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Pathology Buzzwords - Pastpapers > Chempath > Flashcards

Chempath Flashcards

1
Q

Distinguish between HHS (HONK) and DKA

A

DKA presents with a high anion gap due to ketoacidosis. HHS is not characterised by acidosis.

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2
Q

What are the buzzwords for:

  • Medullary
  • Papillary
  • Follicular
  • Anaplasitc

Thyroid tumours?

A
  • Medullary: cancers arise from parafollicilar “C” cells that secrete calcitonin. Associated with MEN2 syndrome.
  • Papillary: are associated with psammoma bodies and Orphan Annie eyes
  • Follicular are associated with nodules and mets
  • Anaplastic affect the elderly, metastasise widely.
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3
Q

Rate limiting haem synthesis

A

ALA synthase

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4
Q

Deficiency of this –> high urea

A

HGPRT in e.g. Lesch Nyhan Syndrome Hyperuricaemia, Gout, PRT (Prutt)

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5
Q

Gynaecomastia + wants viagra

A

Prolactinoma (prolactin will be >6000)

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6
Q

Rounded mass with glands and mucin in Liver

A

Met from pancreatic adenocarcinoma

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7
Q

Histology of acute fatty liver hep

A

Ballooned cells, mallory denk bodies, neutrophils

Does this not describe alcoholic hepatits instad of acute liver disease?

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8
Q

Alcoholic hepatitis with fibrosis

A

Ballooned cells, mallory denk bodies, MEGAMITOCHONDRIA, pericentricular fibrosis

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9
Q

AFP raised in?

A

HCC, pregnancy, testicular Ca

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10
Q

What type of Billrubin can be seen in urine?

A

Conjugated only (e.g. obstructive jaundice)

Unconjugated bilirubin is not watersoluble

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11
Q

Corrected calcium

A

measured + 0.02(40-albumin)

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12
Q

Baby with seizures, low Ca, low PTH

A

Primary hypoparathyroidism in e.g. Di George

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13
Q

Low mood after renal transplant for longstnading renal disease (high Ca, high PTH)

A

Tertiary hyperparathyroidism

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14
Q

B12 vs folate deficiency

A

B12: glossitis, jaundice, dementia, other AI conditions, vegans Folate: diarrhoea, methotrexate IBD can cause either (methotrexate->folate, loss of terminal ileum absorption->B12)

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15
Q

Vitamins B1 B2 B3 (Niacin) B6

A

B1 - thiamine. WKS/beri beri –> cardio/neuro (RBC transketeolase)

B2 - Riboflavin (glossitis, RBC glutanthione reductase)

B3 Niacin - Pellagra - dementia, diarrhoea, dermatitis, casals necklace

B6 - Pyridoxine (dermatitis, anaemia, neuropathy)

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16
Q

Denosumab target

A

RANK-L on Osteoclasts (inhibit) for osteoporosis or bony mets

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17
Q

Allopurinol interacts with

A

Azathioprine

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18
Q

Acute intermittent porphyria Ix

A

Urine PBG (and Urine ALA)

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19
Q

In guthrie how do you measure Hypothyroid CF MCADD

A

TSH Immune reactive trypsin Acylcarnitine

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20
Q

Normal anion gap

A

18mM

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21
Q

Primary hyperparathyroidism Vit D levels

A

Vit D is low as it is consumed

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22
Q

High Ca + haematuria (painful)

A

Renal stone

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23
Q

Band keropathy

A

Long term hyperCa

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24
Q

Addisons + primary hypothyroidism + diabetes

A

Schmidt syndrome (AIPS2) Think the diagram I drew of the organs in a funny shape to remember

= APECED

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25
Q

HTN + Adrenal mass (3 causes)

A

Phaeo, Conns, Cushings

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26
Q

High functioning adrenal (3 causes)

A

Cushings, Conns, CAH

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27
Q

Low functioning adrenal

A

Sepsis, haemorrhage, discontinuation of steroids, Addisons

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28
Q

MI Markers

A

Troponin - rises within 4-6 hours, peaks 12-24 hours, remains high for 3-10 days CK - rises withing 24 hours (check if double MI) Myoglobin rises quickly

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29
Q

MEN 1

A

Pituitary, Pancreas, Parathyroid

30
Q

MEN 2a

A

Parathyroid, Phaeo, Thyroid (med)

31
Q

Men 2b

A

Phaeo, Thygoid, Ganglioneuroma

32
Q

High TSH, high T4, low T3

A

Sick Euthyroid??

