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Clinical Pathology Final > Final Info > Flashcards

Final Info Flashcards

1
Q

What is osmolality? And what is normal osmolality?

A

a measure of the number of osmotically active particles per weight of solution. 300 msm/kg is normal.

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2
Q

What are the major contributors to osmolality of extracellular fluid under normal conditions?

A

Sodium, Chloride, Bicarb, Potassium are 94%

Urea and glucose are 4%

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3
Q

What things cause hyperosmolality of a serum?

A

Increased concentrations of one or more solutes, example hypernatremia, hyperglycemia, increased BUN

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4
Q

What is hyperosmolar syndrome?

A

A clinical syndrome that is most frequently observed in animals with a measured osmol of greater than 350, see neuro signs.

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5
Q

What are some things that cause an increased Osmolal gap?

A

Increase in unmeasured solutes in the blood, IV mannitol infusion, IV radiographic contrast agents, ethanol, methanol, Ethylene glycol

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6
Q

What is hypo-osmolality? What are animals that have ho always?

A

They are always hyponatremic, you can see with dehydration if it happens to rapidly you can see intravascular hemolysis.

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7
Q

What three things do blood gas analyzers measure?

A

pH, pC02, pO2

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8
Q

What is a normal pO2 range? what are the names for above and below?

A

80 to 100, above is hyperoxemia, below is hypoxemia

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9
Q

Measured paO2 is the result of what two processes?

A

Absorption of O2 from alveolar air, venous admixture

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10
Q

Can you use paO2 to determine the oxygen carrying capacity of the blood?

A

No, it does not reflect reduced blood oxygen carrying capacity caused by anemias or disorders of hemoglobin.

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11
Q

What are some of the causes of hypoxemia?

A

decreased paO2, increased venous admixture, alveolar hypoventilation, increased venous admixture.

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12
Q

What are two diseases that may affect the ability of hemoglobin to carry oxygen, but may have a normal paO2?

A

Carbon monoxide poisning

Methemoglobinemia

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13
Q

What effects paCo2? What are fluxuations called?

A

affected by alveolar ventilation, if you see hypocapnia then you have alveolar hypervent, if you have hypercapnia then alveolar hypovent.

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14
Q

If you see paO2=50 which is hypoxemia
and paC02= 20 which is hypocapnia
What is the diagnosis?

A

Hypoxemia due to venous admixture

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15
Q

What is blood pH regulated by?

A

Adjusting the balance between pCO2 and HCO3

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16
Q

Increased pCO2 causes

A

acidemia

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17
Q

Decreased pCO2 causes

A

alkalosis

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18
Q

Increased HCO3 causes

A

alkalosis

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19
Q

Decreased HCO3 causes

A

acidosis

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20
Q

What is the main clinical value of Total CO2?

A

Provides a reasonable estimate of bicarb

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21
Q

What are the four normal components of the anion gap?

A

Albumin(50%), Phophates, Sulfates, Salts of organic acids

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22
Q

What are some common reasons for an increased AG?

A 
Lactic acidosis
Ketoacidosis
Renal failure
Some toxicities(EG)
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23
Q

What are some common reasons for a decreased AG?

A

Hypoalbuminemia

Increased blood cations: hypercalcemia

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24
Q

What do you see in a secretion acidosis? and what is the normal cause?

A

Decreased biocarb
Cl WRI or increased
AG WRI

*Loss of bicarb=major cause.

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25
Q

What do you see in a titration acidosis? what is a normal cause?

A

Decreased HCO3
Cl WRI
AG increased

*Things that cause increased unmeasured anions

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26
Q

What are some things that you see in metabolic acidosis? What is the normal cause?

A

Increased HCO3
Decreased Cl-
AG WRI

*Almost always loss of gastric or abomassal HCL

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27
Q

What is the primary effect of hypoalbuminemia on the blood?

A

Decreases AG which increases HCO3

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28
Q

In a mixed metabolic acidosis and alkalosis what do you normally see?

