Other

Question 1

Allopurinol

Contraindicated with…?

Answer 1

Azathioprine

Aza metabolised to mercaptopurine. Mercaptopurine oxidised by xanthine oxidase. Effectively double dose of Aza

Question 2

Acute gout

Treatment

Answer 2

NSAIDS

Colchicine (inhibit polyermisation of tubules which is needed in mitosis). Reduced motility of NPLs at low conc so no inflam response.

Glucocorticoids

Question 3

Lesch Nyhan Syndrome

Answer 3

Complete HGPRT deficiency.
Hyperuricaemia
Choreiform movements, developmental delay

Question 4

Schmidt’s Syndrome

Answer 4

Addisons Disease + Primary Hypothyroidism

Question 5

Normal ranges:

CO2
Bicarbonate
O2

Answer 5

4.7-6kPa

22-30mmol/l

10-13kPa

Question 6

Normal anion gap range?

Answer 6

14-18mmol/l

Question 7

Causes of elevated anion gap?

Answer 7

Methanol 
Uraemia
DKA
Propylene glycol
Isoniazid
Lactic acidosis
Ethylene glycol
Salicylate a

Question 8

Osmolar gap =?

Normal range?

Use?

Answer 8

Osmolality (measured) - osmolarity (calculated)

<10

Elevation provides evidence for presence of abnormal solute.

Question 9

Organic acidurias blood tests?

Answer 9

Hyper ammonia with metabolic acidosis

High anion gap

Question 10

Galactoseamia

Presentation?

Answer 10

Conjugated hyperbilirubinaemia and sepsis

GAL-1-PUT deficiency

Question 11

Lysosomal storage disease

Answer 11

Urine mucho polysaccharide and oligosaccharides

Question 12

Peroxismal disorders

Answer 12

Severe muscular hypotonia

Disorder in metabolism of very long chain fatty acids

Question 13

Metabolic acidosis

4 causes?

Answer 13

Lactate build up
DKA
renal Tubular acidosis
Intestinal fistula (HCO3 loss)

Question 14

Metabolic alkalosis

3 causes

Answer 14

Pyloric stenosis
HypoK
Bicarbonate ingestion

Question 15

Resp acidosis

3 causes

Answer 15

Decreased ventilation - morphine, COPD

Poor perfusion

Impaired gas exchange - pneumonia

Question 16

Resp alkalosis

2 causes

Answer 16

Hyperventilation / anxiety

Artificial ventilation