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Clin Path > Chemical Chemistry > Flashcards

Chemical Chemistry Flashcards

1
Q

What is an Enzyme?

A

protein responsible for catalyzing a reaction
converting substrate into a product
organ specific

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2
Q

What effects Enzyme Activity?

A

molecules converted to different molecules
certain drugs and toxins
pH, temp, and concentration of enzyme

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3
Q

What are other chemicals/substances measured in blood?

A

hormones
electrolytes
other metabolites and metabolic by products of organ function

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4
Q

What are the purposes of measuring chemicals in blood?

A

-recognition and diagnosis of disease
-monitoring disease progress/activity
-prescription of proper therapy and
evaluating response to treatment
-pre surgical/pre anesthetic

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5
Q

What is the “Beer’s Law”?

A

concentration of a substance can be calculated by determining its ability to absorb light of a specific wavelength

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6
Q

What is Spectrophotemetry?

A

measures the amount of light transmitted through a solution

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7
Q

What is preferred when running tests?

A

serum

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8
Q

What anticoagulant do you use when using plasma?

A

heparin

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9
Q

When should you collect your samples?

A

prior to initiation of treatment (some meds inhibit enzyme activity)

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10
Q

Why should the animal be calm when collecting a sample?

A

epinephrine release
physiological response
causes splenic contractions
epinephrine inhibits insulin activity

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11
Q

What should the sample tube be labeled with?

A

patient name, owner name, animal ID #
date and time of collection
request form if sent to outside lab

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12
Q

What are the 3 types of factors that influence results?

A

pre-analytical
analytical
post analytical

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13
Q

What are factors that influence results?

A 
time
specimen interference
pharmacologic/theraputic drugs
chemical contamination
patient influences
improper handling of sample
improper labeling of sample
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14
Q

Prolonged contact of RBC’s with serum decreases serum glucose at a rate of…

A

10% / hour

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15
Q

Time

A
  • pre analytical
  • glucose levels decrease (10%/hour)
  • bilirubin is oxidized to biliverdin (exposure to fluorescent lighting)
  • sample evaporation (increased concentration of values. TP, Na, K)
  • bacterial growth decreases glucose concentration
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16
Q

Specimen Interference

A

analytical
hemolysis
lipemia
icterus

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17
Q

What causes hemolysis in a blood sample?

A
  • drawn into a moist syringe
  • mixed to vigorously after collection
  • forced through a needle into a blood tube
  • frozen (as whole blood)
  • collected without cleaning alcohol from skin
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18
Q

What are the effects of hemolysis on test results?

A
  • spectrophotometric influence
  • fluid (water) from ruptured RBCs dilute sample, causing decrease concentration of blood constituents
  • analyte release (increased TBIL, organic phosphate and others)
  • enzyme release (ALT, AST, lactate dehydrogenase)
  • reaction inhibition (pH change affects enzyme activity)
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19
Q

What are the effects of Lipemia on test results?

A
  • light scattering (false elevations in TBIL, Hbg)
  • volume displacement (false dec. esp. electrolytes)
  • enhances hemolysis
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20
Q

What can you do to a Lipemic sample to remove fat?

A

refridgerate sample for a couple seconds

re centrifuge

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21
Q

What are the effects of Icterus on test samples?

A
  • spectral interference

- bilirubin reacts with reagents, resulting in false decreases

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22
Q

Pharmacologic/Therapeutic Agents

A
  • topical, oral, parenteral
  • pre analytical
  • analytical
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23
Q

What are drug effects on test results?

A
  • decrease enzyme activity
  • exogenous steroids reduce endogenous steroid levels
  • increase in liver enzymes, BUN and glucose
  • affects seen in electrolytes
  • NSAID’s increase BUN and CREA
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24
Q

Chemical Contamination

A
  • analytical
  • use chemically pure tubes
  • tubes don’t have to be sterile
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25
Q

Patient Influences

A
  • pre analytical
  • inherent=species, breed, age, gender
  • controllable= stress level, exercise, drugs, estrous cycle
  • time of last meal
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26
Q

What is affected with Post Prandial Samples?

A 
increased glucose and lipemia
increased GFR (glomular filtration rate)
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27
Q

Improper Handling of Sample

A
  • pre analytical
  • too warm = increased enzyme activity and destruction of chemicals
  • complete analysis within 1 hour after collection
  • frozen=mix thouroughly after thawing to avoid concentration gradients
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28
Q

Improper Labeling of Sample

A

post analytical

contributed to clerical/record keeping/labeling errors

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29
Q

Where are Immunoglobulins produced?

