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Pathology and final year > Chem path > Flashcards

Chem path Flashcards

1
Q

Causes of hypokalaemia

A

-GI loss: vomiting, diarrhoea
- renal loss: hyperaldosteronism, thiazide and loop diuretics, renal tubular acidosis type 1 and 2
- redistribution into cells: insulin, b-blockers, refeeding syndrome

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2
Q

consequences of hypokalaemia

A

muscle weakness
nephrogenic DI (polyuria and polydipsia)
ECG changes: T wave flattening, U waves, arrhythmias

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3
Q

normal range of potassium

A

3.5-5.5mmo/L

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4
Q

investigations and management of hypokalaemia

A

U&Es
monitor ECG changes
aldosterone:renin ratio (if high suggests conn’s as high aldosterone will negatively feedback on renin)

K replacement:
3-3.5mmol/L –> Oral KCl (2 sandoK tablets, TDS for 48hrs)
<3mmol/L –> IV KCl (10mmol/hr) risk of cardicac arrest

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5
Q

Causes of hyperkalaemia

A

Artefact- haemolysis when taking blood

intracellular –> extracellular mvmt of K: DKA(insulin shortage), rhabdomyolysis, haemolysis

decreased excretion:
mineralocorticodeficiency (Addisons), K sparing diuretics, ACEi, ARBs, NASAIDs, renal tubular acidosis type 4

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6
Q

Describe the ECG changes in hyperkalaemia

A

Tall tented T waves
loss of P wave
widened QRS
arrhythmia

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7
Q

management of hyperkalaemia

A
  1. repeat bloods incase artefact
  2. 10mls 10% calcium gluconate (stabilise myocardium)
  3. 100mls 20% dextrose + 10units short acting insulin eg. actrapid (draws K into cells and dex to prevent hypo)
  4. nebulised salbutamol
  5. treat cause
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8
Q

acid- base balance: pCO2 and pH in each met/resp acidosis/ alkalosis

A

metabolic acidosis- pCO2 low, pH low
metabolic alkalosis - pCO2 high, pH high
respiratory acidosis - pCO2 high, low pH
respiratory alkalosis- pCO2 low, pH high

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9
Q

causes of each met/resp acidosis/ alkalosis

A

met acidosis:
DKA, renal tubular acidosis, addisons, lactate(shock, sepsis), aspirin, ETOH

met alkalosis
bicarbonate ingesion, Conns, vomiting, burns

resp acidosis
hypoventilation: COPD, opioids, sedatives

resp alkalosis
hyperventilation: panic disorder/ anxiety, asthma,

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10
Q

causes of metabolic acidosis with a high anion gap

A

KULT

Ketoacidosis
uraemia (renal failure)
lactate
toxins (alcohol, salicylate, mannitol)

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11
Q

equation to calculate the anion gap
normal range

A

anions- cations
(Na+K)- (Cl+HCO3)

normal range: 14-18mol/L

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12
Q

what is the best marker of liver function?

A

prothrombin time

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13
Q

causes of isolated raised ALP

A

physiological: pregnancy (ALPregnancy), growth spurths

pathological: osteoblast activation; Pagets disease, osteromalacia, cholestasis, cirrhosis

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14
Q

why is ALP normal in myeloma?

A

plasma cells suppress osteoblasts
osteoblast activation secretes ALP

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15
Q

Causes of low albumin

A

nephrotic syndrome
chronic liver disease
protein losing enteropathy
sepsis

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16
Q

raised GGT and ALP

A

cholestatic/ obstructive picture

raised GGT in alcoholic liver disease

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17
Q

raised AST:ALT 2:1

A

supportive alcoholic liver disease

remember ALT- Last in the ratio

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18
Q

raised AST:ALT 1:1

A

supportive of viral liver disease

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19
Q

ALT>AST

A

chronic liver disease

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20
Q

what is the INR

A

it is the prothrombin time (time for the production of thrombin) which has been standardised to age and population and expressed as a ratio of ‘normal’

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21
Q

which clotting factors does the liver synthesise

A

V, VII, IX, X, XII, XIII

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22
Q

causes of pre, hepatic and post hepatic jaundice

A

pre hepatic- haemolysis, congestive cardiac failure, thalassaemia

hepatic- viral/ alcoholic hepatitis, cirrhosis, gilberts syndrome, crigler Najjar syndrome

post hepatic- primary biliary cholangitis, sclerosing cholestasis, gall stones, cancer of head of pancreas, cholangio carcinoma

