Chemical Pathology Flashcards
A 65-year-old chronic alcoholic presents to the A&E Department with a minor head injury. On examination he is found to be pale. Blood tests show a high MCV. What is the likeliest result of MCV (fl) in a normal person?
All Answer Choices A. 15 B. 30 C. 130 D. 290 E. 4 F. 2.2 G. 90
G. 90
A 40-year-old woman presents with a two month history of tiredness, intermittent pyrexia and abdominal pain. On examination she has an enlarged palpable spleen. Blood tests show anaemia with a raised white cell count. What is the likeliest result of a white cell count (x 109 per l) in a normal person?
All Answer Choices A. 15 B. 30 C. 130 D. 290 E. 4 F. 2.2 G. 90
E. 4
A 5-year-old boy presents with a purpuric rash and petechiae following a recent viral infection. Blood tests showed thrombocytopenia. What is the likeliest result of a platelet count (x109/l) in a normal adult?
All Answer Choices A. 15 B. 30 C. 130 D. 290 E. 4 F. 2.2 G. 90
D. 290
A 35-year-old man presents with hypertension. Blood tests show normal sodium, urea and glucose and a raised potassium. What is the likeliest result of potassium (mmol/l) in a normal person?
All Answer Choices A. 15 B. 30 C. 130 D. 290 E. 4 F. 2.2 G. 90
E. 4
A 70-year-old woman presents in a coma with a long history of polyuria and polydipsia. Investigations show that her plasma osmolarity is raised. What is the likeliest result of plasma osmolarity (mmol/l) in a normal person?
All Answer Choices A. 15 B. 30 C. 130 D. 290 E. 4 F. 2.2 G. 90
D. 290
A 14-year-old boy presents with symptoms of chronic liver failure. LFTs display abnormally high levels of transaminases with normal alk phos & bilirubin levels. There’s marked accumulation of copper-associated protein in hepatocytes obtained from a biopsy. His serum copper levels and caeruloplasmin are abnormally low.
A. Wilson's disease B. Chronic hepatitis C C. Primary hepatocellular carcinoma D. Chronic hepatitis B E. Crigler Najjar syndrome F. Hepatitis A G. Primary biliary cirrhosis H. Budd-Chiari syndrome
A. Wilson’s disease
A 30-year-old Thai male presents to a day surgery unit for a cholecystectomy. His LFTs reveal very elevated transaminases with normal bilirubin & alk phos levels. Microscopy of a liver biopsy identifies antigens from a dsDNA virus in the cytosol of hepatocytes.
A. Wilson's disease B. Chronic hepatitis C C. Primary hepatocellular carcinoma D. Chronic hepatitis B E. Crigler Najjar syndrome F. Hepatitis A G. Primary biliary cirrhosis H. Budd-Chiari syndrome
D. Chronic hepatitis B
A 58-year-old woman presents with recent onset of Jaundice. LFTs reveal increased bilirubin & markedly elevated alk phos & normal transaminases. Further investigations uncovered raised IgM and serum cholesterol. Anti mitochondrial antibodies are also detected. A liver biopsy shows enlargement of the portal tracts by white blood cells and granulomas. Bile ducts are also less than normal.
A. Wilson's disease B. Chronic hepatitis C C. Primary hepatocellular carcinoma D. Chronic hepatitis B E. Crigler Najjar syndrome F. Hepatitis A G. Primary biliary cirrhosis H. Budd-Chiari syndrome
G. Primary biliary cirrhosis
A 48-year-old male returning from a 6mths round the world trip presents with a recent Hx of nausea, anorexia & distaste for cigarettes. He developed jaundice; his urine became dark and his stools pale. His spleen was palpable. Investigations showed bilirubinuria, increased urinary urobilinogen & a raised serum AST & ALT. Within 4 weeks his symptoms had completely subsided.
