EMQ: enzymes, chemistry

Question 1

Acid phosphatase​

Alanine aminotransferase (ALT)​

alkaline phosphatase​

Aspartate amino transferase (AST)​

Calcium​

Cholesterol​

Creatinine​

Fructosamine​

Glucose​

HBA1c​

potassium​

sodium​

Triglyceride​

urea​

vitamin D​

Which one is increased in a patient with Paget’s disease of the bone?​

Answer 1

ALP

Question 2

Acid phosphatase​

Alanine aminotransferase (ALT)​

alkaline phosphatase​

Aspartate amino transferase (AST)​

Calcium​

Cholesterol​

Creatinine​

Fructosamine​

Glucose​

HBA1c​

potassium​

sodium​

Triglyceride​

urea​

vitamin D​

Which one is increased in a patient with osteomalacia?

Answer 2

ALP

Question 3

Acid phosphatase​

Alanine aminotransferase (ALT)​

alkaline phosphatase​

Aspartate amino transferase (AST)​

Calcium​

Cholesterol​

Creatinine​

Fructosamine​

Glucose​

HBA1c​

potassium​

sodium​

Triglyceride​

urea​

vitamin D​

Which one is increased in a patient following an acute myocardial infarction?

Answer 3

AST

Question 4

Increased osteoblast activity​

Increased osteoclast activity​

​

The former will increase osteocalcin production. As well as….

Answer 4

ALP

Question 5

Acid phosphatase​

Alanine aminotransferase (ALT)​

alkaline phosphatase​

Aspartate amino transferase (AST)​

Calcium​

Cholesterol​

Creatinine​

Fructosamine​

Glucose​

HBA1c​

potassium​

sodium​

Triglyceride​

urea​

vitamin D​

Which one is raised in Addison’s disease?

Answer 5

Potassium

Question 6

Acid phosphatase​

Alanine aminotransferase (ALT)​

alkaline phosphatase​

Aspartate amino transferase (AST)​

Calcium​

Cholesterol​

Creatinine​

Fructosamine​

Glucose​

HBA1c​

potassium​

sodium​

Triglyceride​

urea​

vitamin D​

Which one of the above is most increased in a patient with jaundice caused by a gallstone?

Answer 6

ALP

Question 7

Acid phosphatase​

Alanine aminotransferase (ALT)​

alkaline phosphatase​

Aspartate amino transferase (AST)​

Calcium​

Cholesterol​

Creatinine​

Fructosamine​

Glucose​

HBA1c​

potassium​

sodium​

Triglyceride​

urea​

vitamin D​

Which one is most increased in a patient with jaundice caused by viral hepatitis?

Answer 7

ALT

Question 8

Acid phosphatase​

Alanine aminotransferase (ALT)​

alkaline phosphatase​

Aspartate amino transferase (AST)​

Calcium​

Cholesterol​

Creatinine​

Fructosamine​

Glucose​

HBA1c​

potassium​

sodium​

Triglyceride​

urea​

vitamin D​

Which one is most increased in a patient with jaundice caused by chronic alcoholic cirrhosis?

Answer 8

AST

Question 9

Acid phosphatase​

Alanine aminotransferase (ALT)​

alkaline phosphatase​

Aspartate amino transferase (AST)​

Calcium​

Cholesterol​

Creatinine​

Fructosamine​

Glucose​

HBA1c​

potassium​

sodium​

Triglyceride​

urea​

vitamin D​

Which one is most increased in a patient with prostatic carcinoma?

Answer 9

Acid phosphatase (PSA)

Question 10

What investigations are useful to make the diagnosis in Pagets disease?

Answer 10

Bloods
X ray

Question 11

What does this show?

Answer 11

Disorgansied bone remodelling (femur)

Looser’s zones

-> PAGET’S DISEASE

Question 12

What is this?

Answer 12

T-99 bisphosphonate scan showing increased uptake in the humerus

Question 13

What are T-99 scans used for normally?

Answer 13

Normally used to see bone turnover in cancer patients to look for bony metastases

Question 14

What can T-99 scans be used for in endocrinology?

Answer 14

Thyroid scan (T-99 is a label)

Question 15

What condition is this?

Answer 15

Grave’s Disease

Question 16

What is this?

Answer 16

Hot nodule

Question 17

What type of scan is this?

What is the diagnosis?

Answer 17

Gallium scan

Insulinoma

Question 18

What scans do you use for:

Abdominal mets from cancer​

Bony mets​

​Primary Neuroendocrine tumours (insulinomas)​

​Thyroid scans​

Parathyroid scans​

phaeochromocytomas

Answer 18

Fluorodeoxyglucose (FDG PET)​

Tc bisphosphonate​

​Gallium 68 dotatate​

​​Tc 99 pertechnetate​

​Sesta MIBI​

MIBG

Question 19

What is osteomalacia caused by?

Answer 19

Osteomalacia is caused by a lack of vitamin D. This results in secondary hyperparathyroidism, which in turn attempts to stimulate bone formation.

Question 20

Which enzymes increase in MI?

Answer 20

Troponins​

CK (MB)​

AST​

LDH

Question 21

Label this:

Answer 21

Question 22

What is the normal range of PTH?

Answer 22

1.1 – 6.8 pM