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Clinic Pathology 2 > Blood Chemistries > Flashcards

Blood Chemistries Flashcards

1
Q

What do blood chemistries evaluate

A

the various blood levels to help assess the different body functions

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2
Q

Why should you not freeze whole blood?

A

causes hemolysis

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3
Q

What samples can be used to run blood chemistries

A

serum, plasma, whole blood

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4
Q

Why is a grey top tube used for glucose determination?

A

Because it prevents RBCs from metabolizing glucose

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5
Q

What body system cannot be evaluated well with chemistries?

A

respiratory system

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6
Q

Enzyme number is usually _ in blood

A

low

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7
Q

If enzyme number is high in serum, cell have:

A

ruptured and released enzyme into serum or cell increased enzyme production and excess leaked out of cell

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8
Q

What should be done regarding patients prior to collecting blood for chemistries?

A

fasting for at least 2 hours

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9
Q

The following are functions of the _:
-synthesis of plasma proteins
-clotting factors
-macromolecule metabolism
-detox of toxins
-secretion of bile
-is run by enzymatic reactions

A

liver

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10
Q

Liver assays- what is hepatocellular damage

A

hepatocytes are damaged and enzymes leak into blood causing rise in blood levels

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11
Q

Liver assays-Hepatocellular damage: What is Alanine Aminotransferase (ALT)?

A

screening test for liver damage. there is no correlation b/w ALT levels and severity of liver damage

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12
Q

Liver assays-Hepatocellular damage: _ or _ can elevate ALT

A

corticosteroids or anticonvulsants

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13
Q

Aspartate Aminotransferase (AST) is not _ specific

A

liver

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14
Q

Liver assays-Hepatocellular damage: Sorbitol Dehydrogenase (SD) is primarily from _, is unstable in serum (activity decreases rapidly, samples assayed within 12 hours), and is not common to average vet lab

A

hepatocyte

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15
Q

What do indirect enzyme assays measure

A

enzymatic reaction

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15
Q

Liver assays- enzymes associated with _ (bile duct obstruction) and hepatocyte metabolic defects

A

cholestasis

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15
Q

Liver assays-Choleostasis: Sources of Alkaline Phosphatase (AP) in young and old animals

A

Young: developing bone (Osteroblasts and Chondroblasts)
Old: hepatobiliary cells

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16
Q

Alkaline Phosphatase (AP) is used to detect _ in SA

A

cholestasis

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17
Q

Why is AP not useful in cattle and sheep?

A

wide fluctuation are normal in those species

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18
Q

Liver assays-Choleostasis: Gamma Glutamyltransferase or -peptidase (GGT) primary source is in the liver but is also in the ,,_, and _

A

kidneys, pancreas, intestine, and muscle

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19
Q

What can cause GGT to be elevated

A

liver disease

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20
Q

Liver function tests

A

Bilirubin, Bile acids, Dye excretion, cholesterol, albumin, ammonia

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21
Q

If there is in elevation in AST what test should be run to confirm true liver damage?

A

Creatine kinase

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22
Q

_ is a test of hepatic function, in essence the ability of the hepatocyte to take up unconjugated bilirubin in blood, conjugate it, and excrete it into bile where it is broken down in the intestine by bacteria

A

Bilirubin

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23
Q

What species is SD usually performed?

A

large animals

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24
Q

What tests indicate hepatobiliary disease?

A

AP, ALKP, GGT

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25
Q

Increased conjugated(direct) total bilirubin is caused by what?

A

Heptocellular damage, bile duct injury/obstruction?

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26
Q

What will you see in with increase direct total bilirubin

A

bilirubinuria

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27
Q

Increased unconjugated (indirect) total bilirubin is caused by

A

RBC destruction, defects in transport to liver to be conjugated

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28
Q

The liver does NOT overproduce _ and if high, determines dehydration

A

albumin

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29
Q

If excess bile acids in circulation what does this mean?

A

liver did not clear them out, this is usually the test to diagnose a portosystemic shunt

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30
Q

Bile acids aid in

A

fat digestion

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31
Q

Bile acids increase with

A

-post prandial
-PSS
-Chronic hepatitis
-Cirrhosis
-Cholestasis
-Neoplasms

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32
Q

Bile acids are normally low in circulation, why?

