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Diagnostics > Comprehensive Profile > Flashcards

Comprehensive Profile Flashcards

1
Q

What is Alanine Aminotransferase (ALT)

A

ALT is a cellular enzyme released in response to injury of liver cells.

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2
Q

What are some common causes of decreased ALT?

A

Rarely clinically relevant, end stage liver disease.
End stage liver disease (decreased albumin, ALP, glucose, cholesterol, BUN, increased bilirubin)

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3
Q

What are some common inflammatory causes of increased ALT?

A

Inflammatory Infectious:
Bacterial cholangiohepatitis
Leptospirosis
FIP (Feline Infectious Peritonitis)
Histoplasmosis
Infectious canine hepatitis
Inflammatory Noninfectious:
Chronic hepatitis
Cirrhosis
Pancreatitis

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4
Q

What are some common toxic causes of increased ALT?

A

NSAIDS (non steroidal anti inflammatory drugs)
Phenobarbital
Corticosteroids
Methimazole/carbimazole

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5
Q

Increased ALT causes (Liver hypoxia or hypoperfusion)?

A

Anemia (decrease in RBC numbers, hemoglobin concentration, or PCV)
CHF (the heart cannot deliver enough blood to the body and fluid backs up into a dogs lungs or abdomen)
Shock (inadequate cellular energy production or decreased oxygen utilization)

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6
Q

What are some metabolic diseases that cause increased ALT?

A

Hyperthyroid in cats
Hepatic lipidosis in cats
Cushing’s disease
Diabetes or DKA

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7
Q

What are some other causes of increased ALT?

A

Neoplasia (abnormal growth of tissue)
Trauma

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8
Q

What is albumin (ALB)?

A

An important regulator of osmotic equilibrium in the body and is also a carrier for highly protein bound substances such as calcium, thyroxine, fatty acids and some drugs).

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9
Q

What are some common causes of decreased ALB? (Decreased production)

A

Liver Disease (atrophy, fibrosis / cirrhosis, portosystemic shunt - abnormal connection between the portal vascular system and systemic circulation, neoplasia)
Maldigestion (exocrine pancreatic insufficiency)
Malabsorption (small intestinal disease)
Malnutrition (cachexia - weakness and wasting of the body due to severe chronic illness, dietary deficiency, parasites)
Inflammation (negative acute phase reaction)
Compensatory (with hyperglobulinemia)

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10
Q

What are some common causes of decreased ALB? (Increased loss)

A

Hemorrhage (especially external) - GIT, Urinary
Protein-losing nephropathy (PLN)
Protein-losing enteropathy (PLE)
Addisons Disease
Hemodilution (excess IV fluids)

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11
Q

What are some common causes of increased ALB?

A

Hemoconcentration (pre renal azotemia)

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12
Q

What is alkaline phosphatase (ALP)?

A

ALP is primarily an indicator of cholestatic liver disease, it also increases with severe bone destruction and due to steroid induction

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13
Q

What are common causes of decreased ALP?

A

Not clinically significant
Hemolysis - rupture or destruction of RBCs
Assay performed on EDTA plasma

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14
Q

What are some common causes of increased ALP?

A

Cholestasis (slowing or stalling of bile flow through the biliary system)
Cushings Disease in dogs
Hepatic Lipidosis in cats
Diabetes
Gall Bladder Stones
Hyperthyroidism in cats
Neoplasia
Inflammatory (pancreatitis, cholangiohepatitis)

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15
Q

What are some common causes of increased ALP (Induction by drugs or hormones)?

A

Corticosteroids
Phenobarbital
Thyroxine

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16
Q

Increased ALP due to increased osteoblastic activity in bone causes?

A

Young animals (increased up to 3-4 times level expected in mature dogs)
Osteosarcoma - most common bone tumor in dogs
Other bone neoplasia

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17
Q

ALP key focuses

A

Liver
Bone
Parathyroid
Intestinal

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18
Q

What is amylase (AMYL)?

A

Amylase is an enzyme produced primarily in the pancreas to digest dietary carbs in the intestine.

