Biochemistry Flashcards
What blood tests can be done to test if the patient is a chronic drinker?
Gamma GT
MCV
Triglycerides
Why are triglycerides high in alcohol excess?
Due to increased synthesis in the liver
If a patient presents to A+E, is unconscious and you suspect they have been drinking what tests should you do?
Glucose - exclude hypoglycaemia
Serum osmolality
What is the simplest formula for serum osmolality?
2x [Na]
What is a normal serum osmolality?
275-295 mmol/kg
A patient comes in comatose and has their electrolytes measured. They come back normal and therefore their calculated osmolality is normal (290 mmol/kg). However their measured osmolality was not (340 mmol/kg). What is this gap called?
Osmolal gap
Something else contributing to osmolality
If an alcoholic has abdominal pain, what should you measure?
Amylase
LFT
What are the liver function tests?
ALT Bilirubin Alk phos Albumin GGT PTR
What is ALT a measure of?
Liver damage
Where is ALT found?
Liver
Where is ALP found?
Liver Bone Small intestine Kidneys Placenta
Where is albumin synthesized?
Liver
Albumin is raised in a systemic inflammatory response. True or false?
False
It false in a systemic inflammatory response
What does the prothrombin ratio measure?
Clotting factors synthesized in the liver
Indicaor of current liver synthetic function
Gives indication of patient’s bleeding tendency
If an alcoholic presents with vomiting, what tests should you do?
U&Es
LFT
Amylase
ABG
What should you measure if a patient presents with haematemesis?
U&E
LFT
PTR
Lactate
In the metabolic pathway, the substance from which bilirubin is formed from is…?
Biliverdin
Haemoglobin -> haem -> biliverdin -> bilirubin
Moderate alcohol consumption as part of a Mediterranean diet is known to increase/decrease blood LDL/HDL levels
Increase blood HDL levels
How does antabuse work?
Inhibits aldehyde dehydrogenase
Facial flushing and a general feeling of being unwell is caused by what?
Aldehyde
What are hepatocytes bordered by microscopically?
The space of Disse
What medication is commonly used for medically assisted alcohol withdrawal?
Chloriazepoxide
Ethanol is sometimes used to treat patients with a raised osmolol gap. True or false?
True
How many kcals does 1g of alcohol contain?
7kcals
What is AST short for?
Aspartate aminotransferase
Why do you measure lactate in a patient with haematemesis?
To assess perfusion
Where does aspiration pneumonia usually occur?
The superior segment of the right lower lobe
The lower segment of the middle lobe
How long does it take delerium tremens to develop?
3-10 days
What is portal hypertension associated with: hepatomegaly or splenomegaly?
Splenomegaly
What drug use is acute pancreatitis associated with?
Steroid use
What clotting factors are made in the liver?
II
VII
IX
X
