Chemical Pathology 17 - EMQs on Enzymes, Chemistry Flashcards

1
Q

What type of technetium is used in bone scans vs thyroid scans?

A

Bone scans: Tc bisphosphonate

Thyroid scans: Tc pertechnate

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2
Q

Which type of nuclear medicine test is most useful for identifying Ca cells themselves?

A

FDG-PET

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3
Q

Which type of nuclear medicine test is most useful for identifying primary neuroendocrine tumours (eg insulinomas)?

A

Gallium 68 dotatate PET and CT (identifies somatostatin receptor)

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4
Q

Which type of nuclear medicine test is most useful for parathyroid scans?

A

Sesta MIBI scan

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5
Q

Which type of nuclear medicine test is most useful for investigating for a phaeochromocytoma?

A

MIBG (looks for phaeo mets)

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6
Q

Recall the timeline of elevation of troponin I, AST and LDH elevation post-MI

A

Troponin I - first few hours
AST - first day
LDH - over first 5 days

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7
Q

Which LFT result will be most deranged in obstructive jaundice?

A

ALP

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8
Q

Descrine the pathophysiology of alcoholic hepatitis causing portal hypertension

A

Alcoholic hepatitis –> hepatocyte death
The person becomes ill and recovers, and the hepatocytes regenerate. However, rather than regenerating as before, they form a NODULE
This nodule disrupts hepatic micro-architecture between the portal vein and the central vein
If enough nodules appear, this increases pressure in the portal vein –> portal HTN

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9
Q

Which enzymes are most elevated by gallstones vs viral hepatitis and why?

A

Gallstones: ALP - stones tend to cause most damage near portal triad, where more ALP is made

Viral hepatitis - ALT - the virus tends to affect hepatocytes around the central vein the most, where ALT is predominantly produced

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