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Path Past Papers > Chempath COPY > Flashcards

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
Q

Addisons + primary hypothyroidism + diabetes

A

Schmidt syndrome (AIPS2)

Think the diagram I drew of the organs in a funny shape to remember

26
Q

HTN + Adrenal mass (3 causes)

A

Phaeo, Conns, Cushings

27
Q

High functioning adrenal (3 causes)

A

Cushings, Conns, CAH

28
Q

Low functioning adrenal

A

Sepsis, haemorrhage, discontinuation of steroids, Addisons

29
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

30
Q

MEN 1

A

Pituitary, Pancreas, Parathyroid

31
Q

MEN 2a

A

Parathyroid, Phaeo, Thyroid (med)

32
Q

Men 2b

A

Phaeo, Thygoid, Ganglioneuroma

33
Q

High TSH, high T4, low T3

A

??? :(

34
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

35
Q

T1DM has low Na, everything else is normal

A

hyperlipidaemia

36
Q

High K, low Na, urine osmolality >20

A

CKD/Renin (RAS) cause not aldosterone

37
Q

Urine osmolality > plasma osmolality

A

SIADH

38
Q

Low K, alkalosis, hypotension, hypercalciuria

A

Bartter

39
Q

Low K and acidosis

A

RTA

40
Q

NAFLD LFTs

A

High ALT and AST ratio 1:1
High GGT

Normal Br and Alb

41
Q

Low caeruloplasmin

A

Wilsons

42
Q

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

A

Collagen

43
Q

Vit E deficiency

A

Haemolytic anaemia, areflexia, ataxia

44
Q

Vit B6 deficiency

A

Pyroxidine
Dermatitis, peripheral neuropathy, sideroblastic anaemia

can be caused by isoniazid

45
Q

Fair skin, brittle hair, developmental delay, LDs

A

HCU

46
Q

G6PD, hypoglycaemia, big kidneys and liver

A

von Gierke’s

47
Q

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

A

MSUD

48
Q

Cherry-red spot and dymorphia

A

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

49
Q

Phenytoin toxicity

A

ataxia and low BP

50
Q

Lithium

A

tremor and thirst

51
Q

Gentamicin toxicity

A

Ears and kidneys
Tinnitus - ringing in ear
Gentleman caller ringing

52
Q

Low vit D, low Ca, high PTH

A

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

53
Q

Chronic renal failute, high Ca, high PTH

A

3° hyperparathyroid

54
Q

Thiamine (B1) test

A

Red cell trasketolase activity

55
Q

Floppy neonate not feeding

Cataract and conjugated jaundice post milk feed

A

Galactosaemia

56
Q

Why do you give Calcium gluconate in hyperkalaemia

A

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

57
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

58
Q

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

A

Drugs causing it

59
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

60
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

61
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

Path Past Papers (38 decks)

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