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Path Past > Chem Path > Flashcards

Chem Path Flashcards

1
Q

Deficiency in a vegan woman

A

B12 and Iron and probably lots of other things

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2
Q

Intrinsic Factor deficiency causes…

A

B12 deficiency

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3
Q

Polyendocrinopathies (Schmidt’s Syndrome)

A

Addisons, T1DM, Hypothyroidism. Also associated with pernicious anaemia and coeliac disease so B12 deficiency again

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4
Q

Crohn’s Nutritional deficiency due to affected terminal ileum

A

B12

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5
Q

Coeliac Can Cause

A

Iron, calcium, folate and b12

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6
Q

Indian woman presents with tiredness with macrocytic anaemia. and is vegan

A

B12 deficiency

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7
Q

Patient with coeliac has glossitis and blood film shows macrocytic anaemia

A

B12 deficiency

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8
Q

Patient with dementia symptoms and dermatitis and diarrhoea

A

B3/Niacin causing Pellagra

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9
Q

6 year old boy with bowed legs

A

Rickets. Vit D deficiency

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10
Q

A patient with high PTH. You suspect osteomalacia

A

Vit D deficiency

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11
Q

What do you give in Wernicke’s encephalopathy

A

Thiamine (B1)

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12
Q

What deficiency causes Beri Beri?

A

Thiamine (B1)

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13
Q

What deficiency raises PTH levels?

A

Vitamin D

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14
Q

Only raised ALP. with bone pain

A

Paget’s

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15
Q

LFT’s for: Intrahepatic cholestasis abnormality

A

Raised ALP and bilirubin

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16
Q

LFT’s for Cirrhosis

A

Raised AST and ALT

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17
Q

LFT’s for Gilberts

A

Mildly raised unconjugated bilirubin, all else normal

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18
Q

LFT’s for Viral Hepatitis

A

ALT>AST

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19
Q

LFT’s for Paracetamol Overdose

A

Massively raised AST and ALT

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20
Q

LFT’s for Alcoholic Liver Disease

A

AST>ALT

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21
Q

LFT’s for Gallstones

A

Raised ALP and conjugated bilirubin

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22
Q

Haemachromatosis and what stain is used

A

Build up of iron in liver and dye used is Prussian blue stain

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23
Q

Rate limiting enzyme in haem synthesis

A

ALA Synthase

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24
Q

Deficiency leads to high urate levels and can cause Lesch Nyhan syndrom

A

HGPRT

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25
Q

What condition and enzyme deficiency can present as a salt wasting crisis

A

CAH and 21 hydroxylase deficiency

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26
Q

What can be used to diagnose Beta Thalassaemia trait?

A

HbA2 levels raised.

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27
Q

What enzyme is raised in mumps

A

Amylase

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28
Q

What do you see in a patient with T1DM’s kidneys

A

Renal sclerosis

29
Q

Emphysema in a non-smoker

A

A1AT deficiecny

30
Q

Normal Ca, Phosphate and PTH levels

A

Ca 2.2-2.6
Phosphate 0.8-1.4
PTH 0.8-8.5

31
Q

Osteoporosis Bloods

A

Normal

32
Q

Osteomalacia Bloods

A 
Low Vitamin D
Raised PTH
Raised ALP
Low/Normal calcium
Low/Normal Phosphate
33
Q

Breast Cancer with Mets Bone Bloods

A 
Raised ALP
Raised Calcium
Low PTH
Raised Phosphate
Vit D can be anything
34
Q

Paget’s Disease Bone Bloods

A

Raised ALP

Rest Normal

35
Q

Primary Hyperparathyroidism Bone Bloods

A 
Raised (or inappropriately normal) PTH
Raised Calcium
Low Phosphate
Variable ALP
Variable Vitamin D
36
Q

Renal Bone Disease Bone Bloods

A 
Low or Borderline Calcium
Raised PTH
Increased Phosphate
ALP raised or normal
Vitamin D normal
Due to decreased 1 alpha hydroxylase
37
Q

Hypoparathyroidism Bone Bloods

A 
Low PTH
Low Calcium
Raised Phosphate
Normal Vitamin D
Normal ALP
38
Q

What would the potassium be in a patient with untreated DKA be?

