biochemistry (done) Flashcards

1
Q

measurements of pre-analytical panal?

(6 marks)

A
  • blood urea nitrogen (BUN)
  • creatinine
  • alkaline phosphate (ALKP)
  • alanine transferase (ALT)
  • total protein (TP)
  • glucose
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2
Q

measurements of general health profile?

(12 marks)

A
  • blood urea nitrogen (BUN)
  • creatinine
  • alkaline phosphatase (ALKP)
  • alanine transferase (ALT)
  • total bilirubin
  • total protein (TP)
  • albumin (ALB)
  • globulin
  • amylase
  • glucose
  • calcium
  • phosphate
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3
Q

why might we perform biochem test?

(5 marks)

A
  • pre GA
  • monitoing disease progression
  • screening for systemic disease
  • highlight subclinical disease
  • discretionary diagnostic tool
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4
Q

what do the results of the biochem test allow?

(6 marks)

A
  • confirm suspected diagnosis
  • aid in differential diagnosis
  • assess severity of disease
  • monitor progress
  • monitor side effects / disease progression
  • monitor therapy
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5
Q

what sample tube does biochem test require?

(1 mark)

A

lithium hepaprin anticoagulant / serum gel tubes

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6
Q

use of serum gel tube?

(2 marks)

A

prevent sample from haemolysing during transport
once spun down, blood portions remain seperate.

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7
Q

use of fluoride oxalate tube?

(2 marks)

A

use if sent to lab for glucose - glucose is used up whilst sitting in blood so lower results seen if not

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8
Q

types of biochemistry analyser?

(2 marks)

A
  • minimum dat base kits e.g. glucometer
  • dry + wet chemistry machine e.g. catalyst one
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9
Q

RVN role

(1 mark)

A

interpret abnormalities in core analytes and inform VS

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10
Q

what are the renal parameters?

(3 marks)

A
  • urea (BUN)
  • creatinine
  • SDMA
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11
Q

use of urea testing?

(3 marks)

A
  • UREA = 80-90% of nitrogenous waste excreted by the body
  • identify renal dysfunction
  • NOTE: high BUN can be result of high protein diet
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12
Q

what does the concentration of BUN within plasma depend on?

(3 marks)

A
  • body protein uptake
  • body capacity to catabolise proteins
  • body ability to excrete this metabolite
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13
Q

interpretation of urea results?

(2 marks)

A

other influential factors can impact results so additional diagnostics required - urinalysis testing + phosphorus reading taken

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14
Q

use of creatinine testing?

(3 marks)

A
  • creatinine and phosphocreatinine facilitate muscle contraction
  • more useful indicator of renal function
  • level can be influenced by patients muscle mass/injury
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15
Q

interpretation of creatinine results?

(3 marks)

A
  • indicate filtration capacity of glomerulus
  • may not be apparant until significant damage occured
  • if GFR decrease = increase CREA.
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16
Q

use of SDMA testing?

(3 marks)

A
  • biomarker of glomeruluar filtration
  • more accurate than BUN and creatinine
  • allows kidney disease to be identified earlier
17
Q

use of alkaline phosphate (ALKP) testing?

(liver parameter)

(2 marks)

A
  • hepatic function decreased - ALKP released into blood (elevated)
  • increase during pregnancy + bone growth - additional testing
18
Q

use of alanine aminotransferase (ALT) testing?

(liver parameter)

(3 marks)

A
  • enzyme found in liver
  • indicator of hepatocellualr injury - not liver disease
  • increase seen with severe muscle injury, hepatocyte degeneration, cardiac insufficency, inflammatory disorders
19
Q

what are the 3 sources from which glucose is derived?

(6 marks)

A
  • intestinal absorption - dietary carbohydrate broken down + absorbed in intestine
  • hepatic production - gluconeogenesis = formation of glucose from non-carb sources, glycogenolysis = conversion of stored glycogen to glucose
  • kidney production - glucogenesis
20
Q

interpretation of glucose parameters?

(3 marks)

A
  • hyperglycaemia seen as result of lack of insulin - also transient stress response (cats)
  • hypo seen with insulin OD, exercise, poor nutrition, ingestion of toxins, pregnancy + stress
  • single test not sufficent to detect significatn clinical disorder - supporting tests = urine dip + fructosamine
21
Q

use of bile acid stimulation test?

(1 mark)

A

determine liver function as healthy liver can extrete bile acids + damaged liver can not.

22
Q

what tests are done alongside bile acid stim test?

(1 mark)

A

ALKP and ALT test

23
Q

what does a bile acid stim test involve?

(4 marks)

A
  1. obtain fasted blood sample (12hrs)
  2. feed patient fatty meal to induce gall bladder contraction
  3. resample after 2 hours
    * sample should be carefully labelled pre + post prandial
24
Q

use of ACTH stim test?

(2 marks)

A
  • test adrenal gland function by assessing plasma cortisol levels before + after inj of synthetic ACTH (can body produce cortisol in responce to ACTH?)
  • allows diagnoses of cushing and addisons
25
what does an ACTH stim test involve? ## Footnote (4 marks)
1. unmedicated IV blood sample (off meds for 6h at least) 2. administration of IV synthetic ATCH - stim production of cortisol 3. re-sample 30-60mins post inj * samples carefully labelled T=0 and T=30mins
26
use of T3/T4/TSH tests? ## Footnote (1 mark)
evaluates thyroid function allowing identification of hyppo/hyperthyroidism
27
errors in anaylsis + reporting ## Footnote (6 marks)
* sample haemolysis will result in an increase in potassium, magnesium + phosphorus * icteric + lipaemic sample can impact result * ensure samples labelled to avoid mixing of patient results * EDTA markedly increase potassium + decrease calcium results * predominantly sample into lithium heparin, some specify serum * ensuring correct tube is used
28
quality assurance ## Footnote (8 marks)
* suitable sampling technique * suitable preservation / anticoagulant * regular maintenance / servicing * regular calibration * appropriate response to result * use external lab to confirm unexpected result * sufficient training of personnel to avoid handler error * ensure chemistry dry slides / wet chem are in date and stored to manufacter guide
29
how does the ELISA test work? ## Footnote (3 marks)
* enzyme linked immunosorbent essay * sample combined with conjugate containing enzyme linked antigen specific antibody * antibody binds to antigen in infected animal = result in colour change
30
ELISA tests used in practice? ## Footnote (6 marks)
* FIV / FeLV combo * SNAP parvo * Canine Snap cPL * ovuCHECK premate test * ACTH stim test * T4 snap test
31
advantages of ELISA? ## Footnote (5 marks)
* equip and reagents inexpensive with long shelf life * widely available * highly specific and sensitive * quick and easy to perform with rapid results * snap electronic readers now available to reduce incidence of operator
32
disadvantages of ELISA? ## Footnote (4 marks)
* enzyme activity may be affected by plasma constituents * can be time consuming, as must be timed * false positives and negatives can occur * commercially available but can be expensive