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NAVLEEEEEEE > Clinical Pathology-Clinical Chemistry > Flashcards

Clinical Pathology-Clinical Chemistry Flashcards

1
Q

What factors causes increased BUN?

A

Decreased glomerular filtration rate
Increased dietary protein
GI bleeding

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2
Q

Why are BUN levels not the best method of evaluating kidney function opposed to CREA?

A

there is 60% resorption of BUN in the kidneys

CREAT is 100% excreted (no resorption)

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3
Q

What is indicated when there is elevation of CREA on bloodwork?

A

less than 25% of original functioning renal mass remains

normal CREA doesn’t exclude kidney disease

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4
Q

T/F: Younger animals have lower serum CREA than older animals

A

True

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5
Q

What is a factor that increases or decreases CREA levels aside from kidney function?

A

Muscle mass amount
If there is a breed with higher muscle mass, they will have higher creatinine levels, a breed with less muscle mass or cachexia will have less creatinine

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6
Q

When is an increase in serum P levels seen?

A

When more than 85% of nephrons are nonfunctional (chronic renal dz)

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7
Q

What is tubular resorption of phosphorus regulated by?

A

Parathyroid hormone

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8
Q

Why might younger animals have increased serum P?

A

Bone growth

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9
Q

What should the sodium concentration in the urine of a patient with pre-renal azotemia look like?

A

Sodium conservation with low fractional excretion of sodium (sodium concentration is low in urine)

The kidneys are still working and they are conserving sodium to try and hang on to any water molecules it can

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10
Q

What should the sodium concentration in the urine of a patient with primary renal disease look like?

A

The sodium concentration in the urine should be high because the glomerular filtration is not adequately functioning

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11
Q 
Classify the following urine concentration values:
A. >1.031
B. <1.007
C. 1.008-1.012
D. 1.013-1.030
A

A. Hypersthenuria
B. Hyposthenuria
C. Isosthenuria
D. Minimal concentration

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12
Q

How is USG measured?

A

Refractometry is the most accurate measurement method as opposed to a dipstrip

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13
Q

What time of the day is the urine most cocentrated?

A

First morning urination

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14
Q

T/F: Trace proteins or +1 proteins in urine are normal with an elevated USG

A

True

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15
Q

What is suggested if there is heavy proteinuria with no urine sediment present?

A

Glomerular disease

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16
Q

When does glucose appear in the urine?

A

When plasma glucose is over 180 mg/dL in dogs and 300 mg/dL in cats

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17
Q

What type of urine (acidic or alkaline) are struvite crystals found in and what are they associated with?

A

Alkaline urine

Struvite urinary stones

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18
Q

What type of urine (acidic or alkaline) are calcium phosphate crystals found in?

A

Alkaline urine

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19
Q

What type of urine (acidic or alkaline) are calcium carbonate crystals found in?

A

Alkaline urine

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20
Q

What type of urine (acidic or alkaline) are amorphous phosphate crystals found in?

A

Alkaline urine

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21
Q

What type of urine (acidic or alkaline) are ammonium biurate crystals found in?

A

Alkaline urine

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22
Q

What type of urine (acidic or alkaline) are uric acid crystals found in and what are they associated with?

A

Acidic urine

Dalmatian breed

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23
Q

What are urate crystals associated with?

A

Portosystemic shunt

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24
Q

What type of urine (acidic or alkaline) are cystine crystals found in and what are they associated with?

A

Acidic urine

Cystinuria

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25
Q

Why are oxalate monohydrate crystals found in the urine and what are they associated with?

A

Acute renal failure due to ethylene glycol ingestion

26
Q

What are some clinical signs of a patient with mild dehydration (5%-6%)?

A

Dry mucous membranes
Slight loss of skin turgor
Injected conjunctiva
Inelasticity of skin

27
Q

What are some clinical signs of a patient with moderate dehydration (7%-9%)?

A

Loss of skin turgor with slow return
Prolonged capillary refill time
Enophthalmos

28
Q

What are some clinical signs of a patient with severe dehydration (10%-12%)?

A

Extreme loss of skin turgor
Peripheral vasoconstriction
Cold extremities
Prolonged capillary refill time

29
Q

What are some clinical signs of a patient with severe dehydration (13%-15%)?

