ChemPath EMQ on emzymes and chemistry Flashcards
describe how creatinine is generated
creatine kinase = protein in muscle
generates creatinine as a waste product
excreted by kidneys
builds up in kidney failure
What 4 enzymes increase after an MI
- Troponins
- CK (MB)
- AST ( found within myocytes, raised 3-14 days)
- LDH
when is AST higher than ALT and vice versa
AST higher than ALT (2:1) in patients with chronic alcoholic cirrhosis
ALT higher than AST in viral hepatitis
Is vitamin D high or low in primary hyperparathyroidism
low
PHT activates 1 - alpha hydroxylase meaning that vitamin D is consumed
what enzyme rises the most in 1) acute renal failure caused by dehydration 2) chronic renal failure caused by fall in GFR
1) urea
2) creatinine
list 2 indications for dialysis
1 - hyperkalaemia
2 - acidosis (give soidum bicarb)
3 - pulmonary oedema
what can be used as a marker of glucose control over the past 3 weeks
FRUCTOSAMINE
can be used to monitor glucose control in pregnancy
Features and treatment of Paget’s disease
- increased activity of osteoclasts and osteoblasts
- high ALP and osteocalcin
- bowed tibia
- warm
- often asymptomatic
- treat with BISPHOSPHONATES
- technetium bisphosphonate scan
what scan is used to detect abdominal mets from cancer
flourodeoxyglucose (FDG PET)
what scan is used to detect bony mets
Tc bisphosphonate
what scan is used to detect primary neuroendocrine tumours (insulinomas)
gallium 68 dotatate
what scan is used to detect thyroid problems
Tc99 pertechnetate
what scan is used to detect parathyroid problems
Sesta MIBI
what scan is used to detect phaeochromocytomas
MIBG
what liver enzyme is important in gluconeogenesis
AST
