Chemical Pathology 17 - EMQs on Enzymes, Chemistry Flashcards
What type of technetium is used in bone scans vs thyroid scans?
Bone scans: Tc bisphosphonate
Thyroid scans: Tc pertechnate
Which type of nuclear medicine test is most useful for identifying Ca cells themselves?
FDG-PET
Which type of nuclear medicine test is most useful for identifying primary neuroendocrine tumours (eg insulinomas)?
Gallium 68 dotatate PET and CT (identifies somatostatin receptor)
Which type of nuclear medicine test is most useful for parathyroid scans?
Sesta MIBI scan
Which type of nuclear medicine test is most useful for investigating for a phaeochromocytoma?
MIBG (looks for phaeo mets)
Recall the timeline of elevation of troponin I, AST and LDH elevation post-MI
Troponin I - first few hours
AST - first day
LDH - over first 5 days
Which LFT result will be most deranged in obstructive jaundice?
ALP
Descrine the pathophysiology of alcoholic hepatitis causing portal hypertension
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
Which enzymes are most elevated by gallstones vs viral hepatitis and why?
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