Clin Lab Final review Flashcards
Whole blood is comprised of ___ and ___
Fluid and cells
The fluid component of blood is comprised of _____
Plasma
The cellular component is comprised of ____, ____, and ____
RBCs, WBCs, platelets
If it is a heparin plasma sample that has been stored overnight in the refrigerator it should be _____to remove any possible _____
respun to remove fibrin strands
Plasma from which fibrinogen has been removed
Serum
During clotting process, soluble fibrinogen is plasma is converted to what?
An insoluble fibrin clot
Used to run chemical assays
Anticoagulated blood (plasma)
Serum
What is the preferred anticoagulant for chemistry tests?
Heparin
May cause falsely increased inorganic phosphate levels in the blood
Heparin
May interfere with lactate dehydrogenase activity
Heparin
Should not be used if plasma samples are needed for chemistries
EDTA
Interferes with color development in some alkaline phosphate tests
EDTA
Binds metallic ions that may be necessary for enzyme activity, and binds calcium unavailable for assays
EDTA
Alters the makeup of serum/plasma
Hemolysis
Assays should be done ideally within ____ hr(s)
1 hours
Total Protein, Albumin, Globulin, Albumin/Globulin Ratio, Fibrinogen are all examples of _____ assays
Protein assays
Help form cells, organ, tissues, maintain osmotic pressure, act as buffers in acid-base balance, serve as hormons, function in blood coagulation, defend body against pathogenic microorganisms
Functions of Plasma in the body
Serve as transport/carrier molecules for most constituents of plasma
Function of protein in the body
Total plamsa protein include _____
Fibrinogen
Total serum proteins do not include _____
Fibrinogen
Total protein may be affected by alatered hepatic synthesis, altered protein distribution, breakdown/excretion, and _____ or _____
Dehydration or overhydration
Dehydration causes _____ total protein concentration
elevated
Overhydration causes ______ total protein concentration
Decreased
What are two methods in measuring TP?
Refractrometer, Biuret
Important protein in plasma/serum
Albumin
Makes up 35-50% of total plasma protein
Albumin
Responsible for maintaining osmotic pressure of plasma
Albumin
Albumin is made by ____
Hepatocytes
What may cause decrease in albumin synthesis
Liver disease, renal disease, dietary intake, intestinal protein absorption
What may increase albumin levels?
Hemolysis
Globulin estimate is equal to the difference between what?
TP and albumin
Complex group of proteins made in the liver
Globulins
Primarily transport and bind proteins
Globulin
Make up 3-6% of the total plasma protein made by hepatocytes
*Important in horses
Fibrinogen
Elevated by acute inflammatory/tissue damage
Plasma fibrinogen
There is no fibrinogen in ____
Serum
What are the 4 most common liver assays?
Alanine/Aspartate Aminotransferase
Sorbitol/Glutamate Dehydrogenase
Species in which hepatocytes are a major source of ALT
Dogs, cats, primates
In horses, ruminants, pigs, and birds hepatocytes do not contain enough ____ and are not a good indicator of disease
ALT
Renal cells, cardiac cells, skeletal muscles and pancreas are all sources for ____
ALT
Most accurate indicator of liver disease in small animals
Alanine Aminotransferase (ALT)
True or false, ALT is specific enough to identify specific liver disease
False
Hemolysis and lipemia can artifically ______ ALT levels
Increase
Only found in cases of severe liver disease
Aspartate Aminotransferase (AST)
AST is found where?
RBC, cardiac muscles, skeletal muscles, kidneys, and pancreas
Liver disease, hemolysis, strenuous exercise and IM injection may all result in elevated ___
AST
Primary source of Sorbitol Dehydrogenase (SDH)
Liver cells
Useful in determining liver damage in large animals
SDH
SDH is unstable in ____
Serum
Plasma level of SDH rise with _____ damage/necrosis
Hepatocellular
Liver specific in all species
Glutamate Dehydrogenase (GLDH)
GLDH has increased concentration in what species hepatocytes
cattle, sheep, and goat
Ideal choice for measuring liver function in large animals and exotics
GLDH
Sensitive and specific indicator of liver disease
GLDH
Increased levels of GLDH indicate _____ damage and necrosis
Liver damage
Alkaline Phosphatase and GGT are enzymes associated with _____
Cholestasis
Isoenzyme present in cells within hepatobiliary system, osteoblasts, and chondroblasts
Alkaline Phosphatase (AP, ALKP)
Most often used to detect Cholesasis in dogs and cats
Alkaline Phosphatase
Primary source of GGT or GT
Liver
Higher levels of ____ are found in cattle, horses, sheep, and goats
GGT
Elevated levels are seen in liver disease, especially obstructive liver disease
GGT
Bile Acid tests are more specific _____ function test
liver function
Bile acids have a _______ function
Hepatobiliary
Bile acid is made from _____ in the liver cells
Cholesterol
Bile acids are stored in the _____ until they move into the duodenum and aid in fat storage
gall bladder
Serum level is normally low in ____ ____
Bile acids
Liver removes 75-90%
Bile acids
Hemolysis and lipemia may falsely _____ bile acid measurements
Decrease
Elevated bile acids may indicate what?
