CBC/Chemistry/Urinalysis Flashcards

1
Q

examples of hind-gut fermenters

A

elephants, manatees, horses, etc…

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2
Q

what is the importance behind the idea that everything changes over time

A

appearance changes daily

blood work can change drastically daily

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3
Q

CBC

A

complete blood count

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4
Q

CBC components

A

red blood cell (RBC) parameters
white blood cell (WBC) parameters
platelets
total plasma proteins (TPP)

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5
Q

components for RBC, the “hemogram” (CBC)

A
PCV-packed cell volume
RBC count-cell count
Hb-hemoglobin
RBC morphology-shape/appearance of cells
six of cells and Hb content in cells
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6
Q

components for WBC, the “leukogram” (CBC)

A

WBC count-total cell count

  • differential-counts different types of WBC
  • morphology-shape/appearance of cells
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7
Q

other components (CBC)

A

platelets-involved with coagulation: platelet count, morphology-shape/appearance of platelets, and without platelets-you would bleed to death
total plasma protein (TPP)-by measuring protein you can tell if the patient is dehydrated or not

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8
Q

CBC venipuncture blood drawing tube with anticoagulant

A

keeps blood from clotting (coagulation)

allows separation into plasma (liquid), and cellular (WBC, RBC, platelet part)

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9
Q

CBC venipuncture blood drawing tube without anticoagulant

A

clot forms

“spin” centrifuge to separate the clot from the serum (this fluid does not contain any clotting factors

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10
Q

PCV

A

hematocrit/packed cell volume
separates the cellular an liquid portions of the blood
shown as %
decreased %=absolute: anemia relative: over hydration (too much fluid)
increased % absolute: polycythemia vera-“too many RBCs” relative: dehydration (less fluid portion

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11
Q

RBC in CBC

A
RBC count
how many RBC per microliter of blood
number vs percent
hemoglobin
morphology-size
morphology-shape
morphology-color
RBC parasites
regenerative anemia
degenerative anemia
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12
Q

RBC CBC morphology-size

A

anisocytosis: variation is size
normocytosis: WNL
microcytosis: too small, iron deficiency anemia, and hepatic (liver dx)
macrocytoszs: too big, anemias (regenerative RBC are bigger first)

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13
Q

RBC CBC morphology-shape

A

various, some which suggest specific causes or diseases

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14
Q

RBC CBC morphology-color

A

normochromasia: WNL
hypochromasia: look pale due to less hemoglobin (Hb)
polychromasia: RBC’s of different shades, due to carrying amounts of Hb-associated with anemia

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15
Q

RBC CBC parasites

A
hemobartonella
cytauxzoan
babes
plasmodium
etc...
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16
Q

RBC CBC regenerative anemia

A

good response by body to try to solve problem of anemia
acute hemorrhage
RBC destruction

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17
Q

RBC CBC degenerative anemia

A
poor response 
iron deficiency-microcytic
hyochromic-not enough iron
chronic dx-normocytic
normochromic-kidney dx, hepatic dx
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18
Q

WBC in CBC (leukogram)

A
total count (errors can be caused by clumping, nucleated RBC, or breakage of cells)
differentials (neutrophils, lymphocytes, monocytes, eosinophils, basophils, neoplastic cells-abnormal, and leukemia)
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19
Q

WBC CBC Neutrophils

A

increased: inflammation, infection, excitement (epinephrine response), corticosteroids
decreased: infection (used up), not enough produced
inflammatory leukogram
degenerative left shift-evidence of band cells neutrophils (“young” neutrophils) released from the bone marrow-this tells you that the infection is very serious
inflammatory leukogram-toxic left shift associated with toxemia (toxins from bacteria

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20
Q

WBC CBC lymphocytes

A

increased: some virus infections, excitement
decreased: corticosteroids (unknown etiology), other

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21
Q

WBC CBC monocytes

A

increased with inflammation

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22
Q

WBC CBC eosinophils

A

increased: inflammation due to allergies and parasitism
decreased: corticosteroids

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23
Q

WBC CBC basophils:

A

increased with inflammation heart worm disease (inflammation from it)

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24
Q

when to request a CBC for the patient?

