Biochemistry OSPE Revision - BPHARMA
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Questions and Answers

What are the different types of blood samples?

Arterial, venous and capillary

What is the main purpose for each type of blood sample?

  • Venous: Lipid profile, blood glucose Etc (correct)
  • Capillary: point-of-care testing (POCT)like emergency blood glucose monitoring using glucometer (correct)
  • Blood gases for arterial (correct)

Mention one complication for each type of blood sample?

  • Pain - Capillary sample (correct)
  • Arterial Spasm- Arterial sample (correct)
  • Hematomas- Venous sample (correct)

What are the two main regulatory hormones of blood glucose level?

<p>Insulin and glucagon</p> Signup and view all the answers

What is the main function of each hormone?

<p>Insulin: decrease the blood glucose level (A), Glucagon: Increase the blood Glucose level (B)</p> Signup and view all the answers

What are the early symptoms of Hypoglycaemia?

<p>Shakiness(tremor) (A), headache (B), fatigability. (C), Sweating (D)</p> Signup and view all the answers

What are the causes of hypoglycaemia?

<p>Insulin excess dose for diabetic (accidental or deliberate) (A), Exercise (B), Endogenous insulin: Insulinoma. (C), Inadequate or poorly timed food intake (D)</p> Signup and view all the answers

What is POCT?

<p>Point-of-care testing (POCT) or near-patient testing or bedside testing</p> Signup and view all the answers

What are examples of POCT?

<p>Oximeter for oxygen saturation (A), Glucometer for BG level (B)</p> Signup and view all the answers

What are the advantages of POCT?

<p>Quick, efficient, and cost-effective</p> Signup and view all the answers

What is the main storage form of lipids?

<p>Triglyceride.</p> Signup and view all the answers

Mention three important functions of lipids in the human body?

<p>Source of the fat-soluble vitamins (A), Source of the essential fatty acids (B), Source of energy (high energy value, 25% of body need) (C), A thermal insulator in the subcutaneous tissue against loss of body heat, etc.... (D)</p> Signup and view all the answers

What are lipoproteins?

<p>Are complex particles which transport lipids between different tissues.</p> Signup and view all the answers

What are the two main parts of lipoproteins?

<p>A surface monolayer: Hydrophilic lipid components and hydrophilic protein (A), A core: Hydrophobic part - Non-polar consisting of TAGs and/or cholesteryl esters (B)</p> Signup and view all the answers

List the four classes of lipoproteins, and the role of each class?

<p>Chylomicrons: transport the absorbed TG absorbed from the intestine to the different tissues (A), LDL: Bad Cholesterol, transport cholesterol from the liver to different tissues (Deposition of Cholesterol in tissues) (B), VLDL: transport TG from the liver to other tissues (C), HDL: Good cholesterol, transport the cholesterol from the tissue back to the liver (reverse cholesterol transport) (D)</p> Signup and view all the answers

What is the indication for requesting a lipid profile?

<p>Monitoring for RISK atherosclerosis (A), Monitoring the treatment of patients with hyperlipidaemias (B)</p> Signup and view all the answers

Whom to test for a lipid profile?

<p>Diabetes mellitus (A), Hypertensive (B), Obesity (C), Family history of CHD before the age of 55 years (D), Smoking habits (E), Personal history of CHD(coronary heart disease) (F)</p> Signup and view all the answers

How can you calculate the VLDL and LDL from other parameters?

<p>VLDL = Triglycerides/5. LDL cholesterol = Total Cholesterol - (VLDL+ HDL).</p> Signup and view all the answers

What is the metabolic disorder?

<p>Inherited metabolic disorders are caused by a defect in the enzymes or their co-factors that metabolize protein, carbohydrate, or fat.</p> Signup and view all the answers

What are three metabolic disorders?

<p>Alkaptonuria (A), Phenyl ketonuria (B), Homocystinuria (C)</p> Signup and view all the answers

What is the defective enzyme in PKU? Mention its function?

