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Chemistries Flashcards

1
Q

basic function tests

A

hepatic function test, renal function test, thyroid function test, electrolyte function test

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2
Q

what are the basic panels done for each function test?

A

hepatic: albumin/globulin, alk phos, ALT, AST, GGT, total bilirubin, bile acids, fibrinogen
renal: BUN, creatine
thyroid: T4, T3, TSH, free T4
electrolytes: potassium, calcium, sodium

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3
Q

what to do before collecting a sample for chemistries?

A

get patient history (fasting, meds, etc), know which samples are needed

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4
Q

which anticoagulant should be used for sample collection of chemistries?

A

heparin plasma, lithium heparin
no EDTA

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5
Q

what should be done with the chemistry sample after collecting?

A

centrifuge right away
serum can be kept in the fridge or freezer but make sure it returns to room temp before using

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6
Q

what tests can dehydration effect the results of?

A

serum or plasma protein, PCV, BUN, urine specific gravity

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7
Q

what effect can the quality of serum/plasma have on the test results?

A

quality of serum/plasma can cause a false increase in values

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8
Q

icterus serum/plasma

A

normal for some species
or can be caused by liver disease or hemolysis

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9
Q

hemolysis serum/plasma

A

usually from handling

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10
Q

lipemia serum/plasma

A

increased lipids (triglycerides) from metabolic disease, diet, or lack of fasting

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11
Q

advantages and disadvantages of in-house analyzers for chemistries

A

advantages: will get results sooner
disadvantages: sending out can save money, might not have enough staffing that can do chemistries

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12
Q

Abaxis VetScan for chemistries

A

uses rotors/cartridges
panels/profiles can’t be customized
step-by-step interface
rotors are expensive

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13
Q

Idexx Catalyst One for chemistries

A

variety of profiles
uses plastic clips or individual slides
can be customized
no direct interface
expensive

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14
Q

Idexx VetTest for chemistries

A

variety of profiles
can be customized
interface walks you through the steps
slides are less expensive

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15
Q

Abaxis 1-Stat for chemistries

A

small and portable: used for mobile procedures and fieldwork
multiple profiles are available
uses cartridges
small samples
2 minute results
not customizable
requires software updates

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16
Q

kidney function

A

conserve/eliminate water, electrolytes, nutrients, and remove ammonia waste (urea and creatinine)

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17
Q

blood urea nitrogen

A

principal waste product of protein metabolism

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18
Q

creatinine

A

muscle waste product

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19
Q

increased BUN and creatinine

A

azotemia

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20
Q

what is the normal kidney function in terms of BUN and creatinine removal?

A

BUN and creatinine are primarily cleared by the kidneys through glomerular filtration and excreted in urine with minimal tubule reabsorption

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21
Q

SDMA

A

symmetric dimethylarginine glomerular filtration
Idexx test
not affected by muscle breakdown
can detect from 40-25% renal dysfunction

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22
Q

uric acid

A

like a paste, not more soluble than BUN
preferred indicator of kidney function in birds/reptiles as well as Dalmatians
Dalmatians have decreased conversion to allantoin (oxidized uric acid) which is more water soluble than urea so they excrete uric acid

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23
Q

liver function

A

metabolism of amino acids/carbs/lipids, synthesis of albumin/cholesterol/clotting factors, digestion and absorption of nutrients related to bile formation, secretion of bile and pigments, elimination of toxins and catabolism of drugs