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19
Q

What are some common causes of decreased amylase?

A

Severe hepatic dysfunction / polysystemic shunts
Decreased amylase is rarely clinically significant

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20
Q

What are some common causes of increased amylase?

A

Pancreatic acinar cell damage (inflammation, necrosis, neoplasia, pancreatic duct obstruction)
Decreased renal clearance / inactivation (pre renal disorders such as shock, dehydration, poor cardiac output)
Renal disease
Post renal disorders (urinary tract obstruction or rupture)

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21
Q

What is calcium (Ca)?

A

Calcium is an ion that is required by the body for numerous Intracellular and extracellular function, major component of bone structure.

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22
Q

What are some common causes of decreased calcium?

A

Chronic kidney disease (dogs/cats)
Acute pancreatitis (dog/cat)
Decreased serum albumin
Hypoparathyroidism
Ethylene glycol toxicity (dog/cat)
Puerperal tetany/eclampsia (dog/horse)
EDTA contamination

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23
Q

What are some common causes of increased calcium?

A

Hypercalcemia due to malignancy (lymphoma, multiple myeloma, anal gland adenocarcinoma, thymoma, other neoplasms)
Idiopathic hypercalcemia in cats
Primary hyperthyroidism
Kidney disease (more common in horses)
Addisons Disease
Fungal infection
Toxins

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24
Q

What is creatinine associated with (Cr)?

A

Renal Disease

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25
Q

What is globulin?

A

Globulins are produced in the liver and also by the cells of the immune system, play a role in maintaining osmotic balance, immune system function, and inflammatory response.
Globulin concentration will increase with dehydration and should also increase with antigenic stimulation.

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26
Q

What are some common causes of decreased globulin?

A

Hemorrhage (external especially)
GI Disease (PLE, Parasitism, Small Intestine Disease, EPI)

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27
Q

What are some common causes of increased globulin?

A

Hemoconcentration
Inflammation
Infection
Neoplasia

28
Q

What is glucose (Glu)?

A

Glucose is the basic energy source of the body (BG=Blood Glucose)

29
Q

What are some common causes of decreased glucose?

A

Artifact
Hypoglycemia
Liver failure / Severe liver disease
Sepsis / Endotoxemia
Insulinoma
Addisons Disease
Drugs & Toxins (insulin, sulfonylureas, xylitol)

30
Q

What are some common causes of increased glucose?

A

Diabetes
Stress, After eating, Diestrus (dogs)
Pancreatitis
Cushings Disease
Drugs: dextrose, glucocorticoids, megestrol acetate, progesterone, epinephrine)

31
Q

What is phosphorus (P)?

A

Phosphorus is essential for energy production, protein synthesis, and acid/base balance in the body, major component of bone.

32
Q

What are some common causes of decreased phosphorus?

A

Increased urinary excretion (DKA, diuretics, hyperparathyroidism, Hypercalcemia of malignancy)
Translocation from ECF to ICF (bicarbonate admin, insulin therapy, insulinoma)
Eclampsia in dogs
Artifact

33
Q

What are some common causes of increased phosphorus?

A

Decreased urinary excretion (Decreased GFR, renal failure, azotemia)
Artifact (hemolysis)

34
Q

What is potassium (K)?

A

K is an Intracellular ion that is responsible for maintenance of fluid and electrolyte balance, essential for muscle and nerve function.

35
Q

What are some common causes of decreased potassium (K)?

A

Chronic kidney disease in cats
V+, D+, Choke in horses
Renal loss due to diuretics or post obstructive or prolonged diuresis
Decreased intake (K deficient fluid therapy or diets)
Translocation from ECF to ICF (insulin therapy, bicarbonate infusion, Alkalemia)

36
Q

What is potassium (K) often associated with?

A

Malnutrition and renal disease, this electrolyte is used to diagnose the cause of vomiting and diarrhea (and cardiac symptoms).

37
Q

What is sodium (Na)?