A

plasma cells

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30
Q

What are the functions of Plasma Proteins?

A
  • form structural matrix of all cells, tissues and organs
  • maintain osmotic pressure
  • serve as enzymes
  • act as buffers in acid/base balance
  • serve as hormones
  • coagulation
  • defending body against pathogenic microorganisms
  • serve as transport/carrier molecules
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31
Q

What are the Protein Assays?

A 
total protein
albumin 
globulins
A/G ratio
fibrinogen
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32
Q

How is Total Protein determined?

A

refractometer

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33
Q

What does Total Plasma Protein measure?

A

fibrinogen
albumin
globulin

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34
Q

What does Total Serum Protein measure?

A

albumin

globulin

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35
Q

What is Hypoproteinemia?

A

decrease in total protein

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36
Q

What causes decreases in Total Protein?

A
  • liver disease (decreased synthesis)
  • altered distribution (ascites)
  • over hydration (hypervolemia)
  • hemorrhage
  • protein losing nephropathies/enteropathies
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37
Q

What is Hyperproteinemia?

A

increase in total protein

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38
Q

What causes increases in Total Protein?

A

kidney dysfunction
dehydration (#1)
increased synthesis of globulin

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39
Q

What is Albumin?

A

major binding/transport protein

responsible for maintaining osmotic pressure

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40
Q

What % of Albumin makes up TP?

A

35%-50%

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41
Q

What causes decreases in Albumin?

A 
liver disease (#1)
decreased dietary intake
decreased intestinal protein absorption
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42
Q

What causes increases in Albumin?

A

renal disease

dehydration

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43
Q

How do you estimate Globulin concentration?

A

determining difference between total protein and albumin concentrations

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44
Q

What are the 3 categories of Globulins?

A

alpha globulins
beta globulins
gamma globulins
separated by electrophoresis

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45
Q

What are Alpha Globulins?

A
  • transport and bind proteins and drug molecules
  • include lipoproteins HDL and VLDL (cholesterol transport)
  • chylomicrons (dietary lipid transport)
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46
Q

What are Beta Globulins?

A

include complement, transferrin, ferritin, LDL

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47
Q

What are the functions of Beta Globulins?

A
  • iron transport
  • heme binding
  • fibrin formation and lysis
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48
Q

What are Gamma Globulins?

A

antibodies

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49
Q

How do you determine A/G Ratio?

A

dividing the albumin concentration by the globulin concentration
albumin / globulin

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50
Q

Alteration in normal A/G ratio is the first indication of what?

A

protein abnormality

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51
Q

What is the normal A/G ratio in dogs and horses?

A

> 1.0

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52
Q

What is the normal A/G ratio in cats and cattle?

A

<1.0

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53
Q

What causes an increase in Fibrinogen?

A

increased with acute inflammation or tissue damage

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54
Q

What is the most common method of Fibrinogen evaluation?

A

heat precipitation test

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55
Q

What are the Hepatobiliary Assays?

A 
ALT
AST
SDH
GLDH
(AP)(ALP)
GGT
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56
Q

What are the functions of the Hepatic Cells?

A
  • metabolism of amino acids, carbs and lipids
  • synthesis of plasma proteins
  • conjugation of bilirubin
  • synthesis of cholesterol
  • production of bile
  • detoxification
  • drug metabolism (biotransformation)
  • drug elimination
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57
Q

What % of liver function must be loss in order for clinical signs to show?

A

70%-80%

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58
Q

What predictable c/s do liver and gallbladder malfunctions produce?

A
  • jaundice/icterus
  • hypoalbuminemia
  • hemostatic dysfunction
  • hypoglycemia
  • hyperlipoproteinemia
  • hepatoencephalopathy
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59
Q

What is Liver Disease?

A

includes any process resulting in:

  • hepatocyte injury
  • chemostasis
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60
Q

What are causes of Hepatocyte Injury and Chemostasis?

A 
hypoxia
metabolic disease
toxicoses
inflammation
neoplasia
trauma
bile duct obstruction
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61
Q

What is Liver Failure?

A

usually results from some form of liver disease

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62
Q

How is Liver Failure recognized?

A
  • failure to clear blood of substances usually eliminated by the liver
  • failure to synthesize substances normally produced by the liver
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63
Q

What are Hepatobiliary Assays designed to measure?

