This free survey is powered by QUESTIONPRO.COM
  1. Surveys
  2. 2010
  3. November
  4. B
  5. Biochemistry knowledge survey
0%
Exit Survey »
 
 
 
 
 
 
 
As chemical pathology registrars working both with patients and in the laboratory, we are interested in how biochemical test results are interpreted by clinicians. This anonymous survey is designed to assess this in the context of some scenarios which could reasonably occur in clinical practice.

Many thanks for your assistance.

Ben Jones (Imperial College Healthcare NHS Trust)
Claire Meek (Cambridge University Hospitals NHS Trust)
 
 
 
Please indicate your grade:

 
Medical student
 
F1
 
F2
 
CT1/CT2/ST1/ST2
 
ST3 or above, or SpR
 
Staff grade / Associate specialist
 
Consultant
 
 
 
If CT1/ST1 or above, please indicate your specialty:

 
Medical specialty
 
Surgical specialty
 
Paediatrics
 
Obstetrics / gynaecology
 
Emergency medicine
 
Intensive care
 
Anaesthetics
 
Radiology
 
Psychiatry
 
Laboratory-based specialty
 
Other
 
 
You suspect subarachnoid haemorrhage in a patient with a sudden onset headache. CT is negative but CSF xanthochromia is reported as positive (ie in keeping with subarachnoid haemorrhage). However, another member of your team has concerns the validity of the result. Please indicate which of the following could have led to a FALSE POSITIVE result by answering yes or no:

Yes No
Delay in delivering sample to lab
Exposure of sample to light prior to analysis
Raised serum bilirubin
Sample taken <12 hours after onset of symptoms
Bloodstained tap
 
 
With regard to point of care testing, please indicate if the following are true or false:

True False
An ICU patient with pancreatitis due to hyperlipidaemia and alcohol excess has a serum sodium of 116 mmol/L measured on the blood gas analyser – this is likely to be unreliable because the analyser is susceptible to pseudohyponatraemia
The absence of ketones on dipstick testing in an unwell patient with type 1 diabetes virtually excludes diabetic ketoacidosis
A patient with diabetes has a blood glucose reading of 2.1 mmol/L from their glucometer. This is likely to be an overestimate, ie the lab result is likely to be lower
Diabetic nephropathy is unlikely given the absence of proteinuria on dipstick testing
The blood gas analyser can be used to accurately measure content of other biological fluids, eg pleural fluid or urine pH
The blood gas analyser measures corrected (adjusted) calcium
 
 
You are a GP in a rural practice. The courier has forgotten to collect your blood samples for transport to the local laboratory, but they can be collected tomorrow. Please indicate whether the following are true or false (assume the samples have been collected in the appropriate tube):

True False
The samples should be kept in the fridge overnight to prevent degradation
The delay may lead to spuriously high serum potassium results
There should be little effect on plasma glucose results
Serum creatinine should be unaffected
Serum samples from patients with severe anaemia may be more likely to give misleading results in this situation
 
 
With regard to renal function, please indicate whether the following are true or false:

True False
Significant renal disease is unlikely in most patients with a serum creatinine of 100 umol/l (reference range 60 – 118)
GFR could have fallen by >50% before an increase in creatinine from baseline is observed
In acute renal failure, eGFR (estimated GFR) is a more reliable marker of severity than serum creatinine
An increase in creatinine from 100 to 150 umol/l represents a greater change in GFR compared to an increase from 500 to 800 umol/l
Ingestion of a protein-rich meal can increase the serum creatinine concentration
 
 
With regard to thyroid function, please indicate whether the following are true or false:

True False
A low free T4 level with a normal TSH is diagnostic of primary hypothyroidism
A normal free T4 with a suppressed TSH is commonly due to thyroxine treatment
Unwell patients should have their TFTs checked to screen for sick euthyroid syndrome (non-thyroidal illness syndrome)
After commencing thyroxine replacement for primary hypothyroidism, TFTs should be checked at 2 weeks to monitor adequacy of treatment
An elevated free T4 and elevated TSH is a common pattern seen in hyperthyroidism
 
 
Please indicate if the following are compatible with a patient with a serum osmolality of 330 mosmol/kg (NR 275 - 295):

Yes No
Diabetes insipidus
Syndrome of inappropriate ADH hormone secretion (SIADH)
Stable stage V (severe) chronic kidney disease
Hyperlipidaemia
Ethanol intoxication
 
 
 
Please add any comments in the box below:
   
 
Survey Software Powered by QuestionPro Survey Software