ChemPath

Question 1

Low Na, Normal Osmo

Answer 1

Pseudo-hyponatraemia

- hyperlipid/hyperprot

Question 2

hyponat, Urine osmo >20

Answer 2

renal cause hyponat (CKD, diuretics)

Question 3

hyperpigmentation, Hyponat, hyperkal

Answer 3

Addisons

Question 4

hyponat with inappropriately high urine osmo

Answer 4

SIADH

Question 5

hyponat with raised plasma osmo

Answer 5

ethanol, glucose, mannitol

Question 6

hyperkalaemia + deranged urea/creatinine levels

Answer 6

Renal failure

Question 7

Hypokalaemia, calcium in urine, hypotension

In babies

Answer 7

Bartter syndro

Question 8

hypokalaemia with acidosis

Answer 8

renal tubular acidosis

Question 9

rises in GGT and ALP that are greater than the rises in AST/ALT

Answer 9

cholestasis (from gallstones)

Question 10

Normal LFTs, isolated rise in unconjugated bilirubinaemia, normal conjugated bilirubinaemia

Answer 10

Gilbert syndro

Question 11

raised AST and ALT levels (AST:ALT ratio <1), Inc GGT

Normla BIlirubin/albumin

Answer 11

NAFLD

Question 12

AST and ALT >1000, AST/ALT higher than GGT and ALP

Answer 12

hepatic pathilogy - paracetamol poisoning?

Question 13

Hyponat, Hyperkal, +ve short synthacthen

Long synthACTHen - cortisol <900 after 24 hrs

Answer 13

primary adrenal insuff (addisons)

Question 14

hyponat, hyperkal, +ve short synthacth,

Long synACTHen - cortison >900 after 24hrs

Answer 14

secondary adrenal insufficiency

Question 15

Normal calcium bone studies, isolated rise in ALP

Answer 15

Paget’s

Question 16

Inc PTH, low/inappropriately normal Ca, inc ALP

Answer 16

Osteomalacia

Question 17

dec PTH, hypocal, hyperphos

Answer 17

pri hypoparathyroidism

Question 18

bone disease with normal bone studies

Answer 18

Osteoporosis

Question 19

raised amylase in child with parotitis

Answer 19

Mumps

Question 20

causes of raised amyllase

Answer 20

inflam of parotid glands, pancreatitis

Question 21

Bence-Jones plasma protein

Answer 21

MM

Question 22

CA125

Answer 22

Ovarian cancer

Question 23

low plasma ceruloplasmin levels

Answer 23

wilsons disease

Question 24

raised alpha fetoprotein

Answer 24

hepatocellular carcinoma

germ cell tumours

Question 25

raised plasma albumin

Answer 25

dehydration

Question 26

low plasma albumin

Answer 26

liver disease, nephrotic syndro, malabs

Question 27

corrected Ca calculation

Answer 27

Serum Ca + 0.02 x(40-serum albumin)

NB low albumi -> low bound Ca, normal Free Ca

Question 28

Osteonec of jaw

Answer 28

bisphosphonate treatment (alendronate)

Question 29

ECG - early peaked t waves, broad QRS, flat P waves

Answer 29

hyperkal

Question 30

Inc ALT > inc ASP > inc GGT + ALP

Answer 30

hep (prob viral)

Question 31

Inc ASP > inc ALT > inc GGT + ALP

Answer 31

alco hep

Question 32

isolated rise in unconjugate bilirubin, Normal ALP/ALT etc

Answer 32

Gilbret’s syndro

Question 33

ALP v raised on its own, other results normal

Hx of headaches

Answer 33

Pagets

Question 34

blood tests show hypoketotic hypoglycaemia

Answer 34

MCADD

Question 35

high phelyalanine levels in blood

retardation

Answer 35

PKU

Question 36

AKI, inc anion gap, calcium oxalate crystals in urine

Answer 36

ethylene glycol poisoning

Question 37

vitamine def

anaemia, poor coordination, absent reflexes

Answer 37

Vit E

Question 38

vitamine def

being treated for TB, dev rash on skin

Answer 38

Vit B6

Question 39

hyponat, urine Cosmo <20, ankle oedema

Answer 39

congestive cardiac F