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Laboratory Diagnostics > Biochemistry > Flashcards

Biochemistry Flashcards

1
Q

What is biochemistry?

A
  • Measurement of concentration or activity of important biological substances in bodily fluids
  • Measure ions and molecules
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2
Q

What are the positives of in house testing?

A
  • Results same day
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3
Q

What are the positives of commercial lab testing?

A
  • Can test wide range parameters
  • Gold standard testing
  • Cheaper per parameter
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4
Q

What are the negatives for in house testing?

A
  • Equipment to buy
  • Consumables to buy
  • Staff training
  • Staff time
  • Not all parameters measurable
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5
Q

What are the negatives for commercial lab testing?

A
  • Wait for result
  • Abnormal results
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6
Q

What is the difference between plasma and serum?

A
  • Plasma is from unclotted blood and serum is from clotted blood
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7
Q

When would you use an orange top tube (heparin anticoagulant)?

A
  • Plasma
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8
Q

When would you use a white top tube (no anticoagulant)?

A
  • Serum
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9
Q

When would you use a brown top tube (no anticoagulant, has gel)?

A
  • Serum
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10
Q

What does biochemistry measure?

A
  • Electrolytes
  • Total protein
  • Kidney parameters
  • Liver parameters
  • Pancreas parameters
  • Hormones
  • Other muscle and heart parameters
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11
Q

What are electrolytes in biochemistry?

A
  • Major cations (sodium and potassium)
  • Major anions (chloride and bicarbonate)
  • Also measures calcium and phosphate
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12
Q

What do changes in sodium (cation) show?

A
  • Increase: dehydration
  • Decrease: over-hydration
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13
Q

What do changes in potassium (cation) show?

A
  • Increase: Cell lysis, hypoadrenocorticism and renal insufficiency
  • Decrease: Diabetic ketoacidosis
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14
Q

What do changes in bicarbonate (anion) show?

A
  • Increase: alkalosis
  • Decrease: acidosis
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15
Q

What do changes in calcium show?

A
  • Increase: issues with parathyroid or neoplasia
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16
Q

What do changes in phosphate show?

A
  • Increase: Diet or decrease in renal function
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17
Q

What does an increase of lactate show?

A
  • Suggest lactic acidosis, which can show an issue with oxygen saturation in tissues
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18
Q

What does the liver make when metabolising?

A
  • Protein
  • Albumin
  • Cholesterol
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19
Q

What happens when the liver detoxifies product?

A
  • Converts ammonia into urea
  • Excretes bilirubin into bile
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20
Q

When is liver function lost?

A
  • When 70% of tissue is non-functional
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21
Q

How does liver damage occur via bile stasis/cholestasis?

A
  • If bile not flowing due to inflammation/obstruction, ALP and GGT increase in blood
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22
Q

How does liver damage occur via cell death?

A
  • ALT and AST get released whrn hepatocytes burst
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23
Q

What are the secondary factors that increase liver enzymes?

A
  • Increase in corticosteroids/cushings disease
  • Hyperthyroidism
  • Daibetes mellitus
  • Pancreatitis
  • Obesity
  • Starvation
  • Various drugs
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24
Q

How does the liver function with the circulation of bile acids?

A
  • 90% of bile acids reabsorbed from intestine and recycled by the liver
  • If not functioning well, bile acids can’t be reabsorbed
  • Biliary system needs to have free flow of bile or bile backs up into blood
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25
Q

What is a common liver damage test and what is it?

A
  • Bile acid stimulation test
  • Detects abnormal increase in bile acids; compare fasting blood sample and fed blood sample
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26
Q

What other levels can be tested to look for liver damage except bile acids?

A
  • Bilirubin
  • Albumin
  • Glucose
  • Clotting factors
  • Ammonia
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27
Q

What is the function of the kidney?

A
  • Excretes waste products such as urea, creatinine and SDMA
  • Controls hydration
  • Balance electrolytes
  • Produces erythropoietin
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28
Q

What is the glomerular filtration rate?

A
  • The volume of filtrate produced in the Bowman’s capsule in unit time
  • Useful measure of kidney function
29
Q

How can the glomerular filtration rate be measured?

A
  • Inject a harmless, freely filtered chemical and measure how much remains in the blood overtime
  • Estimate GFR using creatinine and SDMA, can stage CKD
30
Q

How can the kidney be investigated?

A
  • Look at GFR
  • Increase in waste products in the blood
  • Loss of ability to concentration urine, causing PUPD (when this happens 2/3 of renal function lost)
31
Q

What does an increase in urea show?

A
  • Alone, elevation unlikely to be a renal cause
  • Related protein metabolism, so affected by diet and liver as well as the kidney
32
Q

What does an increase in creatinine show?

A
  • Alone, elevation unlikely to be renal cause, as creatinine increases at 75% loss of kidney function
  • Muscle metabolism
33
Q

What does an increase in SDMA show?

A
  • Elevation suggests renal damage (elevate at 40% renal loss)
34
Q

Why is creatinine isn’t great to estimate GFR?

A
  • When there is a large change in GFR, there is a little change in creatinine levels in early renal disease and vice versa in advanced renal failure
35
Q

What is azotaemia?

A
  • Abnormal increase in concentrations of non-protein nitrogenous wastes in blood
36
Q

What is uraemia?

A
  • Adverse clinical signs due to severe azotaemia
37
Q

What are the clinical signs in the pre-renal stage?

A
  • Low volume and very concentrated urine
  • Dehydration
  • Hypovolaemia
38
Q

What are the clinical signs of renal stage?

