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Lab D > Lab 1 Homeostasis > Flashcards

Lab 1 Homeostasis Flashcards

1
Q

What anticoagulant is generally used for hematology and how does it work?

A

EDTA

Irreversibly chelates Ca2+

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2
Q

How are most blood biochemistry parameters evaluated?

A 
In serum (blood is clotted)
or heparinized plasma
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3
Q

How does heparin work on plasma?

A

Enhanced the binding of coagulation factors to antithrombin III which blocks the conversion of fibrinogen to fibrin

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4
Q

What type of heparin is used for electrolyte measurements?

A

Lyophilized, calcium equilibrated heparin

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5
Q

Which anticoagulant is used for the testing of blood clotting parameters and how does it work?

A

Na2-Citrate 3.8%
Reversibly chelates Ca2+
Also suitable for blood smear (low damage in blood cell metabolism)

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6
Q

Give the three water compartments in the body

A

Extracellular
Intracellular
Transcellular

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7
Q

What is the fluid in the water compartments influenced by?

A

Lungs, kidneys, skin, GI tract

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8
Q

Give total water content of the body

A

600-650 ml/BWkg

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9
Q

What two kinds of volume disturbances can be distinguished?

A

Perfusion and hydration disorders

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10
Q

How can you measure the water volume of each compartment in the body?

A

Not possible, but can be estimated based on some measurable parameters

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11
Q

What does a decrease of tissue perfusion mean?

A

Volume deficit in intravascular space

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12
Q

5 clinical signs to evaluate perfusion:

circulatory problems

A 
Capillary refill time (CRT)
Mucous membrane color
Strength of pulse
Heart rate
Blood pressure (central venous pressure)
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13
Q

7 clinical signs to evaluate hydration

interstitial/intracellular water supply

A

Skin turgor (elasticity)
Mucous membranes
Sunken eyes, prolapse of third eyelid (cats
Eye turgor
Skin around oral cavity or anus
Body weight changes
Urine production, specific gravity of urine

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14
Q

What blood parameters can be used to evaluate volume disturbances?

A

PCV, Ht
Hb concentration
TP or Alb conc
Change in MCV of RBC (osmotic)

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15
Q

What happens at 5-15% loss of total blood volume?

A

No change in blood pressure

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16
Q

What happens at 15-25% loss of total blood volume?

A

Tachycardia, peripheral vasoconstriction, increased BP

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17
Q

What happens at 35-45% loss of total blood volume?

A

Severe BP decrease, oliguria and peripheral vasodilation - shock

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18
Q

What happens at 50% loss of total blood volume?

A

Death

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19
Q

What does Packed Cell Volume give information about?

A

The ratio of whole blood volume to the volume of red blood cells

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20
Q

What can be detected by PCV

A

Fluid volume changes and quantitative changes of RBCs

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21
Q

Give three methods to measure PCV

A

Microhematokrit/microcapillary method
Automated cell counter
Handheld HCT meter

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22
Q

Microhematokrit/microcapillary method

A

Blood into microcapillary, centrifuge, read result on Ht scale

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23
Q

Automated cell counter

A

ACC measure MCV and the number of RBCs

The machine automatically calculates the PCV

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24
Q

Handheld HCT meter

A

Measures Ht and total Hgb in whole blood
Species chip and test strip inserted into meter
Uses optical reflectance

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25
Q

Physiological Ht range for most species

A

0.35-0.45 l/l or 35-45%

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26
Q

Interpretation of PCV results

A

Decrease: oligocythaemia or anaemia
Increase: polycythaemia

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27
Q

Physiological polycythaemia

A

Congenital
Newborn
Physiological long-term hypoxia

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28
Q

Relative polycythaemia

A

Dehydration

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29
Q

Absolute polycythaemia

Primary/Secondary

A

Increased RBC production

Primary:
no increase in EPO
Bone marrow neoplasia, polycyt. absoluta vera

Secondary:
because of increased EPO
True: long term hypoxia
(BOAS dogs, RAO, right-left shunt of heart)
Not true: no hypoxia 
EPO producing tumour of kidney/liver
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30
Q

Complex polycythaemia

A

Hypervolaemic polycythaemia

Life threathening acute stress or extreme physical exercise - constriction of blood vessels and spleen

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31
Q

False polycythaemia

A

Long sample storage with EDTA

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32
Q

False oligocythaemia

A

Microcytosis

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33
Q

Physiological oligocythaemia

A

Increased plasma volume in the 3rd trimester

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34
Q

Relative oligocythaemia

A

Pathological increase in plasma volume (hyperhydration)

Iatrogen, terminal phase of chronic kidney insufficiency

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35
Q

Absolute oligocythaemia

A

After acute bleeding

Decreased RBC production:

