Chemical Pathology - Clinical Chem Flashcards
(23 cards)
st johns wort contains what active compound? commonly used in what condition?
(Hypericum perforatum)
depression
is hypocalcaemia or hypercalcaemia associated with depression?
Hypercalcaemia (stones, moans, bones, psychiatric overtones)
what’s a colle’s fracture?
= anterior displacement of the radius (i.e. radius towards the PALM of the hand)
falling on an extended wrist, hand splayed towards ground
what’s smith’s fracture?
= posterior displacement of the radius (i.e. radius towards the BACK of the hand)
falling on a flexed wrist, inwards
what’s pott’s fracture?
ankle fracture involving both tibia and fibula
do renal stones cause macroscopic or microscopic haematuria?
macroscopic due to tear in urothelium
microscopic = glomerulonephritis, painless
what are the PTH levels in malignancy, primary hyperparathyroidism & sarcoidosis?
malignancy = high PTH
sarcoid = low PTH
primary hyperpara. = inappropriately normal or high
are calcium & urate stones radio opaque or lucent?
calcium - radio opaque
urate - radio lucent
what is an ophthal. consequence of hypercalcaemia?
band keratopathy
give 4 other consequences of hypercalcaemia
osteitis fibrosa cystica
peptic ulcer disease
renal stones
pancreatitis
what sign is characteristic of OFC?
‘pepper pot skull’ or ‘salt & pepper’ sign due to resorption of bone
what are 4 clinical manifestations of multiple myeloma
CRAB hypercalcaemia renal failure anaemia bone disease - raindrop sign, punched out lesions
what are 6 risk factors for renal calcium stones?
FH dehydration hypercalciuria hypercalcaemia HPT recurrent UTI - proteus mirabalis
what’s the presentation of renal stones (4)?
pain
haematuria
recurrent infections
renal failure
what 3 investigations for renal stones?
CT KUB
stone analysis
urine and serum biochemistry
what’s the most common renal calcium stone?
calcium oxalate monohydrate
radio opaque & well circumcised
what’s the management of calcium renal stones?
Most stones will pass give painkillers: • PR diclofenac is very good Lithotripsy Cystoscopy Lithotomy prevent by drinking lots of water and treating hypercalcaemia
what’s the management of hypercalcaemia?
urgent treatment required if over 3mmol/L
fluids - IV saline 0.9% 4 hourly 1L bags
IV furosemide
potentially IV pamidronate later on (not initially)
if not urgent then ensure well hydrated and avoid thiazides. consider parathyroidectomy.
what tests are required for parathyroidectomy?
Technetium Sesta MIBI and USS performed
if both concordant whole neck doesn’t need to be opened
if not then open neck and remove largest gland
what may be seen on hand XR in hyperparathyroidism?
cystic changes in the radial aspect
what do histological brown tumours indicate?
long standing, undiagnosed hyperparathyroidism of excess osteoclast activity
may also see multinucleate giant cells
what are the clinical pictures of sarcoidosis (4)?
bilateral hilar lymphadenopathy
non-caseating granulomas
low PTH
summer hypercalcaemia
which types of MEN are associated with hypercalcaemia?
MEN 1
MEN 2a