A

Vascular collapse
Renal failure
Death

30
Q

What changes occur with isotonic dehydration?

A

Equal losses of water and solute

Increased packed cell volume with increased plasma proteins

31
Q

What changes occur with hypertonic dehydration?

A

More water than solute lost
Sodium and chloride concentration increases
PCV increases with increased TP
Most commonly seen with diabetes insipidus

32
Q

What changes occur with hypotonic dehydration?

A

More solute than water lost
Concentrations of sodium and chloride decrease
Most common type of dehydration

33
Q

Why do you see hyponatremia with hyperlipidemia or hyperproteinemia?

A

The plasma sample is diluted due to the excess lipids/proteins making pseudohyponatremia evident

34
Q

What is the most common cause of hypercalcemia in dogs?

A

Neoplasia (lymphoma being the most common)

Elevated total and ionized calcium w/ parathyroid hormone suppressed

35
Q

What do you notice with the serum and ionized calcium levels with renal disease?

A

Ionized calcium levels are typically normal to decreased while the serum total calcium is elevated

36
Q

What are the leakage enzymes in the liver?

A

Leakage: ALT, AST, SDH and GLDH

37
Q

What are the induced enzymes in the liver?

A

Induced: ALP and GGT

38
Q

Which two leakage enzymes are liver specific?

A

SDH and GLDH

39
Q

Where are the three sources of ALP in the body?

A

Bone, Liver and Corticosteroid induced

40
Q

What can an increased ALP be associated with (remember it is an induced enzyme)

A

increased osteoblast activity (young animals)
cholestasis
corticosteroid administration or anti-convulsants

41
Q

When is an elevation of bilirubin seen?

A

Increased hemoglobin (RBC destruction)
Decreased uptake/conjugation from hepatocytes
Decrease in outflow of conjugated bilirubin

42
Q

When is the postprandial bile acid concentration greatly exaggerated?

A

PSS

43
Q

If there is liver damage in a patient, what should you notice with the glucose levels?

A

Increased glucose due to the decreased conversion of glucose –> glycogen in the liver

44
Q

What is a sensitive indicator for pancreatitis?

A

Trypsin-like immunoreactivity

Trypsinogen is secreted only by the pancrease and converted to trypsin in the SI

45
Q

When would you use a fecal float vs. a Baermann technique for parasites?

A

Fecal float: parasitic ova and oocysts

Baermann: detection of larvae in feces

46
Q

When would you perform a fecal occult blood test?

A

Patients with chronic diarrhea or loose stools, microcytic anemia or those treated with NSAIDs

47
Q

What does a positive fecal occult blood test mean?

A

Upper GI tract inflammation, ulceration or neoplasia

48
Q

If the serum folate is decreased where is the location of malabsorption?

A

Proximal small intestine

49
Q

If the serum vitamin B12 is decreased, where is the malabsorption?

A

Distal small intestine

50
Q

What will be decreased in dogs and cats with EPI?

A

Cats: serum vitamin B12 and folate levels
Dogs: serum vitamin B12 and folate is normal to increased

51
Q

If there is SI bacterial overgrowth, what do the vitamin B12 and folate look like?

A

Vitamin B12: decreased

Folate: increased

52
Q

Which enzyme is considered muscle specific?

A

Creatinine kinase

53
Q

Skeletal muscle injury, cardiac muscle injury or muscle catabolism will cause what enzyme to be increased?

A

Creatinine kinase

54
Q

What other enzyme can you look at when determining muscle injury?

A

AST

55
Q

What does sensitivity mean when interpreting lab data?

A

Ability to predict presence of disease or fraction of those with a specific disease that the assay predicts

56
Q

How is sensitivity calculated?

A

TP/(TP+FN) *100

57
Q

What does specificity mean when interpreting lab data?

A

Ability to predict absence of disease, or the fraction of those without disease that the assay correctly predicts

58
Q

How is specificity calculated?

A

TN/ (FP +TN) * 100

59
Q

How do you calculate PPV?

A

(% of patients who test positive that actually have dz)

PPV= TP/(TP + FP) * 100

60
Q

How do you calculate NPV?

A

(% of patients with a neg test result who do not have the dz)
NPV= TN/(TN+FN) *100

NAVLEEEEEEE (2 decks)

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