A

Loss of gain of one anion group, most common is loss of Cl and increased unmeasured

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29
Q

What is the effect of aldosterone on renal excretion of electrolytes?

A

aldosterone promotes renal excretion of K+ and H+ and retention of Na+ and Cl-

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30
Q

What is in high concentration in the blood and extracellular fluid, in relatively low concentrations in cells, the main contributor to plasma osmolality?

A

Sodium

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31
Q

What are the major sources of input and loss of Na+

A

Input is through gastrointestinal absorption, loss is through third space loss, alimentary, cutaneous, and renal

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32
Q

What are the three primary causes of hypernatremia?

A

Excessive sodium free water loss, excessive sodium intake with restricted water intake, hyperaldosteronism.

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33
Q

Where is most of the bodies potassim located? What can fluxuations cause?

A

In the cells, can see cardiac function problems.

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34
Q

How does acidemia affect potassium?

A

Shifts it out of the cells to maintain electroneutrality

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35
Q

How does alkalemia affect potassium?

A

Shifts K+ into the cells

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36
Q

What are some clinical causes of hypokalemia?

A

Real and GI loss, alkalemia and insulin treatment

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37
Q

What are some clinical causes of hyperkalemia?

A

renal failure, ruptured bladder, urethral obstruction, acaedmia, massive tissue necrosis, intravascular hemolysis

38
Q

What can cause pseudohyperK+

A

blood sampling artifact

39
Q

When are changes in serum chloride often seen?

A

Secondary to changes in serum sodium,

40
Q

What are the clinical causes of sodium independent changes to serum chloride concentrations?

A

Vomiting, abomasal loss, hyper salivation in horses, secretion acidosis

41
Q

What are the most likely causes of hypoalbuminemia?

A

Decreased hepatic albumin production
Increased loss of albumin
Overhydration

42
Q

What is hyperalbuminemia normally caused by?

A

dehydration

43
Q

What are the typical clinical signs of hypoalbuminemia?

A

edema, ascites and hydrothorax

44
Q

What are the four protein results given on the serum chemistry profile? Which 2 are measured and which 2 are calculated?

A

Serum total protein= measured
Albumin= measured
Serum globulins: calculated
Albumin/Globulin ratio= calculated

45
Q

If the albumin concentration is below RI and the A/G ratio is within RI what are some diseases?

A

Hemorrhage, exudation, PLE

46
Q

ALT measures what damage?

A

Hepatocytes

47
Q

SDH measures what damage?

A

Hepatocytes

48
Q

AST measures what damage?

A

Hepatocytes, Skeletal muscle, Erythrocytes

49
Q

LDH measures what damage?

A

Hepatocytes, Skeletal muscle, Erythrocytes

50
Q

What are the four markers for reduced hepatic biosynthesis?

A

Glucose, Cholesterol, Albumin, Urea

51
Q

What are the markers of reduced hepatic clearance?

A

Serum bilirubin, Serum bile acids, Blood ammonia

52
Q

What two test screen for cholestasis?

A

ALP and GGT, also serum concentrations of biliary compounds

53
Q

What is the leukon response to stress?

A

Up in WBC, Neutrophils and Monocytes(dogs)

Down in Lymphocytes and Eosinophils

54
Q

What is the leukon response to inflammation?

A

Up in WBC, Neutrophils, Monocytes
Drop in Eos
Lymphocytes=stay same

55
Q

What is the USG cut off in cats, dogs, horses/cattle that says the renal functional mass is ok?

A

> 1.035 to 1.040 in cats
1.030 in dogs
1.025 in horses/cattle

56
Q

What is the USG in animals with Renal failure?

A
  1. 008-1.035=cats
  2. 008-1.030=dogs
  3. 008-1.026=horses/cattle
57
Q

What are the 3 top causes of impaired urine concentrating ability?