<p>The defective enzyme in PKU is phenylalanine hydroxylase. Its function is to metabolize phenylalanine to tyrosine.</p> Signup and view all the answers

What are the characteristic presentations of PKU?

<p>The characteristic feature is the musty odour of sweat and urine (A), Usually presented as Neurological Symptoms: Seizures, developmental delay (B)</p> Signup and view all the answers

What is the biochemical base of the musty odour?

<p>Urine-due to deposition of phenylacetate</p> Signup and view all the answers

What is the biochemical test used to confirm PKU? Explain the observation and its inference?

<p>The ferric chloride test for phenyl pyruvic acid is used to confirm PKU. A yellowish green color is observed, indicating the presence of phenyl pyruvic acid.</p> Signup and view all the answers

What is homocystinuria?

<p>It is a clinical condition where methionine and another amino acid, homocysteine build up in the blood.</p> Signup and view all the answers

What is the defective enzyme? Explain the consequences?

<p>The defective enzyme is cystathionine beta-synthase (CBS). This enzyme is involved in the conversion of homocysteine to cystathionine. In homocystinuria, this enzyme is deficient or lacking. This leads to defective connective tissue formation.</p> Signup and view all the answers

What is the biochemical test used to confirm Homocystinuria? Explain observation and inference?

<p>The cyanide nitroprusside test is used to confirm homocystinuria. A purple ring is formed when you add sodium nitroprusside. This indicates the presence of cysteine and homocysteine, which react with sodium nitroprusside to produce a pink to purple color.</p> Signup and view all the answers

What is Alkaptonuria?

<p>It's a black urine disease.</p> Signup and view all the answers

What is the defective enzyme? Consequences?

<p>The defective enzyme in alkaptonuria is homogentisate 1,2 dioxygenase. This enzyme is responsible for breaking down homogentisic acid, a byproduct of tyrosine metabolism. Deficiencies in this enzyme lead to the accumulation of homogentisic acid in the blood, which is excreted in the urine and may cause damage to cartilage, heart valves, and kidney stones.</p> Signup and view all the answers

What are the main functions of the kidney?

<p>Endocrine function: Hormones. (A), Homeostatic regulation: Water -Salt Balance, Acid - base Balance (B), Protein conservation (C), Excretion &amp; Elimination: Urine formation &amp; Removal of organic wastes products of nitrogen from body fluids (urea, creatinine, uric acid) (D)</p> Signup and view all the answers

What are the substances that usually excreted in the urine?

<p>creatinine (A), urea (B), uric acid (C)</p> Signup and view all the answers

Substances that are retained by the kidney?

<p>amino acids (A), Glucose (B), Sodium (C)</p> Signup and view all the answers

How is the kidney regulating the amount of water inside the body?

<p>The kidneys adjust the amount of water lost in urine. They also secrete the renin hormone, which plays a crucial role in regulating blood pressure and controlling fluid balance.</p> Signup and view all the answers

What is the response of the kidney for blood acidosis?

<p>The kidneys respond to blood acidosis by secreting H+ ions into the urine and reabsorbing HCO3- ions. This helps to restore the body's acid-base balance.</p> Signup and view all the answers

What is the kidney response for blood alkalosis?

<p>In response to blood alkalosis, the kidneys retain H+ ions and excrete HCO3- ions in the urine. This helps to restore the body's acid-base balance.</p> Signup and view all the answers

When is erythropoietin secreted and how it works?

<p>Erythropoietin is a hormone secreted by the kidneys in response to low oxygen levels in the blood, such as in anemia. It works by stimulating the production of red blood cells (RBCs) in the bone marrow, which helps to increase the oxygen-carrying capacity of the blood.</p> Signup and view all the answers

Do patients with chronic kidney disease can develop anemia? Why?

<p>True (A)</p> Signup and view all the answers

How glomerular function is assessed? Example?

<p>Glomerular function is assessed by measuring the filtration rate of waste products from the blood. This is typically done using a creatinine clearance test. Creatinine is a waste product produced by muscle metabolism that is filtered by the kidneys. The creatinine clearance test measures the rate at which creatinine is filtered from the blood and excreted in the urine.</p> Signup and view all the answers

Which is better to use? Why?