A. Wilson's disease B. Chronic hepatitis C C. Primary hepatocellular carcinoma D. Chronic hepatitis B E. Crigler Najjar syndrome F. Hepatitis A G. Primary biliary cirrhosis H. Budd-Chiari syndrome
F. Hepatitis A
A 55-year-old woman presents with a short Hx of nausea and abdominal pain; tender hepatomegaly and ascities. LFTs show mildly raised transaminases, bilirubin and normal alk phos. The woman also had polycythaemia rubra vera. Liver biopsy suggests venous outflow obstruction.
A. Wilson's disease B. Chronic hepatitis C C. Primary hepatocellular carcinoma D. Chronic hepatitis B E. Crigler Najjar syndrome F. Hepatitis A G. Primary biliary cirrhosis H. Budd-Chiari syndrome
H. Budd-Chiari syndrome
A liver enzyme raised after a myocardial infarction
A. Aspartate transaminase B. Alanine transaminase C. Gamma globulin D. Albumin E. Alkaline phosphatase F. Gamma glutamyl transpeptidase G. Prothrombin time H. Total bilirubin I. Activated partial thromboplastin time J. Direct bilirubin
A. Aspartate transaminase
A test of the integrity of the extrinsic pathway
A. Aspartate transaminase B. Alanine transaminase C. Gamma globulin D. Albumin E. Alkaline phosphatase F. Gamma glutamyl transpeptidase G. Prothrombin time H. Total bilirubin I. Activated partial thromboplastin time J. Direct bilirubin
G. Prothrombin time
The intrinsic pathway is initiated by the activation of the ‘contact factor’ of plasma and can be measured by the a PTT test. The extrinsic pathway is initiated by the release of tissue factor and can be measured by the PT test.
An enzyme markedly raised in obstructive jaundice along with direct bilirubin
A. Aspartate transaminase B. Alanine transaminase C. Gamma globulin D. Albumin E. Alkaline phosphatase F. Gamma glutamyl transpeptidase G. Prothrombin time H. Total bilirubin I. Activated partial thromboplastin time J. Direct bilirubin
E. Alkaline phosphatase
Raised in alcohol abuse
A. Aspartate transaminase B. Alanine transaminase C. Gamma globulin D. Albumin E. Alkaline phosphatase F. Gamma glutamyl transpeptidase G. Prothrombin time H. Total bilirubin I. Activated partial thromboplastin time J. Direct bilirubin
F. Gamma glutamyl transpeptidase
Levels can be affected by diet
A. Aspartate transaminase B. Alanine transaminase C. Gamma globulin D. Albumin E. Alkaline phosphatase F. Gamma glutamyl transpeptidase G. Prothrombin time H. Total bilirubin I. Activated partial thromboplastin time J. Direct bilirubin
D. Albumin
Levels can be affected by diet
A. Aspartate transaminase B. Alanine transaminase C. Gamma globulin D. Albumin E. Alkaline phosphatase F. Gamma glutamyl transpeptidase G. Prothrombin time H. Total bilirubin I. Activated partial thromboplastin time J. Direct bilirubin
D. Albumin
A 26-year-old receptionist presents to her GP with a history steatorrhoea, abdominal pain and weight loss, as well as feeling tired all the time. Initial blood tests reveal a microcytic anaemia.
A. Anti-DsDNA B. Anti-gastric parietal cell antibodies C. Anti-acetylcholine receptor antibody D. Ham's test E. c-ANCA F. Anti-scl70 G. Anti-smooth muscle antibody H. Anti-endomysial antibodies I. ANA J. p-ANCA K. Osmotic fragility test L. Anti-GAD M. Anti-mitochondrial antibody
H. Anti-endomysial antibodies
Coeliac disease: Anti-endomysial antibodies/ Tissue-transglutaminase antibodies
A 60-year-old woman with hypothyroidism presents with progressive dyspnoea and tiredness. FBC reveals macrocytic anaemia.
