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VT 266 Clin Path & Parasitology > Blood Chemistry > Flashcards

Blood Chemistry Flashcards

1
Q

Blood Chemistey analysis involves?

A

The comparison of measurable blood components of a patients to the normal values of the general population

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2
Q

Very low levels of enzymes are?

A

Normal

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3
Q

Increased levels of enzymes are seen when?

A

cells are damaged

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4
Q

Enzymes are

A

Are proteins found inside cells that increase the rate of biochemical reactions but the enzymes itself does not get altered/changed.

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5
Q

Factors influencing enzyme activity:

A

‣ Temperature, dehydration, UV light, PH extremes (excessive alcohol), Organic solvents, heavy metal solvents.

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6
Q

Enzyme names usually end w/ the suffix

A

“-ASE”

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7
Q

Liver function:

A

is the largest internal organ w/ many vital functions
• Metabolism of carbohydrates - Fats
• Synthesis of albumin - Clotting Factors
• Secretion of Bilirubin
• Metabolism & elimination of toxins/drugs

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8
Q

Enzymes values are often associated with what type of disease?

A

Liver Disease

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9
Q

explain hepatocellulary Injury

A

“inflammation/damage to the liver cells that cause blockages in the liver ducts not allowing fluid to go through causing a back up”

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10
Q

Alanine Aminotransferase (ALT) is what organ specific in what species?

A

• Liver specific in dogs & cats not other animal
• Not liver specific in horses, cattle & Swine

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11
Q

Increased Alanine Aminotransferase (ALT) levels may be due to?

A

drug administration:
◦ Glucocorticoids
◦ Anticonvulsants

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12
Q

ALT stands for?

A

Alanine Aminotransferase (ALT)

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13
Q

Aspartate Aminotransferase (AST) is not what?

A

• Not liver specific but its enough of it in large animals to have value to us

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14
Q

Aspartate Aminotransferase (AST) increased levels

A

• AST increased levels often seen w/ muscle inflammation, & hemolysis of blood sample
◦ You must decipher if the elevated levels are due to AST from a hepatocellullary injury to the liver or if the patient has muscle inflammation

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15
Q

AST stands for?

A

Aspartate Aminotransferase (AST)

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16
Q

what test is often added on when you have high levels of Aspartate Aminotransferase (AST)

A

◦ You can add on Creatine Kinase which is a lab test that test for muscle damage to help decipher between AST and muscle inflammation

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17
Q

Sorbitol Dehydrogenase is

A

• Liver specific in all species
• Not routinely measured in veterinary medicine due to cost

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18
Q

Alkaline Phosphatase (Alk Phos, AP) is ran why?

A

to check Liver enzymes associated w/ obstruction of bile flow

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19
Q

Alkaline Phosphatase (Alk Phos, AP) is

A

• Not liver specific

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20
Q

High concentration of Alkaline Phosphatase (Alk Phos, AP) is found in the?

A

liver & bones

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21
Q

Alkaline Phosphatase (Alk Phos, AP) is useful in what species and not useful what species?

A

• Useful in dogs and cats
• Not useful in horses and cattle

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22
Q

increased levels of Alkaline Phosphatase (Alk Phos, AP) are often seen?

A

◦ Bone Injury/Broken Bone
◦ Rapidly Growing Animals (Rapid Puppy Growth)
◦ Use of Glucocorticods and/or Anticonvulsants
• Determining between a bone issue and a liver issue is the true tricky part to this test

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23
Q

What disease is associated with increased levels of Alkaline Phosphatase (Alk Phos, AP)?

A

Cushings Disease will have elevated Alk Phos Levels
◦ Can even have other normal liver values
◦ Most of the times this is the only warning sign that an animal as early signs of cushings disease and/or if they have it already

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24
Q

Alk Phos and/or AP stands for?

A

Alkaline Phosphatase

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25
Q

Gamma Glutamyltranspeptidase/Glutamyltransferase (GGT) primary source is?

A

Liver is primary source

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26
Q

increased Gamma Glutamyltranspeptidase/Glutamyltransferase (GGT) levels may be seen when?

A

when prescribed glucocorticoids &/or anticonvulsants

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27
Q

GGT stands for?

A

Gamma Glutamyltranspeptidase/Glutamyltransferase

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28
Q

Gamma Glutamyltranspeptidase/Glutamyltransferase is ran why?