<p>Creatinine level (A)</p> Signup and view all the answers

Are proteins normally detected in the urine? Explain your answer?

<p>Proteins are normally detected in the urine in very small amounts. The glomerular basement membrane is a barrier that prevents large molecules like protein from passing into the urine. However, in small amounts, protein is filtered out of the blood by the kidneys and excreted in the urine. This is known as trace proteinuria.</p> Signup and view all the answers

If detected in urine name this condition and mention 3 causes?

<p>The condition name is Proteinuria and it's considered a sign of kidney disease and can be caused by these three factors: glomerular defect (Allowing macromolecules such as albumin to cross), tubular defect (Low molecular weight molecule such as macroglobulins are passed in the urine), and overproduction of certain proteins (Leading to excess excretion such as Bence Jones proteins).</p> Signup and view all the answers

What are the parameters of the LFT?

<p>The parameters of the liver function test include serum protein, albumin, liver enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total bilirubin, direct bilirubin, indirect bilirubin, and prothrombin time.</p> Signup and view all the answers

What are the causes of Hypoalbuminemia?

<p>Decreased amino acids: from both diet or synthesis as in Malnutrition and Malabsorption. (A), Defective in liver synthesis: liver disease (B), Increase the loss: from the kidney as in renal disease as (nephrotic syndrome) or from the GIT (protein losing enteropathies) (C), Physiological: Pregnancy (D), Increase the catabolism: Surgery and Trauma (E)</p> Signup and view all the answers

Mention the liver Enzymes and related disorder?

<p>ALP indicate biliary disease as Obstructive jaundice (A), GGT indicate secondary metastasis to the liver and drug induce haptic damage as anticonvulsants use (B), AST and ALT indicate Hepatic cell damage as in hepatitis, cirrhosis, Alcohol and drug intake (C)</p> Signup and view all the answers

What is PT? What does it indicate?

<p>PT stands for Prothrombin Time. It's a test measuring how long it takes for a blood clot to form based on a protein produced by the liver called prothrombin. Abnormal PT values can indicate problems with the liver's ability to produce clotting factors.</p> Signup and view all the answers

What is Hyperbilirubinemia?

<p>Hyperbilirubinemia is a condition where the level of bilirubin in the blood becomes elevated. Bilirubin is a yellow pigment produced when red blood cells break down. When the bilirubin level is high in the blood, it can cause yellowish discoloration of the skin, eyes, and mucous membranes.</p> Signup and view all the answers

What are the causes of jaundice (Hyperbilirubinemia)?

<p>Hemolysis: lysis of RBCs in hemolytic anemia e.g. sickle cell anemia (A), Hepatocellular disease: Hepatic disease cause low conjugation efficiency leading to increased unconjugated (indirect) bilirubin in blood as in hepatitis (B), Obstructive of gall bladder: Conjugated bilirubin is prevented from passing to the intestine, due to Gallstones, tumors of GB and pancreas. (C)</p> Signup and view all the answers

What is high alpha fetoprotein indicating?

<p>High levels of alpha-fetoprotein (AFP) in the blood can indicate hepatocellular carcinoma, which is a type of liver cancer.</p> Signup and view all the answers

Mention two causes?

<p>Coronary artery disease: e.g. Atherosclerosis, thrombus, embolus and aneurysm (A)</p> Signup and view all the answers

List cardiac markers and their clinical importance in diagnosis?

<p>The Earliest marker: Myoglobin, disadvantage: Non specific for cardiac damage (A), The gold standard test : Troponin, last for 7-10 days (B)</p> Signup and view all the answers

What is isozyme and its importance?

<p>Isozymes are enzymes that catalyze the same biochemical reaction but have slightly different structures and physical properties. They are important for diagnosis because they can be used to identify the tissue or organ from which an enzyme originated.</p> Signup and view all the answers

What are the components of TFT?

