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Transition Block > Biochemistry > Flashcards

Biochemistry Flashcards

1
Q

What are main factors that determine potassium excretion?

A

GFR and plasma potassium conc.

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2
Q

Where is 98% of potasssium in the body located?

A

intracellularly

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3
Q

What is severe hyperkalaemia defined as?

A

> 7mmol/L

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4
Q

What are the ECG features of hyperkalaemia?

A

tall tented T waves and widened QRS

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5
Q

What are the causes of decreased excretion leading to hyperkalaemia?

A

renal failure; hypoaldosteronism

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6
Q

What is the most common cause of hyperkalaemia due to hypoaldosterism?

A

ACEi and spironolactone

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7
Q

What are the common causes of redistribution out of cells resulting in hyperkalaemia?

A

rhabdomyolysis; extensive trauma; tumour lysis syndrome

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8
Q

What is the funciton of adjusted calcium?

A

avoids problems with total calcium in patients with an abnormal serum albumin

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9
Q

What is the likely cause of hypocalcaemia if PTH concentration is elevated?

A

vitamin D deficiency

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10
Q

What are the common causes of hypercalcaemia?

A

primary hyperparathyroidism and hypercalcaemia of malignancy

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11
Q

What diseases synthesis 125-dihydroxycholecalciferol?

A

sarcoid; TB and lymphomas

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12
Q

What causes milk alkali syndrome?

A

high calcium and bicarb intake- e.g with antacids

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13
Q

When is treatment of hypercalcaemia urgent?

A

> 3.5mmol/L

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14
Q

What is the function of IV fluids in hypercalcaemia?

A

restore GFR and promote duiresis

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15
Q

What is the mainstay of therapy with hypercacaemia of mlignancy?

A

bisphosphonates

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16
Q

What condition can mimic primary hyperparathyroidism?

A

familial hypocalciuric hypercalcaemia

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17
Q

When should familial hypocalciuric hypercalcaemia be considered?

A

asymptomatic hypercalcaemia in a young person

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18
Q

What is the characteristic bone resorption seen with hyperparathyroidism?

A

osteitis fibrosa cystica

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19
Q

How do bisphosphonates work?

A

inhibit bone resorption

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20
Q

What is the effect on potassium with metabolic acidosis?

A

potassium ions are displaces from the cell by hydrogen ions to maintain electrochemical neutrality

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21
Q

What is the effect of insulin on potassium?

A

stimualtes cellular uptake of potassium

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22
Q

What is the inheritance of hyperkalaemic periodic paralysis?

23
Q

What is the presentation of hyperkalaemic periodic paralysis?

A

recurrent attacks of muscle or paralysis preceipitates by rest after exercise

24
Q

Why may blood products result in hyperkalaemia?

A

stored RBCs release K down its conc grad

25
Waht is pseudohyperkalaemia?
hyperkalaemia due to its movement out of cells during or after venesection
26
What are the commonest causes of pseudohyperkalaemia?
delay in centrifugation separating plasma/serum from the cells/clot; in-vitro haemolysis and increases platelet or WBC count
27
What common drug is administered as potassium salt?
some penicillins
28
What are the features of adrenal insufficiency?
lethargy; anorexia; pgimentation of hands and mouth; abdo pain and weight loss
29
What are the syptoms of a acute adrenal crisis?
postural hypotension; vomiting; dehydration
30
What are the biochemical abnormalities of adreanl insufficiency?
hyponatraemia; hyperkalaemia and elevated urea
31
What is the result of lack of aldosterone?
sodium loss- reduction of extracellular fluid volume- hypotension and pre-renal uraemia
32
What does the hypovolaemia and hypotension in adrenal insufficiency stimualte?
AVP secreiton causing water retention and without cortisol kidneys arent able to excrete water as well
33
Waht is the overall change in total body water in adrenal insufficiency?
reduced
34
What are the causes of total adrenal destruction?
bacterial and fungal infections-TB; amyloidosis; metastatic carcinoma
35
What is the mnemonic for the layers of the adrenal gland?
GFR
36
What is the mnemonic for what the layers of hte adrenal gland produce?
blood; sugar; sex and magic
37
What are the causes of pseudohyponatraemia?
multiple myeloma or hyperlipidaemia
38
Waht might tell you that pseudohyponatraemia will come as a result?
milky blood
39
How can hyponatraemia and pseudohyponatraemia be differentiated?
serum osmolality
40
Why is there no clinical evidence of water retention in SIADH?
water retention occurs slowly and the retained water is distributed evenly over all body compartments
41
Why may Addison's patients have normal biochemistry?
self-medication- increased sodium intake
42
What is the difference between the effect on ADH between non-osmotic and osmotic stimuli?
non-osmotic stimuli produce a much greater ADH
43
What does mineralocorticoid activity refer to?
sodium retention in exchange for K or H
44
What are the limbic system functions?
M2OVE: memory; motivation; olfactory; emotion; olfactory; visceral afferents
45
What is the difference between plasma and serum?
sserum- specimen has clotted before spin down cells whereas plasma- hasnt clotted
46
What is storing blood samples overnight associated iwth?
hyperkalaemia
47
What is the anticoagulant in FBC?
potassium EDTA
48
What is the function of potassium EDTA in FBC tube?
stops clotting by chelating
49
What is yellow top tube for?
biochemistry
50
What is the other name for ADH?
AVP arginine vasopressin
51
What are the non-osmotic stimuli of ADH release?
hypovolaemia/hypotension; pain; vomiting
52
What causes SIADH?
ADH is being secreted in response to non-osmotic stimulus
53
What does hypovolaemia and hyponatraemia mean?
too little sodium

Transition Block (35 decks)

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