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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?

22
Q

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

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
What action does the following hypothalamic hormone have on the pituitary hormones? - GnRH
LH and FSH release
26
What action does the following hypothalamic hormone have on the pituitary hormones? - TRH
TSH and Prolactin release
27
What action does the following hypothalamic hormone have on the pituitary hormones? - Dopamine
Prolactin inhibition
28
What action does the following hypothalamic hormone have on the pituitary hormones? - CRH
ACTH release
29
When performing a combined pitutary function test, what do you administer and why?
Insulin - observing rise in GH and cortisol in response to hypoglycaemia GnRH - observe LH and FSH TRH - observe rises in TSH and prolactin
30
What size are pituitary microadenomas?
less than 1cm
31
What size are pituitary macroadenomas?
Greater than 1cm
32
What hormones are produced from the anterior pituitary?
ADH | Oxytocin
33
What are the main physiological effects of oxytocin?
Expulsion of breast milk | Increase uterine contractions
34
What is TURP syndrome?
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
What is the normal range for serum osmolality?
275-296 mmol per kg
36
What is the risk of correcting a hyponatraemia too quickly and what are the symptoms?
Central Pontine Myelinolysis - depends on area of brain but generally paralysis, dysphagia, dysarthria
37
Potential causes of hypovolaemic hyponatraemia with raised urinary sodium above 20mmol/l?
Diuretics Addison's Salt-losing nephropathies (remember raised urinary sodium is telling you it's renal rather than non-renal)
38
Potential causes of hypovolaemic hyponatraemia with low urinary sodium below 20mmol/l?
Vomiting Diarrhoea Excess sweating Third space losses (ascites, burns) Low urinary sodium is telling you it's non-renal.
39
Potential causes of a euvolaemic hyponatraemia?
SIADH Primary polydipsia Hypothyroidism
40
Potential causes of a hypervolaemic hyponatraemia with raised urinary sodium greater than 20mmol/l
Renal failure
41
Potential causes of a hypervolaemic hyponatraemia with low urinary sodium less than 20mmol/l
Cardiac failure Cirrhosis Inappropriate IV fluid
42
Elevated blood urea nitrogen Elevated creatinine Low urine output
AKI
43
``` Haematuria Proteinuria Hypertension Azotemia (raised nitrogen blood components) Blurred vision Oliguria ```
Nephritic Syndrome
44
Thin glomerular basement membrane with podocytes that have pores large enough to allow blood and protein into the urine
Nephritic Syndrome
45
Proteinuria Hypoalbuminaemia Oedema
Nephrotic syndrome
46
Treatment of nephrotic syndrome?
Supportive Nutrition - proteins Diuretics to clear oedema Corticosteroids for kidney damage
47
Muddy brown casts | epithelial cells found in urine
Acute tubular necrosis

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