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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?

A

AD

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
Q

Waht is pseudohyperkalaemia?

A

hyperkalaemia due to its movement out of cells during or after venesection

26
Q

What are the commonest causes of pseudohyperkalaemia?

A

delay in centrifugation separating plasma/serum from the cells/clot; in-vitro haemolysis and increases platelet or WBC count

27
Q

What common drug is administered as potassium salt?

A

some penicillins

28
Q

What are the features of adrenal insufficiency?

A

lethargy; anorexia; pgimentation of hands and mouth; abdo pain and weight loss

29
Q

What are the syptoms of a acute adrenal crisis?

A

postural hypotension; vomiting; dehydration

30
Q

What are the biochemical abnormalities of adreanl insufficiency?

A

hyponatraemia; hyperkalaemia and elevated urea

31
Q

What is the result of lack of aldosterone?

A

sodium loss- reduction of extracellular fluid volume- hypotension and pre-renal uraemia

32
Q

What does the hypovolaemia and hypotension in adrenal insufficiency stimualte?

A

AVP secreiton causing water retention and without cortisol kidneys arent able to excrete water as well

33
Q

Waht is the overall change in total body water in adrenal insufficiency?

A

reduced

34
Q

What are the causes of total adrenal destruction?

A

bacterial and fungal infections-TB; amyloidosis; metastatic carcinoma

35
Q

What is the mnemonic for the layers of the adrenal gland?

A

GFR

36
Q

What is the mnemonic for what the layers of hte adrenal gland produce?

A

blood; sugar; sex and magic

37
Q

What are the causes of pseudohyponatraemia?

A

multiple myeloma or hyperlipidaemia

38
Q

Waht might tell you that pseudohyponatraemia will come as a result?

A

milky blood

39
Q

How can hyponatraemia and pseudohyponatraemia be differentiated?

A

serum osmolality

40
Q

Why is there no clinical evidence of water retention in SIADH?

A

water retention occurs slowly and the retained water is distributed evenly over all body compartments

41
Q

Why may Addison’s patients have normal biochemistry?

A

self-medication- increased sodium intake

42
Q

What is the difference between the effect on ADH between non-osmotic and osmotic stimuli?

A

non-osmotic stimuli produce a much greater ADH

43
Q

What does mineralocorticoid activity refer to?

A

sodium retention in exchange for K or H

44
Q

What are the limbic system functions?

A

M2OVE: memory; motivation; olfactory; emotion; olfactory; visceral afferents

45
Q

What is the difference between plasma and serum?

A

sserum- specimen has clotted before spin down cells whereas plasma- hasnt clotted

46
Q

What is storing blood samples overnight associated iwth?

A

hyperkalaemia

47
Q

What is the anticoagulant in FBC?

A

potassium EDTA

48
Q

What is the function of potassium EDTA in FBC tube?

A

stops clotting by chelating

49
Q

What is yellow top tube for?

A

biochemistry

50
Q

What is the other name for ADH?

A

AVP arginine vasopressin

51
Q

What are the non-osmotic stimuli of ADH release?

A

hypovolaemia/hypotension; pain; vomiting

52
Q

What causes SIADH?

A

ADH is being secreted in response to non-osmotic stimulus

53
Q

What does hypovolaemia and hyponatraemia mean?

A

too little sodium

Transition Block (35 decks)

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