A

to check Liver enzymes associated w/ obstruction of bile flow

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29
Q

Bilirubin

A

Not an enzyme - this is just a breakdown of hemoglobin which are released by lysed RBCs

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30
Q

Increased bilirubin is associated with?

A

◦ Increased RBC destruction
◦ Liver disease because the bilirubin does not have anywhere to go w/ the clogged liver duct therefore it’s backing out.
◦ UV light will breakdown Bilirubin
• False elevated readings: Lipemia and hemolysis of the blood sample

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31
Q

Bile Acid is?

A

• Substance produced by the liver & secreted in bile to promote the digestion and absorption of fat from the small intestine
• Bile acids are reabsorbed from the Small Intestine & removed from circulation by the liver

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32
Q

Bile Acid levels may be increased when?

A

• in portosymstemic shunts & chronic liver disease
• 3-4 months of age will begin to show signs

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33
Q

Kidney Functions:

A

◦ Eliminates metabolic wastes
◦ Maintains normal homeostasis:
‣ Regulates electrolyte, essential organic molecule levels
◦ Produce important hormones (Erythropoietin)
◦ The renal artery brings blood from the heart to the kidney to be filtered
◦ The renal vein takes the “clean” blood from the kidney back to the heart
‣ The nephron takes the waste product and send it the glomerulus to the bowman’s capsule into the loop of henle & out through the collecting ducts to the urethra & into the bladder.
‣ Blood and urine do not mix.

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34
Q

Urine consists of?

A

95% of urine is water
5% Electrolytes & waste

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35
Q

Blood Urea Nitrogen Blood Chemistry Test (BUN)

A

• This test checks for Urea in the blood
• Urea is a metabolic waste that results from amino acid breakdown
◦ Amino acids are eliminated from the body through urine
• Freely filtered at the glomerulus
• BUN essentially tests to see if their is a problem with the kidneys but does not tell us exactly what is the wrong or where exactly within the kidney is the problem.

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36
Q

Azotemia refers to

A

increased BUN level

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37
Q

Increased Blood Urea Nitrogen (BUN) may be due to?

A

Increased BUN (Azotemia) may be due to:
Renal Abnormalities &
Common to see an elevated BUN when an animal is Dehydrated
- False positives may occur if animal ingests a high protein meal prior to test

38
Q

Creatinine Blood Chemistry Tests

A

Renal Disease
• Creatinine is a waste product
◦ A nitrogen containing molecule released from muscle at a constant rate (waste product)
• Freely filtered by the kidney at a constant rate
• All waste products need to be released by the body

39
Q

Increased Creatinine levels are due to?

A

Increased levels of Creatine are due to the same problems that lead to elevated BUN:
◦ Prerenal Abnormalities
◦ Renal Abnormalities
◦ Postrenal Abnormalities

40
Q

Two parts of the pancreas

A

◦ Exocrine: Has Ducts & is in charge of releasing digestive enzymes
◦ Endocrine: No ducts, dumps directly into circulation, in charge of releasing insulin

41
Q

The pancreas is involved in:

A

Digestion of food
Regulation of blood glucose (Insulin)

42
Q

Digestive Enzymes produced by the pancreas include:

A

Amylase - Starch, Carbs & Sugar
Lipase - Fat
Trypsin: Protein

43
Q

Pancreatitis

A

Inflammation of the pancrease
‣ Generally acute/sudden onset due to eating food that is not normally in their diet
• Inflammation of the pancreas shrinks the ducts of the exocrine portion of the pancreas causing a reduction in digestive enzymes being released into the GI. Therefore the digestive enzymes stay inside the pancreas and/or are backed up into the pancreas and those digestive enzymes begin digesting the pancreas itself which causes inflammation of the pancreas/Pancreatitis

44
Q

Amylase & Lipase Blood Chemistry Test -

A

Pancreatic Disease/Pancreatitis
• Common add on to a normal blood chemistry panel
• Found primarily in the pancreas but also found in other parts of the GI tract
• increased levels associated w/ injury to the pancreatic cells
◦ Elevations 3Xs the normal level is considered significant and is considered Pancreatitis

45
Q

Pancreatic Lipase Immunoreactivity (PLI)

A

• Highly specialized test for pancreatitis & often sent to an outside lab
◦ For both dogs & cats
• Used to diagnose Exocrine Pancreatic Insufficiency (EPI)
◦ Not producing the digestive enzymes
• Help to determine:
◦ Acute pancreatitis
◦ Checking digestive enzymes function
• Treatment: Supplement w/ digestive enzymes
• Generally ran in house (20ish minutes)
• The Lipase levels will remain elevated for much longer
• This is a quick snap test that will help determine if the pancreatitis is acute or if there is something else going on