A

enzymes released from damaged hepatocytes
enzymes associated with cholestasis
hepatocyte function tests: measure substances eliminated and produced by liver

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64
Q

What tests are used to test for enzymes released from damaged hepatocytes?

A

ALT
AST
SDH
GLDH

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65
Q

What is ALT?

A

alanine aminotransferase

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66
Q

What species is ALT considered enzyme specific for?

A

dogs
cats
primates

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67
Q

What are other sources of ALT?

A 
RBCs
renal cells
cardiac muscle
skeletal muscle
pancreas
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68
Q

What causes an increased ALT?

A

steroids

anticonvulsants

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69
Q

What is ALT screening used for?

A

liver disease

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70
Q

What is the increase, peak and return to normal time of ALT?

A

increases within 12 hours of damage
peaks within 24-48 hours
returns to normal in weeks

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71
Q

What is AST?

A

aspartate aminotransferase

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72
Q

AST is found in significant amounts where?

A 
RBCs
cardiac muscle
skeletal muscle
kidneys
pancreas
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73
Q

What does an increased AST indicate?

A 
non specific liver disease
strenuous exercise
IM injection
muscle inflammation or necrosis
hemolysis
74
Q

What is SDH?

A

sorbitol dehydrogenase

75
Q

What is GLDH?

A

glutamate dehydrogenase

76
Q

Where are small amounts of SDH and GLDH found?

A

kidneys
small intestine
skeletal muscle
RBCs

77
Q

What are disadvantages of SDH and GLDH?

A

unstable in serum (especially SDH)

tests not readily available in average vet clinics

78
Q

What is Cholestasis?

A

stoppage/suppression of bile flow due to intrahepatic or extrahepatic factors, resulting in regurgitation of biliary substances into blood and jaundice

79
Q

What tests are used for Cholestasis?

A

(AP)(ALP)

GGT

80
Q

What is (AP)(ALP)?

A

alkaline phosphatase

81
Q

(AP)(ALP) is present as an isoenzyme where?

A 
osteoblasts
chondroblasts
intestinal epithelium
placenta
renal epithelium
liver
82
Q

How is (AP)(ALP) determined?

A

electrophoresis

83
Q

What causes an increased AP?

A

osteosarcoma

84
Q

What is the half life of AP?

A

3 days in dogs

6 hours in cats

85
Q

What is GGT?

A

gamma glutamyltransferase

86
Q

Where are the highest concentrations of GGT located?

A

liver
pancreas
kidney

87
Q

Where is GGT also located?

A

mammary glands
intestine
muscle cell

88
Q

What is GGT an excellent indicator for?

A

cholestasis in cattle, sheep and swine

89
Q

What increases GGT?

A

cholestasis

acute hepatocyte injury

90
Q

What do Hepatocyte Function tests test for?

A

levels of substances modified, produced and/or secreted by liver

91
Q

What are the most common/useful Hepatocyte function tests?

A

bilirubin

bile acid tests

92
Q

When will abnormalities show in Hepatocyte Function tests?

A

70%-80% of liver is damaged

93
Q

What Hepatocyte Function tests are rarely performed?

A

dye excretion
ammonia tollerance
caffeine clearance

94
Q

What does Bilirubin test measure?

A

circulating conjugated (direct bilirubin) and unconjugated (indirect bilirubin) bilirubin to pinpoint cause of jaundice

95
Q

What causes an increase in conjugated bilirubin?

A

bile duct injury or obstruction

96
Q

What causes an increase in unconjugated bilirubin?

A

excessive hemolysis
liver disease/failure
decreased albumin

97
Q

What synthesizes bile acids?

A

hepatocytes from CHOL and conjugated with amino acids

98
Q

What % of bile acid is reabsorbed into blood?

A

95%

99
Q

What are potential sources of error when testing bile acid?

A
  • inadequate fasting or spontaneous contraction (increased bile acids)
  • prolonged fasting, diarrhea, GI malabsoption (decrease bile acid)
  • lipemia
100
Q

What are positive aspects of bile acid testing?

A
  • may detect liver problems before c/s manifest
  • good test to follow progress of liver disease treatment
  • ELISA test is now available for in-house use
101
Q

What is Cholesterol?

A

plasma lipoprotein produced primarily in the liver and ingested in food

102
Q

What does Cholestasis do to cholesterol?