A

b/c liver removes 75%-90% via portal circulation

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33
Q

How many tests should be run for bile acids

A

2, one fasted and one 2 hours after eating

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34
Q

Kidney functions

A

-Homeostasis
-Remove end products of nitrogen metabolism
-Produce (renin, erythropoietin, prostaglandins)

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35
Q

What does BUN stand for

A

blood urea nitrogen

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36
Q

What is urea

A

product of AA breakdown in liver
(kidneys ability to filter urea (GFR)
(sensitively- low- 75% kidney tissue non-functional before elevated)
(plasma passively filtered in glomerulus)

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37
Q

What tests measure BUN

A

azostick and chemical assay

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38
Q

Normal range of BUN on azo-stick

A

<26mg/dl

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39
Q

The following are causes of _ BUN:
-high protein diet; strenuous exercise= increased AA breakdown
-bleeding ulcer (high protein meal)

A

Increased

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40
Q

The following are causes of _ BUN:
-sample contamination of urease-producing bacteria (Staph. aureus, Proteus spp., Klebsiella spp)

A

decreased

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41
Q

Causes of azotemia

A

-Dehydration
-UT obstruction
-Renal dz

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42
Q

Creatinine is formed from Creatine Phosphate- found in _ _ _ (splits to provide energy for ADP + P= ATP)

A

skeletal muscle fiber

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43
Q

Creatinine is found in most body fluid

A

sweat, vomitus, and feces

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44
Q

Creatinine is an indicator of

A

glomerular filtration (urinary obstruction)

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45
Q

_% kidney tissue damage before creatinine is elevated

A

75

46
Q

Why is SDMA a better tool for diagnosing and monitoring CKD in thin geriatric animals, especially cats and animals with other diseases that cause muscle wasting?

A

it is not impacted by muscle mass

47
Q

Pancreas endocrine tests

A

-Insulin (CHO metabolism)
-Glucagon (elevated BG levels)
-Glucose

48
Q

_ should always be present in feces, abnormal if not

A

Trypsin

49
Q

What is trypsin

A

a proteolytic enzyme, aids in digestion of proteins

50
Q

What are the methods of pancreas -exocrine tests for trypsin

A

-test tube method
-x-ray film method

51
Q

What is the most specific test for diagnosing exocrine pancreatic insufficiency

A

determination of trypsin-like immunoreactivity (TLI)

52
Q

How is a TLI done

A

taking a single fasting blood sample sent to a lab

53
Q

What does amylase do

A

breakdown starches and glycogen

54
Q

Pancreatic exocrine tests

A

TLI
Amylase
Lipase

55
Q

What causes increased levels of amylase

A

acute pancreatitis, flare ups of chronic pancr., pancreatic duct obstruction

56
Q

Normal amylase in dogs/cats= _x higher than in humans (important if using human lab)

A

10

57
Q

What does lipase do

A

break down lipids

58
Q

_ is required for activity of lipase

A

calcium

59
Q

Lipase may be more _ than amylase

A

sensitive

60
Q

Level of / not directly proportional to severity of pancreatitis

A

amylase/lipase

61
Q

Lipase and amylase have _ sensitive and specificity for pancreatitis

A

poor

62
Q

When is creatine kinase elevated

A

when striated myocytes damaged/destroyed and leak CK out of cell into blood

63
Q

Creatine kinase is organ-specific and can only tell what

A

that muscle is damaged, not which muscle, or severity of damage

64
Q

Where is cholesterol produced

A

everywhere but primarily liver, adrenal cortex, ovaries, testes, intestinal epithelium

65
Q

Hypercholesterolemia dx what _

A

hypothyroidism

66
Q

_ _ controls synthesis and destruction of cholesterol

A

Thyroid hormone

67
Q

Hypercholesterolemia also caused by

A

hyperadrenocorticism, diabetes mellitus, nephrotoxic syndrome

68
Q

Plasma prot is produced by _ and _ _

A

liver and immune system

69
Q

The following are functions of _:
-Structural matrix
-Osmotic pressure
-Enzymes
-Hromones
-Blood coag
-Body defense
-Transport/carrier molecules

A

TP

70
Q

TP consists of

A

albumin + globulin +/- fibrinogen

71
Q

concentration of TP is affect by

A

altered formation in the liver, distribution, breakdown, and dehydration or over hydration

72
Q

TP helps determine _ status

A

hydration

73
Q

Plasma contains _

A

fibrinogen

74
Q

How is globulin measured

A

total serum protein - albumin

75
Q

Hypoproteinemia is usually due to

A

albumin loss

76
Q

Hypoalbuminemia is usually due to

A

any diffuse liver dz (also renal dz, dietary intake, intestinal proteins absorption)

77
Q

How to calculate albumin:globulin

A

divide albumin by globulin

78
Q

normal albumin:globulin in dogs, horse, sheep, goat

A

> 1.00

79
Q

normal albumin:globulin in cattle, pigs, and cats

A

<1.00

80
Q

Elevated fibrinogen indicates

A

acute inflammation or tissue damage

81
Q

Heat precipitation test is used to test what

A

fibrinogen

82
Q

The following are functions of _:
-Maintain water balance, osmotic pressure
-Maintain normal muscular function
-Maintain normal nervous system
-Maintain and activate several enzymes
-Acid base regulation

A

Electrolytes

83
Q

When testing calcium, never use _ or _ tubes

A

EDTA or oxalate

84
Q

Calcium is _% in bones

A

99

85
Q

Function of calcium

A

neuromuscular excitability and tone, blood coagulation

86
Q

Calcium is an indicator of

A

neoplasia, parathyroid dz, bone disease

87
Q

Inorganic phosphorus is _% in bones and _% in energy storage, release & transfer (ATP), CHO metabolism, make up Nucleic acids and phospholipids

A

80%, 20%

88
Q

Sodium is in

A

plasma and interstitial fluid

89
Q

Sodium plays a role in

A

water distribution, osmotic pressure, maintenance

90
Q

Hemolysis can cause _ levels of sodium

A

lower

91
Q

Hyperkalemia

A

acidosis (exchange for H ion in plasma), cellular damage/necrosis

92
Q

Hypokalemia

A

indadequate K intake, fluid loss (V/D)

93
Q

Functions of potassium

A

muscular fxn, respiration, cardiac fxn, nerve impulse transmission, CHO metabolism

94
Q

Magnesium is _% in bones (closely related to P and Ca)

A

50

95
Q

Mg:Ca imbalance causes release of Act=

A

muscle tetany

96
Q

Functions of magnesium

A

activates E systems, production and decomposition of Ach

97
Q

What test is helpful in diagnosing Addison’s disease

A

Na+:K+

98
Q

If Na+:K+ <25:1 what test should be run to R/O Addison’s disease

A

ACTH STIM test

99
Q

Functions of chloride

A

maintains water distribution, osmotic pressure, normal cation: anion ratio

100
Q

What sample is best for chloride

A

serum

101
Q

Functions of bicarbonate

A

bicarb/carbonic acid buffer system (blood pH), transport of CO2

102
Q

Excess bicarb is excreted via

A

kidneys

103
Q

What is normal blood pH

A

7.35-7.45

104
Q

If blood pH is below 7.3 this is called

A

acidosis (excess H+)

105
Q

If blood pH is above 7.4 it is called

A

alkalosis (low H+)

106
Q

Both _ and _ systems work to regulate the pH in acid-base imbalance

A

respiratory and renal

107
Q

_ acid-base imbalance works within minutes

A

Respiratory

108
Q

_ acid-base imbalance works for days to restore balance

A

renal

109
Q

What organ plays a major role by actively secreting or resorbing bicarbonate

A

kidneys

110
Q

What molecule carries oxygen AND serves as a blood buffer

A

Hemoglobin

111
Q

Metabolic acidosis or alkalosis is caused by everything other than the _ system

A

respiratory

112
Q

If RR decreases, less CO2 is eliminated, this causes _ and increase in partial pressure CO2

A

hypercapnia

113
Q

If RR increases, this causes _ and decrease in PCO2

A

hypocapnia

114
Q

_ are produced when glucose metabolism is abnormal

A

ketones

115
Q

_ can cause alkalosis

A

Vomiting

Clinic Pathology 2 (12 decks)

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