Chronic hepatitis, cirrhosis, cholestasis, neoplasms
Considered a waste material, carried to liver bound to albumin
Bilirubin (TBIL)
Bilirubin is insoluble in water until taken to ____
liver
Bilirubin becomes water soluble after being conjugated with _____
sugars
Sensitive to light and must be stored in the dark
Bilirubin
Plasma lipoprotein produced primarily in the liver as well as ingested food
Cholesterol
Seen in inherited diseases, diabetes mellitus, hypothyroidism, cholestais and in the case of some drugs.
Hypercholesterolemia
Abnormally low cholesterol values could be due to decreased absorption, production and altered _____
metabolism
BUN, serum creatinine, urine protein/ creatinine ratio and SDMA are all ____ assays
Kidney assays
Used to evaluate kidney function based on its ability to remove nitrogenous wase from blood
BUN
This test is not very sensitive and only detects kidney failure at 75%
BUN and Creatinine
When the kidney is not functioning properly, ____ is not being removed
Urea
______ _____ diets may increase BUN
High protein diets
BUN may also be elevated due to ________
Dehydration
Diffuses out of muscle cell and into body fluids
Creatinine
Creatinine is eliminated in _____
Urine
Used to evaluate renal function
Creatinine
Azotemia is when BUN and creatinine are _____
Elevated
Measures urinary protein loss
Urine protein/Creatinine ratio
Used to screen for early renal disease, monitor the course of renal disease, and assess therapeutic response
Urine protein/creatinine
In healthy dogs, the protein/creatinine ratio should be ___
Less than 1
Ratio indicating pre renal or functional origin
1-5
Ratio that indicates renal disease
>5
Protein/Creatinine ratio may be falsely elevated due to what?
Fever, exercise, change in temperature
Methylated arginine amino acid
SDMA (Symmetric dimethylarginine)
SDMA is excreted by _____
kidneys
SDMA is specific for kidney disease and increases earlier than creatnine allowing detection as early as ____% loss to ____ % loss
25%-40% loss
As ____ decreases, SDMA increases
GFR
True or false, SDMA is NOT affected by other non-kidney diseases
True
Lean muscle mass impacts creatinine but not ____
SDMA
Reduced urine SG typically occurs when there is on average a _____ loss of GFR
67%
Trypsin, Amylase, Lipase are all ____ assays
Pancreas assay
Proteolytic enzyme
Trypsin
Trypsin is more readily detected in ___ than in blood
Feces
True of false, absence of trypsin in feces is abnormal
True
Two fecal tests used for Trypsin
Test tube method utilizing Knox Gelatin
X-Ray Film Test
Using the test tube method, failure to gel indicates _____
presence of trypsin
Primary source for Amylase
Pancreas (exocrine)
Increased levels of ______ indicate acute pancreatitis, flare ups of chronic pancreatitis, and obstruction of pancreatic ducts
Amylase
Primary source of Lipase
Pancreas (exocrine)
Functions to break down long chain fatty acids of lipids
Lipase
Lipase assays are more sensitive to pancreatitis than ____
amylase
Other pancreas tests include endocrine function of ____ and ____
Glucose and Fructosamine
Utilization of glucose depends on the amount of ____ and ____ produced by the pancreas
insulin and glucagon
For glucose tests what should be separated from serum/plasma immediately after collection
RBCs
What happens if plasma is left in contact with RBCs at room temperature?
Glucose levels may drop 10%/hr
What pancreas test is not effected by hemolysis
Glucose
More specific indicator of pancreatic endocrine activity than glucose
Fructosamine