33
Q

Tertiary hyperparathyroidism

A

Often in people with CKD Longstanding 2° hyperparathyroidism –> gland hyperplasia –> permanent dysregulated high secretions of TSH –> 1° hyperparathyroidism picture End result: High PTH, high Calcium, variable PO4 levels

34
Q

T1DM has low Na, everything else is normal

A

hyperlipidaemia

35
Q

High K, low Na, urine osmolality >20

A

CKD/Renin (RAS) cause not aldosterone

36
Q

Urine osmolality > plasma osmolality

A

SIADH

37
Q

Low K, alkalosis, hypotension, hypercalciuria

A

Bartter

38
Q

Low K and acidosis

A

RTA (renal tubular acidosis)

39
Q

NAFLD LFTs

A

High ALT and AST ratio 1:1 High GGT Normal Br and Alb

40
Q

Low caeruloplasmin

A

Wilsons

41
Q

Vitamin C deficiency affects what thing to cause bleeding gums and poor dentition?

A

Collagen

42
Q

Vit E deficiency

A

Haemolytic anaemia, areflexia, ataxia

43
Q

Vit B6 deficiency

A

Pyroxidine Dermatitis, peripheral neuropathy, sideroblastic anaemia can be caused by isoniazid

44
Q

Fair skin, brittle hair, developmental delay, LDs

A

HCU (homocystinuria)

45
Q

G6PD, hypoglycaemia, big kidneys and liver

A

von Gierke’s

46
Q

Toxic encephalopathy causing poor feeding, hypotonia and seizures Sweet odour and sweaty feet

A

MSUD

47
Q

Cherry-red spot and dymorphia

A

LYsosomal storage disorder (e.g. Fabry’s)

48
Q

Phenytoin toxicity

A

ataxia and low BP

49
Q

Lithium

A

tremor and thirst

50
Q

Gentamicin toxicity

A

Ears and kidneys Tinnitus - ringing in ear Gentleman caller ringing

51
Q

Low vit D, low Ca, high PTH

A

Osteomalacia (not 2° hyperparathyroidism as vit D is the causative problem)

52
Q

Chronic renal failute, high Ca, high PTH

A

3° hyperparathyroid

53
Q

Thiamine (B1) test

A

Red cell trasketolase activity

54
Q

Floppy neonate not feeding Cataract and conjugated jaundice post milk feed

A

Galactosaemia

55
Q

Why do you give Calcium gluconate in hyperkalaemia

A

As it is cardioprotective and helps prevent fatal dyrhythmia (does not lower K)

56
Q

CKMB is useful for what in heart medicine

A

detecting re-infarction as levels rapidly return to normal so would know if was a second one

57
Q

In an SIADH picture what must you exclude before diagnosing SIADH?

A

Drugs causing it

58
Q
  1. Causes of pseudo-hyponatraemia 2. what will the osmolality be doing?
A
  1. High lipids or proteins or a spurious sample 2. The osmolality will be normal (low in true hyponatraemia) It is caused by dilution
59
Q

High PTH but high PO4 and low Ca

A

Pseudohyperparathyroidism Generic resistance to PTH High PTH but Ca and PO4 respond as if low PTH

60
Q

Anion gap MUDPILES (or KULT)

A

Metformin *Uraemia *DKA (Ketones) Paraldehyde Iron *Lactic acid Ethanol/methanol Salicylates * Are KUL Non* are all the Toxins

61
Q

Acute intermittent porphyria treatment and route of administration

A

IV haem arginate

62
Q

PTH derivative used to treat osteoporosis

A

terparatide

63
Q

Type of gallstone present in patients with hereditary spherocytosis (or any increased haemolysis)?

A

Calcium bilirubinate

64
Q

What liver enzyme is raised in MI?

A

AST

65
Q

Scan for neuroendocrine tumours

A

Gellium 68 dotatate

66
Q

Scan for general cancer mets

A

Fluorodeoxyglucose

67
Q

Bone scan

A

Technetium bisphosphonate

68
Q

Scan for thyroid cancer

A

Technetium pertechnetate

69
Q

Scan for phaeochromocytoma

A

MIBG scan

70
Q

What is the value for impared fasting and glucose tolerance?

A

Fasting = 6-7

Glucose tolerance 7.9-11

Pathology Buzzwords - Pastpapers (7 decks)

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