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Flashcards in Biochemistry of Alcohol Deck (25)
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1

What are the biomarkers of chronic alcohol abuse?

-Gamma GT: upregulated by ethanol
-Triacylglyceride: increased synthesis in liver
-raised MCV (mean corpuscular volume)

2

What bloods must be done on patients with suspected alcohol-induced coma?

-glucose: are they hyperglycaemic?
-serum osmolality:

3

What is the main contributing electrolyte to serum osmolality? What is the reference interval?

Na, Sodium
275-295 mmol/kg

4

What is the osmolal gap?

The difference between the measured osmolality and the calculated osmolality

5

How is osmolality calculated?

2([Na] + [K]) + [urea] + [glucose]
(simplified)

6

What is a possible contributor to the osmolal gap in comatose patient?

alcohol

7

List the LFTs:

ALT
Bilirubin
ALP
Albumin
GGT
PTR (prothrombin ratio)

8

ALT is a marker of liver function

False
Marker of hepatocyte damage

9

Sources of ALP?

liver
bone
kidneys
small intestine

10

Where is Gamma GT found?

Liver, kidneys, pancreas, prostate

11

What is the half life of albumin?

3 weeks

12

During systemic inflammatory response levels of albumin rise

False
albumin levels fall

13

Prothrombin ratio is a good marker of current liver synthetic function (T/F)

True

14

What is the prothrombin half-life (T/F)

3-4 days

15

What biochemical tests are run on a patient presenting with vomiting?

U&E
ABG
LFT
Amylase

16

What is the differential diagnosis of vomiting in an alcoholic patient?

1. acute gastritis
2. oeseophageal stricture
3. pyloric stenosis

17

Vomiting causes metabolic acidosis (T/F).
Explain why.

False
-metabolic alkalosis
-loss of H+ drives the release of bicarbonate into blood

18

Why is metabolic alkalosis aggravated in vomiting patients with pyloric stenosis?

Normally, loss of acid from stomach is 'compensated' by loss of alkali (bicarbonate) from duodenum.
In pyloric stenosis, mostly acidic stomach contents are lost

19

High bicarbonate and low H+ indicate...
If CO2 was high, this would indicate...

metabolic alkalosis
-that it's compensated metabolic alkalosis (via decreased breathing rate)

20

What biomarkers are relevant in a haematemesis patient?

U&E
LFT
PTR
Lactatic acid

21

Very high Urea is seen in haematemesis patients (T/F)
Explain

True
proteins from the blood are metabolised

22

What hormones are released in response to low blood volume?

Aldosterone - promotes Na and water retention

ADH - promotes water retention

23

In alcoholic patients, what can be a cause of low blood volume?

Hypoalbuminaemia - failure of synthesis by cirrhotic liver

24

Extremely low bicarbonate may be a sign of what?

Ingestion of methanol

25

Why is lactate high in a haematemesis patient?

Loss of blood decreases perfusion of peripheral tissues. They therefore go into anaerobic metabolism, producing lactic acid.