Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Path EMQ 1 liners > Chem Path > Flashcards

Chem Path Flashcards

1
Q

Demeclocycline

A

SIADH. Reduces responsiveness of collecting tubules to ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tolvaptan

A

SIADH. V2r antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

DI treatment

A

Thiazide diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Simple heam pathway

A

ALA –> (PBG synthase) PBG –> (HMB synthase) –> porphyrinogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute intermittent porphyria enyzme deficiency and manifestations

A

HMB
Neuro visceral only.
NO cutaneous because absence of porphyrinogens
ALA + PBG in urine = initially coloureless (unlike porphyrinogens) but then oxidise to ‘port wine urine’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Acute intermittent poprphyria precipitating factors

A

ALA synthase inducer = steroids, ethanol, barbiturates
Stress = infection, surgery
Reduced caloric intake
Premenstrual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hereditary coproporphyria and Variegate porphyria are…?

A

Acute porphyrias with skin lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Congenital erythopoietic porphyria
Erythropoietic protoporhyria
Porphyria cutanea tarda
are…?

A

Non-acute porphyrias
Skin lesions ONLY
Raised COLOURED (port wine) porphyrins in faeces or urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Erythropoietic protoporphyria

A

Photosensitivity, burning, itching, oedema following sun exposure.
NO BLISTERS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Porphyria cutanea tarda

A

Uroporphyrinogen decarboxylase deficiency
Vesicles on sun exposed sites
Raised uroporphyrins and coproporphyrics and ferritin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

High uptake hyperthyroidism drug treatment

A

Carbimazole
Propylthiouracil - rarely used now because of risk of aplastic anaemia

(Also symptomatic beta blockade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Osteopenia caused by hypo or hyperthyroidism

A

Hyper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thyroid neoplasia

Psammoma bodies

A

Papillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Thyroid neoplasia

Originate in parafollicular C cells

A

Medullary
Produce calcitonin
MEN2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MEN1

A

Pituitary
Pancreatic (insulinoma)
Parathyroid (hyperparathyroidism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MEN2

A

Parathryoid
Phaeochromocytoma
Medullary thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MEN3

A

Phaeochromocytoma
Medullary thyroid
Mucocutaneous neuromas
(+Marfanoid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cushings disease

A

Pituitary tumour secreting ACTH

HIGH dose dexamethasone (2mg) succeeds in suppressing pituitary cause of Cushings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Causes of Addison’s

A

AI, TB, tumour mets, adrenal haemorrhage, amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Adrenal cortex zones from outside to inside

A

Glomerulosa, Fasciculata, Reticularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Alfacalcidol

A

Vitamin D analogue for those with renal failure (can’t convert vit D to active form)
Can treat hypocalcaemia due to RF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hypercalcaemia, high phosphate, with suppressed PTH

Rarer causes

A 
Sarcoid (+other granulomatous disorders) - expresses renal 1alpha hydroxylase 
Vitamin D excess
Thyrotoxicosis
Milk-alkali syndrome
Thiazide diuretics (mild)
Hypoadrenalism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Alcoholic hep AST:ALT ratio