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23
Q

features of acute porphryia

A

the P’s:
Painful abdomen
peripheral neuropathy
Psychosis
acute abdominal pain and neuropsychiatric Sx (eg. confusion, halluconations)

–> AIP until proven otherwise

HMB (hydroxymethylbilane) synthase deficiency leading to build up of porphobilinogen

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24
Q

what are porphryias

A

rare metabolic conditions where there is enzyme deficiencies in the haem biosynthesis leading to build up of toxic haem precursors

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25
Q

features of porphyria cutanea tarda

A

commonest

uroporphyrinogen decarboxylase deficiency

leading to uroporphyrin build up

photosensitivity
facial hyperpigmantation
blistering
milia
scarring
exacerbated by ETOH

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26
Q

describe the combined pituitary function test

A

administration of GnRH, TRH and insulin then measure levels of pituitary hormones at 0,30,60.90 and 120 mins

thyroxine, glucose, cortisol, LH/FSH, prolactin, TSH, GH

insulin: should raise ACTH and GH

TRH: should raise TSH and prolactin

GnRH: should raise LH/FSH

fasting overnight

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27
Q

pituitary macroadenoma

A

tumor >1cm

can compress pituitary stalk leading to less dopamine reaching the lactotrophs –> hyperprolactinaemia

can compress optic chiasm - bitemporal hemianopia with superior quadrantinopia

(NB craniopharyngoma causes inferior quadrantinopa)

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28
Q

causes of pseudohyponatraemia

A

hyperlipidaemia
hyperproteinaemia

Na actually normal but the lipids/proteins take up a large proportion of the serum and dilute the sodium because the conc of Na is calculated by Na/serum vol not Na/H20

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29
Q

how to calculate osmolarity

A

2(Na+K) + glucose + urea

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30
Q

Enzyme deficiency in acute porphryia

A

hydroxymethylbilane synthase deficiency

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31
Q

Enzyme deficiency in acute intermittent porphryia

A

hydroxymethylbilane synthase (same as acute porphryia)

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32
Q

Management of high K on blood test

A
  1. repeat blood test as may be artefact
  2. 10ml 10% calcium gluconate
  3. 100mls 20% dextrose and 10units short acting insulin
  4. nebulised salbutamol
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33
Q

Enzyme deficiency in porphyria cutanea tarda and resultant raised intermediate

A

uroporphyrinogen decarboxylase

raised urinary uroporphyrins and coproporphyrins (pink red flourescence with wood lamp)

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34
Q

Precipitating factors for acute intermittent porphyrias

A

ALA synthase inducers- steroids, barbituates, ethanol

stress- infection, surgery

reduced caloric intake

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35
Q

features of porphyria cutanea tarda and precipitating factors

A

photosensitivity
facial hyperpigmentation
blistering
milia
scarring

exacerbated by ETOH

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36
Q

Causes of excess ADH

A

Lung- SCLC, pneumonia
Brain- traumatic brain ingery, meningitis, tumours
Iatrogenic- SSRIs, amitryptilin, carbamazapine, PPIs

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37
Q

Most common type of thyroid neoplasia

A

Papillary (75-85%)

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38
Q

Risk for MALT lymphoma

A

chronic H pylori infection
chronic hashimotos

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39
Q

Histology of medullary cancer of thyroid

A

sheets of dark cells, amyloid deposition within tumour

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40
Q

Histology of papillary cancer of thyroid

A

Psammoma bodies (foci of calcification), orphan annie eyes (empty appearing nuclei with central clearing)

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41
Q

Histology of anaplastic thyroid cancer

A

undifferentiated follicular, large pleomorphic giant cells, spindle cells with sarcomatious appearance

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42
Q

tumour markers for different thyroid cancers

A

papillary and follicular - thyroglobulin

medullary- CEA and calcitonin

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43
Q

Which neoplasias are involved in MEN1

A

(3Ps)
Pituitary
Pancreas (insulinoma)
Parathyroid

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44
Q

Which neoplasias are involved in MEN2a

A

(2P 1M)
Parathyroid
Phaeochromocytoma
Medullary thyroid

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45
Q

Which neoplasias are involved in MEN2b

A

(1P 2M)
Phaeochromocytoma
Medullary thyroid
Mucocutaneous neuroma
(Marfanoid)

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46
Q

Drug toxicity signs:

Ataxia and nystagmus

A

Phenytoin

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47
Q

Drug toxicity signs:

