Metabolic

Question 1

Drugs that decrease K+ (3)

Answer 1

Thiazides
Loops
Acetazolamide

Question 2

Name another lipid lowering drug other than a statin

Answer 2

Ezetimibe

Question 3

When to suggest familial hypercholesterolaemia?

Answer 3

If total cholesterol >7.5 OR
Personal or FH of premature coronary heart disease <60yo

Question 4

if one parent is affected by familial hypercholesterolaemia, arrange testing in children by age ?
if both parents are affected by familial hypercholesterolaemia, arrange testing in children by age ?

Answer 4

10 and 5

Question 5

What is the Simon Broome criteria?

Answer 5

Clinical diagnosis of familial hypercholesterolaemia is now using Simon Broome criteria

Question 6

Hypercalcaemia mx (4)

Answer 6

3-4L NaCL/day
Bisphosphonates (typically take 2-3 days to work, with max effect at 7 days)
Calcitonin
Steroids

Question 7

ECG changes seen in hyperkalaemia (3)

Answer 7

Tented T waves
Small P waves
Widened QRS

Question 8

Causes of hyperkalaemia (6)

Answer 8

1. AKI
2. Drugs eg heparin, ciclosporin
3. Metabolic acidosis
4. Addison’s
5. Rhabdo
6. Massive blood transfusion

Question 9

Causes of hypernatraemia (3)

Answer 9

Dehydration
Diabetes insipidus
Excessive IV saline

Question 9

Causes of hypocalcaemia (6)
Mx

Answer 9

Vitamin D deficiency
CKD
HypoPTH
Rhabdo
Magnesium deficiency
Pancreatitis

10mls of 10% calcium gluconate over 10 mins

Question 10

Low K+ w HTN (4)

Answer 10

Cushing’s syndrome
Conn’s syndrome (primary hyperaldosteronism)
Liddle’s syndrome
11-beta hydroxylase deficiency

Question 11

Low K+ w/o HTN causes (5)

Answer 11

Diuretics
GI loss (e.g. Diarrhoea, vomiting)
Renal tubular acidosis
Bartter’s syndrome
Gitelman syndrome

Question 12

early symptoms may include: headache, lethargy, nausea, vomiting, dizziness, confusion, and muscle cramps
late symptoms may include: seizures, coma, and respiratory arrest
= which electrolyte imbalance?

Answer 12

Hyponatramia

Question 13

How can you prevent osmotic demyelination syndrome?

Answer 13

Na+ can only be raised by 4 to 6mmol/l in a 24 hour period

Question 14

Mx of SIADH (2)

Answer 14

Fluid restrict
Demeclocycline

Question 15

Vitamin deficiency name and disease
A
B1
B3
B6
B7
B9

Answer 15

A retinoid night blindness
B1 thiamine beriberi, wernicke, korsakoff
B3 niacin pellagra
B6 pyridoxine anaemia, seizures, irritability
B7 biotin dermatitis seborrhoea
B9 folic acid megaloblastic anaemia

Question 16

Vitamin deficiency
Name and disiease
B12
C
D
E
K

Answer 16

B12 cyanocobalamin
C ascorbic acid scurvy gingivitis, bleeding
D rickets, osteomalacia
E tocopherol, haemalytic anaemia peripheral neuropathy
K haemorrhagic disease, bleeding

Question 17

What is pellagra?

Answer 17

Dermatitis
Diarrhoea
Dementia
Caused by niacin deficiency B3