A

2:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Colestyramine

A

Prevents bile acids from being reabsorbed, thus stimulates production of more BAs which uses up more cholesterol. Therefore lowers LDLs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
LDLR, apoB, PCSK9 dominate mutations in...
Familial hypercholesteraemia PCSK9 binds LDLR and promotes its degredation. Gain of function mutation = Increased degredation of receptor --> higher circulating LDL levels. Novel form of LDL lowering therapy is anti-PCSK9 MAb
26
LipoproteinA is a cardiovascular disease RF that should be treated with...
Nicotinic acid
27
Empagliflozin - SGLT2 inhibitor
Stops Na and glucose reabsorption from proximal tubule - pee out glucose and decreases BP. Good for patients with HF and diabetes
28
Liraglutide - GRP1 agonist
Stimulates release of insulin. Reduction in primary CV outcome in T2DM patients.
29
Aggressive treatment of BP
``` Aspirin High dose statin (atarvastatin 40-80mg) Optimal BP control Thiazides Assess for T2DM ```
30
Retinol
Vitamin A | Deficiency = colour blindness
31
Cholecalciferol
Vitamin D | Deficiency = osteomalacia/rickets
32
Tocopherol
Vitamin E | Deficiency = anaemia/neuropathy
33
Phytomenadione
Vitamin K Deficiency = defective clotting Test PTT time
34
Thiamine
Vitamin B1 Deficiency = Beri Beri, neuropathy and Wernicke's Wet beri beri = fast HF, SOB and leg oedema Dry beri beri = numbness of hands and feet, confusion, trouble moving legs, pain Test RBC transketolase
35
Riboflavin
Vitamin B2 Deficiency = glossitis Test RBC glutathione reductase
36
Pyridoxine
Vitamine B6 Deficiency = dermatitis/anaemia. Test RBC AST activation
37
Cobalamin
Vitamin B12 | Deficiency = pernicious anaemia
38
Ascorbate
Vitamin C | Defciency = scurvy
39
Folate
Deficiency = megaloblastic aneamia, NT defect
40
Niacin
Vitamin B3 | Deficiency = Pellagra - dementia, dermatitis, diarrhoea
41
Iodine
Deficiency = goitre/hypothyroid
42
Copper
Deficiency = anaemia
43
Flouride
``` Deficiency = dental caries Excess = flourosis, mottled enamel ```
44
Zinc
Deficiency = dermatitis
45
Cystic fibrosis
Mutation in CFTR. Failure of Cl ion movement from inside epithelial cell into lumen --> increased reabsorption of Na and water --> viscous secretions Screening test - IMMUNE REACTIVE TRYPSIN (Trypsinogen produced by pancreas and transported to intestine, in CF mucus obstructs pancreatic ducts)
46
PKU
Phenylalanice hydroxylase deficiency Blue eyes, fair hair/skin Retardation
47
Medium chain AcylCoA dehydrogenase deficiency
Fatty acid oxidation disorder - impaired ability to break down medium chain fatty acids. Hypoglycaemia and sudden death triggered by fasting or vomiting LOW KETONES Acylcarnitine levels by tandem mass spec Treat with regular CHO
48
Specificity
% probability that someone without the disease with correctly test negative
49
Sensitivity
% probability that someone WITH the disease will correctly test positive
50
PPV
Probability that someone who tests positive actually has the disease
51
NPV
Probability that someone who tests negative doesn't actually have the disease
52
Urea cycle disorders
9 in total High ammonia Encephalopathy, developmental delay, respiratory alkalosis Treat with low protein diet
53
Organic acidurias
Involve the metabolism of branched chain amino acids (leucine, isoleucine, valine). Truncal hypotonia, limb hypertonia, myoclonic jerks, UNUSUAL ODOUR Metabolic acidosis with high anion gap (not lactate) Neutropenia Treat with low protein diet, acylcarnitine, haemofiltration Invx: blood spot carnitine profile
54
Maple syrup urine disease
Sweaty feet
55
Galactosaemia
Conjugated hyperbilirubinaemia, hepatomegaly, sepsis, hypoglycaemia Cataracts Mx: Low lactose/galactose diet
56
Glycogen storage disorder
Excessive glycogen storage, but also prevents glucose export from gluconeogenetic organs Present at 3-6 months, hypoglycaemia with lactic acidosis Treat with regular CHO
57
Mitochondrial disorders
E.g. MELAS Defective oxidative phosphorylation Can present in ANY ORGAN at ANY TIME with ANY FORM OF INHERITANCE Classic presentation is chronic muscle weakness with hyperlactataemia Elevated lactate after periods of fasting (overnight) Elevated CK Invx: muscle biopsy/ragged red fibres
58
Peroxisomal disorders
Cannot catabolise very long fatty acids or make bile acids
59
Lysosomal disorders
e.g. Tay Sachs Neuroregression Slow progressing
60
Diabetes diagnosis
Fasting glucose >7 Glucose tolerance test >11.1 Random glucose >11.1 HbA1c >48
61
Impaired glucose tolerance
Oral glucose tolerance test >7.8 but <11.1
62
Impaired fasting glucose
>6.1 but <7
63
Low glucose
Increase in ACTH, cortisol and GH
64
Causes of increased insulin with low glucose
``` Insulinoma Qunine (malaria treatment ) Pentamidin - antimicrobial for PCP, toxo, leishmania Sulphonylureas Beckwith Weidemam syndrome ```
65
Low glucose, low insulin
Liver failure Starvation Anorexia Adrenal failure - lack of adrenaline, NA and cortisol to raise glucose
66
Paediatric renal function
Low GFR Less reabsorption Reduced concentrating ability Persistant Na loss due to relatively ALD insensitive distal tubules
67
Normal GFR
120ml/hr
68
Measures of GFR
Inulin - research purposes | Creatinine - look for CHANGE OVER TIME to ESTIMATE GRF
69
AKI
Rise in serum creatinine over 26.5 in 48 hrs, or 1x5 baseline in 48 hrs (over 3x is severe) OR Urine output <0.5mls/kg/hr
70
Indications for dialysis
``` Pulmonary oedema Hyperkalaemia Metabolic acidosis Uraemic encephalopathy Drug toxicity (e.g. lithium) ```
71
CKD stages
``` Stage 1 = GFR>90 2 = 60-89 3 = 30-59 4 = 15-29 5 = <15 ```
72
CKD common causes
Diabetes Atherosclerotic renal disease HTN
73
CKD consequences
``` Acidosis Hyperkalaemia Anaemia (EPO) Renal Bone disease (vitamin D) CVD disease: vascular calcification and subsequent atherosclerosis (biggest morality), uraemic cardiomyopathy Uraemia and death ```
74
Gout and purine metabolism
Purines --> hypo-xanthine --> oxidised by xanthine oxidase to xanthine then urate Purine: adenosine, guanosine and inosine
75
Rate limiting step of de novo purine synthesis
PAT enzyme Only predominates in organs with high cell turnover, ie bone marrow, because purine synthesis is metabolically very hard work
76
Main enzyme in salvage pathway
HPRT | Dominate pathway in purine synthesis (salvages purine from purine catabolism)
77
Lesch Nyhan syndrome
Can't do salvage pathway - massively removes feedback inhibition of PAT --> high urate levels Developmental delay apparent at 6 months Choreiform movements at 1 year Spasticity, mental retardation SELF MUTILATION - bites lips and digits Hyperuricaemia - gouty arthropathy
78
Secondary causes of hyperuricaemia
Any condition with increased cell turnover, e.g. myeloproliferative disorder, chronic haemolytic anaemia, sever psoriasis... Decreased urate excretion - CRF
79
Gout most commonly in...
1st metatarsal phalangeal joint | MONOSODIUM URATE CRYSTALS
80
Gout managment
Reduce inflammation: NSAIDs, colchicine, glucocorticoids ALLOPURINOL - inhibits xanthine oxidase, hence inhibits production of uric acid Increase renal excretion with PROBENECID
81
Gout investigations
Tap effusion View sample from joint with POLARISED LIGHT MICROSCOPE THROUGH RED FILTER Urate cyrstals are NEGATIVELY BIREFRINGENT - they appear BLUE PERPENDICULAR to red compensator filter. Also NEEDLE SHAPED. Pyrophosphate crystals are positively birefringent in the same axis to red compensator (pseudogout)

Path EMQ 1 liners (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions