Chem Path BB Flashcards
Viral hepatitis genome types
Hep A = +ssRNA Heb B = dsDNA Hep C = +ssRNA Hep D = -ssRNA Hep E = +ssRNA
A liver enzyme raised after a myocardial infarction
Alkaline Phosphatase
1) APTT measures effect of what drug and pathway
2_ PT measures…
APTT: Heparin, intrinsic pathway
PT: warfarin, extrinsic pathway
Varies with posture when sample is taken.
albumin
varies with exercise
creatine kinase
medication for respiratory condition, causes heart attacks
Theophylline
Phase i of metabolism of lipid soluble drugs
cytochrome P450 oxidation
Features of digoxin toxicity
arrhythmia: the most common arrhythmias are ventricular extrasystoles, ventricular bigeminy / trigeminy and atrial tachycardia with complete heart block
anorexia, nausea and vomiting and occasionally, diarrhoea
confusion especially in the elderly
yellow vision (xanthopsia), blurred vision and photophobia
Decreased excretion, increased plasma concentration and increased risk of toxicity may occur when this taken in conjunction with thiazide diuretics
Lithium
Symptoms of under treatment and toxicity may be similar
Digoxin
Is ototoxic and nephrotoxic
Gentamycin
peak and trough levels should be taken
Gentamycin
urine test was found to be positive for 6-MAM
Heroin
agressive, paranoid, heart racing, then dead.
cocaine
Breakdown products of cocaine
EME = ecgonine methyl ester
BE = benzoylecgonine
accidentally ingested liquid paraquat. Rx?
activated charcoal
Carbon monoxide poisoning Rx:
Hyperbaric O2
massive overdose of atenolol.
IV atropine, then glucagon if needed
Which of the above techniques can be used to test for benzodiazepines and various antipsychotic drugs?
Liquid chromatography
Which can look for all the classes of drugs of abuse
Immunoassay
Which drug is found in the most addict related deaths?
morphine
Hypovolaemic with urinary Na+<10 mmol/L
vomiting
Hypotension with urinary Na+>20 mmol/L
Diuretic excess
Hypervolaemic with urinary Na+>20 mmol/L
Chronic renal failure
Prev. congestive heart failure, likely cause of hypokalaemia
Diuretic use
Cortisol suppressed only by HIGH dose dex suppression test
Cushing’s DISEASE
The commonest enzyme deficiency seen in CAH
21 hydroxylase deficiency
Levels of this steroid are raised in the serum of CAH patients
17 hydroxyprogesterone
Increased levels are seen in the urine of CAH patients
pregnanetriol
A good indicator of renal function
Serial creatinine readings
Renal complications of ACEi
Renal artery stenosis
Useful in staging and monitoring treatment of extracapsular spread of prostatic carcinoma
Acid phosphatase
Raised in active sarcoidosis
Angiotensin converting enzyme (ACE)
Which enzyme rapidly rises post myocardial infarction but then rapidly declines and is a useful marker of reinfarction?
Creatine kinase MB
Following chemotherapy (for Hodgkin’s lymphoma?) which enzyme would you expect to be elevated?
LDH
Organophosphate poisoning, what is raised
Plasma cholinesterase
SCID is frequently caused by a deficiency in which enzyme?
Adenosine deaminase
McArdle’s glycogen storage disease (type V), which enzyme deficiency
Mycophosphorylase
Which enzyme deficiency in Fabry’s
Galactosidase A
south-east asian, difficulty seeing in dark, kidney stones
Vit A deficiency
Askanazy cells
Hashimoto’s thyroiditis
young man, stridor, multi-nodular goitre
simple colloid goitre
Tender goitre, unvaccinated child
Giant cell thyroiditis (This IS the same as De queverain’s)
Recommended therapy used in an attack of acute intermittent porphyria,
Haem arginate
Drug that can result in chronic porphyria
alcohol
Neurotoxic product(s) of heme breakdown producing neurovisceral damage in certain porphyrias
5-aminolevulinic acid
Autosomal dominantly inherited (or spontaneous mutation) porphyria with cutaneous manifestations only, resulting from uroporphyrinogen decarboxylase deficiency
porphyria cutanea tarda
Product(s) of heme breakdown resulting in photosensitivity (i.e. cutaneous) damage in certain porphyrias
activated porphyrins and oxygen free radicals
