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Aaska's path > CHEM > Flashcards

CHEM Flashcards

1
Q

how can you differentiate between renal and extra renal causes of hypovolemic hyponatraemia?

A

sodium <20= extra renal (diarrhoea, vomitting)
sodium >20= renal

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2
Q

loosers zones

A

osteomalacia pseudofractures

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3
Q

widened epiphysis at wrists

A

rickets

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4
Q

costochondral swelling

A

rickets

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5
Q

osteoporosis t score

A

<-2.5

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6
Q

osteopaenia t score

A

<-1.25-2.5

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7
Q

colles fracture

A

osteoporosis

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8
Q

vertebral kyphosis fracture

A

osteoporosis

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9
Q

t score v z score

A

t score= matched to mean of young and healthy
z score= matched to mean of same age and sex

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10
Q

receptor ADH acts on

A

V1- smooth muscle
V2-kidney

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11
Q

how ADH increases water reabsorbed

A

aquaporin 2 channels inserted

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12
Q

causes of hypovolemic hyponatraemia

A

diarrhoea
vomiting
diuretics

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13
Q

urine sodium interpretable when

A

on diuretics

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14
Q

causes of euvolemic hyponatraemia

A

hypothyroidism
adrenal insufficiency
SIADH

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15
Q

causes of hypervolemic hyponatraemia

A

HF
cirrhosis
nephrotic syndrome

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16
Q

complication of rapid correction of hyponatraemia

A

central pontine myelinolysis

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17
Q

test for diabetes insipidus

A

water deprivation test (osmolality fails to rise)

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18
Q

sodium level for hyponatraemia

A

<135

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19
Q

ballooning degenration/ mallory denk bodies

A

alcoholic hep

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20
Q

high AST and ALT

A

hepatocyte damage

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21
Q

high alk phosp

A

obstructive jaundice

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22
Q

disease of b12 deficiency

A

pernicious anaemia

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23
Q

disease of b1 deficiency

A

beri beri

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24
Q

disease of b3 deficiency

A

pellagra

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25
Q

2 components of bile

A

bilirubin
bile salts

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26
Q

TCA OD

A

tachycardia
hypotension
dilated pupils
ataxic gait
flushed extremities
dry mouth
first degree heart block

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27
Q

acidosis with persistent hypokalemia

A

type 1 renal tubular acidosis

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28
Q

what drug increases the fractional excretion of uric acid (used in non acute gout)

A

probenecid

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29
Q

what equation is used to figure out acid/base imbalances

A

h20 + co2= hco3- + h+

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30
Q

in sarcoidosis production of what hormone causes increased calcium

A

1 alpha hydroxylase

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31
Q

where is 1 alpha hydroxylase normally produced

A

kidney

32
Q

how does aldosterone affect sodium

A

increases

you are trying to increase water reabsorption so you hold on to sodium to draw water in

33
Q

osmolality equation

A

2(na+k) + urea +glucose

34
Q

anion gap equation

A

(na+k) - (cl+ hco3)

35
Q

normal anion gap

A

14-18

36
Q

causes of a raised anion gap

A

GOLDMARK
glycol (OD)
oxoproline (chronic paracetamol use)
lactate (sepsis)
lactate (short bowel syndrome)
methanol (OD)
aspirin (OD)
renal failure
ketoacidosis

37
Q

causes of a normal anion gap metabolic alkalosis

A

ABCD
addisons
bicarb loss (diarrhoea, laxatives)
chloride gain (infusion of nacl)
drugs (acetazolamide)

38
Q

what is fanconi syndrome

A

failure of PCT to reabsorb molecules

39
Q

whats the most potent LDL reducing drug

A

evolocumab

40
Q

van de bergh direct reaction measures

A

conjugated bilirubin

41
Q

colchine moa

A

inhibiting polymerisation of tubulin to reduce motility of neutrophils

42
Q

overdose of what causes ringing in ears

A

salicyclate

43
Q

allopurinol moa

A

inhibits xanthine oxidase

44
Q

impaired glucose tolerance test and results

A

OGTT= 7.8-11.0

45
Q

fanconi syndrome signs

A

Polyuria, polydipsia and dehydration (due to glucosuria)
Growth failure (in children)
Metabolic acidosis (Type 2 Renal Tubular Acidosis)
Hypokalaemia
Proteinuria
Hyperuricosuria

46
Q

what test tells you if someone has true hyponatraemia

A

serum osmolality

46
Q

calcium level in osteoporosis

A

normal

47
Q

factitious hypoglycaemia can be due to use of

A

insulin or sulphonylureas

48
Q

what drug to give with azothioprine

A

xanthine oxidase inhibitor

49
Q

tpmt full form

A

thiopurine methyltransferase

50
Q

urate crystals under polarised light are what colour when parallel vs perpendicular to red light filter

A

parallel= orange
perpendicular= blue

51
Q

impaired fasting glucose

A

6.1-6.9

52
Q

cholestryamine binds to what to reduce cholesterol

A

bile acids

53
Q

diagnostic test for porphyrias

A

urine porphobilinogen

54
Q

acute intermittent porphyria enzyme deficient

A

hydroxymethylbilane synthase

55
Q

osmolarity equation

A

(2 x sodium) + urea + glucose

56
Q

hypokalemia with acidosis

A

renal tubular acidosis (not type 4, this has hyperkalemia)

57
Q

colchicine moa

A

inhibits polymerisation of tubulin to reduce migration of neutrophils

58
Q

allopurinol moa

A

inhibits xanthine oxidase to reduce urate synthesis

59
Q

probenecid moa

A

increases fractional excretion of uric acid

60
Q

pH imbalance associated with hypokalemia

A

alkalosis

61
Q

how does granulomatous tissue in sarcoidosis cause hypercalaemia

A

increases 1 alpha hydroxylase

62
Q

normal anion gap metabolic acidosis

A

ABCD
addisons disease
bicarbonate loss (diarrhoea, laxative abuse, renal tubular acidosis)
chloride gain (nacl infusion)
drugs (acetazolamide)

63
Q

inadequate function of the proximal renal tubules of the kidney and is associated with glucosuria, hypophosphatemia and hyperuricosuria

A

fanconi syndrome

64
Q

tertiary hyperparathyroidism

A

after kidney transplant

65
Q

most potent medication for reducing LDL

A

evolocumab

66
Q

direct vs complete van de bergh reaction measures

A

direct= conjugated
complete= total

67
Q

what enzyme catalyses the formation of bile via the classical pathway

A

cholesterol 7 alpha hydroxylase

68
Q

where in the nephron is most bicarb reabsorbed

A

PCT

69
Q

what test is done to confirm if hyponatraemia is true

A

serum osmolality

70
Q

endogenous source of insulin in hypoglycaemia

A

insulinoma
sulphonylurea

71
Q

what cant you give to someone on azothioprine with tmpt deficiency?

A

xanthine oxidase inhibitors eg allopurinol

72
Q

bitter almond taste in mouth

A

cyanide poisoning

73
Q

acute porphyria drug

A

haem arginate

74
Q

how does prednisolone affect LDL

A

increases

75
Q

1st line medication for cyanide poisoning

A

b12

Aaska's path (9 decks)

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