Arrhythmias, heart block, confusion, seeing yellow-green

A

Digoxin

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48
Q

Drug toxicity signs:

tremor, lethargy, fits, arrhythmias, renal failure

A

Lithium

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49
Q

Drug toxicity signs:

Tinnitus, deafness, nystagmus, renal failure

A

aminoglycosides
ie. gentamycin, vancomycin

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50
Q

Drug toxicity signs:

Arrhythmias, convulsions, anxiety, tremor

A

Theophylline

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51
Q

Most common cause of hypercalcaemia

A

hypercalcaemia of malignancy

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52
Q

X ray appearance of uric acid

A

radiolucent

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53
Q

X ray appearance of calcium oxalate

A

radio-opaque

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54
Q

fat soluble vitamins

A

A, D, E and K

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55
Q

Signs of B3 deficiency

A

Niacin
Pellagra - B3=3Ds

Dementia
dermatitis
diarrhoea

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56
Q

signs of B6 deficiency

A

Dermatitis
anameia (sideroblasti)

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57
Q

Signs of B2 deficiency

A

Riboflavin

Glossitis

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58
Q

features of Bartter syndrome

A

automomal recessive
defect in thick ascending limb of loop of henle

NKCC2 or ROMK gene mutations

hypokalaemia, alkalosis and hypotension

hypercalcuria

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59
Q

effect of ACE inhibitors on potassium

A

Causes hyperkalaemia due to reduced potassium excretion

reduced angiotensin II and hence reduced aldosterone therefore reduced excretion

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60
Q

what is an AST and ALT of >2000IU/L indicative of?

A

paracetamol poisoning

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61
Q

what is Crigler-Najjar syndrome

A

reduction in UDP glucuronosly transferase needed in the conjugation of bilirubin

more severe version of Gilberts

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62
Q

What is Dublin-Johnson syndrome?

A

reduced secretion of conjugated bilirubin into bile
raised conjugated bilirubin levels

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63
Q

tumour marker in hepatocellular carcinoma

A

alpha-fetoprotein

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64
Q

level of plasma cortisol indicative of adrenal insufficiency after short and long synACTHen test

A

short synACTHen <550nmol/L

long synACTHen <900nmol/L (indicative of primary adrenal insufficiency)

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65
Q

what is Schmidst syndrome

A

also known as autoimmune polyendocrine syndrome type 2

associated with:
addisons
hypothyroidism and T1DM

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66
Q

vitamin deficiency signs:

ataxia and areflexia

A

vitamin E deficiency

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67
Q

cause of vitamin B6 deficiency

A

TB treatment esp isoniazid

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68
Q

features of phenylketonuria

A

fair haired
developmental delay between 6-12 months
low IQ

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69
Q

features of maple syrup urine disease

A

impaired metabolism of leucine, isoleucine and valine causing accumulaiton f toxic compounds

encephalopathy- lethargy, poor feeding, hypotonia, seizures
sweet odor and sweaty feet

70
Q

features of short chain acytl CoA dehydrogenase (SCAD) deficiency

A

neonatal failure to thrive
hypotonia
metabolic acidosis
hyperglycaemia

71
Q

functions of the liver

A

metabolism- glycolysis, glucogen strorage, gluconeogenesis, lipolysis

protein synthesis - plasma proteins, clotting factors

xenobiotic metabolism- P450 rnzyme system, acetylation, coxidation, conjugation

hormone metabolism

Bile synthesis

Reticuloendothelial function- kupffer cells, EPO

72
Q

contents of bile

A

bile salts, bilirubin phospholipid, cholesterol, amino acids, steroids, enzymes, porphyrins, vitamins, and heavy metals, as well as exogenous drugs, xenobiotics and environmental toxins

73
Q

how is bilirubin synthesised?

A

spleen: RBC –> Heme –> unconjugated bilirubin

blood: unconj-bili albumin complex

liver: unconjugated bili –> conjugated bili

gut: conj bili –> urobilinogen

74
Q

serum markers of liver cell damage

A

ALT
AST
ALP
GGT

75
Q

markers of liver function

A

albumin
prothrimbin time /coagulation factors
bilirubin

76
Q

where is ALT present

A

LIVER
muscle
kidney
brain
pancreas

77
Q

AST:ALT ratio >2

A

suggest alcoholic liver disease

78
Q

isolated raised GGT

A

alcoholic liver disease

79
Q

what is raised in biliary system injury

A

ALP

80
Q

causes of raised ALP

A

biliary injury
bone damage
pregnancy

81
Q

causes of low albumin

A

chronic liver disease
malnutrition
nephrotic syndrome
protein losing enteropathy
sepsis

