Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Hematology > Clinical Chemistry > Flashcards

Clinical Chemistry Flashcards

1
Q

What are Reference ranges

A

normal values

reference ranges established by measuring the laboratory parameters in a group of normal animals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the anatomy of the liver

A

receives nutrient blood hepatic artery- (20%) blood supply
80%-hepatic portal vein from- stomach, intestines, pancreas, spleen
blood leaves the liver- HEPATIC VEIN –> Caudal VENA CAVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the portal triad

A

hepatic a., portal v. –> blood flow toward central v

bile duct–> bile flows in opposite direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the function of the liver

A

metabolism of fats, carbohydrates, and protein
Stores Glucose as glycogen
Production of albumin and other plasma proteins
Detoxification ( drugs, ammonia)– urea
Bile Metabolism –excretion of bilirubin
Produces Coagulation Factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why would an animal be jaundice if his liver wasn’t working

A

His body cannot reabsorb the bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why wound an animal have hypoalbuminemia if his liver wasn’t working

A

Because the liver isn’t producing albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why would the animal have problems with hemostasis if his liver wasn’t working

A

The liver isn’t producing the clotting factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why would the animal have hypoglycemia if his liver wasn’t working

A

There are glucose stores in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why would the animal have Hyperlipoproteinemia if his liver wasn’t working

A

Due to the lack of metabolism of proteins and fats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why would the animal have hepatoencephalopathy if his liver wasn’t working

A

Because the ammonia isn’t being filtered out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

At what point in liver damage does clinical signs occur

A

Usually liver disease is greatly progressed before clinical signs appear ( 80%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 3 types of tests used to evaluate the liver for damage

A

Enzymes released by damaged hepatocytes = leakage enzymes

Enzymes Associated with Cholestasis

Hepatic function tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the Enzymes released by damaged hepatocytes

A

Alanine Aminotransferase ALT (SGPT)

Aspatate Aminotransferase AST (SGOT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What tests are used to find enzymes released by damaged hepatocytes

A

Sorbitol (Iditol) Dehydrogenase SDH

Glutamate Dehydrogenase GLDH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Cholestasis

A

obstruction of flow of bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the enzymes associated with cholestasis

A

Alkaline Phosphatase ALK

Gamma glutamyl transpeptidase GGT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the four hepatocyte function tests

A

Bilirubin
Bile Acids
Dye excretion
Bile Acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the significance of ALT in cats and dogs

A

In Dogs Cats, primates, hepatocyte is major source  Considered liver specific in these species

It is considered a screening test for liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can cause a false positive increase in ALT in cats and dogs

A

There will be a Mild increase  in feline hyperthyroidism + steroid therapy + anticonvulsant tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is specific about ALT in horse, ruminant, pig, bird

A

it is not clinically significant as a marker for liver function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When are elevations seen in ALT

A

elevations seen w/n 12 hours of liver hepatocyte damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When do elevations of ALT return to normal

A

in 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the significance of elevated AST in cats and dogs

A

Enzyme is in the mitochondria thus more severe liver damage required to elevate it

AST also found in muscle tissue- cardiac+ skeletal + RBCs- rise after strenuous exercise, or muscle damage as well as hemolysis will cause an elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When do AST levels return to normal

A

Rise more slowly and return to normal w/n a day (short half life)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How do you distinguish if AST levels are from muscle or liver damage

A

Increase in AST but normal ALT = muscle damage

CK will rise only with muscle damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is CK

A

Creatinine Kinase is an enzyme that is in muscle tissue, but not in liver. skeletal muscle, and cardiac muscle damage
CK is frequently assayed if an animal has an elevated blood AST level but shows no clinical signs of liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What causes CK elevations

A

from intramuscular injections,
persistent recumbency, surgery,
vigorous exercise, electric shock, laceration, bruising, and hypothermia. Myositis and other myopathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When is CK included on a biochem profile

A

In horses or Cows to screen for liver damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is Sorbitol (Iditol) Dehydrogenase

A

Primarily found in hepatocyte
Shows liver damage in large animals ( ALT NOT USEFUL)
Can be use in all species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is special about testing Sorbitol Dehydrogenase

A

Unstable in serum- samples have to be frozen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is AP/ALK

A

Found In Liver, osteoblast (BONE)
corticosteroid induces an isoenzyme of AP
Young animals - elevated AP due to - bone development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is AP/ALK used to determine

A

Used to detect cholestasis in dog and cat
Will see elevations with cushings b/c of x/s cortisol
Very significant in cat
Not useful in large animals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do you determine Indirect Bilirubin amount

A

Usu 2/3 of the Total Bilirubin

see ↑ liver problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What happens to direct bilirubin in cholestasis

A

↑ with actual biliary obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are bile acids

A

Synthesized in the hepatocyte from cholesterol and glycine or taurine
Secreted in the bile duct for fat digestion
95% actively reabsorbed from the ileum back into the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What do you do if you see elevated SBA

A

—> serum BA are usually very low.