Bone marrow suppression
(Heavy metal poisoning, mycotoxins, viral infections)
Deficiencies: Fe, Cu, pyridoxal, cobalamine, folic acid
Decreased lifespan in circulation: immune-med hemolytic anemia
Sequestration of RBCs in spleen (splenomegaly)

36
Q

Complex oligocythaemia

A

Hypovolaemic oligocythaemia

Absolute oligocythaemia with vomiting/diarrhea

37
Q

Additional information by examining blood in Ht tubes after centrifuging

A

Colour change of plasma
Buffy coat
Microfilaria larvae

38
Q

Mention 4 color changes of plasma

A
  1. Reddish tint: hemolysis
  2. White/opaque: alimentary hyperlipidaemia
  3. Yellow: hyperbilirubinaemia (horse physiological, cattle b-carotene)
  4. Chocolate brown: methaemoglobinaemia
39
Q

Buffy coat in Ht tube

A

WBCs
1-2 mm
Increase/decrease can be seen

40
Q

Mild dehydration

A

<5% hardly detectable
5-6% skin turgor
6-8% enophtalmos, dry mucosa

41
Q

Moderate dehydration

A

8-10% longer CRT, dry mucosa, enophtalmos, tachycardia, severe skin turgor

42
Q

Advanced dehydration

A

10-12% signs of shock, disturbed consciousness
weak pulse, tachycardia, low BP, cold extremities

12-15% shock, life threathening

43
Q

Common PCV lab errors

A

Improper mixing
Leak of RBC during centrifuging
Anticoagulant effect (clumping or swelling)

44
Q

Serum osmolality

A

Osmotic pressure of body fluids expressed in kg

Depends on concentration of osmotically active substances: Na/K/Cl and urea, glucose and ketone bodies

45
Q

What sample is used to measure serum osmolality

A

Heparinised plasma or serum

46
Q

Methods to measure serum osmolality

A

Mathematical

Osmometer

47
Q

Mathematical measurement of serum osmolality

A

2 (Na+K) + urea + glucose

Advantage: no additional equipment needed

48
Q

Osmometer

A

Measures freezing point of sample compared to freezing point of water (0C)

49
Q

Osmolar gap

A

Difference between calculated and measured osmolarity

Gives information about toxins

50
Q

Hyperosmolarity

A

> 310 mOsm/kg

Concentrated EC fluids

51
Q

Hypoosmolarity

A

<270 mOsm/kg

Diluted EC space

52
Q

What can happen if we try to decrease blood glucose in advanced DM patients too quickly with exogenous insulin administration?

A

Rapid change in osmolarity
Hypophosphataemia, hypokalaemia
Cellular oedema in brain or lungs

53
Q

What can increase osmolar gap?

A

Ethanol, ethylene-glycol, methyl-alcohol or isopropyl-alcohol in the blood

54
Q

Electrolyte concentration

Sample

A

Ionogram
Heparinised whole blood
Ca2+: calcium ion-equilibrated Na- or Li- heparinate

55
Q

Why not use Na/K EDTA for ionogram analysis?

A

Increases conc of Na/K and decreases Ca to zero

56
Q

Na+
Reference range
What does it do
Conc depends on

A

140-150 mmol/l
Maintains plasma osmolarity: cannot move freely through biological membranes

Depends on intake, per os and IV
Excretion: 
prox tubules: 60% reabsorbed
Aldosterone effect
Distal tubules
Excretion of other osmotically active substances
Sweating (horses)
57
Q

Causes of hypernatraemia

A 
1. Dehydration
Decreased intake
Polyuria (diabetes insipidus)
Vomiting, diarrhea
Hyperthermia, panting
  1. Na+ retention in kidneys
    Primary/secondary hyperaldosteronism
  2. Other
    Hypertonic saline solution overdose
    Salt poisoning
58
Q

Causes of hyponatraemia

A 
1. Water poisoning
Per os (ru)
Overdose of IV hypotonic fluid
  1. Retention of water
    Cardiac insufficiency
    Renal or hepatic insufficiency
3. Na+ loss
Diarrhea
Renal loss, hypoadrenocorticism
Sweating
Body cavity sequestration
  1. Water efflux from IC to EC
59
Q

K+
Reference range
Conc depends on

A

3.5-5.5 mmol/l
Intake
Excretion (90% reabs)
increases in presence of aldosterone effect
Depends on pH
Insulin: cotransport of K+ with glucose into cells

60
Q

7 causes of hypokalaemia

A 
Decreased intake
Long term polyuria
Administration of loop-diuretic drugs
Enteral potassium loss
Primary/Secondary hyperaldosteronism
Alkalosis
Insulin
61
Q

causes of hyperkalaemia

A 
Increased intake
Acute kidney failure
Urinary bladder rupture
Hypoaldosteronism (also hyperadrenocorticism)
Acidosis
62
Q

Pseudohyperkalaemia

A

Damage of tissue cells or RBS (necrosis, hemolysis)

ø Dogs

63
Q

Why is the normal range of K+ narrow?