<p>T4 (A), T3 (B), TSH (C)</p> Signup and view all the answers

Correlate the level of T3 and TSH for the diagnosis thyroid disease?

<p>TSH (Thyroid Stimulating Hormone) levels are typically elevated in hypothyroidism, indicating that the pituitary gland is releasing more TSH to stimulate the thyroid to produce more thyroid hormones. This occurs when the thyroid gland is underactive and not producing enough thyroid hormones. In hyperthyroidism, TSH levels are typically low, as the thyroid gland is overactive and producing too much thyroid hormone. Free T4 levels are usually low in hypothyroidism and high in hyperthyroidism. Low levels often point to hypothyroidism, while high levels might suggest hyperthyroidism.</p> Signup and view all the answers

Two functions of thyroid hormones?

<p>Metabolic: increase BMR (A), Regulate heat production (B), Growth: Essential for growth and development during fetal and neonatal period of life. (C)</p> Signup and view all the answers

Mention two symptoms of hypothyroidism and hyperthyroidism and possible causes?

<p>Hyperthyroidism: Symptoms: Weight loss, heat intolerance, tachycardia, tremors. Causes: Graves' disease, toxic multinodular goiter. (A), Hypothyroidism: Symptoms: Fatigue, weight gain, cold intolerance, bradycardia. Causes: lodine deficiency, Hashimoto's thyroiditis. (B)</p> Signup and view all the answers

Biochemical techniques used to assess TFT?

<p>The biochemical techniques used to assess thyroid function tests (TFT) include ELISA (Enzyme-Linked Immunosorbent Assay) and RIA (Radioimmunoassay)</p> Signup and view all the answers

Flashcards

Arterial Blood Sample

Blood drawn from an artery, typically used for measuring blood gases (oxygen and carbon dioxide levels) and pH.

Venous Blood Sample

Blood drawn from a vein, commonly used for determining various biochemical markers like lipid profiles, blood glucose, and electrolytes.

Capillary Blood Sample

Blood drawn from a capillary, typically used for rapid point-of-care tests (POCT) like blood glucose monitoring.

Arterial Spasm

A complication that can occur after an arterial blood draw, where the artery constricts, making it difficult to obtain blood.

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Hematoma

A complication of venous blood draws resulting in a painful and discolored bruise due to blood accumulating under the skin.

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Pain

A common complication with capillary blood draws, caused by repeated punctures or improper technique.

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Insulin

A hormone produced in the pancreas that lowers blood glucose levels by facilitating glucose uptake into cells.

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Glucagon

A hormone produced in the pancreas that raises blood glucose levels by stimulating the release of stored glucose from the liver.

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Hypoglycemia

A condition characterized by low blood glucose levels, leading to various symptoms like shakiness, sweating, and fatigue.

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Causes of Hypoglycemia

Hypoglycemia can be caused by inadequate food intake, excessive exercise, insulin overdose, or conditions like insulinoma (tumor in the pancreas producing excess insulin).

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Point-of-Care Testing (POCT)

Testing performed at or near the patient, providing rapid results and facilitating quick decision-making.

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Advantages of POCT

POCT offers several advantages, including quick turnaround time, efficiency, and often cost-effectiveness compared to traditional laboratory testing.

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Lipid

A diverse group of organic compounds that are not soluble in water, including fats, oils, and steroids.

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Triglyceride

The primary storage form of lipids in the body, composed of three fatty acid molecules linked to a glycerol molecule.

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Importance of Lipids

Lipids play crucial roles in the body, including serving as an energy source, transporting fat-soluble vitamins, providing insulation, and contributing to cell structure.

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Lipoproteins

Complex particles that transport lipids throughout the body, consisting of a core of hydrophobic lipids surrounded by a hydrophilic surface monolayer.

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Chylomicrons

Largest lipoproteins that transport dietary triglycerides from the intestines to other tissues.

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VLDL

Lipoproteins that transport triglycerides synthesized in the liver to other tissues.

