Pathology EMQ template.

Name:

Candidate number:

Theme: Paediatric clinical chemistry – paediatric reference ranges

 

OPTION LIST

 

A	Sodium	I
B	Magnesium	J
C	Conjugated bilirubin	K
D	Unconjugated bilirubin	L
E	Potassium	M
F	Calcium	N
G	Bicarbonate	O
H	Phosphate	P

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. Higher at birth then falls rapidly to below the lower limit of normal before rising again to reach normal adult concentrations by 72 hours.

 

 

2. Mean and upper limit higher in newborn due to the reduced effect of aldosterone on the distal tubule.

 

 

3. Higher at birth; falls but remains higher than adult concentrations throughout childhood; rises at puberty then falls to adult concentration.

 

 

4. Becomes raised shortly after birth (raised levels are never present at birth) due to normal postnatal haemolysis, immaturity of the relevant hepatic enzymes and enterohepatic circulation. Plasma concentration rarely exceeds 100 μmol/L. Does not persist beyond 14 days. High concentrations (>350 μmol/L) can cause brain damage – kernicterus.

 

 

5. Often accompanies hypocalcaemia and should be supplemented along with calcium in treating hypocalcaemia.

 

 

 

ANSWERS

1. F

2. E

3. H

4. D

5. B