A

Raised Potassium

39
Q

How to calculate osmolality

A

2(Na+K)+urea+glucose

40
Q

How to calculate anion gap

A

Na+K-Cl-Bicarb

41
Q

Impaired Glucose tolerance values

A

7.8-11.1

42
Q 
Patient with bloods:
Raised glucose
Raised Potassium
Acidotic pH
Low Bicarb
A

DKA

43
Q 
Patient with bloods
Raised glucose
Raised Na
Raised osmolality
Normal pH
Normal Bicarb
A

HONK

44
Q

What would bicarbonate levels be in pyloric stenosis?

A

Raised bicarbonate levels.

You get a hypochloraemic hypokalaemic metabolic alkalosis

45
Q

Low Sodium, High potassium, low Mg

A

Addison’s

46
Q

High sodium, low potassium, HTN

A

Conn’s

47
Q

A 67-year-old woman presented with confusion 2 days after a cholecystectomy. She had experienced some pain postoperatively, largely relieved by analgesia. On examination, she was disoriented, her heart rate was 66 beats per minute and her blood pressure was 162/82 mmHg. She only had minor discomfort of the abdomen. The urine sodium was 90mmol/l (NR 20-200mmol/l depending on hydration of patient).

The figure below shows the colours you would see on the dipstick after it has been dipped in the urine, and it was yellow in colour, consistent with an SG of 1.030.

Investigations:

Haemoglobin 130 g/L (115-165)

MCV 92 fL (80-96)

white cell count and platelet count normal

serum sodium 120 mmol/L (137-144)

serum potassium 3.7 mmol/L (3.5-4.9)

serum urea 3 mmol/L (2.5-7.0)

serum creatinine 90 µmol/L (60-110)

serum albumin 36 g/L (37-49)

random plasma glucose 5 mmol/L

A

SIADH

48
Q

High serum osmolality and high sodium. Low urine osmolality

A

DI

49
Q

High serum osmolality High potassium

A

DKA

50
Q

Impaired glucose tolerance test
Diabetes glucose tolerance
Fasting glucose diabetes
Impaired fasting glucose

A

7.8-11
>11
>7
6.1-6.9

51
Q

High LH
High FSH
All else normal

A

Premature ovarian failure

52
Q

Slightly raised prolactin

Rest normal

A

Non-functioning adenoma

53
Q

Significantly raised prolacting

A

Prolactin secreting macroadenoma

54
Q

Raised GH, others suppressed. How to daignose

A

Acromegaly, glucose tolerance test

55
Q

Myxoedema

A

Raised TSH

Low T3, Low T4

56
Q

Polyuria, polydipsia, hyponatraemia and high serum osmolality, high serum glucose

A

Diabnetes Mellitus, Pseudohyponatraemia

57
Q

Polyuria, polydipsia, high serum osmolality, low urine osmolality

A

DI

58
Q

Patient three days post OP, has low sodium, raised urine osmolality. Euvolaemic

A

SIADH

59
Q

`Hypovolaemic hyponatraemia

A

D+V, Diuretics, Salt losing nephropathy

If urine sodium is low, then it’s likely to be non-kidney

60
Q

Hypervolaemic hyponatraemia

A

Kidney, liver and heart failures

61
Q

Euvolaemic hyponatraemia

A

Hypothyroidism, Adrenal Insufficiency, SIADH.

62
Q

Low Sodium, High Potassium, HTN

A

Addison’s

63
Q

Woman with thin skin, proximal myopathy, impaired fasting glucose. DM excluded already, what test to do and what diagnosis?

A

Dexamethasone suppression test

Cushing’s syndrome

64
Q

Polyuria, polydypsia, low sodium on bloods, normal serum osmolality. What test to do next?

A

Blood glucose as it may be pseudohyponatraemia

65
Q

Patient notices swollen big fingers and ring doesn’t fit anymore. What test to do next?

A

Oral glucose tolerance test
Acromegaly
Measure GH levels

66
Q

Addison’s disease test

A

Short SynACTHen test

67
Q

Best way to monitor blood glucose control over a period of 2-3 months

A

HbA1C

68
Q

What hormone lowers calcium levels

A

calcitonin

69
Q

Raised TSH, Raised T4, Low T3

A

TSH secreting tumour OR poor sensitivity to TSH (ie body doesn’t recognise T4 is present enough so TSH is high)

Path Past (8 decks)

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