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LDL

Low-density lipoproteins known as the 'bad cholesterol' because high LDL levels can contribute to atherosclerosis.

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HDL

High-density lipoproteins known as the 'good cholesterol' because they help remove cholesterol from the body and transport it back to the liver.

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Lipid Profile

A blood test that measures levels of different lipoproteins (LDL, HDL, and triglycerides) to assess cardiovascular risk and monitor treatment.

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Metabolic Disorders

Inherited conditions caused by defects in enzymes or their cofactors involved in the breakdown of proteins, carbohydrates, or fats.

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Phenylketonuria (PKU)

A metabolic disorder caused by a deficiency in phenylalanine hydroxylase, leading to the accumulation of phenylalanine in the body.

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Homocystinuria

A metabolic disorder caused by a deficiency in cystathionine beta-synthase, resulting in the accumulation of homocysteine in the blood.

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Alkaptonuria

A metabolic disorder caused by a deficiency in homogentisate 1,2 dioxygenase, leading to the accumulation of homogentisic acid in the body.

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Functions of the Kidney

The kidneys play vital roles in the body, including excreting waste products, regulating fluid and electrolyte balance, maintaining acid-base balance, producing hormones, and conserving proteins.

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Substances Excreted in Urine

The kidneys eliminate waste products like urea, creatinine, and uric acid through urine formation.

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Substances Retained by the Kidney

Useful substances like glucose, amino acids, and sodium are reabsorbed by the kidneys back into the bloodstream.

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Kidney Regulation of Water Balance

The kidneys maintain water balance by adjusting the volume of urine produced and by secreting the hormone renin.

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Kidney Response to Acidosis

To combat acidosis in the blood, the kidneys secrete H+ ions into the urine and reabsorb bicarbonate ions.

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Kidney Response to Alkalosis

To correct alkalosis, the kidneys retain H+ ions and excrete bicarbonate ions in urine.

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Erythropoietin

A hormone produced by the kidneys in response to low blood oxygen levels, stimulating the production of red blood cells.

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Chronic Kidney Disease and Anemia

Patients with CKD often develop anemia due to impaired production of erythropoietin.

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Glomerular Filtration Rate (GFR)

A measure of how well the kidneys are filtering waste products from the blood, assessed through clearance tests like creatinine and urea clearance.

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Creatinine Clearance Test

A test to determine GFR by measuring the amount of creatinine excreted in urine, providing a good indicator of kidney function.

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Study Notes

Biochemistry OSPE Revision - BPHARMA

  • Blood Samples: Different blood samples include arterial, venous, and capillary.
  • Arterial Samples: Used for blood gas analysis.
  • Venous Samples: Used for lipid profiles, blood glucose, etc.
  • Capillary Samples: Used for point-of-care testing (POCT), like emergency blood glucose monitoring using a glucometer.
  • Complications: Arterial spasm (arterial sample), hematoma (venous sample), pain (capillary sample).

Blood Glucose Regulation

  • Hormones: The two main regulatory hormones for blood glucose levels are insulin and glucagon.
  • Insulin Function: Decreases blood glucose levels.
  • Glucagon Function: Increases blood glucose levels.

Hypoglycemia

  • Symptoms: Shakiness, sweating, headache, and fatigue.
  • Causes: Inadequate/poorly timed food intake, exercise, excessive insulin dose (accidental or deliberate), Insulinoma.

Point-of-Care Testing (POCT)

  • Definition: Point-of-care testing involves near-patient or bedside testing.
  • Examples: Glucometer for blood glucose (BG) level, oximeter for oxygen saturation.
  • Advantages: Quick, efficient, and cost-effective.

Lipids

  • Definition: Lipids are a heterogeneous group of water-insoluble organic compounds.
  • Storage Form: The main storage form of lipids is triglycerides.
  • Importance in Human Body: Source of energy (25% of body needs), source of fat-soluble vitamins.

