SCFHS exam preparation (Saudi Arabia) – page 15

Albumin is made only by the liver, so a low level in chronic liver disease reflects reduced synthetic function. Because its half-life is about 3 weeks, it changes slowly.

Normal GFR in young adults is about 90–120 mL/min/1.73 m² or more. A GFR below 15 indicates kidney failure. About 1200 mL/min is renal blood flow, not GFR.

Hyperuricemia can lead to deposition of monosodium urate crystals in joints, causing gout.

Azotemia refers to accumulation of nitrogenous waste products such as urea and creatinine in the blood, usually from reduced kidney function.

ADH inserts aquaporin water channels in collecting duct cells, increasing water reabsorption and concentrating urine. Aldosterone acts mainly on sodium and potassium.

High potassium changes cardiac membrane excitability and can cause life-threatening arrhythmias and cardiac arrest, so critical potassium values are phoned immediately.

Calcium is essential for coagulation and muscle contraction. PTH raises blood calcium by acting on bone, kidney and (via vitamin D) the intestine.

Normal arterial pCO2 is 35–45 mmHg (4.7–6.0 kPa). 80–100 mmHg is the pO2 range and 22–26 is the bicarbonate range in mmol/L.

Arterial bicarbonate is normally about 22–26 mmol/L. 7.35–7.45 is the pH range, 35–45 is pCO2 in mmHg and 135–145 is sodium.

PSA is a serine protease made by prostatic epithelial cells, both normal and malignant, so it is prostate-specific but not cancer-specific.

Hemosiderin is the insoluble, aggregated storage form of iron and stains blue with Perls' Prussian blue. Transferrin is a soluble plasma transport protein.

Chronic blood loss is the usual cause of iron deficiency in adults, and in women of reproductive age this is most often menstrual loss (along with pregnancy).

The therapeutic range lies between the minimum effective concentration and the concentration at which toxicity becomes likely. TDM aims to keep levels within it.

Theophylline is a bronchodilator used in asthma and COPD. It has a narrow therapeutic range, and toxicity causes vomiting, arrhythmias and seizures.

Lead inhibits pyrimidine 5′-nucleotidase, so ribosomal RNA remnants remain and appear as coarse basophilic stippling in red cells.

Neutrophils are recruited within hours to acute bacterial inflammation and phagocytose the organisms. Plasma cells are part of the later antibody response.

The child's own immune system made the antibodies and memory cells after natural infection, so the immunity is natural and active.

Eosinophils release toxic granule proteins such as major basic protein that damage large parasites like helminths. They also take part in allergic reactions.

Human IgG has four subclasses, IgG1 to IgG4, which differ in their heavy chains, hinge regions and functions.

Agglutination is the clumping of particles (cells, latex or other carriers) by antibody. Precipitation occurs when soluble antigens and antibodies form insoluble lattices.