Elevated SBA- screen for liver function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How do you test for elevated bile acids

A

Need 2 blood samples 1- fasting + 2 hour post prandial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is a portosystemic shunt

A

Often congenital

ductus venosus fails to collapse at birth  this allows blood to bypass or shunt around the liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the clinical signs of a portosystemic shunt

A

clinical signs include “stunted” growth

May have mild microcytic anemia- ammonium biurate crystals and will have increase Bile Acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are liver function tests used in research settings

A

Indocynine Clearance
Ammonia Tolerance
Caffeine Clearance
Bromsulfophthalein Excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is cholesterol

A

Plasma lipoprotein produced by liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are cholesterol levels a screening test for

A

Screening test for hypothyroidism
T4 controls synthesis and destruction of cholesterol
Also elevations seen with other endocrine diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is elevated cholesterol usually associated with

A

Elevated CHOL is often associated w Hyperlipemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the functions of the kidneys

A 
Filter waste and other products
Water and electrolyte Balance
Acid-base balance
Activate Vit D
Renin-angiotesin ( blood pressure control)
EPO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the BUN

A

Urea is an end product of amino acid metabolism

The more protein in diet- the more urea is formed in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What happens to UREA in the body

A

All urea passes through the glomerulous – about ½ gets reabsorbed by the renal tubules and ½ will get excreted

47
Q

In what situations do you see elevated BUN

A

Dehydration

High protein diet
+strenuous exercise -

Loss of kidney function (75%)

48
Q

What is creatinine

A

Formed from creatine from the msl
Remains constant with constant physical activity
Total amount of Creatinine is related to msl mass
All creatinine is filtered through the kidney
None is reabsorbed
Not influenced by a high protein diet

49
Q

How much of the kidney must be destroyed to see elevated creatinine

A

Must have >75% kidney destruction to see elevation

50
Q

What is GFR

A

Glomerular Filtrate Rate

51
Q

How is GFR and Creatinine related

A

Any condition that alters GRF alters creatinine since all is excreted and none is reabsorbed

52
Q

What does the BUN/Creatinine ratio show

A

75% kidney destroyed b/f inc in Bun/CREAT

Not that sensitive for early detection of renal dse

GFR has to be decrease 4 fold b/f there is an increase

53
Q

What is micro albuminuria used for

A

Can be useful To detect early onset kidney disease

54
Q

what do you look for in UA for evidence of kidney disease?

A

Low Spec. Gravity, protein loss

55
Q

Why is the UPC used to detect early renal disease

A

Based on the concept that the tubular concentration of urine increases both the urinary protein and creatinine concentrations equally

56
Q

How do you evaluate UPC

A

Cystocentesis is preferred method

5- renal dse

57
Q

What is SDMA

A

SDMA is a methylated form of the amino acid arginine, which is produced in every cell and released into the body’s circulation during protein degradation. SDMA is excreted almost exclusively by the kidneys, making it a good marker for estimating kidney function

58
Q

What is uric acid produced

A

By product of protein metabolism
Transported to kidney by albumin- passes thru the glomerulous and gets reabsorbed by the tubule cell- gets converted to allantoin and then excreted in the urine

59
Q

Describe the defect of the dalmation

A

Uric acid is excreted into urine to create urate urolith

60
Q

In avian and reptile, describe uric acid significance

A

Uric acid is major end product of nitrogen metabolism

Uric acid is used to measure renal function in Avian and Reptile species

61
Q

What is Gout

A

uric acid crystals deposit in joints, tendons, and surrounding tissues and cause inflammation.

