Investigation Results Flashcards
(71 cards)
1
Q
High WCC
A
Infection, leukaemia, steroid use
2
Q
Low WCC
A
Bone marrow cancer, viral infection
3
Q
What do lymphocytes change with?
A
Viral infections
4
Q
High eosinophils
A
Atopy, parasitic infections, vasculitis
5
Q
High basophils
A
Infections, inflammatory disorders
6
Q
High Hb
A
Lung disease, bone marrow disease
7
Q
Low Hb
A
Anaemia
8
Q
High platelets
A
Inflammation, infection, bleeding
9
Q
Low platelets
A
Viral infection, autoimmune conditions
10
Q
High MCV
A
B12 + folate deficiency Liver disease Hypothyroidism Pregnancy Alcohol excess
11
Q
Low MCV
A
Anaemia, thalassemia
12
Q
High urea
A
AKI, CKD, HF, GI bleed
13
Q
High sodium
A
Dehydration
14
Q
Low sodium/ chloride
A
D+V, sweating, CKD, Addisons
Too much water due to HF, cirrhosis
15
Q
High potassium
A
Kidney disease, Addisons, infection, DM, NSAIDs, B blockers, ACE inhibitors, potassium sparing diuretics
16
Q
Low potassium
A
D+V
17
Q
High bicarbonate
A
Vomiting, lung disease, Cushing’s, metabolic alkalosis
18
Q
Low bicarbonate
A
Addisons, diarrhoea, DKA, metabolic acidosis, kidney disease, aspirin OD
19
Q
High TSH, normal T3 + T4
A
Subclinical hypothyroidism
20
Q
High TSH, low T4 + T3
A
Hypothyroidism
21
Q
Low TSH, normal T4 + T3
A
Subclinical hyperthyroidism
22
Q
Low TSH, high T4 + T3
A
Hyperthyroidism
23
Q
Low TSH, low T4 + T3
A
Non-thyroid illness
24
Q
What is ALT + AST?
A
ALT = specific to liver AST = liver, heart, skeletal muscle, kidneys, pancreas
25
Very high ALT + AST
Drug induced hepatitis, viral hepatitis, liver ischaemia
26
Moderate increase in AST + ALT
Chronic/ alcoholic hepatitis, biliary obstruction
27
Mild increase in AST + ALT
Cirrhosis, fatty liver
28
ALT higher than AST
Acute liver damage eg hepatitis
29
AST higher than ALT
Damage due to alcohol
30
High AST
Haemolysis after MI
31
High total bilirubin
Blockage of hepatic system eg gallstones
32
High conjugated bilirubin
Blockage of bile ducts, hepatitis, cirrhosis
33
High unconjugated bilirubin
Haemolysis, sickle cell, pernicious anaemia
34
Where is ALP produced?
Biliary ducts, bone, small intestines, kidneys
35
Very high ALP
Cholestasis (gallstones, pancreatic carcinoma)
36
High ALP
Hepatitis, cirrhosis, infiltration (abscess, liver carcinoma)
37
High ALP with calcium + phosphate abnormal
Bone disease
38
Low albumin + low protein
Cirrhosis
Alcoholism
Chronic inflammation
Kidney disease
39
Low albumin + normal protein
Infection
40
Low + increased protein
Myeloma
41
High albumin
Dehydration
42
Prolonged PT, normal PTT
Liver disease, decreased Vit K, decreased factor VII
43
Normal PT, prolonged PTT
Decreased VIII, IX, XI, XII, vW disease
44
Prolonged PT + PTT
Decreased I, II, V or X, DIC
45
How to interpret blood gases
O2 - are they hypoxic
pH
Respiratory - PaCO2
Metabolic - HCO3-
46
What should PaO2 be?
10 below inspired O2
47
What does a low pH + high PCO2 mean?
Respiratory acidosis
| Pneumonia, COPD, over sedation from drugs
48
High pH low PCO2
Respiratory alkalosis
| Hyperventilation, emotional distress, severe infection
49
Low pH, low bicarbonate
Metabolic acidosis
| Diabetes, shock, kidney failure
50
High pH, high bicarbonate
Metabolic alkalosis
| Hypokalaemia, chronic vomiting, sodium bicarb OD
51
High creatine kinase
Muscle damage
52
High ESR
Infection, inflammation, anaemia, kidney failure
53
Low ESR
Polycythaemia, extreme leucocytosis
54
High lactate
Decreased O2, metformin, shock, infection
55
High amylase
Pancreatitis, cancer of pancreas or gallbladder, perforated ulcer, mumps, ectopic
56
X Ray presentation
```
Intro - identify patient, type of X ray
Date + time taken
RIP: rotation, inspiration, penetration
Obvious abnormalities
Systematic approach of anatomical structures
```
57
Lung x ray structures
```
Trachea
Hilar structure
Zones of lung
Costophrenic angles + hemidiaphragms
Heart size + contours
Bones + soft tissue
```
58
Sepsis results
```
Temp <36 or >38
HR >90
RR >20
WCC <4 or >12
PaCO2 <4.3
Lactate >2
```
59
ECG interpretation: rhythm abnormalities
Supraventricular tachycardias:
AF = irregular without P waves
Atrial flutter = regular with sawtooth baseline
Atrial tachycardia = regular with abnormal P waves
VF = no discernible P waves/ QRS complexes
VT = broad complex tachycardia
60
ECG interpretation: perfusion abnormalities
Infarction: ST elevation, T wave inversion, pathological Q waves
STEMI: ST elevation
Ischaemia: ST depression, new wave T inversion
61
ECG interpretation: LV hypertrophy
R wave >5 big squares in V5/6, T wave inversion
62
ECG interpretation: RV hypertrophy
Dominant R wave in V1
| T wave inversion in right chest leads
63
ECG interpretation: hypertrophic cardiomyopathy
LV hypertrophy signs + dramatic T wave inversion in lateral leads
64
ECG interpretation: hyperkalaemia
Low flat P waves, wide bizarre QRS, slurring into ST segment, tall tented T waves
65
ECG interpretation: hypokalaemia
Small flattened T waves, prolonged PR, depressed ST, prominent U wave
66
ECG interpretation: hyper/hypocalcaemia
Hyper: short QT
Hypo: prolonged QT
67
ECG interpretation: PE signs
Tachycardia
RV strain
T wave inversion in right chest lead
68
What does NEWS measure?
```
RR
O2
Temp
Systolic BP
HR
LOC
```
69
What to do with NEWS 1-4?
4-6 hr obs
| Inform nurse
70
What to do with NEWS >5?
1 hrly obs
Inform medical team + urgent assessment
Clinical care in an environment with monitoring
71
What to do with NEWS >7?
Continuous monitoring
| Immediately inform medical team + seen by reg, transfer to HDU/ ICU