A

increases in some species because bile is a major route of CHOL excretion from the body

103
Q

What can CHOL be used as a screening test for?

A

What can CHOL be used as a screening test for?

104
Q

What hormone controls synthesis and removal of CHOL from the body?

A

thyroid hormone

105
Q

What are other diseases associated with Hypercholesterolemia?

A

hyperadrenocorticism (cushing’s)
diabetes mellitus
nephrotic syndrome

106
Q

What are the key functions of the kidneys?

A
  • conserve or eliminate water and electrolytes in times of imbalance
  • maintain normal blood pH by excretion or conservation of hydrogen ions
  • remove end products of protein metabolism
  • production of : rennin, EPO, prostaglandins
  • aid in activation of vitamin D
107
Q

What can be analyzed to evaluate kidney function?

A

blood

urine

108
Q

What is BUN?

A

blood urea nitrogen

109
Q

What are the Renal Assays?

A

BUN
CREA
BUN/CREATININE RATIO

110
Q

What is BUN a end product of?

A

amino acid catabolism

111
Q

What causes an increase in BUN?

A

when kidneys dont remove sufficent urea

112
Q

What is Azotemia?

A

increased urea in circulation

113
Q

What are causes of Azotemia?

A

alteration in blood flow through kidneys
urinary tract obstruction
dehydration
strenous excercise

114
Q

What can affect BUN?

A

differences in rates of protein catabolism between males/females, younger/older animals, different species, and nutritonal status

115
Q

What is the most accurate test for BUN?

A

photometric (vet test)

116
Q

What is the least accurate tests for BUN?

A

chromatographic

117
Q

What is CREA?

A

creatinine

118
Q

What produces CREA?

A

formed from phosphocreatinine, a product of muscle metabolism that diffuses out of muscle cells into the blood

119
Q

What is CREA proportionate to?

A

muscle mass; blood level should be constant

120
Q

Where is CREA filtered?

A

through glomeruli

eliminated through the urine

121
Q

What does CREA test?

A

glomerular function

122
Q

What causes an increase in CREA?

A

lack of functional glomeruli

123
Q

What is CREA also influenced by?

A

shock

bladder or urethral obstruction

124
Q

What do disproportionate increases in BUN indicative of?

A

dehydration

125
Q

What are other tests used to test kidney function?

A
  • creatinine clearance tests (exo or endo)
  • single injection inulin clearance (GF only)
  • sodium sulfinilate (GF only)
  • dye clearance (renal tubules)
  • water deprivation tests
  • vasopressin response
126
Q

When is a Water Deprivation test used?

A

when PU/PD can’t be explained

127
Q

What are contraindications of Water Deprivation tests?

A

dehydrated patient

azotemia

128
Q

Most Pancreatic disturbances involve what?

A

exocrine function

129
Q

What is the most common endocrine disturbance (Pancreatic)?

A

diabetes mellitus

130
Q

What is the most common exocrine disturbance (Pancreatic)?

A

pancreatitis

131
Q

Trauma or disease of the pancreas results in…

A

inflammation of pancreatic duct or cellular damage and leads to

  • leakage or backup of digestive enzymes
  • insufficent production of enzymes
132
Q

What are the primary pancreatic enzymes?

A

amylase
lipase
trypsin

133
Q

What is Acute Pancreatitis?

A

autodigestion of pancreas occurs when pancreatic enzymes are prematurely activated in the pancreas

134
Q

What are causes of Acute Pancreatitis?

A 
trauma
hyperlipidemia
hypercalcemia
exposure to toxins
idiopathic
135
Q

What is Chronic Pancreatitis?

A

acute event must occur first

damaged pancreatic cells are replaced with tissue that cannot produce enzymes

136
Q

What are the Exocrine Pancreatic Assays?

A 
amylase
lipase
trypsin
trypsin-like immunoreactivity
pancreatic lipase immunoreactivity
137
Q

Where is Amylase produced?

A

small intestine

salivary glands

138
Q

What does Amylase break down?

A

glucose into starch

139
Q

Increased serum amylase and lipase usually =?

A

pancreatic disease

140
Q

What is diagnostic for pancreatitis?

A

3 fold increase in lipase and amylase

141
Q

What are causes of increased amylase levels?

A
  • enteritis
  • intestinal obsruction
  • intestinal perforation
  • anything that causes a decrease in GF rate
142
Q

What is used to test Amylase?

