Exam 5 Flashcards
List three laboratory analytes that can be used to assess water balance
RBC
plasma proteins
creatinine
what % dehydration with no clinical signs
1-4%
what % dehydration with tacky, sticky mucous membranes
5-6%
what % dehydration with dry mm, dough elastic skin, and slow return skin test
6-8%
what % dehydration with loss of skin tugor, slow return (obvious skin tent test), enophthalmos, slow CRT > 2sec
8-10%
what % dehydration with severe loss of skin turgor without complete return, cold extremities, CRT > 3 sec
10-12%
what % dehydration with renal failure, death
13-15%
most common type of dehydration
why?
hypotonic
GI abnormalities - vomit, diarrhea
also furosemide, horse sweat, renal failure with osmotic diuresis and third space abnormalities
causes of hypertonic dehydration
hypotonic loss (excess water) - free water loss, DI, dogs panting, heat stroke
causes of hyponatremia
secretory diarrhea
hypertonic sweat (horse)
renal tubular disease
secondary to DM
mannitol
causes of hypernatremia
excess Na retention
hypertonic dehydration
NaCl toxicity (excess Na intake + lack of water)
causes of hypokalemia
primarily - vomit & diarrhea
horse sweat
renal loss (loop diuretics or cats w CKD)
anorexia
decreased intake
large animals chewing
alkalosis
insulin
excitement
causes of hyperkalemia
metabolic acidosis
insulin def
hemolysis (esp horses)
thrombocytosis
oliguric renal failure
uroabdomen, obstruction
hypoadrenocorticism
formula for corrected Cl
measured Cl x normal Na
measured Na
causes of true hypochloremia
high gastric vomiting
loop, thiazide diuretics
chronic resp acidosis
components of secretional acidosis
decreased bicarb
increased Cl
normal anion gap
causes of true hyperchloremia
renal tubular acidosis
chronic resp alkalosis
hypertonic dehydration
NaCl toxicity
anion gap formula
AG = (Na + K) - (Cl + bicarb)
causes of increased anion gap “titrational acidosis”
ketons
lactic acid
uremic acids
ethylene glycol metabolites
2 broad mechanisms of respiratory alkalosis
- hypoxemia from hyperventilation
- stim of resp center - CNS disease, gram - sepsis, fever, pain, excitement
2 broad mechanisms of respiratory acidosis
hypoventilation due to airway obstruction, resp center depression, pulmonary disease, restrictive disease
effect of PTH on Ca & P
increased Ca
decreased P
effect of vitamin D on Ca & P
increased Ca & P
majority of serum Ca is in what form?
50% ionized form
40% bound to albumin
what is the most common cause of decreased total calcium
hypoalbuminemia
differentials for hypocalcemia
hypoalbuminemia
renal failure
pancreatitis
eclampsia/periparturient hypocalcemia “cattle milk fever”
what Ca x P solubility product constant is a predisposition for mineralization
> 60-70
transiet hypercalcemia causes
post-prandial
dehydration
lipemia
young, growing dogs
hypoadrenocorticism
pathological hypercalcemia causes
hypercalcemia of malignancy
primary hyperparathyroidism
idiopathic hypercalcemia in cats
renal disease (horses)
vitamin D toxicosis
most common cause of hyperphosphatemia
decreased GFR due to renal azotemia
others:
vitamin D intoxication
excess P intake
primary hypoparathyroidism
most common cause of hypermagnesemia in animals
decreased GFR/renal excretion
indications for transfusion
severe anemia
defect of hemostasis/bleeding disorder
acute blood loss
hypoproteinemia
severe thrombocytopemia
components of WHOLE BLOOD
RBC, platelets, leukocytes, plasma proteins
components of packed RBC
rbc only, replace O2 carrying capacity
components of frozen plasma
no clotting factor
components of fresh frozen plasma
clotting factors
components of cryoprecipitates
VMF
fibrinogen
factor VIII & XIII
what would you use to transfuse severe anemia
packed RBC
what would you use to transfuse defect in hemostasis/bleeding disorder
whole blood
fresh plasma
fresh frozen plasma
cryoprecipitates
what would you use to transfuse acute blood loss
whole blood
packed RBC
crystalloids
what would you use to transfuse hypoproteinemia
fresh plasma
fresh frozen plasma
what would you use to transfuse severe thrombocytopenia
platelet rich plasma
acute transfusion reactions
hemolysis, fever, allergic reaction
delayed transfusion reactions
hemolysis - jaundice, fever, + coomb’s test
examples of non-immunologic transfusion reaction
circulatory overload in heart failure patients
citrate toxicity
ammonia toxicity
infectious agents
components of a major crossmatch
recipient serum
donor RBC
important dog blood types
DEA 1.1
universal donor for dogs
DEA 1.1, 1.2, 3, 5 (-)
universal donor for cat
there is none
blood types in cats
type A, B and AB
equine neonatal isoerythrolysis
arabians & thoroughbreds
Aa antigen in A
Qa antigen in Q
maternal Ab attacks the pateral Ag on foal RBC
SECOND PREGNANCY!!
kitten neonatal isoerythrolysis
type B (strong anti-A Ab) queen with type A or AB kittens
any pregnancy
