Clinical biochemistry

Question 1

Aware of the importance of Laboratory services in the diagnosis and management of diabetes and endocrine disorders

Knowledge of point of care meters

Answer 1

.

Question 2

List 4 reasons lab tests are used

Answer 2

Diagnosis
Monitoring disease/treatment
Prognosis
Screening

Question 3

Define accuracy v precision

Answer 3

Accuracy - correct result

Precision - consistent result

Question 4

What can be used in the acute setting to measure BG (point of care testing), but important to note these methods are not diagnostic (2)

Answer 4

Blood glucose meter

Urine testing
-for glycosuria or ketonuria

Question 5

HbA1c should not be used to diagnose DM in what people (5)

Answer 5

Children
Suspected type 1 DM 
If symptoms <2 months
Acute pancreatic damage
Pregnancy

Question 6

Define factitious hypoglycaemia

Answer 6

hypoglycaemia resulting from the use of insulin or insulin analogues

Question 7

How to differentiate factitious hypoglycaemia from insulinoma

Answer 7

Factitious hypoglycaemia - high insulin levels in absence of elevated C-peptide concentrations

Inuslinoma - elevated C-peptide and insulin levels

Question 8

Chronic biochemical measurements in diabetes (i.e. monitored long term) (5)

Answer 8

Self monitoring plasma glucose
HbA1c
Urine albumin: creatinine (could indicate diabetic renal disease complication, microvascular screening)
Lipid levels (microvascular screening)

Question 9

A 56 year old female with a 12 year history of Type 2 Diabetes was found to have a urine albumin/creatinine ratio of 32 mg/mmol (female reference interval <3.5 mg/mmol)

What could be the cause of her increased albumin:creatinine ratio (ACR)

Answer 9

UTI

Question 10

What investigation is used to screen for diabetic kidney disease (a microvascular complication of DM)

Answer 10

Albumin: creatinine ratio (ACR)

Young people with DM should have ACR tested annually