46
Q

Trypsin-Like Immunoreactivity: Blood Chemistry Test -

A

Pancreatic Disease
• Trypsin-Like Immunoreactivity (TLI) is a blood chemistry test to rule out pancreatitis and exocrine pancreatic insufficiency (EPI)
• Cannot be ran in clinic but will need to be sent to an outside lab
• Trypsin: Digestive enzyme that helps break down proteins

47
Q

Endocrine portion of the pancreas creates insulin that goes into circulation as?

A

Glucose

48
Q

Blood Glucose Test

A

• Blood Glucose levels reflect an equilibrium between:
◦ The amount of glucose entering the bloodstream (Eating)
◦ The amount of glucose leaving the bloodstream
• Glucagon & Insulin help maintain normal blood glucose levels

49
Q

Hyperglycemia

A

To Much Glucose in the Blood
‣ Diabetes mellitus: its a disease where the islets of langerhagn of the pancreas no longer produces insulin
• Clinical Signs: Increased Thirst (Polydipsia), Increased Urination (Polyuria), & Weightloss

50
Q

Hypoglycemia

A

To Little Glucose in the Blood

51
Q

Insulinoma

A

To much insulin in circulation (Tumor in the pancreas causing the pancreatic cells to over make Insulin)

52
Q

A cell is unable to accept the Glucose no matter how much it’s needed if there is no?

A

Insulin
◦ Insulin is needed to unlock the cell to allow Glucose to enter
‣ If no insulin the Glucose just sits outside of the cell in the blood stream causing Hyperglycemia
• Eventually the Glucose will spill over into the urine which is why this can also be seen on urinalysis

53
Q

Blood chemistry tests that are ran to test the plasma proteins:

A

◦ Total Plasma Protein
◦ Albumin
◦ Globulins
◦ Fibrinogen

54
Q

The 3 most important & largest plasma protein fractions are:

A

◦ Albumin
◦ Globulins
◦ Fibrinogen
‣ Beta Protein

55
Q

Total Plasma Protein:

A

• All plasma proteins are added together
• Good indicator of overall health

56
Q

Increased Total Plasma Protein values are associated with?

A

• chronic inflammation and/or infection

57
Q

Low Total Plasma Protein values are associated with?

A

• Can be low or decreased w/ liver disease because the liver cannot make the proteins
◦ The majority of our plasma proteins are produced by the liver This is a blood chemistry test that test the plasma protein

58
Q

Albumin:

A

• an important protein produced by the hepatocytes
• Make up 35-50% of total plasma protein level
• Helps maintain water levels in the circulatory system

59
Q

Globulins:

A

• Second largest plasma protein fraction
• Produced in the liver and by the B-Lymphocytes
• Globulins have various functions

60
Q

Increased Globulins levels are associated with?

A

infection, chronic inflammation and Neoplasia
◦ Cancer creates inflammation

61
Q

Increased albumin is a result of

A

dehydration

62
Q

Fibrinogen:

A

• Protein produced in the liver
• Involved in blood clot formation
◦ Fibrinogen - Fibrin
• Measure in clinic by heating a microhematocrit tube to precipitate fibrinogen
• Makes up 3-6% of total plasma protein

63
Q

Increased levels of fibrinogen are associated with?

A

w/ inflammation and/or tissue injury

64
Q

Electrolytes:

A

• Mineral Ions (Cations, & Anions) found in the circulating blood
• Play an important role in:
◦ Maintenance of water balance
◦ Nerve function
◦ Muscular function

65
Q

Blood Chemstry Tests that test electrolyte levels:

A

◦ Potassium
◦ Calcium
◦ Phosphorus
◦ Sodium
◦ Chloride
◦ Magnesium

66
Q

Potassium:

A

Important in maintaining normal neuromuscular function

67
Q

Hypokalemia:

A

decreased potassium levels

68
Q

Hypokalemia occurs with

A

‣ Renal Failure, vomiting, diarrhea - common to see anytime there is large amount of fluid loss.

69
Q

Hyperkalemia:

A

Increased levels of potassium

70
Q

Acidosis

A

‣ Hyperkalemia: Increased levels of potassium

71
Q

Hyperkalemia is associated with?

