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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
2 components of bile
bilirubin bile salts
26
TCA OD
tachycardia hypotension dilated pupils ataxic gait flushed extremities dry mouth first degree heart block
27
acidosis with persistent hypokalemia
type 1 renal tubular acidosis
28
what drug increases the fractional excretion of uric acid (used in non acute gout)
probenecid
29
what equation is used to figure out acid/base imbalances
h20 + co2= hco3- + h+
30
in sarcoidosis production of what hormone causes increased calcium
1 alpha hydroxylase
31
where is 1 alpha hydroxylase normally produced
kidney
32
how does aldosterone affect sodium
increases you are trying to increase water reabsorption so you hold on to sodium to draw water in
33
osmolality equation
2(na+k) + urea +glucose
34
anion gap equation
(na+k) - (cl+ hco3)
35
normal anion gap
14-18
36
causes of a raised anion gap
GOLDMARK glycol (OD) oxoproline (chronic paracetamol use) lactate (sepsis) lactate (short bowel syndrome) methanol (OD) aspirin (OD) renal failure ketoacidosis
37
causes of a normal anion gap metabolic alkalosis
ABCD addisons bicarb loss (diarrhoea, laxatives) chloride gain (infusion of nacl) drugs (acetazolamide)
38
what is fanconi syndrome
failure of PCT to reabsorb molecules
39
whats the most potent LDL reducing drug
evolocumab
40
van de bergh direct reaction measures
conjugated bilirubin
41
colchine moa
inhibiting polymerisation of tubulin to reduce motility of neutrophils
42
overdose of what causes ringing in ears
salicyclate
43
allopurinol moa
inhibits xanthine oxidase
44
impaired glucose tolerance test and results
OGTT= 7.8-11.0
45
fanconi syndrome signs
Polyuria, polydipsia and dehydration (due to glucosuria) Growth failure (in children) Metabolic acidosis (Type 2 Renal Tubular Acidosis) Hypokalaemia Proteinuria Hyperuricosuria
46
what test tells you if someone has true hyponatraemia
serum osmolality
46
calcium level in osteoporosis
normal
47
factitious hypoglycaemia can be due to use of
insulin or sulphonylureas
48
what drug to give with azothioprine
xanthine oxidase inhibitor
49
tpmt full form
thiopurine methyltransferase
50
urate crystals under polarised light are what colour when parallel vs perpendicular to red light filter
parallel= orange perpendicular= blue
51
impaired fasting glucose
6.1-6.9
52
cholestryamine binds to what to reduce cholesterol
bile acids
53
diagnostic test for porphyrias
urine porphobilinogen
54
acute intermittent porphyria enzyme deficient
hydroxymethylbilane synthase
55
osmolarity equation
(2 x sodium) + urea + glucose
56
hypokalemia with acidosis
renal tubular acidosis (not type 4, this has hyperkalemia)
57
colchicine moa
inhibits polymerisation of tubulin to reduce migration of neutrophils
58
allopurinol moa
inhibits xanthine oxidase to reduce urate synthesis
59
probenecid moa
increases fractional excretion of uric acid
60
pH imbalance associated with hypokalemia
alkalosis
61
how does granulomatous tissue in sarcoidosis cause hypercalaemia
increases 1 alpha hydroxylase
62
normal anion gap metabolic acidosis
ABCD addisons disease bicarbonate loss (diarrhoea, laxative abuse, renal tubular acidosis) chloride gain (nacl infusion) drugs (acetazolamide)
63
inadequate function of the proximal renal tubules of the kidney and is associated with glucosuria, hypophosphatemia and hyperuricosuria
fanconi syndrome
64
tertiary hyperparathyroidism
after kidney transplant
65
most potent medication for reducing LDL
evolocumab
66
direct vs complete van de bergh reaction measures
direct= conjugated complete= total
67
what enzyme catalyses the formation of bile via the classical pathway
cholesterol 7 alpha hydroxylase
68
where in the nephron is most bicarb reabsorbed
PCT
69
what test is done to confirm if hyponatraemia is true
serum osmolality
70
endogenous source of insulin in hypoglycaemia
insulinoma sulphonylurea
71
what cant you give to someone on azothioprine with tmpt deficiency?
xanthine oxidase inhibitors eg allopurinol
72
bitter almond taste in mouth
cyanide poisoning
73
acute porphyria drug
haem arginate
74
how does prednisolone affect LDL
increases
75
1st line medication for cyanide poisoning
b12

Aaska's path (9 decks)

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