Session 5 Chemical Pathology part 2 Flashcards
where is alkaline phosphatase produced?
bone, liver, intestine, placenta- 3rd trimester
when might serum amylase be raised?
pancreatitis
acute MI
ovarian cyst
renal calculi
non-biochemical tests for possible gallbladder pathology?
ultrasound- most accurate
plain abdom X-ray may detect radio-opaque stones
ERCP- look at common bile duct
why must troponin be measured after collection in testube 4hrs after taking sample?
unstable, so drops
why is glucose intolerance seen following MI?
STRESS: cortisol increase
GH increase
catecholamines increase- glycogen release
criteria for prior MI?
development of new pathological Q waves with or without symptoms
imaging evidence of a region of loss of viable myocardium that is thinned and fails to contract, in absence of a non-ischaemia cause
pathological findings of a healed or healing MI
why are myoglobin, total CK and CK-MB more useful as markers for re-infarctions?
shorter 1/2 lives than TnI, which would resultantly still be high if a patient re-infarcted whereas other markers don’t remain elevated
why can troponin not be used alone to diagnose MI?
raised level doesn’t mean MI, but would expect to be raised if MI
examples of conditions with elevated troponins, without overt IHD?
trauma hypertension congestive HF hypotension renal failure sepsis PE
why might arrhytmias occur with sepsis?
acidosis occurs as lactic acid increased via anaerobic met. in tissues receiving poor perfusion
what does a high specificity of BNP mean for diagnosing heart failure?
If BNP is not raised, HF can be ruled out as the diagnosis and BNP is raised in all cases of HF, and so BNP is good for being able to rule out HF
however, BNP may be raised due to other causes
routine lab investigation of HF?
FBC- anaemia worsens prognosis creatinine- HF assoc with RF, GFR falls electrolytes: hyponatraemia as fluid retention, hyperkalaemia, hypokalaemia, hypomagnesaemia albumin- hypo causes oedema LFTs- liver failure may cause oedema ferritin- haemochromatosis can cause HF thyroid function tests- hyper may be assoc with HF as high O2 demand as high met rate, so increased CO hypo may worsen course of HF
classical features of renal failure?
hypocalcaemia high urea high creatinine high anion gap hyperkalaemia met acidosis hyperphosphataemia
common signs and symptoms of HF?
dyspnoea fatigue peripheral oedema orthopnoea weight gain rales- abnormal lung sounds
if patient’s HbA1C is >6.5% without symtoms, why would you want to repeat investigation within 2 wks time to confirm diabetes?
results may have got mixed up
