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SBCP- Clinical Biochemistry Exam Latest Update
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SBCP- Clinical Biochemistry Exam LatestUpdate
Parathyroid hormone - Answer Increases renal absorption of calcium
Increases excretion of phosphate
Increases bone resorption
increases intestinal calcium absorption
Increases Vit D synthesis
Calcium is bound to what in plasma? - Answer Albumin
Vitamin D metabolism - Answer skin photoconversion or reabsorbed in gut -> 1st
hydroxylation in liver -> 2nd hydroxylation in kidney's proximal tubule
(alpha-1-hydroxylase)
Causes of hypercalcaemia - Answer Hyperparathyroidism
Excess Vitamin D
Thiazide diuretics
Excess calcium intake
Malignant disease
Sarcoidosis
Clinical features of hypercalcaemia - Answer Polydipsia, polyuria
Abdominal pain
Renal calculi
Peptic ulcer
High serum calcium and low phosphate - Answer Excess PTH
Excess of serum calcium and phosphate - Answer Excess Vitamin D
Management of Hypercalcemia - Answer Rehydration
Loop diuretic
Monitor potassium
Bisphosphonates
, Hypocalcaemia: Causes - Answer Renal failure
Hypoparathyroidism
Vitamin D deficiency
Hypomagnesaemia (PTH less effective if magnesium is low)
Bisphosphonates
Clinical features of hypocalcaemia - Answer Tetany
+ve Chovstek's & Trousseau's sign
Prolonged QT interval
Management of severe hypocalcaemia - Answer IV calcium gluconate
Phosphate - Answer Mainly intracellular
Required for ATP
85% in bone
Causes of hypophosphatemia - Answer Poor diet, malabsorption
Shift into cells (Respiratory alkalosis, Insulin etc)
Increase urine excretion (hyperparathyroidism)
Renal tubular defects
Clinical features of hypophosphataemia - Answer Seen in refeeding syndrome
May be associated with alcoholism
Rhabdomyolysis (due to lack of ATP, causes cell breakdown)
Refeeding syndrome - Answer In starvation - insulin low, fat and protein metabolised,
intracellular phosphate falls
When feeding recommenced - carbohydrate metabolism causes an insulin surge
causing a greatly increased uptake and use of phosphate in the cells
Hyperphosphatemia - Answer Renal failure
May be due to cellular leak of phosphate, rhabdomyolysis or tumour lysis
causes of hypomagnesemia - Answer Poor intake/absorption
Increased losses GIT and kidneys
Diarrhoea
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