82
Q

what is raised in hepatocellular damage

A

ALT and AST

83
Q

how to determine acute from chronnic liver damage

A

look at albumin- if normal then its acute as albumin as a long half life

84
Q

Isolated raised ALT <120IU/L

A

most likely fatty liver so give lifestyle advise

85
Q

causes of drug induced cholestasis

A

co-amoxiclav

86
Q

courvoisier’s sign

A

painless palpable gall bladder NOT likely to be gallstones (probs pancreatic canceR)

87
Q

causes of AST >1000IU/L

A

paracetamol
viruses eg. hepatitis
ischaemia

88
Q

best marker of acute liver failure

A

INR
represents synthetic function of liver
?? is this not for chronic?

89
Q

post op thyrectomy with tingling- what needs to me measured urgently

A

calcium
- because the surgery may have affected the parathyroids

90
Q

Pagets disease investigations

A

ALP raised
plain Xray
technitium bone scan - Tc bisphosphonate scan

91
Q

Complications of pagets of the skull

A

conductive deafness- if bone in ears affected

compression of VIII can cause nerve deafness

92
Q

enzymes increased in acute MI

A

Troponins
CK
AST
LDH

93
Q

what happens to potassium after acute MI

A

it will fall due to an increase in adrenaline

94
Q

what blood marker is most raised in someone with acute viral hepatitis

A

Alanine aminotranferase
ALT

95
Q

what blood marker is most raised in someone with alcoholic hepatitis

A

aspartate aminotransferase
AST

96
Q

what is low in primary hyperparathyroidism

A

vitamin D

blood tests measure 1 alpha hydroxylase levels
in primary hyperPTH this gets converted into activated D3 so it appears that it D is low

97
Q

what rises in acute dehydration AKI

A

urea

98
Q

what rises in chronic renal failure caused by a fall in the GFR

A

creatinine

99
Q

good marker of glucose control over the last 3 months

and 3 weeks

A

3 months HbA1c
3 weeks fructosamine

100
Q

example of a DDP-4 agonist

A

-GLIPTINS eg.sitagliptin

101
Q

Example of an SGLT2 inhibitor

A

-GLIFOZINS
eg. dapafiglozin

102
Q

example of GLP1 analogue

A

exenatide
liraglutide

103
Q

example of a sulphnyurea

A

glipizide
glimepiride

104
Q

MOA of sulphonyureas

A

increase the secretion of insulin from pancreas

WEIGHT GAIN AND HYPOGLYCAEMIA

105
Q

MOA of metformin

A

improves bodies sensitivity to insulin and stops production of glucose in the liver

106
Q

MOA of SGLT2 inhibitors

A

act on the sodium glucose transporter in the PCT of the kidney tubules and decreases glucose resorption so causes glucosurea

very effective at lowering glucose PLUS 35% decrease in heart failure and 30% decrease in overall mortality

107
Q

MOA of glp1 antagonist

A

Injection
stimulates pancreas to secrete insulin, suppresses glucagon
increase satiety

WEIGHT LOSS

108
Q

MOA of DPP-4 agonist

A

metabolite of glp1 and can be taken orally

stimulates pancreas to release insulin, anti glucagon effect

no effect on weight

109
Q

Example of a thiazolidindiones

A

pioglitazone

110
Q

what clotting factors does the liver synthesise

A

5, 7, 9, 10, 12, 13

111
Q

orphan annie eyes on histology sign of

A

papillary thyroid cancer

112
Q

what are psammoma bodies on histology a sign of?

A

papillary thyroid cancer
serous cystadenoma (ovarian)

113
Q

management of phaeochromocytoma

A

1st: alpha blockade (otherwise b-blockade will lead to unopposed alpha stimulation and hypertensive crisis)
2nd: beta blockade
3rd: surgery when BP well controlled

114
Q

what conditions are associated with phaechromocytoma

A

MEN2a
Von hippen lindau syndrome
neurofibromatosis

115
Q

symptoms and signs of drug toxicity and management:
LITHIUM

A

metallic taste in mouth
tremor
palpitations
GI upset
polyuria, polydipsia
nausia
blurred vision

hyperPTH and hypercalcaemia
renal stones (high Ca)
reduced GCS and confusion
hyperreflexia
circulatory collapse
convulsions
death

