Category: Abnormal Investigations

Hypercalcaemia

Serum calcium concentration is tightly regulated between 2.1-2.6mmol/L. Severe hypercalcaemia is a life-threatening electrolyte emergency requiring prompt recognition and urgent treatment.   Classification Mild (2.65 – 3.00 mmol/L): Patient is often asymptomatic Moderate (3.01-3.40 mmol/L): Can be asymptomatic or symptomatic Severe (>3.40 mmol/L): Risk of dysrhythmia and coma Serum calcium is found in 2 forms

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Hypomagnesaemia

The UK Medicines Information group have provided excellent guidance on how to replace magnesium.Useful advice on treatment: Clinical features Usually asymptomatic Irritability & lethargy Nausea/vomiting Psychiatric: confusion, depression, psychosis Neuromuscular: Tremors, cramps, tetany, weakness & seizures ECG: prolonged PR, ST depression, altered T waves, arrhythmias Causes Dietary such as refeeding syndrome GI losses (D&V, high stoma output)

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Haematuria

You will regularly see patients with blood in their urine, most often picked up incidentally on a urine drip. Your initial assessment should aim to identify whether this is due to a UTI (or other transient cause) and whether it is urological or nephrological with the help of measuring the patient’s blood pressure, bloods (FBC,

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Interpreting Blood Films

A blood film looks at our three cell types (erythrocytes, leukocytes & platelets) under a microscope to identify any abnormalities to give visual clues regarding the functional state of the bone marrow & any systemic diseases. You should treat this article as a reference for where you can read up on differentials based on the

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Interpreting CSF Results

Understanding how to do an LP and interpret the results is an essential skill for most doctors, particularly those planning on a hospital-based specialty. You will often be handed over to review the results and act accordingly during ward cover shifts. As with any handover, ensure when you are asked to chase the results that

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Ascitic Tap and Drain

Ascitic aspiration (tap) is routinely performed for every patient admitted with ascites to identify the underlying cause. The most urgent reason to do it would be to consider the diagnosis of spontaneous bacterial peritonitis (SBP). Occasionally a patient may have a therapeutic aspiration where a larger volume is aspirated to relieve pressure if a drain

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Anaemia

Perhaps the most common blood test you will review daily will be the FBC (full blood count). You will commonly see a low haemoglobin & the tendency is to say “haemoglobin stable” and ignore it. However, both acute or chronic anaemia can have a significant impact on health but can also be the presenting sign

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Reviewing and Requesting Bloods

Here we focus on blood tests requests for a variety of common scenarios you might see in practice and also common further tests you may do as a result of the first abnormality. When ordering blood tests remember three rules Only do investigations which change your management You are responsible for reviewing or handing over

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ABG Interpretation

In this article, we will look at more practical aspects of how to read an ABG and treatment following your interpretation. If you’re looking on how to perform an ABG, read this article. An ABG is vital in any medical emergency call, providing valuable information on a patient’s clinical state quickly. The body tightly controls

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Chest X-Rays

In this article, we focus on the interpretation of a CXR. Have a low threshold to request one as they provide a lot of information with minimal radiation. Typically, if the patient is unwell enough to require admission, then the benefits of CXR outweigh the risks. Common scenarios to order a CXR Any suspicion of

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