Chem Path BB

Question 1

Viral hepatitis genome types

Answer 1

Hep A = +ssRNA
Heb B = dsDNA
Hep C = +ssRNA
Hep D = -ssRNA
Hep E = +ssRNA

Question 2

A liver enzyme raised after a myocardial infarction

Answer 2

Alkaline Phosphatase

Question 3

1) APTT measures effect of what drug and pathway

2_ PT measures…

Answer 3

APTT: Heparin, intrinsic pathway
PT: warfarin, extrinsic pathway

Question 4

Varies with posture when sample is taken.

Answer 4

albumin

Question 5

varies with exercise

Answer 5

creatine kinase

Question 6

medication for respiratory condition, causes heart attacks

Answer 6

Theophylline

Question 7

Phase i of metabolism of lipid soluble drugs

Answer 7

cytochrome P450 oxidation

Question 8

Features of digoxin toxicity

Answer 8

arrhythmia: the most common arrhythmias are ventricular extrasystoles, ventricular bigeminy / trigeminy and atrial tachycardia with complete heart block

anorexia, nausea and vomiting and occasionally, diarrhoea

confusion especially in the elderly

yellow vision (xanthopsia), blurred vision and photophobia

Question 9

Decreased excretion, increased plasma concentration and increased risk of toxicity may occur when this taken in conjunction with thiazide diuretics

Answer 9

Lithium

Question 10

Symptoms of under treatment and toxicity may be similar

Answer 10

Digoxin

Question 11

Is ototoxic and nephrotoxic

Answer 11

Gentamycin

Question 12

peak and trough levels should be taken

Answer 12

Gentamycin

Question 13

urine test was found to be positive for 6-MAM

Answer 13

Heroin

Question 14

agressive, paranoid, heart racing, then dead.

Answer 14

cocaine

Question 15

Breakdown products of cocaine

Answer 15

EME = ecgonine methyl ester

BE = benzoylecgonine

Question 16

accidentally ingested liquid paraquat. Rx?

Answer 16

activated charcoal

Question 17

Carbon monoxide poisoning Rx:

Answer 17

Hyperbaric O2

Question 18

massive overdose of atenolol.

Answer 18

IV atropine, then glucagon if needed

Question 19

Which of the above techniques can be used to test for benzodiazepines and various antipsychotic drugs?

Answer 19

Liquid chromatography

Question 20

Which can look for all the classes of drugs of abuse

Answer 20

Immunoassay

Question 21

Which drug is found in the most addict related deaths?

Answer 21

morphine

Question 22

Hypovolaemic with urinary Na+<10 mmol/L

Answer 22

vomiting

Question 23

Hypotension with urinary Na+>20 mmol/L

Answer 23

Diuretic excess

Question 24

Hypervolaemic with urinary Na+>20 mmol/L

Answer 24

Chronic renal failure

Question 25

Prev. congestive heart failure, likely cause of hypokalaemia

Answer 25

Diuretic use

Question 26

Cortisol suppressed only by HIGH dose dex suppression test

Answer 26

Cushing's DISEASE

Question 27

The commonest enzyme deficiency seen in CAH

Answer 27

21 hydroxylase deficiency

Question 28

Levels of this steroid are raised in the serum of CAH patients

Answer 28

17 hydroxyprogesterone

Question 29

Increased levels are seen in the urine of CAH patients

Answer 29

pregnanetriol

Question 30

A good indicator of renal function

Answer 30

Serial creatinine readings

Question 31

Renal complications of ACEi

Answer 31

Renal artery stenosis

Question 32

Useful in staging and monitoring treatment of extracapsular spread of prostatic carcinoma

Answer 32

Acid phosphatase

Question 33

Raised in active sarcoidosis

Answer 33

Angiotensin converting enzyme (ACE)

Question 34

Which enzyme rapidly rises post myocardial infarction but then rapidly declines and is a useful marker of reinfarction?

Answer 34

Creatine kinase MB

Question 35

Following chemotherapy (for Hodgkin's lymphoma?) which enzyme would you expect to be elevated?

Answer 35

LDH

Question 36

Organophosphate poisoning, what is raised

Answer 36

Plasma cholinesterase

Question 37

SCID is frequently caused by a deficiency in which enzyme?

Answer 37

Adenosine deaminase

Question 38

McArdle’s glycogen storage disease (type V), which enzyme deficiency

Answer 38

Mycophosphorylase

Question 39

Which enzyme deficiency in Fabry's

Answer 39

Galactosidase A

Question 40

south-east asian, difficulty seeing in dark, kidney stones

Answer 40

Vit A deficiency

Question 41

Askanazy cells

Answer 41

Hashimoto's thyroiditis

Question 42

young man, stridor, multi-nodular goitre

Answer 42

simple colloid goitre

Question 43

Tender goitre, unvaccinated child

Answer 43

Giant cell thyroiditis (This IS the same as De queverain's)

Question 44

Recommended therapy used in an attack of acute intermittent porphyria,

Answer 44

Haem arginate

Question 45

Drug that can result in chronic porphyria

Answer 45

alcohol

Question 46

Neurotoxic product(s) of heme breakdown producing neurovisceral damage in certain porphyrias

Answer 46

5-aminolevulinic acid

Question 47

Autosomal dominantly inherited (or spontaneous mutation) porphyria with cutaneous manifestations only, resulting from uroporphyrinogen decarboxylase deficiency

Answer 47

porphyria cutanea tarda

Question 48

Product(s) of heme breakdown resulting in photosensitivity (i.e. cutaneous) damage in certain porphyrias

Answer 48

activated porphyrins and oxygen free radicals