A
  • Dilute, large volume urine that may contain protein
  • PUPD
  • Hypertension
  • Anaemia
39
Q

What are the clinical signs at post-renal stage?

A
  • No urine if urethra blocked, concentrated, may contain blood
  • Dysuria
40
Q

What are the pre-renal insufficiency factors?

A
  • Dehydration
  • Cardiac failure
  • Haemorrhage
41
Q

What are the renal insufficiency factors?

A
  • Toxins
  • Infections
  • Crystals
  • Cysts
42
Q

What are the post-renal insufficiency factors?

A
  • Stone
  • Tumour
  • Prostate affecting ureter/bladder/urethra
43
Q

What are other renal disease tests other than examination of waste product levels?

A
  • Ultrasonography
  • Radiography
  • Blood pressure assessment
  • Proteinuria
  • Urine specific gravity
44
Q

What are the two types of dynamic tests?

A
  • Stimulation test
  • Suppression test
45
Q

What do stimulation tests do?

A
  • Gives exogenous form of stimulating hormone and measures level of hormone in response; should expect an increase
46
Q

What do suppression tests do?

A
  • Gives exogenous form of hormone and measures level of endogenous hormone in response; should expect a decrease
47
Q

What are the thyroid hormones?

A
  • T3: active form
  • T4: thyroid secretes most as T4
48
Q

What do thyroid hormones do?

A
  • Increases metabolic rate
  • Helps cope with period of low-calorie intake by increasing blood glucose and use of body fat and body protein
  • Increases heart rate and force
  • Affects NT’s in brain and mood
49
Q

What is the thyroid disease in dogs?

A
  • Hypothyroidism
  • Immune destruction or caused by a chronic illness which decreases T4 levels
  • Increases cholesterol and triglycerides
50
Q

What is the thyroid disease in cats?

A
  • Hyperthyroidism
  • Thyroid hyperplasia or caused by thyroid tumour
  • Increases T4 levels
  • Causes liver and kidney damage
51
Q

What does cortisol do in the adrenal cortex?

A
  • Increases blood glucose
  • Anti-inflammatory
  • Decreases immunity
  • Controlled by ACTH
52
Q

What does aldosterone do in the adrenal cortex?

A
  • Increases blood sodium and BP
  • Decreases potassium
  • Controlled by RAAS, an increase in potassium and ACTH
53
Q

What happens in hyperadrenocorticism/hypercortisolism (Cushing’s disease)?

A
  • Protein breakdown
  • Increased blood glucose
  • Lipid and calcium breakdown and redistribution
  • Increases BP
54
Q

What are the clinical signs of hyperadrenocorticism/hypercortisolism (Cushing’s disease)?

A
  • Alopecia
  • PUPD
  • Decreased inflammatory and immune responses
55
Q

What are the causes of Cushing’s disease?

A
  • Pituitary tumour
  • Adrenal gland tumour
  • Treatment with corticosteroids
56
Q

What are the biochem, haematoloy and urinalysis findings of a Cushing’s disease patient?

A
  • Increased liver enzymes
  • Hyperglycaemia
  • Increased triglycerides and cholesterol
  • Dilute urine
  • Neutrophilia
57
Q

What is the ACTH stimulation test and what results should be expected?

A
  • Administration of exogenous adrenocorticotropic hormone IV or IM and measure the effect on cortisol production
  • Cushings = normally high pre and post
  • Iatrogneic cushings = low pre and post
58
Q

What happens in Hyperadrenocorticism (Addison’s disease)?

A
  • Decreased aldosterone and/or cortisol
59
Q

What are the biochem, haematology and urinalysis findings in an Addison’s patient?

A
  • Increased potassium
  • Decreased sodium
  • Dehydration
  • Urine concentrated
60
Q

What are the functions of the pancreas?

A
  • Endocrine: releases insulin
  • Exocrine: releases lipase, amylase and trypsin
61
Q

What happens in an endocrine pancreatic disease (diabetes mellitus)?

A
  • Elevated glucose and possibly ketones in blood and urine
  • Liver damage
  • Elevated urea if dehydrated
  • Use glucose curve or CGM
62
Q

What is a CGM?

A
  • Measures glucose in interstitial tissue
  • Slight delay (5-10min) compared with blood glucose curve
  • Monitor 24 hours for 2 weeks
63
Q

What are the reproductive hormones?

A
  • Testosterone and oestrogen
  • Progesterone
  • Relaxin
64
Q

What are the effects of haemolysis?

A
  • False reduction in bilirubin
65
Q

What is icterus (jaundice)?

A
  • Caused by an increase production of bilirubin from haemolysis or a decrease in excretion of bilirubin from liver disease or cholestasis
66
Q

What is lipaemia (fatty blood)?

A
  • Excess fat in blood plasma; centrifuged sample looks creamy
  • Caused by hyperlipidaemia
  • Causes haemolysis
67
Q

What does contamination from the K EDTA blood tube cause?

A
  • Biochem contaminated from K EDTA can cause reduced calcium, increased potassium and decreased ALP and ALT
68
Q

What can fear stress cause on blood results?

A
  • Hyperglycaemia due to adrenaline and cortisol
  • Triglycerides, cholesterol, and liver enzymes increase from cortisol
69
Q

When may you need to fast before a blood sample?

A
  • If measuring urea, glucose, triglycerides, cholesterol, pancreatic enzymes, bile acids and liver enzymes

Laboratory Diagnostics (10 decks)

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