Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 5 MEDICINE Pathology > Past paper corrections Chempath > Flashcards

Past paper corrections Chempath Flashcards

1
Q

What enzyme should be measured before administering azathioprine?

A

Thiopurine methyltransferase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is LMWH monitored in a patient with renal failure?

A

anti xa assay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Diabetic patient recently started ACEi/ARB, now has high creatinine and urea. What is the underlying cause?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Patient presenting with serum Na 130, all other electrolytes within range. Urinary Na 40, Urine Osmolality 680. What is the most likely diagnosis.

how would you manage the patient?

A

SIADH

normal serum sodium is 135-145

fluid restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Boy had pituitary mass removed. He felt a bit dizzy and serum sodium was 129. Observations and all other U&Es showed he was fit to be discharged. What’s the most important medication for him to be prescribed to take as outpatient

A

Prednisolone -> you have to replace cortisol first as patient has hypopituitarism due to surgery adrenal insufficency. 1st line = hydrocortisone. 2nd = prednioslone, dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A patient with T1DM has missed an insulin dose and now presents vomiting with Kussmaul respiration. What is the most likely PCO2 on their ABG?

A

3.5 kPA !!!

normal is 4.6 - 6.4 kPa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Given bloods that showed normal sodium, low potassium and something else. Guess the most likely bicarbonate to the nearest whole number (normal 22-30)

A

39
low potassium means high bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Patient with hypokalaemia. Predict the bicarb result?

A

39!!

learn normal range for bicarb = 22-30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

name the drug used for patients with type 2 diabetes which inhibits the enzyme alpha glucosidase in the brush border membrane of the small bowel

A

acarbose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

name a DDP-4 inhibitor

A

SITA-gliptin

(“site of action” - for spelling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What blood marker is used to check for recurrence of papillary thyroid cancer post resection?

A

thyroglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A patient presents with new-onset type 2 diabetes, an enlarged jaw and forehead and carpal-tunnel syndrome. Which investigation would be most useful to diagnose the likely cause?

A

oral glucose tolerance test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What investigation/test is used to monitor someone on LMWH with renal failure?

A

anti-xa assay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

2cm pituitary mass. Prolactin level: 1400

What’s the diagnosis?

A

non functioning pituitary adenoma!!!

<1000 prolactin -> stress, recent breast of vaginal exam, hypothyroidism, PCOS

1000 - 5,000 = non functioning pituitary adenoma

> 5,000 = prolactinoma!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Note low dose dex suppression test -> failure to suppress = cushings syndrome. Also shown by high 24 hour urine cortisol or high late night salivary cortisol
Step 2 = measure serum ACTH. low = adrenal tumour (do ct) or exogenous glucocorticoid. High = pituitary sampling for ACTH. if high = pituitary tumour. Low = ectopic acth secretion so CT chest abdomen

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is raised when a cell undergoes haemolysis?

A

potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What drug causes hypoglycaemia

A

Quinine, Thiazide, Statin, Glucagon, prednisone - others cause hyperglycemia

18
Q

Which of the following is Vitamin D from plants?

A

ergocalciferol

19
Q

Baby/young child with 21-alpha-OH, what would be likely serum levels?

A

Low sodium & high potassium

No aldosterone to bring about potassium excretion and sodium reabsorption

20
Q

Addison’s patient is admitted in adrenal crisis. Her BP is low. What fluid should be given?

A

IV hydrocortisone

21
Q

30yo man comes to ED having taken a drug overdose. ABG below.
metabolic acidosis

A

aspirin

22
Q

Which liver enzyme can be measured in the blood and specifically suggests obstructive jaundice if levels are found to be raised?

A

gamma -glutamyl transferase GGT

23
Q

A 24 year old patient with known type 1 diabetes presents having missed her insulin, and is now vomiting with Kussmaul’s respiration. Predict the likely bicarbonate concentration in this patient. (bicarbonate reference range 22-29 mmol/L)

A
  1. Bicarb is less than 18 in DKA

as it is a metabolic acidosis!

24
Q

hypoglycemia treatment

A

IM glucagon

25
Q

Which adrenal zone produces cortisol?

A

Zona fasciculata. Salt SUGAR sex

26
Q

What enzyme does allopurinol inhibit?

A

xanthine oxidase

27
Q

What active enzyme in sarcoidosis patients causes hypercalcaemia

A

1 alpha hydroxylase

28
Q

What is the commonest cause of hypercalcaemia in the community?

A

primary hyperparathyroidism

29
Q

Deficiency of which plasma protein occurs in patients with liver disease and a movement disorder?

A

ceruloplasmin

30
Q

60 year old man with BMI of 28 has abdo pain. His LFTs - high total BR, high ALP, high ALT, high AST, high GGT, high creatine kinase. What is the most likely diagnosis?

A

obstructive jaundice due to gallstones
GGT is high !!

31
Q

Increased insulin sensitivity results in low plasma glucose and occurs in which of the following conditions?

A

ACTH deficiency

32
Q

What is increased in urine in hemolytic jaundice?

A

urobilinogen

33
Q

Which of the following binds to receptors in the adrenal and stimulates aldosterone release?

A

angiotensin 2

34
Q

MEN2 medullary thyroid adenoma. What hormone would you measure?

A

calcitonin

⁃ You measure thyroglobulin for papillary thyroid cancer

35
Q

T1DM? with hypoglycaemia, What is the management option if no IV access

A

IM glucagon

36
Q

PCSK9 inhibitor - evolucumab, what does it halve?

A

LDL levels

37
Q

ToF - what type of shunt?

A

right to left shunt

38
Q

What would be high in most common cause of CAH

A

ACTH

39
Q

Which hormone leads to release of prolactin?

A

thyrotrophin-releasing hormone

40
Q

best investigation to confirm a diagnosis of cushings disease (its when the pituitary is affected). think of it as disease = serious! vs syndrome so involves the head

A

pituitary sampling for ACTH. used to be high dose dex but no longer done!

41
Q

Diabetic patient recently started ACEi/ARB, now has high creatinine and urea. What is the underlying cause?

A

renal artery stenosis

Year 5 MEDICINE Pathology (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions