Bloods, hyperkalaemia, hypokalaemia.

Normal MCV: Acute loss, ACD.
Low MCV: Iron-def, Thalaessaemia. (Mennorhagia)
High MCV: B12/Folate def.

Neutrophilia = Infection. Infarct. Inflammation. Cancer. Myeloproliferative. Preggers/exercise.
NEUTROPAENIA: Infection/Drugs/Autoimmune/EtOH.

Eosinophilia – Steroids. Asthma etc.
Lymphophilia: CLL/Lymphoma/NO SPLEEN/renal failure–> raised lymphocytes.

Raised platelets:
a) Reactive i.e. cancer, chronic inflammation, no spleen (raised lympho’s and platelets), haemolysis (raised platelets)
b) Cancer: PCV. Myelfibrosis. ET.

Low platelets:
– Infilitration of marrow e.g. by lymphoma, myelofibrosis.
– Nutrients: Low B12/folate –> macrocytic anaemia and low platelets.
– Destruction: DIC/ITP/Infections
– Too much of a spleen – Lymphoma or liver disease causing hypersplenism.

Too much spleen –> low platelets. Too little spleen –> High platelets. Paradoxical buggers, platelets.

– Acidosis releases potassium.
– Renal failure causes high potassium.
– Addisons (adrenocortical deficiency) causes high potassium.
– Digoxin and amiloride cause high potassium.

Big K+: No P wave, prolonged PR interval, broad QRS, peaked T waves. Eventually hyperkalaemia causes sinusoidal. 
Hyperkalaemia = Ca gluconate, Insulin-Dex, Neb Sab, Dialysis

Low K+: Renal or GI loss.
1) Renal loss – RTA, Conn’s (lots of aldosterone).
2) GI loss via D + V (Eloise had LOW POTASSIUM and she is also an asthmatic – sab!)
3) Insulin causes low potassium. Acidosis causes high potassium.
4) Salbutamol

Low Na: Replace no more than 10mMol in a day
High Na: Due to water loss e.g. too many drips, Inspidus, Conn’s (aldosterone!)

Addison’s is reduced adrenocortical drive. Low Na, high K+, high Ca++.
Cushing’s is excess of glucocorticoids (cortisol up). OPPOSITE of ADDISON’S.
Conn’s is excess of aldosterone. Low K+ with normal or high sodium.

Raised urea, normal creatinine = dehydration, GI bleed, high protein diet.
Urea + creatinine up = Renal failure.

CRF –> Causes anaemia of chronic disease, lowered Calcium in chronic renal failure, high phosphate.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s