Biochemistry

Question 1

What blood tests can be done to test if the patient is a chronic drinker?

Answer 1

Gamma GT
MCV
Triglycerides

Question 2

Why are triglycerides high in alcohol excess?

Answer 2

Due to increased synthesis in the liver

Question 3

If a patient presents to A+E, is unconscious and you suspect they have been drinking what tests should you do?

Answer 3

Glucose - exclude hypoglycaemia

Serum osmolality

Question 4

What is the simplest formula for serum osmolality?

Answer 4

2x [Na]

Question 5

What is a normal serum osmolality?

Answer 5

275-295 mmol/kg

Question 6

A patient comes in comatose and has their electrolytes measured. They come back normal and therefore their calculated osmolality is normal (290 mmol/kg). However their measured osmolality was not (340 mmol/kg). What is this gap called?

Answer 6

Osmolal gap

Something else contributing to osmolality

Question 7

If an alcoholic has abdominal pain, what should you measure?

Answer 7

Amylase

LFT

Question 8

What are the liver function tests?

Answer 8

ALT
Bilirubin
Alk phos
Albumin
GGT
PTR

Question 9

What is ALT a measure of?

Answer 9

Liver damage

Question 10

Where is ALT found?

Answer 10

Liver

Question 11

Where is ALP found?

Answer 11

Liver
Bone
Small intestine
Kidneys
Placenta

Question 12

Where is albumin synthesized?

Answer 12

Liver

Question 13

Albumin is raised in a systemic inflammatory response. True or false?

Answer 13

False

It false in a systemic inflammatory response

Question 14

What does the prothrombin ratio measure?

Answer 14

Clotting factors synthesized in the liver

Indicaor of current liver synthetic function

Gives indication of patient’s bleeding tendency

Question 15

If an alcoholic presents with vomiting, what tests should you do?

Answer 15

U&Es
LFT
Amylase
ABG

Question 16

What should you measure if a patient presents with haematemesis?

Answer 16

U&E
LFT
PTR
Lactate

Question 17

In the metabolic pathway, the substance from which bilirubin is formed from is…?

Answer 17

Biliverdin

Haemoglobin -> haem -> biliverdin -> bilirubin

Question 18

Moderate alcohol consumption as part of a Mediterranean diet is known to increase/decrease blood LDL/HDL levels

Answer 18

Increase blood HDL levels

Question 19

How does antabuse work?

Answer 19

Inhibits aldehyde dehydrogenase

Question 20

Facial flushing and a general feeling of being unwell is caused by what?

Answer 20

Aldehyde

Question 21

What are hepatocytes bordered by microscopically?

Answer 21

The space of Disse

Question 22

What medication is commonly used for medically assisted alcohol withdrawal?

Answer 22

Chloriazepoxide

Question 23

Ethanol is sometimes used to treat patients with a raised osmolol gap. True or false?

Answer 23

True

Question 24

How many kcals does 1g of alcohol contain?

Answer 24

7kcals

Question 25

What is AST short for?

Answer 25

Aspartate aminotransferase

Question 26

Why do you measure lactate in a patient with haematemesis?

Answer 26

To assess perfusion

Question 27

Where does aspiration pneumonia usually occur?

Answer 27

The superior segment of the right lower lobe The lower segment of the middle lobe

Question 28

How long does it take delerium tremens to develop?

Answer 28

3-10 days

Question 29

What is portal hypertension associated with: hepatomegaly or splenomegaly?

Answer 29

Splenomegaly

Question 30

What drug use is acute pancreatitis associated with?

Answer 30

Steroid use

Question 31

What clotting factors are made in the liver?

Answer 31

II VII IX X