A. Anti-DsDNA B. Anti-gastric parietal cell antibodies C. Anti-acetylcholine receptor antibody D. Ham's test E. c-ANCA F. Anti-scl70 G. Anti-smooth muscle antibody H. Anti-endomysial antibodies I. ANA J. p-ANCA K. Osmotic fragility test L. Anti-GAD M. Anti-mitochondrial antibody
B. Anti-gastric parietal cell antibodies
Pernicious anaemia: Anti-intrinsic factor antibodies, and gastric parietal antibodies.
A 40-year-old plumber presents to his GP with a history of wheezing and lethargy, along with recurrent nose bleeds. On examination he has crackles in his upper left lung field. Urine dipstick is positive for blood and protein.
A. Anti-DsDNA B. Anti-gastric parietal cell antibodies C. Anti-acetylcholine receptor antibody D. Ham's test E. c-ANCA F. Anti-scl70 G. Anti-smooth muscle antibody H. Anti-endomysial antibodies I. ANA J. p-ANCA K. Osmotic fragility test L. Anti-GAD M. Anti-mitochondrial antibody
E. c-ANCA
Wegener’s : Antibody to Proteinase-3 : 3 is the 3rd letter of the alphabet; c-ANCA
A 30-year-old market trader presents with tiredness and jaundice, and further history reveals he suffered from a chest infection one week previously. On examination mild splenomegaly is noted, and blood tests show reticulocytosis, hyperbilirubinaemia, and spherocytosis.
A. Anti-DsDNA B. Anti-gastric parietal cell antibodies C. Anti-acetylcholine receptor antibody D. Ham's test E. c-ANCA F. Anti-scl70 G. Anti-smooth muscle antibody H. Anti-endomysial antibodies I. ANA J. p-ANCA K. Osmotic fragility test L. Anti-GAD M. Anti-mitochondrial antibody
K. Osmotic fragility test
Spherocytosis: Osmotic fragility test.
An 80-year-old retired clerk presents with a 2-month history of skin itching and lethargy. Examination is normal. LFTs are: bilirubin 6umol/l (reference range 0-17umol/l); ALT 24U/l (reference range 0-31U/l); Alk Phos 500U/l (reference range 30-130U/l).
A. Anti-DsDNA B. Anti-gastric parietal cell antibodies C. Anti-acetylcholine receptor antibody D. Ham's test E. c-ANCA F. Anti-scl70 G. Anti-smooth muscle antibody H. Anti-endomysial antibodies I. ANA J. p-ANCA K. Osmotic fragility test L. Anti-GAD M. Anti-mitochondrial antibody
M. Anti-mitochondrial antibody
PBC - AMA E2 subtype of pyruvate dehydrogenase complex
A 10-year-old girl presents with weight loss, polyuria, tachypnoea, vomiting. Looks very dehydrated. Beta hydroxybutyrate is raised in the blood.
A. Anti-DsDNA B. Anti-gastric parietal cell antibodies C. Anti-acetylcholine receptor antibody D. Ham's test E. c-ANCA F. Anti-scl70 G. Anti-smooth muscle antibody H. Anti-endomysial antibodies I. ANA J. p-ANCA K. Osmotic fragility test L. Anti-GAD M. Anti-mitochondrial antibody
L. Anti-GAD
Type 1 diabetes: Anti-Glutamic acid decarboxylase antibodies (Anti-GAD).
A 55-year-old woman is warned of future risk of AML given her recent diagnosis of PNH following a spontaneous cerebral venous sinus thrombosis.
A. Anti-DsDNA B. Anti-gastric parietal cell antibodies C. Anti-acetylcholine receptor antibody D. Ham's test E. c-ANCA F. Anti-scl70 G. Anti-smooth muscle antibody H. Anti-endomysial antibodies I. ANA J. p-ANCA K. Osmotic fragility test L. Anti-GAD M. Anti-mitochondrial antibody
D. Ham’s test
Paroxysmal nocturnal haemoglobinuria (PNH): Ham’s test.
A 40-year-old woman presents with polyuria and polydipsia. She has a fasting glucose 5.1mmol/L and an oral glucose tolerance test value of 5.0mmol/L. She has a corrected calcium of 2.80mmol/L and a PTH of 7.2pmol/L.