Lipoproteins

  • Definition: Complex particles that transport lipids between tissues.
  • Components: A core (hydrophobic, TAGs/cholesteryl esters) and a surface monolayer (hydrophilic lipid components and proteins).
  • Classes and Roles:
    • Chylomicrons: Transport absorbed triglycerides from the intestine.
    • VLDL: Transport triglycerides from the liver to tissues.
    • LDL: Transport cholesterol from the liver to tissues (bad cholesterol).
    • HDL: Transport cholesterol from tissues back to the liver (good cholesterol).

Lipid Profile Indications

  • Indications: Monitoring risk of atherosclerosis and hyperlipidemia treatment.
  • Whom to Test: Patients with personal or family history of coronary heart disease (CHD) before age 55, hypertension, diabetes mellitus, obesity, and smoking habits.

Lipid Calculations

  • VLDL Calculation: Triglycerides/5
  • LDL Calculation: Total cholesterol - (VLDL + HDL)

Metabolic Disorders

  • Definition: Inherited disorders caused by defects in enzymes that metabolize proteins, carbohydrates, or fats.
  • Examples: Phenylketonuria (PKU), homocystinuria, alkaptonuria.

Additional Biochemical Tests and Conditions

  • PKU: Biochemical test: Ferric Chloride test for phenylpyruvic acid. Positive test shows a yellowish-green color, indicating phenylpyruvic acid presence.
  • Homocystinuria: Biochemical test: Cyanide Nitroprusside test. Presence of a purple ring indicates homocysteine or cysteine, signifying the condition.
  • Alkaptonuria: Biochemical test leads to a brownish-black color in the urine, which is related to the homogentisic acid presence.

Kidney Functions

  • Main Functions: Excretion and elimination of waste products, homeostasis (water-salt and acid-base balance regulation), endocrine function (hormone production), and protein conservation.
  • Substances Excreted: Urea, creatinine, uric acid.
  • Substances Retained: Glucose, amino acids, and sodium.
  • Kidney Response to Acidosis/Alkalosis: H+ secretion/retention and HCO3- reabsorption/excretion in the urine.

Erythropoietin and Anemia

  • Secretion: Erythropoietin is secreted in response to low oxygen in the blood (low RBCs).
  • Work: Stimulates red blood cell (RBC) production.
  • Chronic Kidney Disease & Anemia: Patients with chronic kidney disease may develop anemia due to impaired erythropoietin production.

Glomerular Function Assessment

  • Assessment: Creatinine level (better than urea clearance as affected less by dietary factors)
  • Normal Detection of Proteins: Trace amounts of proteins are expected.
  • Causes: Glomerular, tubular defects, overproduction of specific proteins (e.g., multiple myeloma).

Liver Function Tests (LFTs)

  • Components: Serum proteins (e.g., albumin), liver enzymes (e.g., ALT, AST, GGT, ALP), bilirubin, and coagulation factors (e.g., prothrombin time).
  • Abnormal LFTs: Reflect liver damage or disease, obstructive jaundice, hepatitis, cirrhosis, etc
  • Enzyme Functions: ALT and AST : Liver cell damage, GGT secondary metastasis to the liver and drug-induced damage and ALP indicate biliary disease.

Other

  • Hyperbilirubinemia/Jaundice: High bilirubin levels resulting in yellowing of the skin and eyes.
    • Causes: Hemolysis, obstructive issues (e.g., gallstones, tumors), or hepatocellular disease.
  • Myocardial Infarction (MI): Blocked blood flow to the heart muscle causing damage.
  • Markers: Troponin is a gold-standard marker for MI diagnosis.
  • Thyroid Function Tests (TFT): Include TSH, T3, and T4 to assess thyroid function (hypo/hyperthyroidism).
  • Biochemistry Techniques: ELISA, RIA.

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Biochemistry OSPE Revision PDF

Description

This quiz covers essential biochemistry concepts for pharmacy students, focusing on various blood sample types and their applications in clinical settings. It also discusses blood glucose regulation, the hormonal role of insulin and glucagon, and the importance of recognizing hypoglycemia. Prepare to test your knowledge in biochemistry and point-of-care testing.

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