Chemical Tests GERR

Question 1

components of Electrolyte profile and most common abnormalities
U&E

Answer 1

1-Urea and Electrolytes (v common )
7 component parts :
-Sodium
-Potassium
-Cl=>Tracks sodium
-CO2=>mainly bicarbonate=>Low= DKA, metabolic and lactic acidosis
-Urea=>end point of protein metabolism, high in GI bleeding, Dehydration, Kidney failure
-Creatinine = waste product of muscle metabolism = more muscle= more creatinine (excreted via the kidney, so if creatine is increasing, indicates kidney disease)
-eGFR=uses age, gender, creatine to estimate eGFR= KIDNEY FUNCTION( reduced eGFR in a malfunctioning kidney)

Question 2

Hyponatremia

Answer 2

-Low sodium levels in the blood
-Blood is low in sodium = osmolality is low & Brain = lots of sodium (high osmolality)
- Water moves from the blood to the brain via osmosis
= swelling of the brain = Cerebral Oedema
-Foramen magnum drains fluid = fluid compresses many important regions = stop breathing, tumours etc

Treatment :
decompressive craniectomy.

Question 3

Hyperkalaemia

4

Answer 3

Hyperkalemia : too much k+ IN PLASMA
Too much in = IV

Shift out of cells =acidosis, muscle break down

Too little out = Kidney failure, Hypoaldosteronism, Drugs such as ACE inhibitors, ANG blocker, K -sparing diuretics

Step 1: protect the heart from arrhythmias ( give ca2+)
Step 2: shift K+ into cells using insulin and glucose to avoid hypoglycemia

Question 4

Liver profile= LFTS

Answer 4

-Bilirubin = Jaundice
-Albumin
ALT AND AST = HIGH = HEPATITUS
ALP AND GGT = HIGH = cholestatic picture ( bile is reduced)

to see the picture => look at coagulation screen , prothrombin time , albumin

Question 5

GI diseases and their lab tests…

HAPTC

Answer 5

• Helicobacter pylori ( ulcers, gastritis)
• Acute pancreatitis ( amylase, lipase)
• Pancreatic insufficiency ( faecal elastase)
• Tumour markers -CEA, CA19-9
• Coeliac disease ( anti-transglutaminase antibody )

Question 6

hypokalemia

Answer 6

Hypokalemia :
Too little K+ in=malnurtition
Shift from the blood into cells= Alkalosis, re-feeding syndrome (starving and then you start to eat), Salbutamol, insulin ( causes K+ into the cell)
Too much out = Hyperaldosteronism, diuretics, Diarrhoea, vomiting