Clinical biochemistry

Question 1

4 reasons to use lab tests

Answer 1

diagnosis
prognosis
screening
monitoring

Question 2

Accuracy

Answer 2

can the method produce the correct results?

Question 3

Precision

Answer 3

can it do it consistently?

Question 4

Biochemistry tests used in diabetes

Answer 4

venous plasma glucose random
fasting plasma glucose
2hr plasma glucose - OGTT
HbA1c

Question 5

Explain what HbA1c is

Answer 5

glucose not taken up into cells due to lack of insulin
enters RBC
HbA1c is intracellular

Question 6

List some groups HbA1c is not used in

Answer 6

pregnant
children and young people 
suspected type 1 DM 
acute pancreatic damage 
symptom onset <2 months
acutely ill high risk patients
medication causing rapid increase in glucose eg steroid

Question 7

Point of care testing methods

Answer 7

urine - glycosuria and ketonuria

glucose meter - capillary blood glucose

Question 8

Factitious hypoglycaemia

Answer 8

high insulin levels

absence of increase in c peptide concentration

Question 9

insulinoma

Answer 9

elevated c peptide level - insulin producing tumour

Question 10

4 biochemical measurements used in diabetes

Answer 10

glucose - self monitoring
HbA1c - glycaemic control
ACR - microvascular - diabetic renal disease
lipids - macrovascular disease

Question 11

Causes of increased ACR

Answer 11

diabetic kidney disease
orthostatic proteinuria
UTI