Blood Tests Revision

9 Questions | By Drbishop | Last updated: Mar 22, 2022 | Total Attempts: 1049

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Test your knowledge of common blood tests used in medicine

Questions and Answers

1.

A 68 year old gentleman is brought into MAU severely unwell. He is pyrexial and shocked. His wife reports he had been complaining of feeling breathless and a cough over the last few days. His only medical history is that he is on Lisinopril for his blood pressure and has been taking Brufen for osteoarthritis in his knees. On examination he is pyrexial (Temp 38.1^oC) with a heart rate of 120bpm and a systolic blood pressure of 90mmHg. He is breathless and examination of his chest shows reduced air entry and bronchial breathing at the right base. A chest x-ray shows right lower zone consolidation. Blood tests and blood cultures are taken and he is catheterised and treated with IV fluids and empirical antibiotics. The first blood tests to come back show: (normal ranges are in brackets) WBC 19.1 x 10⁹/L (4-11) Hb 13 g/dL (Men 13-18, Women 12.1-15.1) Platelets 460 x 10⁹/L (150-450) Na⁺148 mmol/l (135-145) K⁺6.6 mmol/l (3.5-5.0) Urea 37 mmol/l 2(2.5-7.0) creatinine 552 micromol/l (55-110) Which of the following statements are false?
- A.
  
  This gentleman has sepsis
- B.
  
  This gentleman has acute kidney injury
- C.
  
  The most worrying blood result is the creatinine of 552 micromol/l
- D.
  
  His presentation is due to right sided pneumonia
2.

An overweight 54 year old woman attends her GP surgery complaining of lethargy and increased thirst. Her GP performs some blood tests which show a random glucose of 13.2. (4.0-7.8) Which of the following statements is true
- A.
  
  A diagnosis of diabetes mellitus can be made
- B.
  
  A fasting glucose test is required, and if this is greater than 7.1 mmol/l, a diagnosis of diabetes can be made
- C.
  
  This patient probably has Type 1 diabetes mellitus
- D.
  
  This lady probably has type 2 diabetes mellitus and should have an oral glucose tolerance test to confirm the diagnosis
3.

A 19 year old woman is brought in to A&E following a collapse. On examination she is alert, but complaining of feeling weak, tired and has vague abdominal pain. On examination she is hypotensive and her skin looks tanned. Her capillary blood glucose is 3.1. Her mother, who is with her, states that she has no significant medical history and is on no regular medication, but had recently been complaining of feeling lightheaded and losing weight, and had missed a lot of her university course. Her U&Es show: Na⁺ 122 mmol/l (135-145) K⁺5.8 mmol/l (3.5-5.0) Urea 6.0 mmol/l (2.5-7.0) Creatinine 91 micromol/l (55-110) What is the likely diagnosis?
- A.
  
  Type 1 diabetes mellitus
- B.
  
  Insulin overdose
- C.
  
  Anorexia nervosa
- D.
  
  Hyperthyroidism
- E.
  
  Addison's disease
4.

Continuing from the previous case, the admitting doctor decides to perform a short synacthen test to confirm the diagnosis. Baseline cortisol = 160 mmol/l (>170) 30 minute sample = 320 mmol/l (>580) True or False? The above tests suggest hypopituitarism.
- A.
  
  True
- B.
  
  False
5.

A 71 year old lady presents to her GP with tiredness and breathlessness on exertion. Her FBC shows Hb 7.2 g/dL (12.1-15.1) MCV 73 fL (82-98) WBC 8.3 x10^{9 (4-11)} Platelets 336 x10⁹(150-450) What is the most likely cause for this haematological picture?
- A.
  
  B12 deficiency
- B.
  
  Folate deficiency
- C.
  
  Myelodysplasia
- D.
  
  Iron deficiency
- E.
  
  Anaemia of chronic disease
6.

A 39 year old gentleman presents to A&E complaining of feeling unwell and abdominal swelling. He is well known to the A&E staff having frequently presented with problems related to alcohol excess. He admits to drinking over 120 units a week. On examination he is jaundiced and has signs of liver failure and ascites. What would you expect his blood tests to show?
- A.
  
  High albumin, high bilirubin, high liver enzymes, high MCV, high PT
- B.
  
  Normal albumin, high bilirubin, high liver enzymes, normal MCV, normal PT
- C.
  
  Low albumin, high bilirubin, high liver enzymes, high MCV, high PT
- D.
  
  Low albumin, high bilirubin, high liver enzymes, high MCV, normal PT
- E.
  
  High albumin, high bilirubin, high liver enzymes, low MCV, low PT
7.

Interpret these thyroid function tests: TSH 0.02 (0.35-5.5 miu/L) Free T4 29 (9-18 pmol/L) Free T3 18 (3.1-7.7 pmol/L)
- A.
  
  Hypothyroidism
- B.
  
  Hyperthyroidism
- C.
  
  Hypopituitarism
- D.
  
  Pituitary tumour
8.

Interpret these thyroid function tests: TSH 0.02 (0.35-5.5 miu/L) Free T4 7 (9-18 pmol/L) Free T3 1.2 (3.1-7.7 pmol/L)
- A.
  
  Hypothyroidism
- B.
  
  Hyperthyroidism
- C.
  
  Hypopituitarism
- D.
  
  Pituitary tumour
9.

Interpret these thyroid function tests: TSH 12.2 (0.35-5.5 miu/L) Free T4 6 (9-18 pmol/L) Free T3 1.3 (3.1-7.7 pmol/L)
- A.
  
  Hypothyroidism
- B.
  
  Hyperthyroidism
- C.
  
  Hypopituitarism
- D.
  
  Pituitary tumour