A. Impaired glucose tolerance B. Secondary hyperthyroidism C. Psychogenic polydipsia D. Crohn’s disease E. Gestational diabetes F. Primary hyperparathyroidism G. Hypocalcaemia H. Lung cancer I. Tuberculosis J. Impaired fasting glucose K. Malignancy L. Diabetes mellitus type 1 M. Diabetes mellitus type 2 N. Vitamin D deficiency O. Sarcoidosis
F. Primary hyperparathyroidism
A 35-year-old Afro-Caribbean woman presents with polyuria and polydipsia. She also complains of a dry cough. She has a fasting glucose of 5.8mmol/L and an oral glucose tolerance test value of 6.5mmol/L. She has a corrected calcium of 2.7mmol/L and a PTH of <0.1pmol/L.
A. Impaired glucose tolerance B. Secondary hyperthyroidism C. Psychogenic polydipsia D. Crohn’s disease E. Gestational diabetes F. Primary hyperparathyroidism G. Hypocalcaemia H. Lung cancer I. Tuberculosis J. Impaired fasting glucose K. Malignancy L. Diabetes mellitus type 1 M. Diabetes mellitus type 2 N. Vitamin D deficiency O. Sarcoidosis
O. Sarcoidosis
A 15-year-old girl presents with weight loss, polyuria and polydipsia. Over the last few months she reports feeling increasingly tired and complains of perianal itching. On examination you notice a small perianal abscess. Her fasting glucose is 22.3mmol/L. His corrected calcium is 2.5mmol/L and his PTH is 7.0pmol/L.
A. Impaired glucose tolerance B. Secondary hyperthyroidism C. Psychogenic polydipsia D. Crohn’s disease E. Gestational diabetes F. Primary hyperparathyroidism G. Hypocalcaemia H. Lung cancer I. Tuberculosis J. Impaired fasting glucose K. Malignancy L. Diabetes mellitus type 1 M. Diabetes mellitus type 2 N. Vitamin D deficiency O. Sarcoidosis
L. Diabetes mellitus type 1
A 56-year-old obese woman presents with polyuria and polydipsia. She complains of tiredness and depression. Her fasting glucose is 4.9mmol/L and her OGTT is 4.5mmol/L. She has a corrected calcium of 2.4mmol/L and a PTH of 7.1mmol/L.
A. Impaired glucose tolerance B. Secondary hyperthyroidism C. Psychogenic polydipsia D. Crohn’s disease E. Gestational diabetes F. Primary hyperparathyroidism G. Hypocalcaemia H. Lung cancer I. Tuberculosis J. Impaired fasting glucose K. Malignancy L. Diabetes mellitus type 1 M. Diabetes mellitus type 2 N. Vitamin D deficiency O. Sarcoidosis
C. Psychogenic polydipsia
A 58-year-old Afro-Caribbean gentleman presents with polyuria, polydipsia and weight loss. He has an oral glucose tolerance test of 10.1mmol/L. His corrected calcium is 2.5mmol/L and his PTH is 7.0pmol/L.
A. Impaired glucose tolerance B. Secondary hyperthyroidism C. Psychogenic polydipsia D. Crohn’s disease E. Gestational diabetes F. Primary hyperparathyroidism G. Hypocalcaemia H. Lung cancer I. Tuberculosis J. Impaired fasting glucose K. Malignancy L. Diabetes mellitus type 1 M. Diabetes mellitus type 2 N. Vitamin D deficiency O. Sarcoidosis
A. Impaired glucose tolerance
Varies with posture when sample is taken.
A. Creatinine Kinase B. ALT C. Urea D. Potassium E. Cortisol F. Albumin G. Glucose H. Triglycerides I. ALP
F. Albumin
Plasma renin activity also varies with posture - it rises in the upright position. Some people have so-called benign postural and/or exercise-induced albuminuria.
