Biochemistry OSPE Revision PDF

Biochemistry OSPE Revision – BPHARMA Q1. What are the different types of blood samples? Arterial, venous and capillary Q2. What is the main purpose for each type of sample? 1. Blood gases for arterial 2. Venous: Lipid profile, blood glucose …. Etc 3. Capillary: point-of-...

Biochemistry OSPE Revision – BPHARMA Q1. What are the different types of blood samples? Arterial, venous and capillary Q2. What is the main purpose for each type of sample? 1. Blood gases for arterial 2. Venous: Lipid profile, blood glucose …. Etc 3. Capillary: point-of-care testing (POCT)like emergency blood glucose monitoring using glucometer Q3. Mention one complication for each type you have mentioned? 1. Arterial Spasm- Arterial sample 2. Hematoma- Venous sample 3. Pain – Capillary sample Q4. What are the two main regulatory hormones of Blood glucose level? 1. Insulin. 2. Glucagon. Q5. What is the main Function of each Hormone? 1. Insulin: decrease the blood glucose level. 2. Glucagon: Increase the blood Glucose level. Q6. What are the early symptoms of Hypoglycaemia? Shakiness(tremor), Sweating, headache, and fatigability. Q7. What are the causes of hypoglycaemia? Inadequate or poorly timed food intake. Exercise. Insulin excess dose for diabetic (accidental or deliberate). Endogenous insulin: Insulinoma. Q8. What is POCT? Point-of-care testing (POCT) or near-patient testing or bedside testing. Examples: Glucometer for BG level, Oximeter for oxygen saturation. Q9. What is the Advantage of POCT? Quick, Efficient, and Cost Effective. Q10. What is lipid? Lipids are a heterogeneous group of water insoluble organic compounds. Q11. What is the main storage form of lipids? Triglyceride. Q12. Mention Three importance of lipids in Human body? Source of energy (high energy value, 25% of body need) Source of the fat-soluble vitamins  Source of the essential fatty acids A thermal insulator in the subcutaneous tissue against loss of body heat, etc…. Q13. What are lipoproteins? Are complex particles which transport lipids between different tissues. Q14. Lipoprotein’s has two main parts? A core: Hydrophobic part - Non-polar consisting of TAGs and/or cholesteryl esters A surface monolayer: Hydrophilic lipid components and hydrophilic protein Include apoproteins, phospholipid and unesterified cholesterol Q15. List the Four classes of Lipoprotein’s, and the role of each class? Chylomicrons: transport the absorbed TG absorbed from the intestine to the different tissues. VLDL: transport TG from the liver to other tissues. LDL: Bad Cholesterol, transport cholesterol from the liver to different tissues (Deposition of Cholesterol in tissues). HDL: Good cholesterol, transport the cholesterol from the tissue back to the liver (reverse cholesterol transport). Q16. What is the indication for requesting lipid profile? Monitoring for RISK atherosclerosis. Monitoring the treatment of patients with hyperlipidaemias. Q17. Whom to test for lipid profile? Personal history of CHD(coronary heart disease) Family history of CHD before the age of 55 years. Hypertensive Diabetes mellitus Obesity Smoking habits Q18. How can calculate the VLDL and LDL from other parameters? VLDL = Triglycerides/5. LDL cholesterol = Total Cholesterol - (VLDL+ HDL). Q19. What is the metabolic disorder? Inherited metabolic disorders caused by a defect in the enzymes or their co-factors that metabolize protein, carbohydrate, or fat. Q20. What are three metabolic disorder? Phenyl ketonuria. Homocystinuria Alkaptonuria. Q21. What is the defected enzyme in PKU? Mention its function?  Phenylalanine hydroxylase. Function: metabolize Phenylalanine to Tyrosine Phenyl alanine will be accumulated. Q22. What are the characteristic Presentations of PKU? Usually presented as Neurological Symptoms: Seizures, developmental delay The characteristic feature is the musty odour of sweat and urine. Q23. What is the biochemical base of the musty odour? urine-due to deposition of phenylacetate Q24. What is the biochemical test used to confirm PKU? Explain the observation and its inference? Ferric Chloride Test for phenyl pyruvic acid Observation: Yellowish green colour Inference: presence of Phenyl pyruvic acid which will oxidized to give the colour Q25. What is homocystinuria? A clinical condition where methionine and another amino acid, homocysteine build up in the blood. Q26. What is the defected enzyme? Explain the consequences? cystathionine beta-synthase (CBS). Consequences: Homocysteine replaces cysteine leading to defective connective tissue formation. Q27. What is the biochemical test used to confirm Homocystinuria? Explain observation and inference? Cyanide Nitroprusside test. Observation: Purple ring formed when you add nitroprusside sodium. Inference: Purple ring is formed. Inference: Presence of Cysteine and homocysteine reacts with sodium nitroprusside to produce pink to purple colour. Q28. What is Alkaptonuria? black urine disease. Q29. What is the defected enzyme? Consequences? Defect in enzyme Homogentisate 1,2 dioxygenase Consequences: Homogentisic acid accumulates in the blood and is excreted in the urine. Excessive Homogentisic acid causes damage to cartilage like: osteoarthritis and heart valves, kidney stones Q30. What is the biochemical test used to confirm Homocystinuria? Explain observation and inference? Blackish brown colour is observed  Presence of homogentisic acid which reduces silver to produce brownish precipitate. Q31. What are the main functions of the kidney? Excretion & Elimination: Urine formation & Removal of organic wastes products of nitrogen from body fluids (urea, creatinine, uric acid) Homeostatic regulation: Water -Salt Balance, Acid - base Balance