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Endocrine > Biochemistry > Flashcards

Biochemistry Flashcards

1
Q

What is normal urine output?

A

1 ml/kg/hr

Approx 1-2 litres per 24 hours

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2
Q

What is the definition of polyuria?

A

More than 3 litres per 24 hours

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3
Q

What are the causes of polydipsia/polyuria?

A 
Neurogenic
Nephrogenic
Iatrogenic
Metabolic
Psychiatric
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4
Q

What investigations are helpful in the setting of polyuria?

A

U+Es
Glucose
Calcium
Urine and serum osmolality

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5
Q

How is serum osmolality calculated?

A

2(Na + K) + glucose + urea

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6
Q

What is normal serum osmolality?

A

275-295 mosm/kg

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7
Q

What is the purpose of a water function test?

A

To investigate the cause of polyuria to separate CDI, NDI and PP
MUST NOT BE STEROID OR THYROID DEFICIENT

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8
Q

How is a water deprivation test performed?

A

Up to 8:30: No tobacco or alcohol in 24 hours prior
Allow fluids overnight, light breakfast, no tea or coffee
8:30-4:30: No fluids, dry foods permitted, weight hourly and contact team if weight loss is more than 3% 4:30 - 8:30 pm: DDAVP 2 mcg IM at 4:30 pm and measure urine output hourly for 4 hrs

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9
Q

How is a water deprivation test interpreted?

A

Normal >1.8
Partial DI 1-1.8
Complete DI <1

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10
Q

What should be clinically examined when there is a suspected issue with the pituitary?

A

Fundoscopy - check optic disc; visual field assessment

MRI brain

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11
Q

What is the treatment of pituitary apoplexy?

A

Hormone replacement - levothyroxine, hydrocortisone, testosterone

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12
Q

What are the biochemical findings of addisons?

A

Low sodium
High potassium
Hypotensive

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13
Q

How is a synacthen test performed?

A

0900: baseline bloods for cortisol and ACTH
Give synachten - 250 mcg IM or IV
0930: repeat bloods 30 mins post-synacthen

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14
Q

When is a synachten test CI?

A

Asthma
Pregnancy
Post-pituitary surgery

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15
Q

What is the reference range for cortisol?

A

280-720

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16
Q

What is the classical biochem for conns?

A

High sodium

Low potassium

17
Q

What can be given to treat conns?

A

Spirololactone

18
Q

What are the potential causes of SIADH?

A 
Cancer
Lung disease 
CNS
Drugs (carbamezepine, chlorpromazibe) 
Metabolic (hypothyroid)
19
Q

How can SIADH be treated?

A

Treat underlying cause
Fluid restriction (500-1000ml/24hr)
Demeclocycline
Tolvaptan

20
Q

What is democycline?

A

An antibiotic but reduces responsiveness of collecting tubule to ADH

21
Q

What is tolvaptain?

A

A vasopressor receptor agonist

22
Q

What is the investigations for an addisonian crisis?

A

Check random cortisol

23
Q

What is the treatment of an addisonian crisis?

A

IV hydrocortisone 50-100 mg
IV N. Saline (Na should not increase by more than 8-12 mmol/L per 24 hr)
IV sliding scale insulin

Endocrine (35 decks)

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