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Chem Path Flashcards

1
Q

Serum amylase is elevated in what condition?

A

Acute pancratitis

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2
Q

What is a physiological explanation for a raised creatine kinase?

A

Afro-Caribbean origin

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3
Q

What is a pathological cause of elevated creatine kinase levels?

A

Duchenne Muscular Dystrophy
MI
Statin related myopathy
Rhabdomyolysis

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4
Q 
Which of the following have greater than five times the upper limit of normal raised ALP?
Tumours
Pagets
Fractures
Osteomalacia
Osteomyelitis
A

Pagets

Osteomalacia

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5
Q 
Which of the following have greater than five times the upper limit of normal raised ALP?
Cholestasis
Hepatitis
Cirrhosis
Infiltrative disease
A

Cholestasis

Cirrhosis

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6
Q

How long does it take for Creatine Kinase levels to return to baseline following an MI?

A

2-3 days

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7
Q

How long does it take for Troponin levels to return to baseline following an MI?

A

Greater than 3 days

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8
Q

What is the other name for von Gierke’s disease?

A

Glycogen Storage Disease type 1

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9
Q

What is the enzyme deficiency in Glycogen Storage Disease type 1?

A

glucose-6-phosphatase

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10
Q

Peroxisomal disorders affect the metabolism of what substance?

A

Very long chain fatty acids

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11
Q

How might a neonate with a peroxisomal disorder present?

A

Severe hypotonia
mixed hyperbilirubinaemia
Dysmorphic signs

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12
Q

How might an infant with a peroxisomal disorder present?

A

retinopathy –> blindness
Hepatic dysfunction
Large fontanelle

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13
Q

What is C-peptide an indirect measure of?

A

Secreted insulin

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14
Q

What test do you perform when investigating diabetes insipidus?

A

Fluid deprivation test followed by desmopressin administration

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15
Q

What would you expect to happen with urine osmolarity after a fluid deprivation test and subsequent administration of desmopressin in each of the following conditions:

  • Polydipsia
  • Nephrogenic DI
  • Cranial DI
A

Polydipsia: FD (high osmolarity), Des (high osmolarity)
Nephrogenic DI: FD (low osmolarity), Des (low osmolarity)
Cranial DI: FD (low osmolarity), Des (high osmolarity)

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16
Q

How can the causes of Acute Kidney Injury be classified?

A

Pre-renal (poor perfusion)
Intrinsic (damage to kidney itself, e.g. glomerulus, tubules, interstitium)
Post-renal (urinary obstruction)

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17
Q

How many stages of Chronic Kidney Disease are there and what is each corresponding GFR?

A
  1. greater than 90 ml/min
  2. 60-89
  3. 30-59
  4. 15-29
  5. Less than 15
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18
Q

What is THE MOST common cause of chronic kidney disease?

A

Diabetes

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19
Q

Where can tumours be located in MEN-1?

A

Parathyroid (hyperplasia/adenoma)
Pancreas
Pituitary (prolactinoma)

20
Q

Where can tumours arise in MEN-2a?

A

Thyroid (medullary carcinoma)
Adrenal (phaeochromocytoma)
Parathyroid (hyperplasia)

21
Q

What is the most common form of thyroid cancer?

A

Papillary

22
Q

Which type of thyroid cancer do you keep your eye out for that produces calcitonin?

A

Medullary

23
Q

From what cell type do medullary thyroid cancers arise?

A

parafollicular cells

24
Q

What action does the following hypothalamic hormone have on the pituitary hormones?

  • GHRH
A

GH release

25
Q

What action does the following hypothalamic hormone have on the pituitary hormones?

  • GnRH
A

LH and FSH release

26
Q

What action does the following hypothalamic hormone have on the pituitary hormones?

  • TRH
A

TSH and Prolactin release

27
Q

What action does the following hypothalamic hormone have on the pituitary hormones?

  • Dopamine
A

Prolactin inhibition

28
Q

What action does the following hypothalamic hormone have on the pituitary hormones?

  • CRH
A

ACTH release

29
Q

When performing a combined pitutary function test, what do you administer and why?

A

Insulin - observing rise in GH and cortisol in response to hypoglycaemia
GnRH - observe LH and FSH
TRH - observe rises in TSH and prolactin

30
Q

What size are pituitary microadenomas?

A

less than 1cm

31
Q

What size are pituitary macroadenomas?

A

Greater than 1cm

32
Q

What hormones are produced from the anterior pituitary?

A

ADH

Oxytocin

33
Q

What are the main physiological effects of oxytocin?

A

Expulsion of breast milk

Increase uterine contractions

34
Q

What is TURP syndrome?

A

Complication of Transurethral Resection of the Prostate
Absorption of irrigation fluids in operation through the venous sinuses of prostate –> hyponatraemia as well as other symptoms

35
Q

What is the normal range for serum osmolality?

A

275-296 mmol per kg

36
Q

What is the risk of correcting a hyponatraemia too quickly and what are the symptoms?

A

Central Pontine Myelinolysis - depends on area of brain but generally paralysis, dysphagia, dysarthria

37
Q

Potential causes of hypovolaemic hyponatraemia with raised urinary sodium above 20mmol/l?

A

Diuretics
Addison’s
Salt-losing nephropathies

(remember raised urinary sodium is telling you it’s renal rather than non-renal)

38
Q

Potential causes of hypovolaemic hyponatraemia with low urinary sodium below 20mmol/l?

A

Vomiting
Diarrhoea
Excess sweating
Third space losses (ascites, burns)

Low urinary sodium is telling you it’s non-renal.

39
Q

Potential causes of a euvolaemic hyponatraemia?

A

SIADH
Primary polydipsia
Hypothyroidism

40
Q

Potential causes of a hypervolaemic hyponatraemia with raised urinary sodium greater than 20mmol/l

A

Renal failure

41
Q

Potential causes of a hypervolaemic hyponatraemia with low urinary sodium less than 20mmol/l

A

Cardiac failure
Cirrhosis
Inappropriate IV fluid

42
Q

Elevated blood urea nitrogen
Elevated creatinine
Low urine output

A

AKI

43
Q 
Haematuria
Proteinuria
Hypertension
Azotemia (raised nitrogen blood components)
Blurred vision
Oliguria
A

Nephritic Syndrome

44
Q

Thin glomerular basement membrane with podocytes that have pores large enough to allow blood and protein into the urine

A

Nephritic Syndrome

45
Q

Proteinuria
Hypoalbuminaemia
Oedema

A

Nephrotic syndrome

46
Q

Treatment of nephrotic syndrome?

A

Supportive
Nutrition - proteins
Diuretics to clear oedema
Corticosteroids for kidney damage

47
Q

Muddy brown casts

epithelial cells found in urine

A

Acute tubular necrosis

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