Mx:
STOP lithium
A-E approach
senior review and involve MDT
admit for observation for at least 24hrs
correct any electrolyte abnormalities
haemodialysis in extreme cases

116
Q

symptoms of drug toxicity and management:\
PHENYTOIN

A

ataxia
nystagmus

Mx:
supportive treatment
admit for observation

117
Q

symptoms of drug toxicity and management:
DIGOXIN

A

arrhythmias
heart block
confusion
seeing yellow-green

Mx:
admit
Digibind

118
Q

symptoms of drug toxicity and management:
AMINOCLYCOSIDES (vancomycin, gentamycin)

A

tinnitus
deafness
nystagmus
renal failure

Mx:
stop treatment/ switch to different abx

119
Q

symptoms of drug toxicity and management:
THEOPHYLLINES

A

arrhythmia
convulsion
anxiety
tremor

Mx:
stop or reduce dose

120
Q

symptoms and signs of drug toxicity and management:
LITHIUM

A

metallic taste in mouth
tremor
palpitations
GI upset
polyuria, polydipsia
nausea
blurred vision

hyperPTH and hypercalcaemia
renal stones (high Ca)
reduced GCS and confusion
hyperreflexia
circulatory collapse
convulsions
death

Mx:
STOP lithium
A-E approach
senior review and involve MDT
admit for observation for at least 24hrs
correct any electrolyte abnormalities
haemodialysis in extreme cases

121
Q

symptoms of TCA OD

A

tachycardia
hypotension
reduced GCS
dilated pupils
ataxic gait
flushed hands and feet
thirsty and dry mouth
heart block

122
Q

enzyme deficient in Gilberts that conjugates bilirubin

A

uridine diphospho-glucuronosyltransferase
(UDP glucuronyl transferase)

123
Q

drug used in non-acute gout to reduce urate levels by increasing the fractional excretion of uric acid

A

probenecid

124
Q

MOA of allopurinol

A

xanthine oxidase inhibitor which reduces urate synthesis

125
Q

what is the mechanism of hypercalcaemia in sarcoidosis

A

ectopic alpha-1 hydroxylase released by the granulomatous tissue (macrophages)

and release of PTHr peptide

126
Q

causes of metabolic acidosis with a raised anion gap

A

GOLDMARK

G: Glycols (ethylene glycol and propylene glycol) [overdose]
O: Oxoproline [chronic paracetamol use, usually malnourished women]
L: L-lactate [sepsis]
D: D-lactate [short bowel syndrome]
M: Methanol [overdose]
A: Aspirin [overdose. Initially causes respiratory alkalosis but in moderate/severe overdose causes metabolic acidosis]
R: Renal failure
K: Ketoacidosis [DKA, alcoholic, starvation]

127
Q

causes of metabolic acidosis with normal anion gap

A

ABCD (bicarb lost and replaced with Cl)

Addison’s disease

Bicarbonate loss (diarrhoea, laxative abuse, Renal Tubular Acidosis)

Chloride gain (Sodium Chloride 0.9% infusion)

Drugs (acetazolamide diuretic)

128
Q

conditions associated with coeliac disease

A

T1DM
hashimotos
addisons
autoimmune hepatitis
sjogrens
multiple sclerosis

129
Q

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

A

fanconi syndrome

130
Q

causes of fanconi syndrome

A

Congenital
Wilson’s disease (To be even more unhelpful, Wilson’s is also associated with Type 1 Renal Tubular Acidosis)
Tetracyclines
Multiple Myeloma
Lead poisoning

131
Q

signs and symptoms of fanconi syndrome

A

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

132
Q

what is fanconi syndrome

A

a disease of the PCT of the tubules resulting in inability to reabsorb substances such as electrolytes and glucose

133
Q

most potent LDL reducing drug used in familial hypercholesterolemia

A

evolocumab - a PCKS9 inhibitor

134
Q

mechanism of lomitapide

A

inhibits microsomal triglyceride transfer protein (MTP), thereby blocking the release of VLDL from the liver.

135
Q

what reaction is used to measure conjugated bilirubin

A

van den bergh
fractionation

136
Q

MOA of colchicine in gout

A

reduces inflammation and acts by inhibiting polymerisation of tubulin to reduce migration of neutrophils.

