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Chempath COPY Flashcards

1
Q

Distinguish between HONK and DKA

A

Anion gap

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2
Q

Thyroid cancers

  • Medullary
  • Papillary
  • Follicular
  • Anaplasitc
A

Features

  • MEN2, Calcitonin, Parafrollicular “C” cells
  • Psammoma bodies
  • Nodules and mets
  • Elderly
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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

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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 Br can be seen in urine?

A

Unconjugated only (e.g. haemolysis)

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11
Q

High Br, high ALP, high GGT

A

Could be drug induced cholestasis

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12
Q

Corrected calcium

A

measured + 0.02(40-albumin)

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13
Q

Baby with seizures, low Ca, low PTH

A

Primary hypoparathyroidism in e.g. Di George

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14
Q

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

A

Tertiary hyperparathyroidism

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15
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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16
Q 
Vitamins
B1
B2
B3 (Niacin)
B6
A

B1 - WKS/beri beri –> cardio/neuro (RBC transketeolase)
B2 - Riboflavin (glossitis, RBC glutanthione reductase)
B3 Niacin - Pellagra - dementia, diarrhoea, dermatitis
B6 - Pyridoxine (dermatitis, anaemia, neuropathy)

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17
Q

Denosumab target

A

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

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18
Q

Allopurinol interacts with

A

Azathioprine

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19
Q

Acute intermittent porphyria Ix

A

Urine PBG (and Urine ALA)

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20
Q

In guthrie how do you measure
Hypothyroid
CF
MCADD

A

TSH
Immune reactive trypsin
Acylcarnitine

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21
Q

Normal anion gap

A

18mM

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22
Q

Primary hyperparathyroidism Vit D levels

A

Vit D is low as it is consumed

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23
Q

High Ca + haematuria

A

Renal stone

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24
Q

Band keropathy

A

Long term hyperCa

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25
Addisons + primary hypothyroidism + diabetes
Schmidt syndrome (AIPS2) Think the diagram I drew of the organs in a funny shape to remember
26
HTN + Adrenal mass (3 causes)
Phaeo, Conns, Cushings
27
High functioning adrenal (3 causes)
Cushings, Conns, CAH
28
Low functioning adrenal
Sepsis, haemorrhage, discontinuation of steroids, Addisons
29
MI Markers
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
30
MEN 1
Pituitary, Pancreas, Parathyroid
31
MEN 2a
Parathyroid, Phaeo, Thyroid (med)
32
Men 2b
Phaeo, Thygoid, Ganglioneuroma
33
High TSH, high T4, low T3
??? :(
34
Tertiary hyperparathyroidism
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
35
T1DM has low Na, everything else is normal
hyperlipidaemia
36
High K, low Na, urine osmolality >20
CKD/Renin (RAS) cause not aldosterone
37
Urine osmolality > plasma osmolality
SIADH
38
Low K, alkalosis, hypotension, hypercalciuria
Bartter
39
Low K and acidosis
RTA
40
NAFLD LFTs
High ALT and AST ratio 1:1 High GGT Normal Br and Alb
41
Low caeruloplasmin
Wilsons
42
Vitamin C deficiency affects what thing to cause bleeding gums and poor dentition?
Collagen
43
Vit E deficiency
Haemolytic anaemia, areflexia, ataxia
44
Vit B6 deficiency
Pyroxidine Dermatitis, peripheral neuropathy, sideroblastic anaemia can be caused by isoniazid
45
Fair skin, brittle hair, developmental delay, LDs
HCU
46
G6PD, hypoglycaemia, big kidneys and liver
von Gierke's
47
Toxic encephalopathy causing poor feeding, hypotonia and seizures Sweet odour and sweaty feet
MSUD
48
Cherry-red spot and dymorphia
LYsosomal storage disorder (e.g. Fabry's)
49
Phenytoin toxicity
ataxia and low BP
50
Lithium
tremor and thirst
51
Gentamicin toxicity
Ears and kidneys Tinnitus - ringing in ear Gentleman caller ringing
52
Low vit D, low Ca, high PTH
Osteomalacia (not 2° hyperparathyroidism as vit D is the causative problem)
53
Chronic renal failute, high Ca, high PTH
3° hyperparathyroid
54
Thiamine (B1) test
Red cell trasketolase activity
55
Floppy neonate not feeding | Cataract and conjugated jaundice post milk feed
Galactosaemia
56
Why do you give Calcium gluconate in hyperkalaemia
As it is cardioprotective and helps prevent fatal dyrhythmia (does not lower K)
57
CKMB is useful for what in heart medicine
detecting re-infarction as levels rapidly return to normal so would know if was a second one
58
In an SIADH picture what must you exclude before diagnosing SIADH?
Drugs causing it
59
1. Causes of pseudo-hyponatraemia | 2. what will the osmolality be doing?
1. High lipids or proteins or a spurious sample 2. The osmolality will be normal (low in true hyponatraemia) It is caused by dilution
60
High PTH but high PO4 and low Ca
Pseudohyperparathyroidism Generic resistance to PTH High PTH but Ca and PO4 respond as if low PTH
61
Anion gap MUDPILES (or KULT)
``` Metformin *Uraemia *DKA (Ketones) Paraldehyde Iron *Lactic acid Ethanol/methanol Salicylates ``` * Are KUL Non* are all the Toxins

Path Past Papers (38 decks)

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