Investigations
Basic investigations can be considered under the major headings of Bedside, Laboratory and Radiology. Use the 5 C’s approach to recognise, understand and manage metabolic disturbances.
- Cause – defining the potential causative events that lead to disruption
- Clinical manifestation – evaluate, recognise and diagnose the problem
- Complications – what can go wrong in the short, medium and long term
- Calculations – Calculate to Obviate
- Corrective measures – Call to action…how do you actually fix the problem!
Bedside
Urinalysis
- Urine Color
- Urine Transparency (turbidity)
- Dipstick urinalysis
- Urinalysis Overview Table
- Urine electrolytes – Urinary anion gap
Laboratory
Electrolytes
- Calcium: Overview – HYPERcalcaemia – HYPOcalcaemia
- Magnesium: HYPERmagnesaemia – HYPOmagnesaemia
- Potassium: HYPERkalaemia – HYPOkalaemia
- Sodium: HYPERnatraemia – HYPOnatraemia – SIADH – DI
- Chloride: HYPERchloraemia – HYPOchloraemia
- Phosphate: HYPERphophataemia – HYPOphophataemia
Acid-Base
- Acid-Base: ABG analysis – Anion Gap – SID – NAGMA
- Metabolic acidosis: Overview – evaluation – DDx
- Metabolic alkalosis: Overview – evaluation – DDx
- Respiratory acidosis: Overview – DDx
- Respiratory alkalosis: Overview – DDx
Renal Function
- Urea (Blood urea nitrogen – BUN)
- Creatinine
- Urea-Creatinine ratio
- Urate (Uric Acid)
Liver Function
Other blood tests
- Autoimmune Markers
- Bleeding time
- Blood film
- CK-MB
- Coagulation profile
- D-dimer
- ESR – CRP
- Full blood count – Anaemia
- Osmolar gap
- Platelet function assays
- Thromboelastogram
- Thrombophilia screen
- VBG vs ABG
Other Tests
- Ascitic fluid analysis
- Bone marrow biopsy
- BHCG, Rhesus D and Progesterone
- Cerebrospinal Fluid (CSF)
- Thyroid Function Tests (TFT)
- Paracentesis (Ascitic Tap) fluid analysis
- Pleural Fluid Analysis
- Synovial fluid analysis
Radiology
- Abdominal X-Ray interpretation
- AXR and abdominal CT
- Chest X-Ray interpretation – Normal CXR
- CT Chest
- CT Head interpretation – MRI Head
Critical Care
Compendium