A

‣ Common to see in renal deficiency, urinary blockage, or urinary tract obstructions. Any disorder that decreases the urine output which backloads the potassium into circulation
‣ Can cause cellular damage or neurosis
‣ Ruptured RBC release potassium
‣ Prevent hemolysis in the blood draw.
• Chemical abbreviation is: K+

72
Q

Calcium allows the?

A

muscles to relax. You can constrict your muscle w/out calcium but you cannot relax the muscle without calcium

73
Q

Calcium

A

Cannot be measured in anticoagulated plasma
◦ Can only be measured w/ SERUM
◦ Calcium is used in the anticoagulated blood tubes

74
Q

Hypocalcemia seen in?

A

Hypocalcemia seen in eclampsia/puerperal tetany
◦ Tetany: Unable to relax muscle
◦ Eclampsia: Muscle Tetany during pregnancy
◦ Puerperal Tetany: Muscle tetany during birth

75
Q

Phosphorus:

A

• Important in energy storage - part of normal cell membranes

76
Q

Hyperphosphatemia seen in?

A

chronic renal failure

77
Q

Hyperphosphatemia:

A

High levels of phosphorus in the blood stream

78
Q

Sodium:

A

• Chemical abbreviation: Na+
• Imprant in maintaining water balance in the body
• Sodium really likes Chloride
◦ Sodium Chloride is salt
◦ They work together to maintain the water balance in the body

79
Q

Hyponatremia occurs with vomiting & diarrhea

A

◦ Hyponatremia: Loosing fluids outside of the body
‣ Includes vomiting, diarrhea, & even sweating
• Should release excessive salt in the urine & reabsorbs what the body needs

80
Q

Hypertremia

A

Increased levels of sodium in circulation which causes dehydration
◦ Also can happen if you a lot of super salty food

81
Q

Chloride:

A

• Important in water balance
• Works with Sodium
• Hypochloremia occurs with vomiting
• Anytime the body is losing fluids they are loosing chloride and sodium
• Chloride and Sodium always go together, there will not be one elevated and one decreased they will always be the same: decreased together or increased together

82
Q

Magnesium:

A

• Important in neuromuscular function
◦ Super important when preventing muscle cramps - even more so that potassium

83
Q

Hypomagnesemia

A

◦ Decreased amount of magnesium found in circulation
◦ Seen in Grass Tetany which happens in cows when there strictly fed grass which is low in magnesium and causes uncontrollable muscle cramps.

84
Q

Creatine Kinase (CK) & Creatine Phosphokinase (CPK)

A

◦ Found in muscles tissues
◦ High level occur w/ muscle injury
‣ Whenever a muscle injury happens the muscle tissues poor Creatine kinase into the bloodstream
‣ Inflammation in the muscle fibers
‣ Trauma
‣ Exercise (Often happens with horses)
‣ Surgery
‣ Injection into the muscles causes muscle damage

85
Q

Creatine Kinase (CK) & Creatine Phosphokinase (CPK) is found in?

A

◦ Found in all animals large & small
◦ Fractious Cats often have an elevated CK level when the cat is fighting the blood draw it can cause muscle damage therefore releasing the CK into circulation

86
Q

Elevated AST & Normal CK means that

A

the AST high value is coming from the liver muscle versus the muscles. Therefore this would tell us that something is going on with the liver not the muscles

87
Q

Elevated AST & Elevated CK means that

A

there is muscle damage/injury which often occurs with Horses and other large animals.

88
Q

Creatine is in?

A

the muscle that gets broken down into Creatinine that is released/eliminated from the kidneys

89
Q

Cholesterol is a

A

type of fat that is formed inside the body from fatty acids
◦ cholesterol is an important component of cellular membranes, adrenal & gonadal hormones
◦ Human cholesterol and animal cholesterol are viewed & valued different
◦ Found in many tissues including the liver, adrenal gland, gonads, & Nerves

90
Q

Abnormally high levels of cholesterol are associated with?

A

cholesterol metabolism
‣ Hypothyroidism: Not to producing enough thyroid hormones that helps digest fat
‣ Hyperadrenocorticism (Cushings Disease):
‣ Diabetes Mellitus
◦ In Vet Med we generally do not monitor or try to change a lifestyle due to cholesterol we more use it to determine if a more serious underlying medical conditions is happen.

VT 266 Clin Path & Parasitology (19 decks)

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