biochemical markers

Question 1

• isolated raised ALP

- mixed lytic/sclerotic lesions

Answer 1

Pagets

Question 2

osteperosis PTH, calcium, ALP and phosphate

Answer 2

PTH= normal
calcium= normal
phosphate= normal
ALP= normal

Question 3

primary hyperparathyroidism ALP, PTH, calcium and phosphate

Answer 3

ALP= high
PTH= high
calcium= low
phosphate= low

Question 4

osteomalacia calcium, phosphate and ALP

Answer 4

calcium= low
phosphate= low
ALP= high

Question 5

CKD ALP, PTH, calcium and phosphate

Answer 5

PTH= high
ALP= high
Calcium= low
phosphate= high

Question 6

tertiary hyperparathyroidism PTH, calcium and phosphate

Answer 6

PTH= high
calcium= normal
phosphate= normal

Question 7

what is elevated in polymyalgia rheumatica?

Answer 7

ESR

Question 8

pre renal AKI:

• what is the serum urea: creatinine ratio
• what is the urine sodium

Answer 8

-raised serum urea:creatinine ratio (>100)

!this can be calculated doing (urea)/ (creatinine/100)!

-urine sodium is low whereas serum sodium is high (kidneys trying to hold on to sodium)

Question 9

acute tubular necrosis

• urine sodium?
• urine osmolality?

Answer 9

• urine sodium is high (>40) and the serum sodium is low

- urine osmolality is low

Question 10

patient with CKD has a rise in ACR>30

what do you prescribe?

Answer 10

ACEI

Question 11

what medication may cause hyaline casts to present on urinalysis?

Answer 11

-taking loop diuretics (furesomide)

Question 12

multiple myeloma presentation

Answer 12

• hyperlcalcaemia
• anaemia
• renal failure
• lytic bone lesions
• Bence Jone protein
• serum electrophoresis, serum free light chains
• bone pain
• weakness
• fatigue
• weight loss
• recurrent infections