Birds and reptiles on a too high of a protein diet or with Kidney disease will get gout

62
Q

What is a water deprivation test used for

A

Is done to see if the Kidney can concentrate urine

63
Q

What are differential diagnoses if you have PUPD

A

Cushing’s dse
Diabetes mellitus
Diabetes insipidus
Psychogenic polydipsia

64
Q

What is the goal of the water deprivation test

A

GOAL: Dehydrate the patient safely until endogenous ADH is produced
This happens at 5% body weight loss

65
Q

What must you monitor if you’re doing a water deprivation test

A

When doing a water deprivation test you must monitor body weight and C.S. of dehydration
Monitor urine specific gravity

66
Q

When is the water deprivation test contraindicated

A

Test is contraindicated if animal is already dehydrated or azotemic

67
Q

What is the vasopressin response test used for

A

to see if you have Diabetes Insipidus

68
Q

What are common endocrine pancreas problems

A

Endocrine — Diabetes mellitus, insulinoma

69
Q

What are common exocrine pancreas problems

A

Excocrine – EPI- pancreatitis– cancer

70
Q

What are the exocrine pancreas function tests

A

Exocrine Pancreas – Lipase, amylase, trypsin…..

71
Q

What are the endocrine pancreas function tests

A

Endocrine Pancreas– Insulin + glucagon

72
Q

What happens when there is inflammation of the pancreas

A

trypsin, amylase, lipase- when there is inflamation these enzymes leak into the serum

73
Q

What is EPI

A

Low level enzymes in pancreas

74
Q

What does EPI cause

A

MALDIGESTION– secondary to malabsorption

Causes- Pancreatic Acinar Atrophy (German Shepard)
or loss of pancreatic tissue from chronic pancreatitis

75
Q

How do you test for trypsin levels

A

Can test feces for its presence

Test tube method, x-ray film method

76
Q

Why do you test for trypsin

A

To rule out pancreatic exocrine insufficiency

77
Q

What is Serum Trypsinlike immunoreactivity
 TLI

A

Radioimmunoassay that uses antibodies to trypsin
Detects both trypsin+trypsinogen
TLI is increased in pancreatitis but not that useful a test for pancreatitis

78
Q

What is the TLI good for

A

Specific and sensitive test for pancreatic exocrine insufficiency when decreased

79
Q

What type of blood sample do you need for TLI

A

Use fasting blood sample

80
Q

What is Malabsorption

A

Nutrients are not being absorbed through the microvilli

81
Q

What are tests for malabsorption

A

Tests for Malbsorption

serum Cobalamin + Folate

82
Q

Why do you test for amylase levels

A

Amylase: acute/chronic pancreatitis or obstruction of pancreatic duct will result in elevations
If GFR decreased- rise in amylase

83
Q

What is an insulinoma

A

Tumor of beta cells- produces hypoglycemia with seizures- common in ferrets

84
Q

What does increased fructosamine indicate

A

Increase fructosamine indicates a persistent hyperglycemia

85
Q

What is the half life of albumin

A

Half life of albumin is 1-2 weeks

So gives an indication of glucose control over the last 2 weeks

86
Q

How long do glycosylated Hb last

A

2-4 months

87
Q

What hormone lowers blood glucose

A

Insulin

88
Q

What hormones raise blood glucose

A

glucagon, adrenaline, cortisol, growth hormone

89
Q

What is type 1 diabetes

A

insulin dependant diabetes

pancreas is not producing enough insulin usually because of immune destruction of the beta cells

90
Q

What is type 2 diabetes

A

Type II diabetes- non insulin dependant diabetes – insulin resistance

cats more common – associated with obesity-(fat cells hide receptors)

91
Q

What are the predisposing factors to type 2 diabetes

A 
About 1 in 200 animals affected
Obesity  esp in cats  causes type 2
Middle age
Genetics
Other hormones-- cortisone, progesterone
More in Neutered male cats or middle age intact bitches
92
Q

What does insulin do in the body

A

it allows the cells to use glucose- Even though the blood glucose is high – the cells can not use the glucose- so they breakdown fat and use protein from the lean body mass

93
Q

What are the clinical signs of diabetes

A 
Polyphagia, PUPD, weight loss
Cataracts (dogs)
Polyneuropathy, Plantigrade posture(cats)
Prone to bacterial infections
Hyperglycemia
Glucosuria
94
Q

How do you diagnose diabetes

A

Glucosuria
Hyperglycemia
Fructosasmine elevated ( 2-4 weeks)
Glycosylated hemaglobin increased (2-4 months)

95
Q

What si the goal of treatment of the diabetic

A

Stabilize– glucose levels-
Insulin injection

Minimize post prandial hyperglycemia
Provide optimum amount of nutrients
Minimize clinical signs (PUPD, neuropathy…
Avoid hypoglycemia- fatal

96
Q

What are the 3 steps to dietary treatment of diabetes

A

1-Consistent amounts, consistent timing, consistent ingredients, consistent proportion of CHO, protein, fat – fixed ingredient profile

