Meeran’s Mock Flashcards by Lottie Barot

post thyroidectomy has tingling
which electrolyte to measure?

CALCIUM

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why does postthyroidectomy pt have tingling ?

iatrogenic removal of parathyroid too, resulting in low Calcium

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what marker is raised in Pagets

ALP

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why does pagets have a raised ALP

increased osteoclast and blast activity

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Ix of Pagets

technetium 99 bisphosphonate bone scan

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what does technetium 99 bisphosphonate bone scan show

uptake by bones with high osteoblast activity

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what would a plain XR show in pagets

fractures

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what type of hearing damage does Pagets cause

conductive and sensorineural

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why does Pagets cause conductive and sensorineural hearing loss

conductive - ossicles damage
sensorineural - presses on CN8

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what marker is raised in osteomalacia

ALP

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why is ALP raised in osteomalacia

increased bone turnover
high ALP
slightly low Calcium

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what causes osteomalacia

low vitamin D (secondary hyperparathyroidism)

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what markers are raised after an MI

AST
troponins
CK
LDH

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why is AST increased after an MI

AST is found outside the liver too, including in the heart

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electrolytes in Addisons

high K
low Na

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what marker is raised in jaundice caused by gallstones

ALP

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what is the portal triad

bile duct
portal vein
hepatic artery

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is the blood in central vein ‘clean’ or ‘dirty’ and why

clean - its been through the hepatocytes before entering central vein

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what marker is raised in obstructive jaundice & why

ALP - found near portal triad

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what marker is raised in alcoholism and why

AST - found near central vein

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what marker is raised in jaundice caused by viral hepatitis

ALT&raquo_space; AST

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why does ALT rise after viral hepatitis

inflamed hepatocytes

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what marker is raised in jaundice caused by chronic alcoholic cirrhosis

AST

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why is AST released the most after alcoholic cirrhosis

liver architecture is destroyed by mast cell death –> nodules produced –> release AST

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what marker is raised in prostatic carcinoma (another name for PSA)

acid phosphatase

Calcium, vitamin D and ALP levels in primary hyperparathyroidism

high Ca low vitamin D - gets consumed quickly high ALP

what marker is raised in dehydration causing AKI

urea

if GFR falls in CKD, what will happen to the creatinine

increase

what is the marker of GFR

creatinine

how does the reactivity of urea differ in CKD vs normal person

less reactive in CKD

what is the marker of glucose control over the last 3 months

HbA1c

what is the marker of glucose control over the last 3 weeks

fructosamine

what is fructosamine used for and why

protein with shorter half life than RBC, so better for frequent glucose monitoring

30M polyuria nad polydipsia. High Ca, normal PTH, low PO43-. Dx?

primary hyperparathyroidism

what is primary hyperparathyroidism

inappropriately normal PTH in the presence of high calcium

50F Asian woman with tingling. carpal spasm on BP check. low Ca, very high PTH. Dx?

secondary hyperparathyroidism

what is secondary hyperparathyroidism caused by

chronic low vit D

what is secondary hyperparathyroidism aka

osteomalacia

50F asian woman with nocturne and dizziness. low blood glucose, high calcium, normal PTH, low Na and high K. Dx?

Addisons

60M knee pain. aspiration of joint = positively birefringent crystals. Dx?

pseudo gout

what is lesch-nyan syndrome

uric acid metabolism issue, causing you to get gout

30M polyuria and polydipsia. High Na, everything else normal. Dx?

Diabetes insipidus (vasopressin deficiency)

30M jaundice, conjunctival haemorrhages. Been canoeing in the US. Dx?

Leptospirosis

what is a rodent ulcer aka

basal cell carcinoma

what organ is this from

thyroid - thyroglobulin surrounded by follicular cells

what organ is this from

liver - portal triad and central vein with dense hepatocytes in-between

what organ is this from

kidney - glomeruli (big round things) with tubules near

what organ is this from

adrenal - dense, smooth edge is zona glomerulosa. paler central area is medulla.

high urinary sodium osmolality, low blood sodium osmolality. Dx?

SIADH

what causes the high urinary and low blood sodium zinc in SIADH

reabsorbing lots of water therefore urine very concentrated and blood very dilute

if the blood osmolality is low, what should the urine osmolality be?

VERY low - pee out all the dilute urine to get rid of water

25F hits head then gets very thirsty with nocturia. Low blood sodium osmolality. Dx?

psychogenic polydipsia

25F hits head then gets very thirsty with nocturia. Low blood sodium osmolality. why can't this be DI?

DI is deficiency of vasopressin, causing no water to be reabsorbed therefore Na would be really HIGH

40M HTN. Low K, high renin, high aldosterone. Dx?

renal artery stenosis

40M HTN. Low K, high renin, high aldosterone. why is this renal artery stenosis?

high renin ! also highaldosterone

causes of renal artery stenosis in kids vs elders

kids = fibromuscular elderly = cholesterol

40M HTN. Low K, low renin, high aldosterone. Dx?

Conn's syndrome

40M HTN. Low K, low renin, high aldosterone. why is this conns?

suppressed renin !

tired pt has low Na, high K, low glucose. Dx?

Addisons

ACEi in DM pts - what is their effect on creatinine?

worsens creatinine within days of starting

ACEi in DM pts - what is their benefit?

prevents end stage renal failure

what causes increased creatinine with ACEi in DM pts

ACEi reduce A2 and aldosterone, but also reduced glomerular pressure. this reduces albuminuria, which increases creatinine

what other drug class has a similar effect on the kidneys as ACEi in DM pts

SGLT2i

when should ACEi be stopped in DM pts temporarily and why

sepsis and pneumonia need the GFR back

what kidney condition is an absolute CI to ACEi and why

renal artery stenosis - causes GFR to fall to 0 and pt will die

Tx of choice for albuminuria in DM pt

ACEi

what needs to be checked a few days after starting ACEi in DM pts and why

GFR - to check if there was any underlying renal artery stenosis that could cause GFR to fall to 0 and kill pt

deadly strain of malaria causing organ damage due to impaired microcirculation

plasmodium falciparum

malaria strain that need primaquine 30mg to eradicate liver paras

plasmodium vivax

test to determine species of malaria parasite

THIN film

what is the thick film test for malaria actually for

to detect any malaria there at all

45F itchy skin, raised ALP and AMA+. Dx?

PBC

15M liver disease and Kayser Fleischer rings. Dx?

Wilsons

pt visited India, now has fever, jaundice and malaise. Raised ALT. Dx?

Hep A

45M. High BR, high PTT, low albumin, folate and B12. Leucocytosis. Dx?

alcoholic liver disease - albumin is low therefore chronic

45F with UC has jaundice etc. ERCP = beaded appearance. Raised ALP and BR. Hypergammaglobulinaemia. Dx?

PSC

Meeran’s Mock Flashcards

(76 cards)