Chemistry 12 (TDM and carbohydrates)

Question 1

digoxin excretion and T1/2

Answer 1

renal

36hr

Question 2

dig tox increased by

Answer 2

Quinidine
Calcium channel blockers
hypokalemia
hypercalcemia
hypomagnesemia
hypoxia
hypothyroidism

Question 3

false positive digoxin test in

Answer 3

endogenous digoxin-like substances

neonates, pregnant women, liver or renal failure

Question 4

procainamide causes

Answer 4

drug induced lupus

Also isoniazid and hydralazine

Question 5

improtant facts abotu procainamide metabolism

Answer 5

cleared by liver
metabolite (NAPA) is cleared by kidneys
both are active so measure both

Question 6

Class IA antiarrythmic agents

Answer 6

quinidine
disopyramide
procainamide
all block K and Na channels

Question 7

cinchonism

Answer 7

tinnitus, vertigo and blurred vision caused by quinidine

Question 8

quinidine tox

Answer 8

AMS, cinchonism, wide QRS, prolonged QT, hypotension

Question 9

phenytoin tox

Answer 9

horizontal gaze nystagmus, ataxia, AMS, cardiac conduction problems

Question 10

fetal hydantoin syndrome

Answer 10

from phenytoin
MR, microcephaly, IUGR
midfacial hypoplasia, hypertelorism, flat philtrum

Question 11

amiodarone toxic to

Answer 11

lungs, thyroid, liver, peripheral nerves

Question 12

amiodarone effects with other drugs

Answer 12

clearance decreased by warfarin

increased concentration with digoxin

Question 13

things that counter the effects of insulin

Answer 13

glucagon, epinephrine, steroids, GH, thyroxine, somatostatin, hPL

Question 14

more specific enzymatic assay for glucose

Answer 14

Hexokinase coupled with G6PD

Question 15

in un-separated tube, glucose___

Answer 15

decreases 5-10mg/hr

Question 16

whole blood glucose compared with plasma

Answer 16

whole blood 10-15% less

Question 17

insulin/glucose ration in insulinoma

Answer 17

> 180

Question 18

hyperinsulinemic hypoglycemia most commonly due to

Answer 18

insulinoma

Question 19

non-ketotic, hypoinsulinemic hypoglycemia seen in

Answer 19

autoimmune, liver failure, starvation

Question 20

most frequest antibodies in DM1

Answer 20

GAD65, ICA512, IAA

Question 21

diagnostic of DM

Answer 21

FPG>126
non-fasting >200 with classic symptoms
2hr OGTT >200

Question 22

GMD screen if avg risk

Answer 22

100g OGTT at 24-28wk

+ if 2 of >95 fasting, >180@1hr, >155@2hr, >140@3hr,

Question 23

50g OGTT + if

Answer 23

> 140

Question 24

diagnosis of DKA

Answer 24

hyperglycemia >200
ketosis
met acidosis <15

Question 25

ketones measured by

Answer 25

nitroprusside technique

Question 26

nitroprusside disadvantage

Answer 26

does not measure beta-hydroxybutyrate

Question 27

HHNC

Answer 27

hyperglycemia >600
hyperosmolal >330
dehydration
nL pH