomysial - Anti-tissue transglutimase - Anti-Reticulin - Anti-gliadin
137
What autoantibody may be present in diffuse cutaneous scleroderma?
- RF - Anti-nuclear - Anti SCL-20
138
What autoantibody may be present in goodpasture syndrome?
-Anti-glomerular basement membrane
139
What autoantibody may be present in Grave's disease?
- Anti-TSH receptor | - Anti-peroxidase
140
What autoantibody may be present in Hashimoto's thyroiditis?
- TSH receptor blocking antibodies | - Antiperoxidase
141
What autoantibody may be present in limitated cutaenous syndrome?
- RF - Anti-nuclear - Anti-centromere
142
What autoantibody may be present in Myasthenia gravis
- Anti-nuclear | - Anti-acetylcholine receptor antibodies
143
What autoantibody may be present in pernicious anaemia?
- Anti-parietal cell | - Anti-intrinsic factor
144
What autoantibody may be present in polyarteritis nodosa
-ANCA
145
What autoantibody may be present in primary biliary cirrhosis?
-Anti mitochondrial
146
What autoantibody may be present in rheumatoid disease?
- Rheumatoid factor | - Anti-nuclear
147
What autoantibody may be present in Sjogren syndrome
- RF - Antinuclear - Anti-Ro - Anti-La
148
What autoantibody may be present in SLE?
- Double stranded DNA - RF - Anti nuclear - Anti Ro - Anti Sm
149
What autoantibody may be present in Wegener's syndrome?
-cANCA
150
What are indications of a head CT following trauma?
- GCS of <13 when first assessed or GCS <15 2 hours after injury - Suspected open or depressed skull fracture - Signs of base of skull fracture - Post-traumatic seizure - Focal neurological defecit - >1 episode of vomiting - Coagulopathy + any amneisa or loss of conciousness since injury - >30 mins of amnesia of events before impact
151
5 conditions that may predispose someone to a pneumothorax?
- Chronic disease: COPD, asthma, IPF, CF | - Other: trauma, congenital pulmonary blebs, spontaneous in Marfan's, idiopathic ie central venous line insertion
152
What are the causes of upper lobe fibrosis?
``` -Mneumonic: BREAST >Berylliosis (uncommon) >Radiation fibrosis >Extrinsic allergic alvelolitis >Ank. Spond >Sarcoidosis >TB ```
153
What are the causes of lower lobe fibrosis?
- Asbestosis - Connective tissue disease - Drug induced: amiodarone, methotrexate
154
What are some differentials causing pulmonary odema?
- CCF - Acute renal failure - Adult respiratoyr distress syndrome - After aggressive fluid resus - With a massive acute myocardial infarction/valve rupture - In association with SAH
155
What are the 5 cxr signs visible in CCF?
- Alveolar oedema (perihilar consolidation) - Interlobular septal lines (Kerley B lines) - Cardiomegaly - Dilation of veins in the upper lobe - Pleural effusion
156
What other cxr findings may there be in soemone with a bronchial carcinoma?
- Pleural effusion - Lung collapse (due to endobronchial tumour) - Pulmonary mets - Bony mets - pathological fractures - Secondary pneumonia - Enlarged hilar and paratracheal lymph nodes
157
What are the differential diagnosis for unilateral hilar enlargement?
- Bronchial carcinoma - TB - Lymphoma - Metastatic mediastinal lymph node disease - Atypical sarcoidosis - Vascular anomaly
158
What are the differential diagnoses for a cavitation lung lesion?
- Bronchial carcinoma - Pulmonary mets - TB - Cavitating pneumonia - Lung abscess - Vasculitic disease - Lung infarction - Rheumatoid nodule
159
What are indications for valve replacement?
- Endocarditiscompet - Rheumatic heart disease (mitral valve) - Congenital valve disease (bicuspid aortic valve) - Severe acquired valve incompetence or stenosis - Acute valvular rupture
160
What are the ECG findings in hyperkalaemia?
- Tall tented T waves - Loss of p waves - Broad QRS - Sine wave shaped ECG - Cardiac arrest rhythms
161
What are the ECG findings in hypokalaemia?
- Flat, broad t waves - ST depression - Long QT interval - Ventricular dysrhythmias
162
What are some causes of a raised troponin?
- MI - HF - Myocarditis - PE - Renal failure - Severe sepsis - Supraventricular tachycardia
163
What are some common autosomal dominant inherited diseases?
- Adult polycystic kidney disease - Dystrophia myotonica - Familial hypercholesterolaemia - Huntington disease - Marfan syndrome - Neurofibromatosis - TS
164
What are some autosomal recessively inherited diseases?
- Cystic fibrosis - Herediatary haemochromatosis - Sickle cell disease
165
What are some X-linked recessive inherited conditions?
- Duchenne muscular dystrophy - Fragile X syndrome - Haemophillia A - Haemophillia B
166
What disease is caused by trisomy 21?
-Down syndrome
167
What disease is caused by trisomy 18?
-Edward syndrome
168
What disease is caused by trisomy 13?
-Patau syndrome
169
What disease is caused by 45XO?
-Turner syndrome
170
What disease is caused by 47 XXY?
- Klinefelter syndrome | ass. with behavioural problems and learning disibilities
171
What disease is caused by 47 XXX?
-Triple X syndrome
172
Which chromosome is affected in cystic fibrosis?
-Chromosome 7 - F508 codes for the cystic fibrosis transmembrane conductance regulator.
173
What are some common causes of type 1 resp failure?
- Pulmonary oedema - Pneumonia - Pulmonary embolism - Pulmonary fibrosis
174
What are some common causes of type 2 resp failure?
- COPD - Respiratory centre depression - Respiratory muscle weakness - Abnormal chest wall architecture
175
Why should you calculate an anion gap when interpreting a blood gas showing a metabolic acidosis?
-Determines whether the acidosis is caused by acid loss or excess acids =(Na+K) - (CL+HCO3) -Norma anion gap: <16
176
What are the causes of a normal anion gap?
- HCO3 loss from gut ie diarrhoea | - Renal tubular acidosis
177
What are causes of a raised anion gap?
- Ketoacidosis - Renal failure - Lactic acidosis - Salicylate toxicity - Methanol ingestion - Ethylene glycol (anti-freeze) ingestion
178
What are causes for a metabolic alkalosis?
- Losses from gut ie vomiting - Primary or secondary hyperaldosteronism - Hypercalcaemia - Diuretic use - Bicarbonate ingestion
179
What are some causes of postural hypotension?
- Idiopathic - Dehydration - Drug induced: diuretics, vasodilators, anti-parkinsonian meds) - Addison's disease - Autonomic neuropathy - Mutlisystem atrophy
180
What are some causes of a large sudden drop in GCS?
- Intracerebral bleed - Cerebral oedema - Drugs and alcohol - Trauma - Metabolic causes ie hypoglycaemia
181
What are the findings on synovial fluid analysis using light microscopy in gout?
- Negatively birefringent needle-shaped crystals | - Weakly positively birefringent rhomboidal shaped crystals of sodium urate
182
What are the findings on synovial fluid analysis using light microscopy in pseudogout?
-Weakly positively birefringent rhomboidal shaped crystals of sodium pyrophosphate
183
What is involved within the HASBLED criteria?
Hypertension - Abnormal hepatic and/or renal function - Stroke (hx) - Bleeding (hx) - Labile INR - Elderly (>65) - Drugs Predisposing to Bleeding (Antiplatelet agents, NSAIDs) Or Alcohol Use (>8 drinks/week)

Phase 3B (14 decks)

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