2-Slow absorption of glucose from intestine
Low in simple sugars, High in Complex carbohydrates—barley, sorghum- to slow glucose absorption( low in simple sugars)

3-Fiber- some slow gastrointestinal transit time- hemicellulose, carboxymethylcellulose
Fibers slows absorption of nutrients – ie glucose

97
Q

Describe nutrition goals of a diabetic

A

Protein- good quantity and quality- to protect lean body mass– also will provide amino acids for gluconeogenesis

Antioxidants– Vit E

FAT content will depend on BCS

98
Q

What are the important macros for diabetic animals

A

For Dog Diet
60% CHO
20% Protein
20% FAT

CAT REQUIRE HIGHER Protein, less CHO–

99
Q

What nutraceuticals should you give if an animal is diabetic

A

Chromium- potentiate insulin

Carnithine – help with fat metabolism

Antioxidants-

100
Q

When is a glucose curve done after an animal is diagnosed with diabetic

A

Glucose curve is usually done 4-6 weeks post start of injections

101
Q

How do you perform a glucose curve

A

Hospitalize the animal ( can train owners to do at home)
Follow the pet owner’s normal regime. This includes insulin injections, size, type and timing of meals and exercise routine. – ALSO good to watch Owner give the Insulin
Take a blood sample prior to insulin injection.
Feed the animal ( 1/3 daily ration). Administer the insulin
Take a blood sample every two (to four) hours, if possible for 24 hours but at least until the concentration has crossed back above the renal threshold.
Blood glucose concentrations are measured and plotted against time to produce a blood glucose curve.

102
Q

What is the aim of treatment of diabetes mellitus

A

You want blood glucose concentrations to be below the renal threshold and to avoid hypoglycemia
Thus the goal is to maintain blood glucose concentrations roughly between:

5 and 10-12 mmol/l (90 and 180-216 mg/dl) in dogs
5 and14-16 mmol/l (90 and 252-288 mg/dl) in cats

103
Q

How do you measure the duration of insulin action

A

The duration of insulin action is measured from the time of insulin injection, followed by a fall in blood glucose concentration, to the time that blood glucose exceeds the renal threshold.

104
Q

How is once daily caninsulin treatment to be considered effective in dogs

A

For once daily Caninsulin treatment to be considered effective in dogs the duration of the insulin action needs to be at least 20 hours.

105
Q

How is twice daily caninsulin treatment to be considered effective in dogs

A

For twice daily Caninsulin treatment to be considered effective, the duration of the insulin action has to be around 8-12 hours following each insulin injection.

106
Q

What is the ideal blood glucose curve

A

Normal blood glucose in non-diabetic cats ranges from 2.6 - 8.4 mmol/l.
The renal threshold is 14mmol/l.
The goal is produce a blood glucose curve that approaches the reference range but avoids potentially fatal hypoglycaemia, for example 5 - 14 mmol/l for most of each 24 hour period.

107
Q

What is the Somogyi effect

A

An insulin dose that is too high may bring about the Somogyi effect or rebound hyperglycaemia.
This can also be produced if blood glucose concentrations fall too rapidly. The moment that the Somogyi effect is triggered is very individual – it is a life-saving response.

108
Q

What do long-acting insulins do

A

Long-acting insulins and insulin analogs
Ultralente insulins - 100% crystalline insulin
PZI insulins - contain protamine and zinc
Insulin glargine is an insulin analog that is released slowly over a period of up to 24 hours (in humans) and intended to supply a basal level of insulin.

109
Q

What are intermediate acting insulins

A 
Lente insulins (e.g. Caninsulin) - mixtures of 30% amorphous (semilente) and 70% crystalline (ultralente) insulin in an aqueous suspension. 
NPH insulins - contain protamine
110
Q

What are rapid acting insulins

A

Soluble insulin and semilente insulin: intravenous administration possible
Insulin lispro, insulin aspart and insulin glulisine are insulin analogs that readily absorbed from the injection site which are used to provide a bolus of insulin for after a meal (in humans)

111
Q

What is 40 IU mean

A

40 units per ml

112
Q

How do you do an insulin tolerance test

A

Give .1IU/kg regular- short acting insulin
Insulin resistance if BSL fails to drop50% of the pre fasting level
Insulin receptors are unresponsive to insulin

113
Q

How do you treat hypoglycemia

A

Always be ready to tx hypoglycemia – with IV glucose

Hematology (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions