Blood Chemistries Flashcards
What do blood chemistries evaluate
the various blood levels to help assess the different body functions
Why should you not freeze whole blood?
causes hemolysis
What samples can be used to run blood chemistries
serum, plasma, whole blood
Why is a grey top tube used for glucose determination?
Because it prevents RBCs from metabolizing glucose
What body system cannot be evaluated well with chemistries?
respiratory system
Enzyme number is usually _ in blood
low
If enzyme number is high in serum, cell have:
ruptured and released enzyme into serum or cell increased enzyme production and excess leaked out of cell
What should be done regarding patients prior to collecting blood for chemistries?
fasting for at least 2 hours
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
liver
Liver assays- what is hepatocellular damage
hepatocytes are damaged and enzymes leak into blood causing rise in blood levels
Liver assays-Hepatocellular damage: What is Alanine Aminotransferase (ALT)?
screening test for liver damage. there is no correlation b/w ALT levels and severity of liver damage
Liver assays-Hepatocellular damage: _ or _ can elevate ALT
corticosteroids or anticonvulsants
Aspartate Aminotransferase (AST) is not _ specific
liver
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
hepatocyte
What do indirect enzyme assays measure
enzymatic reaction
Liver assays- enzymes associated with _ (bile duct obstruction) and hepatocyte metabolic defects
cholestasis
Liver assays-Choleostasis: Sources of Alkaline Phosphatase (AP) in young and old animals
Young: developing bone (Osteroblasts and Chondroblasts)
Old: hepatobiliary cells
Alkaline Phosphatase (AP) is used to detect _ in SA
cholestasis
Why is AP not useful in cattle and sheep?
wide fluctuation are normal in those species
Liver assays-Choleostasis: Gamma Glutamyltransferase or -peptidase (GGT) primary source is in the liver but is also in the ,,_, and _
kidneys, pancreas, intestine, and muscle
What can cause GGT to be elevated
liver disease
Liver function tests
Bilirubin, Bile acids, Dye excretion, cholesterol, albumin, ammonia
If there is in elevation in AST what test should be run to confirm true liver damage?
Creatine kinase
_ 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
Bilirubin
What species is SD usually performed?
large animals
What tests indicate hepatobiliary disease?
AP, ALKP, GGT
Increased conjugated(direct) total bilirubin is caused by what?
Heptocellular damage, bile duct injury/obstruction?
What will you see in with increase direct total bilirubin
bilirubinuria
Increased unconjugated (indirect) total bilirubin is caused by
RBC destruction, defects in transport to liver to be conjugated
The liver does NOT overproduce _ and if high, determines dehydration
albumin
If excess bile acids in circulation what does this mean?
liver did not clear them out, this is usually the test to diagnose a portosystemic shunt
Bile acids aid in
fat digestion
Bile acids increase with
-post prandial
-PSS
-Chronic hepatitis
-Cirrhosis
-Cholestasis
-Neoplasms
Bile acids are normally low in circulation, why?
b/c liver removes 75%-90% via portal circulation
How many tests should be run for bile acids
2, one fasted and one 2 hours after eating
Kidney functions
-Homeostasis
-Remove end products of nitrogen metabolism
-Produce (renin, erythropoietin, prostaglandins)
What does BUN stand for
blood urea nitrogen
What is urea
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)
What tests measure BUN
azostick and chemical assay
Normal range of BUN on azo-stick
<26mg/dl
The following are causes of _ BUN:
-high protein diet; strenuous exercise= increased AA breakdown
-bleeding ulcer (high protein meal)
Increased
The following are causes of _ BUN:
-sample contamination of urease-producing bacteria (Staph. aureus, Proteus spp., Klebsiella spp)
decreased
Causes of azotemia
-Dehydration
-UT obstruction
-Renal dz
Creatinine is formed from Creatine Phosphate- found in _ _ _ (splits to provide energy for ADP + P= ATP)
skeletal muscle fiber
Creatinine is found in most body fluid
sweat, vomitus, and feces
Creatinine is an indicator of
glomerular filtration (urinary obstruction)
_% kidney tissue damage before creatinine is elevated
75
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?
it is not impacted by muscle mass
Pancreas endocrine tests
-Insulin (CHO metabolism)
-Glucagon (elevated BG levels)
-Glucose
_ should always be present in feces, abnormal if not
Trypsin
What is trypsin
a proteolytic enzyme, aids in digestion of proteins
What are the methods of pancreas -exocrine tests for trypsin
-test tube method
-x-ray film method
What is the most specific test for diagnosing exocrine pancreatic insufficiency
determination of trypsin-like immunoreactivity (TLI)
How is a TLI done
taking a single fasting blood sample sent to a lab
What does amylase do
breakdown starches and glycogen
Pancreatic exocrine tests
TLI
Amylase
Lipase
What causes increased levels of amylase
acute pancreatitis, flare ups of chronic pancr., pancreatic duct obstruction
Normal amylase in dogs/cats= _x higher than in humans (important if using human lab)
10
What does lipase do
break down lipids
_ is required for activity of lipase
calcium
Lipase may be more _ than amylase
sensitive
Level of / not directly proportional to severity of pancreatitis
amylase/lipase
Lipase and amylase have _ sensitive and specificity for pancreatitis
poor
When is creatine kinase elevated
when striated myocytes damaged/destroyed and leak CK out of cell into blood
Creatine kinase is organ-specific and can only tell what
that muscle is damaged, not which muscle, or severity of damage
Where is cholesterol produced
everywhere but primarily liver, adrenal cortex, ovaries, testes, intestinal epithelium
Hypercholesterolemia dx what _
hypothyroidism
_ _ controls synthesis and destruction of cholesterol
Thyroid hormone
Hypercholesterolemia also caused by
hyperadrenocorticism, diabetes mellitus, nephrotoxic syndrome
Plasma prot is produced by _ and _ _
liver and immune system
The following are functions of _:
-Structural matrix
-Osmotic pressure
-Enzymes
-Hromones
-Blood coag
-Body defense
-Transport/carrier molecules
TP
TP consists of
albumin + globulin +/- fibrinogen
concentration of TP is affect by
altered formation in the liver, distribution, breakdown, and dehydration or over hydration
TP helps determine _ status
hydration
Plasma contains _
fibrinogen
How is globulin measured
total serum protein - albumin
Hypoproteinemia is usually due to
albumin loss
Hypoalbuminemia is usually due to
any diffuse liver dz (also renal dz, dietary intake, intestinal proteins absorption)
How to calculate albumin:globulin
divide albumin by globulin
normal albumin:globulin in dogs, horse, sheep, goat
> 1.00
normal albumin:globulin in cattle, pigs, and cats
<1.00
Elevated fibrinogen indicates
acute inflammation or tissue damage
Heat precipitation test is used to test what
fibrinogen
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
Electrolytes
When testing calcium, never use _ or _ tubes
EDTA or oxalate
Calcium is _% in bones
99
Function of calcium
neuromuscular excitability and tone, blood coagulation
Calcium is an indicator of
neoplasia, parathyroid dz, bone disease
Inorganic phosphorus is _% in bones and _% in energy storage, release & transfer (ATP), CHO metabolism, make up Nucleic acids and phospholipids
80%, 20%
Sodium is in
plasma and interstitial fluid
Sodium plays a role in
water distribution, osmotic pressure, maintenance
Hemolysis can cause _ levels of sodium
lower
Hyperkalemia
acidosis (exchange for H ion in plasma), cellular damage/necrosis
Hypokalemia
indadequate K intake, fluid loss (V/D)
Functions of potassium
muscular fxn, respiration, cardiac fxn, nerve impulse transmission, CHO metabolism
Magnesium is _% in bones (closely related to P and Ca)
50
Mg:Ca imbalance causes release of Act=
muscle tetany
Functions of magnesium
activates E systems, production and decomposition of Ach
What test is helpful in diagnosing Addison’s disease
Na+:K+
If Na+:K+ <25:1 what test should be run to R/O Addison’s disease
ACTH STIM test
Functions of chloride
maintains water distribution, osmotic pressure, normal cation: anion ratio
What sample is best for chloride
serum
Functions of bicarbonate
bicarb/carbonic acid buffer system (blood pH), transport of CO2
Excess bicarb is excreted via
kidneys
What is normal blood pH
7.35-7.45
If blood pH is below 7.3 this is called
acidosis (excess H+)
If blood pH is above 7.4 it is called
alkalosis (low H+)
Both _ and _ systems work to regulate the pH in acid-base imbalance
respiratory and renal
_ acid-base imbalance works within minutes
Respiratory
_ acid-base imbalance works for days to restore balance
renal
What organ plays a major role by actively secreting or resorbing bicarbonate
kidneys
What molecule carries oxygen AND serves as a blood buffer
Hemoglobin
Metabolic acidosis or alkalosis is caused by everything other than the _ system
respiratory
If RR decreases, less CO2 is eliminated, this causes _ and increase in partial pressure CO2
hypercapnia
If RR increases, this causes _ and decrease in PCO2
hypocapnia
_ are produced when glucose metabolism is abnormal
ketones
_ can cause alkalosis
Vomiting