Varies with exercise
A. Creatinine Kinase B. ALT C. Urea D. Potassium E. Cortisol F. Albumin G. Glucose H. Triglycerides I. ALP
A. Creatinine Kinase
Increases during pregnancy
A. Creatinine Kinase B. ALT C. Urea D. Potassium E. Cortisol F. Albumin G. Glucose H. Triglycerides I. ALP
I. ALP
Varies with race
A. Creatinine Kinase B. ALT C. Urea D. Potassium E. Cortisol F. Albumin G. Glucose H. Triglycerides I. ALP
A. Creatinine Kinase
Most likely to vary with time of sampling
A. Creatinine Kinase B. ALT C. Urea D. Potassium E. Cortisol F. Albumin G. Glucose H. Triglycerides I. ALP
E. Cortisol
A 19-year-old woman admitted to hospital with acute asthma suffered a cardiac arrest after treatment. She was already taking several medications for her respiratory condition. What drug excess is likely to have caused this problem?
A. Kidneys B. Conjugation by sulphate/gluconaride C. Oxidation by cytochrome P450 D. Poor compliance E. Lungs F. Low therapeutic index G. Liver H. Theophylline I. High therapeutic index J. Digoxin K. Gentamicin L. Rosiglitazone M. Warfarin N. GI system
H. Theophylline
Failure to respond to drug therapy is commonly caused by what?
A. Kidneys B. Conjugation by sulphate/gluconaride C. Oxidation by cytochrome P450 D. Poor compliance E. Lungs F. Low therapeutic index G. Liver H. Theophylline I. High therapeutic index J. Digoxin K. Gentamicin L. Rosiglitazone M. Warfarin N. GI system
D. Poor compliance
Lipid soluble drugs require metabolism by the liver in two phases. What is Phase I?
A. Kidneys B. Conjugation by sulphate/gluconaride C. Oxidation by cytochrome P450 D. Poor compliance E. Lungs F. Low therapeutic index G. Liver H. Theophylline I. High therapeutic index J. Digoxin K. Gentamicin L. Rosiglitazone M. Warfarin N. GI system
C. Oxidation by cytochrome P450
Drugs are mainly excreted by which organ?
A. Kidneys B. Conjugation by sulphate/gluconaride C. Oxidation by cytochrome P450 D. Poor compliance E. Lungs F. Low therapeutic index G. Liver H. Theophylline I. High therapeutic index J. Digoxin K. Gentamicin L. Rosiglitazone M. Warfarin N. GI system
A. Kidneys
The effect of which drug can be measured by the surrogate marker HbA1C
A. Kidneys B. Conjugation by sulphate/gluconaride C. Oxidation by cytochrome P450 D. Poor compliance E. Lungs F. Low therapeutic index G. Liver H. Theophylline I. High therapeutic index J. Digoxin K. Gentamicin L. Rosiglitazone M. Warfarin N. GI system
L. Rosiglitazone
A 58-year-old man presents to your A&E complaining of chest pain and palpitations. He says he takes several drugs for his ‘heart problems’ and admits to being diabetic. What drug could be causing his problems?
