chem_path_flashcards
(50 cards)
Which of these is a plant product?
Ergocalciferol
Where is 25 hydroxylase found?
Liver
Where is 1 hydroxylase found?
Kidney
What is the first symptom of osteoporosis?
Fracture
What is the plasma calcium level in a patient with osteoporosis?
2.4 mmol/L
Which has the lowest calcium?
Osteoporosis
76yo with previous MI has BP of 140/80 on atenolol. Is there evidence to lower his BP further?
Add thiazide diuretic and lower to 120/80
76yo with previous MI has BP of 140/80 on atenolol. Thiazide diuretic was added. His LDL is 3.0mmol on atorvastatin 80mg. Is there evidence to add a further lipid lower agent?
No
Is there real evidence that good glucose control prevent complications?
Yes
How long does it take to see benefit from good glucose control?
5 years
Which study suggests that tight control increases mortality?
Accord
Hyperkalaemia is a side effect of which of the following drugs?
Ramipril
Hypokalaemia is a side-effect of which of the following drugs?
Furosemide
A 67-year-old man was started on Bendroflumethiazide for hypertension 2 weeks ago. He has had D& V for 2 days. He has dry mucous membranes and decreased skin turgor. Na+: 129 mmol/L. What is the management?
Volume replacement with 0.9% saline
A 57-year-old woman has breathlessness worse on lying flat. Her past medical history includes a non-STEMI. She is on ramipril, bisoprolol, aspirin and simvastatin. She has elevated JVP, bibasal crackles and bilateral leg oedema. Na+: 128 mmol/L. What is the management?
Fluid restrict and treat underlying cause
A 55-year-old man has jaundice. He has a past history of excessive alcohol intake. He has multiple spider naevi, shifting dullness and splenomegaly. Na+: 122 mmol/L. What is the management?
Fluid restrict and treat underlying cause
A 40-year-old woman presents with fatigue, weight gain, dry skin and cold intolerance. On examination she looks pale. Na+: 130 mmol/L. What is the management?
Fluid restrict and thyroxine replacement
A 45-yeard-old woman presents with dizziness and nausea. On examination she looks tanned and has postural hypotension. Na+: 128 mmol/L. K+: 5.5 mmol/L. What is the management?
Fluid restrict and hydrocortisone and fludrocortisone
A 62-year-old man has chest pain, cough and weight loss. He looks cachectic. He has a 30 pack year smoking history. Na+: 125 mmol/L. What is the likely diagnosis?
SIADH due to lung tumour
A 20-year-old man presents with polyuria and polydipsia. On examination he has bitemporal hemianopia. Na+: 150 mmol/L. What is the likely diagnosis?
Central diabetes insipidus
A 20-year-old man presents with polyuria and polydipsia. On examination he has bitemporal hemianopia. Na+: 150 mmol/L. How would you manage?
5% dextrose and treat underlying case
A 65-year-old man with type 2 diabetes mellitus and hypertension presents with malaise and drowsiness. He is on a basal bolus insulin regimen, ramipril, amlodipine, simvastatin and aspirin. Na+: 125 mmol/L. K+: 6.5 mmol/L. How would you manage?
10 ml 10% calcium gluconate + 50 ml 50% dextrose + 10 units of insulin + Nebulized salbutamol + Treat the underlying cause
A 50-year-old man is referred with hypertension that has been difficult to control despite maximum doses of amlodipine, ramipril and bisoprolol. K+: 3.0 mmol/L. What is the initial investigation?
Aldosterone: renin ratio
30yo patient presents with galactorrhoea. A CT scan of her pituitary shows a large (2cm) macroadenoma. Her prolactin levels is 30,000 (normal <600). What is the diagnosis?
Prolactinoma