A
Pale mm
Hemorrhage
FUO (fever of unknown origin)
Hemolysis-RBC breakdown in the body
Organ disease
Cancer
Drug treatments
Infections
Toxic insults
Anemias
“Ain’t doing right, doc”
Weight loss
others
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25
chemistry panel
``` function of organs are reflected in the chemistry panel so we can assess them: Kidney function Liver function Pancreas function GI tract function Bladder function Electrolytes (salts) Fats: triglycerides, cholesterol Blood sugar Other ```
26
ALB
``` albumin: Important blood protein Makes up 35-50% of total plasma protein Hepatocytes synthesize albumin Renal disease, dietary intake and intestinal protein absorption can also influence the level ```
27
ALP
alkaline phosphatase (also AP) - present in many issues, especially osteoblasts, chondroblasts, and cells of the hepatobiliary system - in young animals more likely to be a bone source, older more likely to be liver - most often use is to detect cholestasis (suppression of bile flow), not useful in cattle and sheep
28
osteoblasts
a cell that secretes the matrix for bone formation
29
chondroblasts
a cell that secretes the major component of cartilage
30
hepatobiliary system
composed of the liver (hepato-) and gallbladder/bile ducts/bile (biliary)
31
ALT
alanine aminotransferase - in dogs, cats, and primates primary source is liver - other sources are renal, cardiac, skeletal, and pancreas, although much smaller sources - traditionally used as liver specific - amount in blood serum does not correlate with degree of liver damage
32
AMY
amylase - primary source is the pancreas - function is to break down starches and glycogen - increased levels appear in pancreatitis or obstruction of pancreatic ducts
33
T BIL
total bilirubin - billirubin is a metabolite of the hemoglobin and is a waste product when erythrocytes die - helps determine the cause of jaundice, evaluate liver function, and to check the potency of bile ducts - firect bili is elevated with live damage or bile obstruction, indirect is elevated wth excessive RBC destruction (T bile here is these two added together-if you need to separate, another lab is needed)
34
BUN
Blood Urea Nitrogen - urea, a nitrogenous compound, is a product of amino acid breakdown in the liver - levels are used to evaluate kidney function based on the ability of the kidney to remove nitrogenous waste - 75% of the functional kidney tissue must be non-functional before a rise in this amino acid degradation product
35
CA++
calcium - 99%of Ca++ is found in bones, remaining 1% maintains neuromuscular function, maintains enzyme activity, and facilitates blood coagulation - concentrations are inversely related to inorganic phosphorus concentrations (EX: CA up, PHOS down)
36
PHOS
phosphorus - 20% free, 80% in bones - helps energy storage, rises in certain metabolic conditions
37
CRE
Creatinine - stores energy in muscles in normal situations - filtered through glomeruli and eliminated in urine - used as indicator of renal disease based on the ability of the kidney to filter it
38
GLU
Glucose - indicator of carbohydrate metabolism in the body - helps to measure endocrine function of the pancreas - reflects the balance between intake and absorption and insulin regulation
39
NA+
Sodium - the major cation of plasma and interstitial (extracellular) fluids - role in water distribution and body fluid osmotic pressure
40
K+
Potassium - major intracellular cation - maintains normal muscle function, respiration, cardiac function, nerve impulse transmission, and carbohydrate metabolism. In acidotic animals K ions leave the intracellular fluids as they are replaced by hydrogen ions resulting in high serum potassium levels, decreased levels can occur with inadequate K intake or vomiting and diarrhea
41
TP
Total Protein - total plasma protein measurements include fibrinogen values, total serum protein does include fibrinogen, which has been removed during the clotting process - total protein will be affected or altered by hepatic synthesis, altered protein distribution, or secretion dehydration or overhydration
