BIOCHEMISTRY (principles and transition)

Question 1

what does OIL RIG stand for

Answer 1

oxidation is loss (of electrons)

reduction is gain (of electrons)

Question 2

what is catabolism

Answer 2

breakdown of something

Catabolism = Cut

Question 3

what is anabolism

Answer 3

build up of molecules (Anabolism = Add)

Question 4

what is a zwitterion

Answer 4

amino acid with no charged side groups

Question 5

what is a primary protein

Answer 5

amino acid chain

Question 6

what is a secondary protein (2)

Answer 6

alpha helix

beta sheets

Question 7

what is a tertiary protein

Answer 7

3D globular/fibrous protein

Question 8

what is a 4th generation (i cant remember the name lol) protein

Answer 8

several tertiary proteins eg haem

Question 9

where are steroid receptors

Answer 9

inside the cell

Question 10

what does splicing do

Answer 10

remove introns, leaves exons

Question 11

where does splicing start (base code)

Answer 11

AUG

Question 12

what is an isozyme

Answer 12

an enzymes ‘cousin’

Question 13

which enzymes do not follow the michaelis menton kinetic model

Answer 13

allosteric enzymes

Question 14

what happens to K in competitive antagonists in the michaelis menton kinetic model

Answer 14

it changes

C ompetitive = K C hanges

Question 15

in DKA do you want to give K+ even if K+ is normal

Answer 15

yes

Question 16

is hyperkalaemia caused by K+ salt in IV drugs common

Answer 16

no its rare

Question 17

at what CK is renal failure likely in rhabdomyolysis

Answer 17

CK >10000 U/L

Question 18

cause of hyperkalaemia and hypocalcaemia on blood results

Answer 18

contaminant from purple top to yellow top

purple top contains K+ EDTA
happens if you don’t get enough blood, so take some out of another tube = DONT DO IT!

Question 19

what happens to K+ in blood samples stored in fridge overnight eg in GP practice

Answer 19

hyperkalaemia

Question 20

hyperkalaemia differentials

Answer 20

haemolysis
renal failure
antihypertensive drugs eg spironolactone, ACEi
pseudohyperkalaemia

Question 21

in rural GP practices, what can be used to minimize the effects of hyperkalaemia caused by long time between collecting blood sample and processing blood sample

Answer 21

benchtop centrifuge in the practice

though in the formative this isn’t the most right answer!

Question 22

hypercalcaemia initial management

Answer 22

rehydration

Question 23

if low vit D what should you do

Answer 23

probs nothing

only prescribe vit D supplements if symptomatic

Question 24

in malignancy is PTH high or undetectable

Answer 24

undetectable

Question 25

why is primary hyperparathyroidism diagnosed much earlier

clinical significance of this (what do we no longer see)

Answer 25

hypercalcaemia is detectable

no longer see radiological changes eg osteitis fibrosa cystica

Question 26

what does ADH act on

Answer 26

kidneys 
blood vessels 
heart
pituitary 
liver 
lots of things...

basically more than just the kidneys!

Question 27

what is used to distinguish between central and nephrogenic diabetes insipidus

Answer 27

DDAVP (synthetic analogue of AVP (ADH))

Question 28

when might you do synacthen tests in ITU

Answer 28

to monitor prognosis

poor adrenal function = poor prognosis

Question 29

does ACTH distinguish between primary and secondary adrenal insufficiency

Answer 29

yes

Question 30

if cortisol is being measured, what drugs do you need to withhold

Answer 30

steroids!

Question 31

if HPA axis is suppressed (by drugs etc) how much replacement steroids does someone need

Answer 31

7.5mg daily

Question 32

what happens to patients with adrenal insufficiency when given saline (sodium) in comparison to ‘normal’ people

Answer 32

they cant retain it

Question 33

mineralocorticoid activity definition

Answer 33

exchange of Na+ with K+ or H+

Question 34

what happens to circulating blood volume in oedema

Answer 34

it decreases

Question 35

is pseudohyponatraemia common

Answer 35

no, rare cause of abnormally low Na+ conc

Question 36

which ion do kidneys excrete to regulate volume

Answer 36

Na+

Question 37

ECG for hyperkalaemia

Answer 37

tall T waves

Question 38

what causes pseudohyperkalaemia

Answer 38

increased time between blood being taken and being tested on
eg high K+ in GP but fine when admitted to hospital