MSRA Data Interpretation Flashcards

A patient has Na⁺ 128 mmol/L, serum osmolality 258 mOsm/kg, urine osmolality 620 mOsm/kg, and urine Na⁺ 55 mmol/L. She takes an SSRI. What is the most likely cause?

Answer: SIADH

Low serum osmolality with inappropriately concentrated urine and elevated urine sodium in the context of SSRI use is diagnostic of SIADH.

ABG shows: pH 7.28, PaCO₂ 52 mmHg, HCO₃⁻ 24 mmol/L, PaO₂ 58 mmHg on air. What is the primary disorder?

Answer: Respiratory acidosis

The low pH with elevated PaCO₂ and normal bicarbonate indicates an acute respiratory acidosis with inadequate renal compensation, consistent with acute respiratory failure.

A 60-year-old woman has K⁺ 2.8 mmol/L, Na⁺ 142 mmol/L, Cl⁻ 88 mmol/L, and HCO₃⁻ 38 mmol/L. She takes furosemide. What is the diagnosis?

Answer: Metabolic alkalosis with hypokalaemia

Elevated bicarbonate with hypokalaemia and hypochloraemia in a patient on loop diuretics is classic contraction metabolic alkalosis from volume and chloride loss.

A 50-year-old male has: Hb 95 g/L, MCV 72 fL, serum ferritin 8 µg/L, TIBC 68 µmol/L. What is the diagnosis?

Answer: Iron deficiency anaemia

Microcytic anaemia with low ferritin and elevated TIBC confirms iron deficiency anaemia; ferritin is the most sensitive marker of iron stores.

Troponin I at 3 hours is 0.06 µg/L (reference <0.04) and at 6 hours is 0.22 µg/L. ECG shows no ST changes. How should this rise be interpreted?

Answer: Non-ST elevation myocardial infarction (NSTEMI) requiring ACS management

A rising troponin pattern (delta change >20% over 3–6 hours) with symptoms consistent with ACS confirms NSTEMI requiring antiplatelet therapy and cardiology input.

LFTs show: ALP 480 U/L, GGT 510 U/L, ALT 65 U/L, bilirubin 55 µmol/L, albumin 38 g/L. What pattern do these results suggest?

Answer: Cholestatic liver disease

Disproportionate elevation of ALP and GGT relative to aminotransferases, with raised bilirubin, is the hallmark of a cholestatic (obstructive) pattern of liver disease.