Chem EMQ notes

Question 1

True hyponatraemia - Low Na, Low serum osmol

Answer 1

CKD

Question 2

Pigmented palmar creases, hypoNa, hyperK

Answer 2

Addison’s

Question 3

Malignancy/infx, HypoNa, urine osmol>serum osmol

Answer 3

SIADH

Question 4

HypoGly+HypoK

Answer 4

Insulin overdose

Question 5

HyperK, inc creatinine, acidotic

Answer 5

Renal failure

Question 6

HypoK, acidosis, hypotension, hypoCa, young child

Answer 6

Bartter’s syndrome

Question 7

Low aldosterone, HyperK

Answer 7

ACEi

Question 8

Inc GGT+ALP

Answer 8

Obstructive

Question 9

Inc bili only finding

Answer 9

Gilbert’s

Question 10

Isolated GGT rise

Answer 10

ETOH abuse

Question 11

2AST:1ALT

Answer 11

ETOH liver disease

Question 12

Galactorrhoea normal TFT’s

Answer 12

Prolactinoma

Question 13

HyperN, HypoK HTN, muscle pains

Answer 13

Conn’s

Question 14

Carcino-embryonic antigen

Answer 14

Gastro Ca (colorectal/gastric/pancreatic)

Question 15

CA125

Answer 15

Ovarian Ca

Question 16

Bence-Jones

Answer 16

Multiple myeloma

Question 17

Caeruloplasmin

Answer 17

Wilson’s

Question 18

Amylase, parotitis

Answer 18

Mumps

Question 19

alpha-fetoprotein

Answer 19

Down’s

Question 20

Fair skin, brittle hair, convulsions, developmental delay, learning difficulties.
inborn errors of metabolism

Answer 20

Homocystinuria

Question 21

Musty smelling baby

Answer 21

Phenylketonuria

Question 22

Sweet smelling baby, sweaty feet

Answer 22

Mayple syrup urine disease

Question 23

Cherry-red spot

Answer 23

Fabry’s

Question 24

Carbamezepine’s effect on electrolyte balance

Answer 24

Hyponatraemia

Question 25

High Ca, very high PTH, normal/low phosphate with chronic renal failure

Answer 25

Tertiary hyperparathyroidisim

Question 26

Vitamin B1 test

Answer 26

RBC transkelotase

Question 27

Anorexia's physiological effect on electrolytes

Answer 27

Alkalosis, hypokalaemia, aciduria

Question 28

Exacerbating factors for gout

Answer 28

Chemo, ETOH, Aspirin, Thiazide diuretics

Question 29

Anion gap calculation

Answer 29

[Na+]+[K+]-[HCO3]-[Cl-]

Question 30

Estimated plasma osmolarity calculation

Answer 30

2*([Na+]+[K+])+[Glucose]+[Urea]

Question 31

``` CKD effects on: Acid-base Na K Urea Ca PO4 Hb ```

Answer 31

``` Acidotic Normal/reduced Na HyperK Inc Urea HypoCa HyperPO4 Anaemia ```

Question 32

Elevated anion gap in metabolic acidosis (4)

Answer 32

Ketoacidosis Uraemic Lactic acidosis Toxins

Question 33

Phyiological causes of raised CK

Answer 33

Afro-caribbean <5x ULN

Question 34

Pathological causes of raised CK

Answer 34

Duchenne's, MI, rhabdomyolysis