A

Loss of renal medulla concentration gradient
ADH deficiency/resistance
Loss of >665 of functional renal mass

58
Q

What are the two most common signs of renal failure?

A

Polyuria/decreased concetrating ability

Azotemia

59
Q

What is hyposthenuria and what does it indicate?

A

1.001-1.007, shows work by renal tubulues meaning it is not primary renal failire to to decreased funcitonal mass.

60
Q

What is urine protein concentration used as a primary screening test for?

A

Glomerular and renal tubular disease

61
Q

What is the most commonly used diagnostic test for a glomerulopathy?

A

Urine protein:creatinine ratio

62
Q

What are some other causes of glucosuria other than diabetes mellitus?

A

Excitement or stress
Acquired proximal renal tubular damage
Congenital renal tubular defects
Pseudoglucosuria

63
Q

What species should you never see bilirubinuria in?

A

Cats

64
Q

What are some things that can cause positive occult blood?

A

Hematuria, hemoglobinuria, myoglobinuria

65
Q

Do herbivores have alkaline or acidic urine?

A

alkaline

66
Q

Do neonates and carnivores have alkaline or acidic urine?

A

acidic

67
Q

Hematuria

A

> 5 RBCs/HPF

68
Q

Pyuria

A

> 8 WBCs/HPF

69
Q

What are the markers of reduced hepatic clearance?

A

Serum bilibrubin, serum bile acids, blood ammonia.

70
Q

ALP and GGT

A

Excreated into bile, hepatic synthesis is induced by cholestasis

71
Q

What are the two forms of ALP in horses, cattle and cats?

A

Liver ALP: major source in adults is liver

Bone ALP; is the minor source from bone

72
Q

What ALP form do dogs have that is different?

A

Corticosteroid induced ALP

73
Q

What are some of the causes of increased tALP?

A

Cholestasis, Increased osteoblastic activity(normally in neonates as there is active bone growth)

74
Q

What is canine specific diseases that cause serum ALP activity?

A

Cholestatsis
Phenobarbital
cortisol
Increased osteoblastic activity

*dogs= best sensitivity

75
Q

Causes of increased GGT

A

Cholestasis
Biliary hyperplasia
Corticosteroid treatments in dogs

76
Q

Does GGT or ALP have better increased sensitivity for cholestasis?

A

GGT

77
Q

What are the biliary compounds that are indicative of cholestasis?

A

Bilirubin, bile acids

78
Q

What are the prehapatic causes of hyperbilirubinemia?

A

hemolysis, internal hemorrhage

79
Q

What are the hepatic causes of hyperbili?

A

reduced hepatocytes uptake of unconjugated bilirubin

80
Q

What are the post hepatic causes hyperbili?

A

cholestasis

81
Q

What are the 3 forms of bilirubin that make up serum total bilirubin?

A

Conjugated or direct, unconjugated, delta-bilirubin

82
Q

What is something in horses that can cause marked hyperbilirubinemia?

A

Anorexia

83
Q

What are serum bile acid concentrations diagnostic for?

A

Diagnostic test of hepatic insufficiency and protosystemic hepatic shunts.

84
Q

What is the major use of serum amylase and lipase activity?

A

Screening test for pancreatitis

85
Q

When serum amylase activity is >3x the URL what dieases should you think?

A

pancreatitis

86
Q

When serum amylase of 3x or less than the URL is indicative of what?

A

Nothing

87
Q

Serum lipase activity of >5x the URL has a high suspicion of what?

A

pancreatitis

88
Q

Serum lipase activity of up to 100 fold over the URL is associated with what?

A

Hepatic and pancreatic carcinomas in dogs

89
Q

TLI has high diagnostic accuracy for what?

A

exocrine pancreatic insufficency

90
Q

Serum cyanocobalamin concentrations decrease with?

A

Malabsorption in the distal small instestin, EPI, intestinal bacterial overgrowth

Clinical Pathology Final (3 decks)

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