Biochemistry Flashcards
how can alcohol toxicity to the muscles be measured?
CK
how can acute pancreatitis be detected?
measuring amylase levels
four tests to assess whether the patient is a chronic drinker
LFTs
P450
MCV
triglycerides
two tests if a chronic drinker presents in a coma
- hypoglycaemia
2. serum osmolarity
how to calculate serum osmolarity
2 x [Na]
average range for serum osmolarity
275-295mmol/kg
define an osmolal gap
difference between the measured and expected serum osmolarity
reasons for an osmolal gap when not other usual solutes?
alcohol - methanol poisoning
differential diagnosis for a chronic drinker presenting with abdominal pain
acute pancreatitis
alcoholic hepatitis
peptic ulcer
ascites +/- peritonitis
where is AST found
liver
muscle
red cells
how is ALT produced
produced by hepatocytes in damage
where is ALP found
liver bone small intestine kidney placenta
describe albumin
synthesised in the liver with long half-life
levels fall in systemic inflammation (capillary permeability)
where is GGT located
liver kidney pancreas prostate cell membrane of bile ducts
describe PTR
made in liver with shorter half-life 3-4 days so indicator of current liver function
differential diagnosis for a known alcoholic patient presenting with vomiting
acute gastritis
oesophageal stricture (chronic consumption- fibrosis of varices)
- pyloric stenosis
what to investigate when a known drinker presents with vomiting?
U&E
ABGs
LFTs
amylase
when is there a risk of metabolic alkalosis in vomiting
when the patient has pyloric stenosis because acid is lost from the stomach, but the normal alkali loss from the duodenum does not happen
differential diagnosis for a chronic drinker presenting with haematemesis
acute gastritis
mallory-weiss tear
peptic ulcer perforation
oesophageal variceal burst
investigations for a known alcoholic presenting with haematemesis
U&E
LFT
PTR
lactate (oxygen levels)