Endocrine function: Hormones. Protein conservation. Q32. What are the substances that usually excreted in the urine? urea, creatinine, and uric acid. Q33. Substances that are retained by the kidney? Like :Glucose, amino acids and Sodium Q34. How is the kidney regulating the amount of water inside the body? Adjust the amount of water lost in urine. Secretion of Renin hormone. Q35. What is the response of the kidney for blood acidosis? H+ secretion in the urine and HCO3- reabsorption Q36. What is the kidney response for blood alkalosis? H+ retention and HCO3 excreted in the urine. Q37. When the erythropoietin is secreted and How it works? Erythropoietin secreted in response to low oxygen in the blood e.g. low RBCs. Work: Stimulate RBCs Production. Q38. Do patients with chronic kidney disease can develop anemia? Why? Yes, As erythropoietin is not secreted properly. Q39. How glomerular function is assessed? Example? Using Clearance Test, like creatinine and urea clearance. Q40. Which is better to use? Why? Creatinine level, as it is not affected by dietary factor but depends on the muscle mass. Q41. Are proteins normally detected in the urine? Explain your answer? Only Trace quantities, as the glomerular basement membrane does not usually allow passage of albumin and large proteins. Q42. If detected in urine name this condition and mention 3 causes? Proteinuria 3 main causes: Glomerular defect: allow macromolecules -albumin- to cross as in Diabetic nephropathy Tubular Defect: Low molecular weight molecule as macroglobulin’s passed in the urine. Overproduction of certain protein lead to excess excretion as benz jones proteins in multiple myeloma. Q43. What are the parameters of the LFT?  Serum protein’s and Albumin Blood Liver Enzymes: Alanine amino transferase (ALT), Aspartate amino transferase (AST) Gamma glutamyl transferase (GGT) and Alkaline phosphatase (ALP) Blood Billirubin (total, direct & indirect) Blood Coagulation Factors (prothrombin): Prothrombin Time (PT) Q44. What are the causes of Hypoalbuminemia? Physiological: Pregnancy. Decreased amino acids: from both diet or synthesis as in Malnutrition and Malabsorption. Increase the catabolism: Surgery and Trauma. Defective in liver synthesis: liver disease Increase the loss: from the kidney as in renal disease as (nephrotic syndrome) or from the GIT ( protein losing enteropathies) Q45. Mentions the liver Enzymes and related disorder? AST and ALT indicate Hepatic cell damage as in hepatitis, cirrhosis, Alcohol and drug intake. GGT indicate secondary metastasis to the liver and drug induce haptic damage as anticonvulsants use. ALP indicate biliary disease as Obstructive jaundice Q46. What is PT ? what does it indicate? Prothrombin time I measures how long it takes for a blood clot to form based on a protein produced by the liver called prothrombin Q47. What is Hyperbilirubinemia? It a state of high bilirubin level (conjugated, unconjugated, or both) is so high in the blood that it causes yellowish discoloration of the skin, nail beds, mucous membranes, and sclera (whites of the eyes). Q 48. What are the causes of jaundice (Hyoerbilirubinemia? Hemolysis: lysis of RBCs in hemolytic anemia e.g. sickle cell anemia Obstructive of gall bladder: Conjugated bilirubin is prevented from passing to the intestine, due to Gallstones, tumors of GB and pancreas. Hepatocellular disease: Hepatic disease cause low conjugation efficiency leading to increased unconjugated (indirect) bilirubin in blood as in hepatitis. Q49. What is high alpha fetoprotein indicating? Indicates hepatocellular carcinoma. Q50. What is MI? Is the condition when blood flow to a part of the heart is blocked for a long enough time that part of the heart muscle is damaged or dies. Q51. Mention two causes? Coronary artery disease: e.g. Atherosclerosis, thrombus, embolus and aneurysm. Q52. List cardiac markers and their clinical importance in diuagnosis? The Earliest marker: Myoglobin , disadvantage: Non specific for cardiac damnage. The gold standard test : Troponin, last for 7-10 days.  CK-MB: helpful in Reinfarction diagnosis last only for 72 hours. LDH : Non specific, its value indicate the size of the infarct. Q53. What is isozyme and its importance? Enzymes that catalyze the same biochemical reaction but have slightly different structures and physical properties. Importance: In diagnosis for tissue specifity. CKMB – cardiac problem CKBB- brain problem CK MM- skeletal muscle disease. Q54. What are the components of TFT? TSH T3 T4 Q55. Correlate the level of T3 and TSH for the diagnosis thyroid disease? TSH: Elevated Thyroid Stimulating Hormone (TSH) levels usually indicate hypothyroidism, a condition where the thyroid gland is underactive and not producing enough thyroid hormones. When thyroid hormone levels are low, the pituitary gland releases more TSH to stimulate the thyroid gland to produce more hormones. Free T4 (Thyroxine): This is the primary hormone produced by the thyroid gland. It is a precursor to the more active T3 hormone. Low levels of Free T4 often point to hypothyroidism, while high levels might suggest hyperthyroidism. Q56. Two functions of Thyroid hormones? Metabolic: increase BMR Growth: essential for growth and development during fetal and neonatal period of life. Regulate heat production. Q57. Mention two symptoms of hypothyroidism and hyperthyroidism and possible causes? Hypothyroidism: Symptoms: Fatigue, weight gain, cold intolerance, bradycardia. Causes: Iodine deficiency, Hashimoto's thyroiditis. Hyperthyroidism: Symptoms: Weight loss, heat intolerance, tachycardia, tremors. Causes: Graves' disease, toxic multinodular goiter. Q58. Biochemical techniques used to assess TFT? ElIZA and RIA.