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24
Q

bile

A

emulsification of fat
absorbs fatty acids and vitamins

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25
pigments (liver)
bilirubin from red blood cells and hemoglobin
26
liver tests
enzyme leakage tests: ALT/AST cholestatic tests: ALP/GGT other: bilirubin, albumin/globulin/A:G ratio, fibrinogen, bile acids, ammonia, cholesterol
27
ALT test
liver enzyme leakage test alanine aminotransferase liver specific tests for heptocellular damage on dogs, cats, primates
28
what was ALT formerly known as?
serum glutamate pyruvate transaminase (SGPT)
29
AST test
liver enzyme leakage test aspartate aminotransferase not liver specific increased AST = some type of liver or muscle damage
30
what was AST formerly known as?
serum glutamine oxaloacetate transaminase (SGOT)
31
GD or GLDH
glutamine dehydrogenase interface between carbohydrate and amino acid metabolism highly concentrated in large animal and bird livers levels return to normal 24 hours after eating
32
creatine kinase (CK) or creatine phosphokinase (CPK)
specific for muscle damage can't tell you which muscle is damaged elevation of AST and/or ALT with normal CPK levels suggest hepatocellular injury but could be prior muscle injury and CPK has already returned to normal
33
cholestasis
interruption or obstruction of bile flow or excretion intrahepatic: tumors, carcinoma, infection, leptospirosis extrahepatic: pancreatitis, gallstones CS: juandice, polydipsia, colic, anemia, diarrhea
34
ALP or ALKP test
cholestatic test alkaline phosphate not liver specific for dogs and cats, not large animal elevated ALKP seen in cancer, arthritis, or bone formation in young animals
35
GGT
cholestatic test gamma glutamyl transferase liver specific excellent for horses, ruminants, swine, not dogs/cats preferred for birds
36
bilirubin
waste product of red blood cell breakdown hemoglobin breaks down into bilirubin breaks down into unconjugated insoluble bilirubin liver conjugates with sugars to create a soluble form (conjugated or direct) bilirubin is excreted in bile which becomes urobilinogen in intestines and is excreted in urine/feces
37
what do the different types of elevated bilirubin levels mean?
elevated total or unconjugated bilirubin (indirect) = hemolysis or cirrhosis elevated direct (conjugated) bilirubin = bile stasis such as gallstones or tumors
38
what causes jaundice?
intravascular hemolysis and will see a decrease in PCV
39
what are the major proteins made by the liver?
albumin and globulins
40
what organ is the major site of protein synthesis?
liver
41
what percentage of total protein is made up of albumin?
35-50%
42
what are the different types of globulins and what role do they play?
alpha globulin: blood clotting beta globulin: hormone transport gamma globulin: antibodies globulins are responsible for binding and transporting proteins
43
A:G ratio
albumin:globulin provides early indication of abnormal protein profile dogs, horses, sheep: A:G > 1 cattle, pigs, cats: A:G < 1
44
how is fibrinogen synthesized?
by hepatocytes (liver)
45
fibrinogen
factor necessary for clotting precursor of fibrin (protein of clots) increased fibrinogen levels = acute inflammation or tissue damage
46
enterohepatic recirculation
bile transported from intestines to liver via the portal vein to the hepatocytes and and re-secreted creates efficient digestion
47
how many times are bile acids re-circulated after each meal?
they are re-circulated 3-5x after every meal
48
how are bile acid levels effected by liver function impairment and cholestasis?
it increases the bile acid levels
49
CS of decreased bile acids
prolonged fasting, malabsorption, diarrhea
50
how should dogs and cats be prepped for bile acid sampling?
fasting and taking 2 hour postprandial (after a meal) samples
51
how many bile acid samples are taken for horses?
1 sample because they don't have a gallbladder
52
what animals are bile acids not effective in?
ruminants
53
endocrine function of the pancreas
1% of pancreatic tissue produces insulin and glucagon
54
exocrine function of the pancreas
99% of pancreatic tissue produces digestive enzymes (amylase, lipase, trypsin) bicarbonate secretion to neutralize gastric acids
55
pancreatitis
most common pancreatic dysfunction with higher incidence in dogs
56