A

Sodium is the most abundant cation in the ECF, partially responsible for regulation of fluid volume within the blood stream, important in muscle and nerve function.

38
Q

What are some common causes of decreased sodium (Na)?

A

GI loss through vomiting, diarrhea, excessive salvation, whip worms
Addisons Disease
Diabetes
Renal loss

39
Q

What are some common causes of increased sodium (Na).

A

GI loss of WATER (D+, V+, phosphate enemas)
Pure water loss w/ out replacement (fever, panting, hypersalivation, hyperthermia)
Water deprivation

40
Q

What is sodium often associated with?

A

Dehydration, and diabetes - used to diagnose the cause of vomiting and diarrhea (and cardiac symptoms).

41
Q

What is total bilirubin often associated with?

A

Hepatic disorders

42
Q

What is bilirubin?

A

Bilirubin is an indicator of liver disease, gall bladder disease or hemolysis.

43
Q

Is decreased bilirubin clinically significant?

A

No

44
Q

Increased bilirubin common causes include:

A

RBC destruction (hemolysis)
Diffuse hepatocellular disease (infectious, inflammatory, toxic)
Hepatic lipidosis, neoplasia, cirrhosis/fibrosis, copper storage disease, hypoxia from anemia or congestion, trauma)
Cholestatic disorders

45
Q

What is the significance of total protein?

A

Dehydration, Kidney, Liver Disease, Metabolic and Nutritional Disorders

46
Q

What is total protein?

A

Primarily composed of albumin and globulins with minor contribution from coagulation and fibrinogen.

47
Q

What are some common causes of decreased total protein?

A

Decreased production (intestinal malabsorption, malnutrition, severe GI parasitism, liver insufficiency or failure)
Increased loss (hemorrhage, PLN, PLE)
EPI

48
Q

What are some common causes of increased TP?

A

Dehydration
Chronic Inflammation
Infection
Neoplasia

49
Q

What is the significance of Blood Urea Nitrogen?

A

Liver and Kidney diseases

50
Q

What is blood urea nitrogen (BUN)?

A

BUN is produced in the liver and excreted by the kidneys, marker for kidney and liver dysfunction

51
Q

What are some common causes of decreased BUN?

A

Chronic liver disease
Low protein diets
Diabetes or Cushings Disease
Drugs (corticosteroids, other diuresis causing drugs)

52
Q

What are some common causes of increased BUN?

A

Pre-renal (blood loss, dehydration, poor cardiac output, Addisons, recent high protein meal, GI hemorrhage)
Renal (infectious, inflammatory, toxic, ischemic)
Post renal (bladder rupture, obstruction)

53
Q

What is the significance of alanine aminotransferase (ALT)?

A

Liver diseases, viral hepatitis and cirrhosis, heart disease

54
Q

What is the significance of Albumin (ALB)?

A

Liver and Kidney Diseases

55
Q

What is the significance of alkaline phosphatase (ALP)?

A

Liver, Bone, Parathyroid, Intestinal Disease

56
Q

What is the significance of Amylase (AMYL)?

A

Kidney and Pancreatic Disease

57
Q

What is the significance of Calcium?

A

Parathyroid, Bone and Chronic Renal Disease; Tetany

58
Q

What is the significance of creatinine?

A

Renal disease

59
Q

What is the significance of Globulin?

A

Concentration will increase with dehydration and should also increase with antigenic stimulation

60
Q

What is the significance of glucose?

A

Diabetes, hyperglycemia, hypoglycemia, and liver disease

61
Q

What is the significance of phosphorus?

A

Kidney disease, hypoparathyroidism and nutritional disorders

62
Q

What is the significance of potassium?

A

Malnutrition and renal disease (diagnose vomiting, diarrhea and cardiac symptoms)

63
Q

What is the significance of Sodium?

A

Dehydration, and diabetes. (Diagnose cause of vomiting, diarrhea and cardiac symptoms)

64
Q

What is the significance of total bilirubin?

A

Hepatic disorders

65
Q

What is the significance of BUN?

A

Liver and kidney disease

Diagnostics (2 decks)

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