A. Kidneys B. Conjugation by sulphate/gluconaride C. Oxidation by cytochrome P450 D. Poor compliance E. Lungs F. Low therapeutic index G. Liver H. Theophylline I. High therapeutic index J. Digoxin K. Gentamicin L. Rosiglitazone M. Warfarin N. GI system
J. Digoxin
Possible features of DIGOXIN TOXICITY include:
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
Peak and trough levels of this drug should be taken
A. Aspirin B. Clonazepam C. Digoxin D. Phenobarbitone E. Heparin - unfractionated F. Warfarin G. Heparin - Low molecular weight H. Gentamicin I. Ciclosporin J. Ethosuximide K. Phenytoin L. Theophylline M. Lithium N. Carbamazepine
H. Gentamicin
Symptoms of under-treatment and toxicity may be similar
A. Aspirin B. Clonazepam C. Digoxin D. Phenobarbitone E. Heparin - unfractionated F. Warfarin G. Heparin - Low molecular weight H. Gentamicin I. Ciclosporin J. Ethosuximide K. Phenytoin L. Theophylline M. Lithium N. Carbamazepine
C. Digoxin
Decreased excretion, increased plasma concentration and increased risk of toxicity may occur when this taken in conjunction with thiazide diuretics
A. Aspirin B. Clonazepam C. Digoxin D. Phenobarbitone E. Heparin - unfractionated F. Warfarin G. Heparin - Low molecular weight H. Gentamicin I. Ciclosporin J. Ethosuximide K. Phenytoin L. Theophylline M. Lithium N. Carbamazepine
M. Lithium
Is ototoxic and nephrotoxic
A. Aspirin B. Clonazepam C. Digoxin D. Phenobarbitone E. Heparin - unfractionated F. Warfarin G. Heparin - Low molecular weight H. Gentamicin I. Ciclosporin J. Ethosuximide K. Phenytoin L. Theophylline M. Lithium N. Carbamazepine
H. Gentamicin
Requires regular monitoring of APTT
A. Aspirin B. Clonazepam C. Digoxin D. Phenobarbitone E. Heparin - unfractionated F. Warfarin G. Heparin - Low molecular weight H. Gentamicin I. Ciclosporin J. Ethosuximide K. Phenytoin L. Theophylline M. Lithium N. Carbamazepine
E. Heparin - unfractionated
A man was put into custody after driving under the influence of drugs. On arrest he was reported as acting extremely aggressive and paranoid. He also claimed his heart was racing. One hour later he was found dead. There was suspicion of police brutality.
A. Benzodiazepines B. Ethanol C. Heroin D. Ecstasy E. Methanol F. Strychnine G. Cyanide H. Organophosphate I. Methadone J. Paracetamol K. Cocaine L. Cannabis M. Police brutality N. Carbon monoxide O. Aspirin P. Amphetamines
K. Cocaine
EBE and BE as breakdown products of cocaine:
EME = ecgonine methyl ester
BE = benzoylecgonine
They are the two degredation products of cocaine produced by pseudocholinesterases and hydrolysis respectively.
A 24-year-old woman goes to a party where she has some pills. She subsequently becomes feverish and confused. She was found to be hyperthermic and blood results showed a raised urea and creatinine, her myoglobin was also found to be high.
A. Benzodiazepines B. Ethanol C. Heroin D. Ecstasy E. Methanol F. Strychnine G. Cyanide H. Organophosphate I. Methadone J. Paracetamol K. Cocaine L. Cannabis M. Police brutality N. Carbon monoxide O. Aspirin P. Amphetamines
D. Ecstasy
James Pond comes to A&E claiming he’s been poisoned. Minutes later he dies. His skin was brick red and there was a faint odour of almonds.
A. Benzodiazepines B. Ethanol C. Heroin D. Ecstasy E. Methanol F. Strychnine G. Cyanide H. Organophosphate I. Methadone J. Paracetamol K. Cocaine L. Cannabis M. Police brutality N. Carbon monoxide O. Aspirin P. Amphetamines
G. Cyanide
Following a death in the family, a young woman is brought into the hospital with confusion. On inspection she appears jaundiced. Her friend reports that she had been vomiting earlier and that she had found an empty medicine bottle in her room.
A. Benzodiazepines B. Ethanol C. Heroin D. Ecstasy E. Methanol F. Strychnine G. Cyanide H. Organophosphate I. Methadone J. Paracetamol K. Cocaine L. Cannabis M. Police brutality N. Carbon monoxide O. Aspirin P. Amphetamines
J. Paracetamol
A man was found collapsed on the floor of his room and his breathing was found to be severely depressed. A urine test was found to be positive for 6-MAM.