137
Q

low Ca, high PTH, short 4th and 5th metacarpals diagnosis

A

pseudohypoparathyroidism
(peripheral resistance to PTH)

138
Q

features of an aspirin overdose

A

tinnitus
nausea & vomiting
dizziness
metabolic acidosis with respiratory alkalosis
(This is because salicylates stimulate the respiratory centre causing hyperventilation and inhibit the Krebs cycle resulting in anaerobic metabolism.)

139
Q

Mutations in familial hypercholesterolaemia

A

AD- PCSK1, ApoB, LDLR
AR- LDLRAP1

140
Q

mutations in polygenic hypercholesterolaemia

A

NPC1L1, HMGCR, CYP7A1

141
Q

what is familial hyper-a-lipoproteinaemia

A

deficiency in CETP causing high HDL- relatively benign condition

142
Q

mutation in phytosterolaemia

A

ABC G5&G8

143
Q

where is LDL absorbed

A

coated pits on the liver have LDLr which then endocytose LDL

144
Q

causes of secondary hyperlipidaemia

A

Hormonal- pregnancy, exogenous hormones

metabolic- DM(early onset and MODY), Gout, obesity

renal- nephrotic syndrome, chronic renal failure

alcohol

145
Q

cause of hypolipidaemia

A
  1. Abeta-lipoproteinaemia- autosomal recessive- MTP deficiency affecting long chain fatty acid metabolism
  2. Tangier disease- HDL def
  3. hypo-b-lipoprotinaemia- truncted apoB gene
146
Q

function of PCSK9

A

binds to LDLR and promotes its degredation
loss of function leads to lower LDL levels

147
Q

where are bile acids absorbed?

A

terminal ileum

148
Q

what transporters are responsible for cholesterol regulation in nd out of the ileum

A

NPC1L1 cholesterol into circulation

ABC G5&G8 back into gut

149
Q

what is responsible for HDL uptake into the liver

A

scavenger receptor B1
SR-B1

150
Q

role of MTP (and full name)

A

microsomal triglyceride protease

conjugates cholesterol ester with triglyceride and ApoB to create VLDL

151
Q

role of ACAT

A

converts cholesterol into a cholesterol ester in the liver

152
Q

what mediates the movement of free cholesterol in peripheral cells to HDL?

A

ABC A1

153
Q

what ediates the conversion of cholesterol ester in HDL into VLDL and TG into VLDL into HDL

A

cholesterol ester transfer protein (CETP)

154
Q

XRay of hand in primary hyperparathyroidism might show

A

radial aspect cystic changes

155
Q

when do loosers zones occur

A

vit D deficiency

156
Q

what will bone histology show of someone with primary hyperparathyroidism

A

multinucleate giant cells
-Brown tumours

157
Q

which enzymes are increased in an acute MI

A
  1. Troponins within 2-3hrs
  2. CK within 6-12 hrs
  3. aspartate aminotransferase
  4. LDH
158
Q

which enzyme is most increased in viral hepatitis

A

ALT (alanine amino transferase)
viraL

159
Q

which enzyme is most increased in chronic liver cirrhosis

A

AST (aspartate aminotransferase)
S-Sirrhosis

160
Q

which enzyme is most increased in prostate cancer

A

acid phosphatase aka prostate specific antigen

161
Q

what is the scan used to diagnose pagets?

A

Technitium 99 bisphosphonate scan

162
Q

scan used to look for metastases in oncology

A

fluorodeoxyglucose (FDG)- positron emission tomogrophy (PET)

163
Q

label used to scan for primary neuroendocrine tumours

A

radioactive gallium 68 labelled dotatate (somatostatin)

164
Q

label used in thyroid scans

A

Technitium 99 pertechnetate

165
Q

what scan is used to detect a phaeochromocytoma

A

Meta-Iodo-Benzyl-Guanidine (MIBG)

166
Q

what drugs can cause SIADH

A

sulfonylureas
SSRIs, tricyclics
carbamazepine
vincristine
cyclophosphamide

167
Q

causes of SIADH

A

ectopic ADH secretion from SCLC
infections- TB, pneumonia
stroke
SAH/SDH
PEEP

168
Q

what should the management be for acute, severe, symptomatic hyponatraemia (< 120 mmol/L)

eg presenting with seizures

A

3% hypertonic sodium chloride

169
Q

A 9 year old boy presents to the GP with enlarged orange coloured tonsils.

Examination elicits a peripheral neuropathy and blood tests show very low plasma HDL levels.

What is the most likely diagnosis?

A

tangier disease

170
Q

Which term is used to describe increased bone density?

A

osteosclerosis

Pathology and final year (21 decks)

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