A

photometric

utilizes starch as substrate

143
Q

What may decrease amylase activity?

A

lipemia

144
Q

Why should EDTA not be used as an anticoagulant?

A

amylase activity requires calcium

145
Q

What is the function of Lipase?

A

break down fatty acids and lipids

146
Q

What filters Lipase?

A

kidneys

levels remain normal in early stages of pancreatic disease

147
Q

What are other causes of increased Lipase levels?

A

renal dysfunction
hepatic dysfunction
steroids

148
Q

What is used to test Lipase?

A

hydrolysis of olive oil in fatty acids

CPL (canine pancreatic lipase) snap test

149
Q

What is Trypsin?

A

proteolytic enzyme that breaks down proteins into amino acids

150
Q

Where is Trypsin more easily detected?

A

feces

151
Q

What are the 2 methods of testing Trypsin?

A

test tube method

x ray film test

152
Q

What is the Test Tube Method?

A

mix fresh feces with gelatin solution. wait… if 1. gel forms then NO trypsin (bad) 2. if no gel forms then trypsin present (good)

153
Q

What is the X Ray Film Test?

A

place undeveloped strip of xray film in slurry of fresh feces. wait… if emulsion layer is removed, film will appear clear = trypsin present. if film remains unchanged, looks cloudy green/lavender, no trypsin

154
Q

What is TLI?

A

trypsin-like immunoreactivity

155
Q

Increased trypsinogen leaking into blood + circulating active trypsin=?

A

pancreatitis

156
Q

What clears TLI?

A

kidneys and proteinase inhibitors

157
Q

What is PLI?

A

pancreatic lipase immunoreactivity

158
Q

What does PLI measure?

A

only lipase activity of pancreas

not affected by decreased GFR or gastritis

159
Q

What are the 4 types of islet cells of the pancreas?

A

alpha
beta
delta
PP

160
Q

Alpha

A

20% of cells

glucagon and somatostatin

161
Q

Beta

A

80% of cells

insulin

162
Q

Delta

A

1%

somatostatin

163
Q

PP

A

1%

pancreatic polypeptide

164
Q

What are the Endocrine Pancreatic Assays?

A

Glucose
Fructosamine
Glucose Tolerance Test
Insulin Tolerance Test

165
Q

What is Hyperglycemia favored by?

A

glucagon, epinephrine, thyroxine, glucocorticoids, growth hormone

166
Q

What is the hypoglycemic hormone?

A

insulin

167
Q

What are the functions of Insulin?

A

encourages entry of glucose into cells/tissues for use

prevents exceeding the renal threshhold for glucose

168
Q

What is the prefered anticoagulant for Glucose testing?

A

sodium fluoride

169
Q

What is Fructosamine?

A

represents irreversable reaction of glucose bound to albumin

170
Q

What causes an increase of Fructosamine?

A

persistant hyperglycemia (1-3 wks)

171
Q

What test is used to confirm diagnosis of Diabetes Mellitus?

A

fructosamine

172
Q

What can a Glucose Tolerance Test rule out?

A

diabetes mellitus

173
Q

What is the procedure for the Glucose Tolerance Test?

A
  1. animal is fasted for 12 hours
  2. glucose administered IV
  3. measure blood/glucose at timed intervals and mapped as tolerance curve
174
Q

What is the Insulin Tolerance Test?

A

checks responsiveness of target cells to challenge with IM or SC short acting insulin

175
Q

What is the Insulin Tolerance Test used for?

A

determine appropriate insulin dose and monitor insulin therapy in diabetic animals

176
Q

What is the procedure for the Insulin Tolerance Test?

A
  1. serum glucose is measured in a fasted animal prior to insulin injection (fasting blood glucose)
    - feed animal before injection
  2. every 30 minutes after injection, blood glucose is measured for 3 hrs and mapped as glucose curve
177
Q

What can the Insulin Tolerance Test cause?

A

hypoglycemia

178
Q

What does Gulcagon Tolerance asses?

A

hyperinsulinism

179
Q

What is Hyperinsulinism usually caused by?

A

pancreatic cell tumor

180
Q

What is the procedure for the Glucagon Tolerance test?

A

initial sample is taken prior to injection of glucagon. timed samples are taken 1, 3, 5, 15, 30,45,60 and 120 minutes after injection

181
Q

What does the Insulin/Glucose Ratio test asses?

A

hyperinsulinism

Clin Path (8 decks)

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