A. Benzodiazepines B. Ethanol C. Heroin D. Ecstasy E. Methanol F. Strychnine G. Cyanide H. Organophosphate I. Methadone J. Paracetamol K. Cocaine L. Cannabis M. Police brutality N. Carbon monoxide O. Aspirin P. Amphetamines
C. Heroin
A 30-year-old farmer presents to casualty complaining of diarrhoea and painful mouth ulcers. On questioning he admitted accidentally ingesting liquid paraquat
A. Dicobalt edentate B. Hyperbaric oxygen C. Atropine D. N-acetylcysteine E. Symptomatic and Supportive treatment F. Haemodialysis G. Desferrioxamine H. Activated charcoal I. Glucagon J. Naloxone K. Gastric lavage
H. Activated charcoal
**activated charcoal is NOT helpful in poisoning with: cyanide, iron, ethanol, lithium, acid or alkali, pesticides;
A 15-year-old girl presents with sweats and hyperventilation indicative of a severe metabolic acidosis; after taking a large number of salicylate tablets
A. Dicobalt edentate B. Hyperbaric oxygen C. Atropine D. N-acetylcysteine E. Symptomatic and Supportive treatment F. Haemodialysis G. Desferrioxamine H. Activated charcoal I. Glucagon J. Naloxone K. Gastric lavage
F. Haemodialysis
A 26-year-old woman collapses after a massive overdose of atenolol. She remains in cardogenic shock despite initial treatment with IV atropine
A. Dicobalt edentate B. Hyperbaric oxygen C. Atropine D. N-acetylcysteine E. Symptomatic and Supportive treatment F. Haemodialysis G. Desferrioxamine H. Activated charcoal I. Glucagon J. Naloxone K. Gastric lavage
I. Glucagon
A pregnant 30-year-old woman is found drowsy in her rented flat. She complains of severe nausea for the last 3 hours. Her carboxyhaemoglobin level is 41%.
A. Dicobalt edentate B. Hyperbaric oxygen C. Atropine D. N-acetylcysteine E. Symptomatic and Supportive treatment F. Haemodialysis G. Desferrioxamine H. Activated charcoal I. Glucagon J. Naloxone K. Gastric lavage
B. Hyperbaric oxygen
A 25-year-old man is delirious and hyperpyrexial after taking a pill in a club. He is hyperreflexic and is hyponatraemic
A. Dicobalt edentate B. Hyperbaric oxygen C. Atropine D. N-acetylcysteine E. Symptomatic and Supportive treatment F. Haemodialysis G. Desferrioxamine H. Activated charcoal I. Glucagon J. Naloxone K. Gastric lavage
E. Symptomatic and Supportive treatment
An 18 year old female is brought in to A&E from a rave in the early hours of the morning. On initial examination she is agitated with a heart rate of 120 bpm. She is very sweaty and has wide dilated pupils
A. Tricyclic antidepressants B. Desferrioxamine C. Carbon Monoxide D. Paracetamol E. Acetylcysteine F. Naloxone G. Salicylates H. Lithium I. Ecstasy J. Organophosphates K. Methanol
I. Ecstasy
Both TCA OD and ecstasy OD can cause wide dilated pupils.
Ecstasy is more likely to lead to agitation and TCA drowsiness.
ecstasy may induce vasopressin secretion and an SIADH, with hyponatraemia
A 25 year old male is admitted with hyperventilation. He is sweating and appears nauseous. He says that he has ringing in his ears. Blood gases show that he has mixed acid-base disturbance
A. Tricyclic antidepressants B. Desferrioxamine C. Carbon Monoxide D. Paracetamol E. Acetylcysteine F. Naloxone G. Salicylates H. Lithium I. Ecstasy J. Organophosphates K. Methanol
G. Salicylates
An 80 year old man and his 79 year old wife were brought in after a neighbour found them collapsed in their home. On questioning the neighbour it was found that the couple had not been feeling well for a few weeks and had been complaining of nausea, headaches and dizziness
A. Tricyclic antidepressants B. Desferrioxamine C. Carbon Monoxide D. Paracetamol E. Acetylcysteine F. Naloxone G. Salicylates H. Lithium I. Ecstasy J. Organophosphates K. Methanol
C. Carbon Monoxide
