By Martin Crook

Chemical pathology is on the center of drugs with relevance to the analysis, administration and therapy of sufferers. an information of chemical pathology is needed for plenty of postgraduate expert examinations. 60 chemical pathology circumstances are awarded overlaying a variety of daily, medical difficulties. instances in drugs, surgical procedure, paediatrics and obstetrics and gynaecology are coated. Differential analysis and lists of irregular effects are proven in addition to descriptions of ways a prognosis might be proven by way of compatible chemical pathology investigations

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Indeed, the commonest cause of hypophosphataemia in hospital populations is the administration of intravenous glucose. Other causes of hypophosphataemia (Table 7) should also b e considered in certain patient groups, including poor intake due to starvation, alcoholism, vomiting or malabsorption. Liver disease can 25 Table 7 Some causes of hypophosphataemia Redistribution Intravenous glucose Alkalaemia Insulin administration Re-feeding syndrome Poor intake Post-trauma or myocardial infarction or operation Alcoholism Liver disease and also malabsorption states Septicaemia Hypeφarathyroidism or PTH-related peptide releasefromtumours Osteomalacia and hypophosphataemic rickets Fanconi's syndrome also result in increased cell uptake of phosphate and although not applicable to this patient alkalaemia and insulin therapy.

A young girl being seen for investigation of primary amenorrhoea. The palpable swellings were in fact testes, and it could also b e shown that the ovaries, cervix, uterus and fallopian tubes were absent. 23 The defect occurs in the androgen receptor which either fails to bind dihydrotestosterone (DHT) or has an intracellular post-receptor abnormality. Plasma levels of DHT are usually elevated in this condition. Partial defects of androgen insensitivity syndrome have also been described. e hypergonadotropic hypogonadonism.

3. The patient's mother volunteered to the doctor that she herself was taking oral hormone replacement therapy because of menopausal symptoms. She felt that this was not working and wondered whether 'hormone' blood tests would b e of help. What is the value of measuring serum gonadotrophins or serum oestradiol in this situation? Answers 1. This patient was shown to have complete androgen insensitivity syndrome. Note that the phenotype was female, with no signs of virilization, yet the karyotype was 46 XY male.

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