42
GLOB
Globulin - a complex group of proteins - alpha goblins are synthesized by the liver and transport and bind other proteins - beta globulins include transferrin and ferritin, which are responsible for iron transport - gamma globulins (immunoglobulins) are synthesized by plasma cells and are responsible for antibody production (immunity)
43
BUN and kidney function
proteins broken down to ammonia, then to urea by the liver increased: dehydration, renal dx (kidney) decreased: low protein diet, liver dx creatinine: by produce of muscle metabolism, which is then filtered out by the kidney (increased: renal dx)
44
Liver enzymes and hepatic function
enzymes that indicate hepatic cell damage/leakage: -ALT-alanine aminotransferase -ALP-alkaline phosphatase enzymes that indicate bile backup (cholestasis) in the liver -ALP-alkaline phosphatase -GGt-gamma glutamyl transpeptidase (add on from vet scan) ALT/ALP/T BILI
45
bilirubin and hepatic function
brown/gold pigment increased: hepatic disease hemolysis-RBC destruction
46
electrolytes
``` sodium (Na) potassium (K) chlorine (Cl) calcium (Ca) phosphorus (P) various and multiple changes with dehydration fluid loss/vomiting/diarrhea renal disease endocrine dx -Addison's dx=hypoadrenocorticism -milk fever-hypocalcemia ```
47
CK
creatinine kinase: muscle enzyme (add on)
48
blood sugar
BG: endocrine function of pancreas makes insulin
49
proteins
total: albumin and globulin
50
"fats"
triglycerides and cholesterol
51
acid/base
TCO2-total carbon dioxide-actually measures bicarbonate of blood -full blood gas analysis is not part of the chemistry panel
52
pancreas
``` pancreatitis-elevations of; -amylase-exocrine digestive function -lipase-exocrine digestive function amylase and lipase -may also be slightly elevated in renal disease ```
53
when do we request a chemistry for the patient
``` FUO suspect organ disease vomiting, cause? organ disease cancer weight loss drug treatments (side effects) infections, where? too insults, liver? kidney? anemia, kidney? "ain't doing right, doc" other ```
54
U/A
``` urinalysis -methods: cystocentesis: sticking a needle into the bladder urethral: catheratizing free catch ```
55
U/A evaluation
``` color turbidity odor chemical evaluation specific gravity sediment analysis ```
56
U/A normal color
yellow
57
U/A normal turbidity (cloudiness)
normal is clear unless it has some normal crystals, lipid droplets, mucus, or sperm in it
58
U/A normal chemical evaluation
glucose-negative ketones-negative bilirubin-negative (small amount in concentrated dog urine is ok) blood-(myoglobin or hemoglobin)-negative protein-minimal (look at sediment for RBC,WBC, too) urobilogen-+/-
59
U/A specific gravity
how concentrated? normal: up to 1.065 hyposthenuric (low): 1.00-1.006 isothenuric (same): 1.008 to 1.012. cannot concentrate due to disease telling you that the urine is concentrated which is important because the urine's job is to remove body waste; therefore, if it is concentrated then you know that your kidneys are working properly but if it is not working properly then it won'e be concentrated
60
U/A normal sediment analysis (solids in urine)
solids in urine -normal: occasional RBC, WBC, epithelial cells, sperm, triple phosphate crystals, calcium oxalate crystals. lots of carbonate crystals in horses
61
what can comparing free catch urine and cytocentesis bring tell you
that the infection may not be coming from the bladder. If the cytocentesis urine is normal but there is an infection in the free catch that means there is an infection coming from where the urine passes through and the bladder is okay
62
when do we request an urinalysis for the patient?
``` "squatting and squirting" increased urination difficulty urinating infection? organ disease "ain't doing right, doc" toxins weight loss other ```