E4 Flashcards
When does unconcentrated urine and azotemia not mean renal disease
- Decreased ADH production
Central diabetes Insipidus
2. Inhibition of ADH -
nephrogenic diabetes insipidus
Hypercalcemia
Hypercortisolemia
HyPOnatremia
HyPOkalemia
3.Medullary washout
Ie: Low urea- liver failure/dec fxn
Low sodium- hypoadrenocorticism
Low K- Chronic PU/PD
4. Osmotic diuretic
Ie diabetes mellitus
Fanconi syndromes
Post obstructive
4 ways enzyme concentration increase in blood
Cellular leakage/inc release -damage/death
Induction/inc sxn- angry/neoplasm
Dec inactivation/ clearance -renal excretion
Neonate colostral absorption of maternal enzymes
How many times above reference intervals is elevated enzymes clinically significant
2-3x
2-3 = mild 3-6 = moderate >6 = marked (Except ALP in cats, GGT and SDH <2x increase clinically significant)
When is <2-3x inc enzyme concentration clinically significant
ALP in cats GGT SDH
Low grade inflammatory lesion
Decreased number of target cells via necrosis/fibrosis (liver failure)
* organ function test more reliable*
Inhibition of enzyme activity
When is enzyme concentrations below RI clinically significant
Never
What type of enzymes are muscle (myocyte) enzymes
Leakage
Muscle (myocyte) origin enzymes
CK
AST
LDH
Which leakage enzyme is most specific to muscle (myocyte)
CK
Causes of elevated CK and AST
Trauma Exertion Inherited Inflammation Nutritional Ischemic Toxic
Half life of CK
Short
Half life of AST
Hours to days
Sources of LDH
Skeletal muscle
Liver
WBC/RBC
Usually not included on chem panels
Little clinical significance cause need isoenzyme value
Elevated ALT
Liver disease most usually cause
Mild elevations in dogs and cats
Enzyme elevations seen in young dogs/cats with muscular dystrophy
Elevated CK and ALT
Other uncommon blood changes associated with massive rhabdomyolysis
Hyperkalemia
Hyperphosphatemia
Increased Creatine
