Clinical Biochemistry - Clinical Questions

Question 1

what is the purpose of diagnosis?

Answer 1

Confirmation or rejection of clinical diagnosis

Question 2

what is the purpose of monitoring

Answer 2

Natural history or response to treatment

Question 3

what is the purpose of prognosis?

Answer 3

Prediction of course or outcome of the disease

Question 4

what is the purpose of screening?

Answer 4

Detection of sub-clinical disease

Question 5

what are analytical factors?

Answer 5

accuracy

precision

Question 6

what is accuracy?

Answer 6

can the method produce the correct result

Question 7

what is precision?

Answer 7

can it do this consistently

Question 8

what are the different ways of diagnosing diabetes?

Answer 8

Random venous plasma glucose >11.1mmol/L
Fasting plasma glucose >7.0mmol/L
2 hour plasma glucose >11.1mmol/L in OGTT
HbA1c >48mmol/mol (Type 2 Diabetes only)
If asymptomatic, requires confirmation by repeat
testing on another day

Question 9

when would you not use HbA1c for diagnosing diabetes?

Answer 9

Children and young people
Suspected Type 1 diabetes
Symptoms <2 months
High risk patients who are acutely ill
Patients taking medication that may cause rapid glucose rise (e.g. steroids)
Acute pancreatic damage
Pregnancy
Presence of genetic, haematological or illness-related factors that affect HbA1c and its measurement

Question 10

name some chronic complications?

Answer 10

TIA
diabetic retinopathy
erectile dysfunction
angina
myocardial infarction
cardiac failure