A

Because substantial change in either direction influences the conduction of neural stimuli
Muscle weakness

64
Q

Cl-

Reference range

A

100-125 mmol/l

Most important anion of plasma (With HCO3)

65
Q

Hyperchloraemia

A 
Salt poisoning
Decreased secretion (hyperaldosteronism) and other processes with hypernatraemia
66
Q

Hypochloraemia

A

Abomasal displacement, vomiting, diarrhea, sweating and other processes with hyponatraemia

67
Q

Major cations and anions

A

Cations: Na+, K+
Anions: Cl-, HCO3-

68
Q

Anion gap

A

Other anions

Proteinate, phosphate, sulphate, lactate, oxalate, salicylate

69
Q

Calcium
Role

Presence in blood plasma

A 
Ionized: Ca2+, Total: tCa
Neuromuscular irritability maintenance
Muscle contraction initiation
Cell membrane permeability regulation
Blood clotting processes
Bones and teeth

47% bound to albumins
40% free ionized form
13% chelated form (organic acids)

70
Q

Calcium reference range

Egg-laying poultry

A

2.1-3 mmol/l (Ca2+ half)

Can be doubled (%decrease of ionized fraction)

71
Q

tCa preferred sample

Ca2+ preferred sample

A

tCa: Serum

Ca2+: heparinized plasma

72
Q

Ca2+ measurement

A

Ion-selective electrodes

73
Q

tCa measurement

A

Spectrophotometry

Calcium forms violet complex in high pH with orthocresolphtalein

74
Q

Neuromuscular irritability symptom, calcium test

A

Test for Ca2+ instead of tCa

Calcium binding substances getting into blood stream and bind ionized Ca2+

75
Q

Hypocalcaemia

A

Insufficient intake or absorption (vit D)
Parathyroid gland hypofunction (Mg deficiency)
Lactating animals
Calcium binding substance toxicosis

Usually both low but:
Low Ca2+: caused by alkalosis (bound to albumin)

76
Q

Hypercalcaemia

A

Excessive Ca/vit D intake
Hyper a vitaminosis (cats)
Parathormone hyperfunction
Causes damage to bones and soft tissue calcification

77
Q

tCa can be influenced by

A

Plasma proteins

78
Q

Chronic kidney insufficiency compensation

A

Constant calcium loss: hypocalcaemia
Compensation by PTH excretion
Secondary renal hyperparathyroidism and hypercalcaemia

79
Q

Magnesium forms
Role
Reference range

A 
tMg, Mg2+
ATP metabolism (bound to Mg IC)
Actin-myosin activator
Catalysator for more than 300 enzymes
Facilitates synthesis and breakdown of ACh

0.8-1.5 mmol/l

80
Q

Preferred samples:
tMg
Mg2+

A

tMg: serum or heparinized plasma

Mg2+ heparinised plasma

81
Q

Mg Measurement

A

Mg2+: ion-selective electrodes (ISE) 70% of total Mg

tMg: Spectrophotometry with xylidine-blue reagent (purple complex)

82
Q

Hypomagnesaemia

A

Grass tetany
Early spring grass, especially lactating
Muscle spasms, respiratory distress, death

Absorption disturbance
Increased excretion (renal/enteral)
Hyperthyroidism (also inc IC Mg storage)

83
Q

Hypermagnesaemia

A 
Increased intake
Decreased excretion:
chronic insufficiency
milk fever
hypothyreosis
Hyperadrenocorticism
Dehydration
84
Q

Inorganic phosphate
What does it do
Reference range

A 
Product, reaction partner and a source of several synthetic, transitional and breakdown processes
(ATP, sugar phosphate, glucose-6-P)
Plasma buffer systems
Eq/Ca: 0.8-1.8 mmol/l
Fe/Bo/Ov: 1-2.4 mmol/l
Su/Cap: 1-3 mmol/l
85
Q

Pi sample and measurement method

A

Sample: Serum/heparinised plasma
Spectrophotometry
Acidic: phosphorus reacts with ammonium-molybdate and forms yellow complex

86
Q

PTH effect

A

Induces phosphate and calcium mobilization from the bones and increased Pi-excretion and Ca-reabsorption through kidneys. Net effect: decreased Pi and increased Ca in plasma

87
Q

Calcitonin effect

A

Increases calcium and phosphate absorption from intestines and their incorporation into the bones. Net effect is decreased Pi and Ca conc in the blood.

Decrease of plasma Ph causes a decrease in Pi-conc and an increase in Ca2+ level (tCa no change)

Lab D (8 decks)

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