ChemPath EMQ on emzymes and chemistry Flashcards

1
Q

describe how creatinine is generated

A

creatine kinase = protein in muscle
generates creatinine as a waste product
excreted by kidneys
builds up in kidney failure

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2
Q

What 4 enzymes increase after an MI

A
  • Troponins
  • CK (MB)
  • AST ( found within myocytes, raised 3-14 days)
  • LDH
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3
Q

when is AST higher than ALT and vice versa

A

AST higher than ALT (2:1) in patients with chronic alcoholic cirrhosis
ALT higher than AST in viral hepatitis

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4
Q

Is vitamin D high or low in primary hyperparathyroidism

A

low

PHT activates 1 - alpha hydroxylase meaning that vitamin D is consumed

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5
Q

what enzyme rises the most in 1) acute renal failure caused by dehydration 2) chronic renal failure caused by fall in GFR

A

1) urea

2) creatinine

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6
Q

list 2 indications for dialysis

A

1 - hyperkalaemia
2 - acidosis (give soidum bicarb)
3 - pulmonary oedema

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7
Q

what can be used as a marker of glucose control over the past 3 weeks

A

FRUCTOSAMINE

can be used to monitor glucose control in pregnancy

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8
Q

Features and treatment of Paget’s disease

A
  • increased activity of osteoclasts and osteoblasts
  • high ALP and osteocalcin
  • bowed tibia
  • warm
  • often asymptomatic
  • treat with BISPHOSPHONATES
  • technetium bisphosphonate scan
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9
Q

what scan is used to detect abdominal mets from cancer

A

flourodeoxyglucose (FDG PET)

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10
Q

what scan is used to detect bony mets

A

Tc bisphosphonate

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11
Q

what scan is used to detect primary neuroendocrine tumours (insulinomas)

A

gallium 68 dotatate

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12
Q

what scan is used to detect thyroid problems

A

Tc99 pertechnetate

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13
Q

what scan is used to detect parathyroid problems

A

Sesta MIBI

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14
Q

what scan is used to detect phaeochromocytomas

A

MIBG

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15
Q

what liver enzyme is important in gluconeogenesis

A

AST

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16
Q

what liver enzyme rises most in obstructive jaundice

A

ALP

17
Q

describe the progression of alcoholic hepatitis - cirrhosis

A

alcoholic hepatitis
with support and steroids, they recover
some hepatocytes die but others survive and attempt to regenerate
when they regenerate, they don’t regrow nicely into hexagons
they grow into nodules
development of more nodules - nodular cirrhosis
blood has a hard route to get into central vein
portal hypertension
varices at porto-systemic anastomoses

18
Q

what liver enzyme rises the most in cirrhosis

A

AST

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