BioChem

Question 1

Shock

Answer 1

Interrupted supply and removal of metabolites
Cytokines, catecholamines and cortisol secreted
Symps= tachy, vasoconstriction, hypovolaemia

Question 2

Catabolic State

Answer 2

Catecholamine, glucagon and cortisol released
Muscle broken down
Glycolysis and lipolysis increase aa number
Avoids sepsis and provides nutrition

Question 3

Anabolic State

Answer 3

Restores protein synthesis, nitrogen balance, fat stores and muscle strength
Need good nutrition

Question 4

Refeeding Syndrome

Answer 4

Cells take up potassium, phosphate and magnesium

Hormonal and metabolic changes due to rapid refeeding

Question 5

Nutrition

Answer 5

Brain uses ketones if no glucose

Kidneys and liver make glucose using acids (amino and fatty)

Question 6

Primary malnutrition

Answer 6

Not enough protein, calories or nutrients

Question 7

Secondary malnutrition

Answer 7

Nutrients present

Appetite suppressed, bad absorption or increased demand

Question 8

Calcium

Answer 8

Needed for contraction, excitation, enzymes and clotting
Key part of hydroxyapatite
Controlled by vit D, PTH and metabolites
Total= ionised (active)+ bound (albumin)+ complexed (salts)
Acidosis= more ionised
Alkalosis= less ionised

Question 9

Phosphate

Answer 9

Important in ATP, signalling, metabolism
In DNA, cell membrane and hydroxyapatite
Got in food
Excreted in urine

Question 10

Phosphate Deficiency

Answer 10

Causes= high PTH, excess losses and poor diet
Symps= haemolysis, thrombocytopenia, weakness, rhabdomyolysis, encephalopathy

Question 11

Magnesium

Answer 11

Important in ATP, NMJs, enzymes, ion channels and bone matrix
Excreted by kidneys and GI tract

Question 12

Hypomagnesaemia

Answer 12

Causes= drugs, malnutrition, diarrhoea
Get tetany, hyperreflexia, ataxia, psychosis, weakness
Levels more accurate in leukocytes and muscle

Question 13

Sodium

Answer 13

Normally sodium ECF conc= sodium ICF conc
Blood loss= no change in Na conc
Water loss= increase in Na conc as lost from ICF
Saline drip increase ECF
Dextrose drip increases ICF so decreases Na conc
ADH increases if sodium increaes

Question 14

Potassium

Answer 14

Binds to -ve proteins like Hb
Hyperkalaemia caused by acidosis, haemolysis, drugs, cell death + AKI/CKD
Hypokalaemia caused by polyuria, GI losses, alkalosis and insulin

Question 15

Acidosis

Answer 15

Bicarb lost in kidneys
Stop urea production
Hb RIGHT
Metabolic= excessive H+ production and decrease excretion (low CO2 and low bicarb)
Resp= CO2 retention (increased H+, decreased O2)

Question 16

Alkalosis`

Answer 16

Stimulates urea excretion
Metabolic= Excess or retained bicarb, D+V, get decreased H+ and O2, increased CO2, resp suppression, lose potassium
Resp= Increased CO2 excretion, increased O2, decreased H+