when does glycosuria occur?
when glucose level is above what the kidney can filter out
57
what results are seen with diabetes mellitus diagnosises?
glycosuria and hyperglycemia
58
how is urine glucose tested?
with urine strips
59
blood glucose
measure of carbohydrate metabolism and endocrine functions of the pancreas
60
what is hyperglycemia seen with?
diabetes mellitus, stress, Cushing's, corticosteroids
61
what is hypoglycemia seen with?
liver disease, malabsorption of nutrients, poor sample handling
62
sample handling for blood glucose
blood cells continue to metabolize glucose glucose in tubes (falsely negative results) run on glucometer immediately dogs and cats should fast 8-12 hours don't fast ruminants
63
amylase
exocrine enzyme that creates breakdown of starch to glucose increased values = acute/chronic/obstructive pancreatitis, hyperadrenocorticism, liver disease, non-fasted animals, GI inflammation/obstruction, renal failure hemolysis can also elevate values
64
lipase
exocrine enzyme that creates breakdown of fatty acids and lipids increased values = pancreatitis, renal failure, Cushing's
65
TLI
serum tryspin-like immunoreactivity radioimmunoassay that measures trypsinogen and trypsin-like reactivity in the blood trypsin: breaks down proteins TLI increases after eating so patients need to fast for 12 hours increased values = pancreatitis, not fasted
66
PLI
pancreatic lipase immunoreactivity lipase produced by pancreas test is specific for pancreas reference lab or in-house ELISA test is done increased values = pancreatitis
67
thyroid function
regulates production of Triiodothyronine (T3), Thyroxine (T4), and Calcitonin serum separator tube not recommended because gel can trap large thyroxine molecules
68
Triiodothyronine (T3) hormone
active form of hormone responsible for metabolism and growth
69
Thyroxine (T4) hormone
storage form of the hormone responsible for metabolism and growth
70
Calcitonin
regulates Ca:Phos levels released when blood Ca levels are too high
71
Thyroxine (T4) test
baseline measure of resting thyroid hormone concentration tests for presence of hyperthyroidism/hypothyroidism single low or high results doesn't indicate disease because values can fluctuate and T4 can be affected by other diseases/drugs
72
free T4 by dialysis
measures T4 not bound to protein detects feline hyperthyroidism less sensitive to meds or disease processes than T4
73
hypothyroidism
common in dogs and iatrogenic in cats after hyperthyroid treatment results that indicate: increased TSH, decreases total T4, and decreased free T4
74
cTSH
canine thyroid stimulating hormone stimulates synthesis of thyroid hormones measured with free T4 test (more accuracy in diagnosing hyperthyroidism, FT4 will be decreased and cTSH will be increased)
75
electrolyte functions
substances in blood that carry electrical charges they maintain water balance, osmotic pressure, normal muscular and nervous functions
76
sodium (Na+)
roles: water distribution, maintenance of osmotic pressure of body fluids, urine pH regulation, acid-base balance hyponatremia is a symptom of renal failure, vomiting/diarrhea, diuretics, CHF, overhydration false positive can occur when collected in Heparin
77
potassium (K+)
roles: muscle function, respiration, cardiac function, nerve impulse transmission hyperkalemia is a symptom of late stage renal failure, cellular damage/necrosis hypokalemia is a symptom of fluid loss from diuretics, vomiting, diarrhea
78
calcium (Ca+)
99% is in bone, 1% controls muscle contractions, blood coagulation, nerve impulses, cell membrane/capillary permeability inverse relationship with phosphorus regulated by parathyroid hormone binds with albumin hypercalcemia = parathyroid issues hypocalcemia = eclampsia
79
cholesterol
synthesized in liver found in animal fats in diet increased values = hypothyroidism, diabetes mellitus, liver disease, bile duct obstruction, pregnancy, hyperadrenocorticism decreased values = end life stage liver disease
80
triglycerides
most abundant fat found in the body responsible for lipemic samples increased values = recent fatty meal, impaired fat metabolism, intestinal disease hyperlipidemia can be both the cause and result of acute pancreatitis 12 hour fasting sample preferred

Clinical Pathology (15 decks)

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