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202 > Blood Chemistry For Diagnosis > Flashcards

Blood Chemistry For Diagnosis Flashcards

1
Q

Chromogranin A conc raised?

A

Could be carcinoid syndrome

Used as tumour marker

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2
Q

Why is somatostatin receptor scintography used?

A

Use a compound to bind to somatostatin receptors on tumour

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3
Q

Serotonin means

A

Carcinoid tumours in lung and gut

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4
Q

Oxytocin and ADH for

A

Posterior pituitary, serum competing is a cleavage product for ADH

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5
Q

Serum calcitonin for…

A

Medullary c cells of thyroid

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6
Q

Circadian rhythm of pituitary hormones is controlled by?

A

Supraoptic nucleus

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7
Q

Neural tube defects?

A

Maternal serum alpha-fetoprotein, feral ultrasound

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8
Q

Alpha fetoprotein?

A

Produced by yolk sac and feral liver, most abundant protein

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9
Q

Alpha fetoprotein high and low levels?

A

High- spina bifida

Low- downs

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10
Q

In hyperventilation, respiratory alkalosis what happens?

A

Calcium binds to albumin, hydrogen leaves to bind to bicarbonate

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11
Q

What does nitrous oxide do?

A

Convert B12 from active monovalent to inactive bivalent.

Active b12 is coenzyme for methionine synthase needed to create methyl groups for synthesis of DNA.

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12
Q

Meningism?

A

Headache, neck stiffness, photophobia often with nausea and vomiting

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13
Q

Requirements for CSF labels?

A
  1. Microbiology
  2. Biochemistry
  3. Decreasing cell count
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14
Q

Subarachnoid haemorrhage diagnosis?

A

6hour delay CSF will show bilirubin

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15
Q

Most common cause of subarachnoid haemorrhage?

A

Berry aneurysm

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16
Q

Meningitis glass test?

A

With blanching if rash doesn’t fade, then meningitis.

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17
Q

Why is protein high in meningitis?

A

More permeable blood brain barrier allowing more proteins to enter CSF

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18
Q

Difference in bacterial meningitis and tuberculous meningitis?

A

WBC raised in both, but in bacterial it’s polymorphs and tuberculous lymphocytic

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19
Q

Protein levels in meningitis?

A

Tuberculous very high 6mol, bacterial more than 2.5

Fungal elevated and viral less than 1.5

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20
Q

Glucose in meningitis?

A

Viral more than 50%, fungal less than 50%, bacterial and tuberculous less than 2.5 mol

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21
Q

Multiple sclerosis testing?

A

Oligoclonal banding; positive in CSF not serum

22
Q

How to diagnose Alzheimer’s from CSF?

A

Low conc of Abets42 in CSF and high tau.

23
Q

Apolipoprotein E in plaque formation?

A

ApoE4 promotes plaque formation and ApoE2 inhibits

24
Q

Drippy nose, nasal secretions?

A

Test for asialotransferrin which is high in CSF only

25
Q

Altered states of consciousness:

AEIOU TIPS?

A 
Alcohol
Epilepsy, electrolyte disorders, hepatic encephalopathy
Insulin, in born errors of metabolism
Opiates, overdose, oxygen(hypoxia)
Uraemia
Trauma, temp, toxins, tumour
Infection- sepsis, men,enca
Psychogenic, poisons
Space occupying, stroke, seizure and shock
26
Q

How to test for hypoxia brain injury?

A

Neuron specific enolase, released after neuronal cell death.

27
Q

What can cause cerebral oedema?

A

Diabetic ketoacidosis, hyperosmolar hyperglycaemia with insulin, hyponatraemia

28
Q

What can cause hyponatraemia?

A

Excessive IV of hypotonic fluids

Syndrome of inappropriate ADH secretion

Ectopic ADH-small cell lung carcinoma

MDMA

29
Q

Signs of encephalitis?

A

Altered consciousness for more than 24hours, lethargy change in personality

Fever
Seizures
High WBC in CSF

30
Q

Low serum caeruloplasmin copper?

A

Wilson’s disease

31
Q

Accumulation of amino acids?

A

Phenyketonuria

32
Q

Accumulation of carbohydrates?

A

Galactosaemia

33
Q

Accumulation of mucopolysaccharides?

A

Hurler syndrome

34
Q

Accumulations of sphingolipids?

A

Gaucher disease

35
Q

Why is phenytoin used?

A

For epilepsy, 10-20mg/L

Higher dose causes a much greater conc

36
Q

Phenytoin on fit d metabolism?

A

Phenytoin activates enzyme that inactivate vit d leading to decreased calcium absorption. Low calcium causes parathormone secretion to release calcium from bone.

37
Q

Hoe does risperidone cause increased prolactin?

A

Risperidone blocks dopamine receptor, anterior pituitary, prolactin releasing cells cause high serum prolactin.

38
Q

How to treat bipolar

A

Lithium

39
Q

Effect of lithium on endocrine?

A

Hypothyroidism, because its taken up by the gland reducing thyroxine release

Increased sensitivity to ADH causing polyuria

Hypercalcaemia- I adjusts calcium receptors in parathyroid glans causing increase parathyroid secretion

40
Q

Effects of opiates on hypogonadism?

A

Reduced gonadotrophin secretion, hyperprolactinaemia, antiepileptics increase SHGB and suppress HPA axis

41
Q

Pseudocholinesterase deficiency?

A

Prolonged effect of suxamethonium

42
Q

Test for neural tube defects?

A

Maternal serum alpha fetoprotein

43
Q

Test for meningitis?

A

Increased white blood cells

44
Q

Test for subarachnoid haemorrhage?

A

Xanthocromia

45
Q

Test for multiple sclerosis?

A

Oligoclonal banding

46
Q

Test for Alzheimer’s

A

Elevated tau and low Abeta42

47
Q

Test for drippy nose?

A

Beta transferrin

48
Q

Test for hypoxia brain injury?

A

Neuron specific enolase

49
Q

Test for encephalitis

A

Increased white blood cells

50
Q

Test for night blindness

A

Vit a deficiency in blood

51
Q

Drug monitoring for epilepsy?

A

Phenytoin

52
Q

Drug monitoring for bipolar disorders

A

Lithium

202 (58 decks)

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