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
Q

pigments (liver)

A

bilirubin from red blood cells and hemoglobin

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26
Q

liver tests

A

enzyme leakage tests: ALT/AST
cholestatic tests: ALP/GGT
other: bilirubin, albumin/globulin/A:G ratio, fibrinogen, bile acids, ammonia, cholesterol

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27
Q

ALT test

A

liver enzyme leakage test
alanine aminotransferase
liver specific
tests for heptocellular damage on dogs, cats, primates

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28
Q

what was ALT formerly known as?

A

serum glutamate pyruvate transaminase (SGPT)

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29
Q

AST test

A

liver enzyme leakage test
aspartate aminotransferase
not liver specific
increased AST = some type of liver or muscle damage

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30
Q

what was AST formerly known as?

A

serum glutamine oxaloacetate transaminase (SGOT)

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31
Q

GD or GLDH

A

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

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32
Q

creatine kinase (CK) or creatine phosphokinase (CPK)

A

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

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33
Q

cholestasis

A

interruption or obstruction of bile flow or excretion
intrahepatic: tumors, carcinoma, infection, leptospirosis
extrahepatic: pancreatitis, gallstones
CS: juandice, polydipsia, colic, anemia, diarrhea

34
Q

ALP or ALKP test

A

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
Q

GGT

A

cholestatic test
gamma glutamyl transferase
liver specific
excellent for horses, ruminants, swine, not dogs/cats
preferred for birds

36
Q

bilirubin

A

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
Q

what do the different types of elevated bilirubin levels mean?

A

elevated total or unconjugated bilirubin (indirect) = hemolysis or cirrhosis
elevated direct (conjugated) bilirubin = bile stasis such as gallstones or tumors

38
Q

what causes jaundice?

A

intravascular hemolysis and will see a decrease in PCV

39
Q

what are the major proteins made by the liver?

A

albumin and globulins

40
Q

what organ is the major site of protein synthesis?

A

liver

41
Q

what percentage of total protein is made up of albumin?

A

35-50%

42
Q

what are the different types of globulins and what role do they play?

A

alpha globulin: blood clotting
beta globulin: hormone transport
gamma globulin: antibodies
globulins are responsible for binding and transporting proteins

43
Q

A:G ratio

A

albumin:globulin
provides early indication of abnormal protein profile
dogs, horses, sheep: A:G > 1
cattle, pigs, cats: A:G < 1

44
Q

how is fibrinogen synthesized?

A

by hepatocytes (liver)

45
Q

fibrinogen

A

factor necessary for clotting
precursor of fibrin (protein of clots)
increased fibrinogen levels = acute inflammation or tissue damage

46
Q

enterohepatic recirculation

A

bile transported from intestines to liver via the portal vein to the hepatocytes and and re-secreted
creates efficient digestion

47
Q

how many times are bile acids re-circulated after each meal?

A

they are re-circulated 3-5x after every meal

48
Q

how are bile acid levels effected by liver function impairment and cholestasis?

A

it increases the bile acid levels

49
Q

CS of decreased bile acids

A

prolonged fasting, malabsorption, diarrhea

50
Q

how should dogs and cats be prepped for bile acid sampling?

A

fasting and taking 2 hour postprandial (after a meal) samples

51
Q

how many bile acid samples are taken for horses?

A

1 sample because they don’t have a gallbladder

52
Q

what animals are bile acids not effective in?

A

ruminants

53
Q

endocrine function of the pancreas

A

1% of pancreatic tissue
produces insulin and glucagon

54
Q

exocrine function of the pancreas

A

99% of pancreatic tissue
produces digestive enzymes (amylase, lipase, trypsin)
bicarbonate secretion to neutralize gastric acids

55
Q

pancreatitis

A

most common pancreatic dysfunction with higher incidence in dogs

56
Q

when does glycosuria occur?

A

when glucose level is above what the kidney can filter out

57
Q

what results are seen with diabetes mellitus diagnosises?

A

glycosuria and hyperglycemia

58
Q

how is urine glucose tested?

A

with urine strips

59
Q

blood glucose

A

measure of carbohydrate metabolism and endocrine functions of the pancreas

60
Q

what is hyperglycemia seen with?

A

diabetes mellitus, stress, Cushing’s, corticosteroids

61
Q

what is hypoglycemia seen with?

A

liver disease, malabsorption of nutrients, poor sample handling

62
Q

sample handling for blood glucose

A

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
Q

amylase

A

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
Q

lipase

A

exocrine enzyme that creates breakdown of fatty acids and lipids
increased values = pancreatitis, renal failure, Cushing’s

65
Q

TLI

A

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
Q

PLI

A

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
Q

thyroid function

A

regulates production of Triiodothyronine (T3), Thyroxine (T4), and Calcitonin
serum separator tube not recommended because gel can trap large thyroxine molecules

68
Q

Triiodothyronine (T3) hormone

A

active form of hormone responsible for metabolism and growth

69
Q

Thyroxine (T4) hormone

A

storage form of the hormone responsible for metabolism and growth

70
Q

Calcitonin

A

regulates Ca:Phos levels
released when blood Ca levels are too high

71
Q

Thyroxine (T4) test

A

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
Q

free T4 by dialysis

A

measures T4 not bound to protein
detects feline hyperthyroidism
less sensitive to meds or disease processes than T4

73
Q

hypothyroidism

A

common in dogs and iatrogenic in cats after hyperthyroid treatment
results that indicate: increased TSH, decreases total T4, and decreased free T4

74
Q

cTSH

A

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
Q

electrolyte functions

A

substances in blood that carry electrical charges
they maintain water balance, osmotic pressure, normal muscular and nervous functions

76
Q

sodium (Na+)

A

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
Q

potassium (K+)

A

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
Q

calcium (Ca+)

A

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
Q

cholesterol

A

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
Q

triglycerides

A

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