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FA2 Clinical Pathology > Lecture 18 11/12/24 > Flashcards

Lecture 18 11/12/24 Flashcards

1
Q

What is a serum iron test?

A

test that evaluates iron in circulation bound to transferrin

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2
Q

What is a total iron binding capacity test?

A

test that evaluates plasma’s capacity to carry iron

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3
Q

What is a % saturation test?

A

calculated result that indicates what % of transferrin molecules are bound by iron

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4
Q

What is a ferritin test?

A

immunoassay that quantifies plasma ferritin concentrations and correlates to total body stores

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5
Q

What is a bone marrow iron test?

A

visual qualitative assessment of hemosiderin stored in marrow macrophages

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6
Q

Which test is considered “gold standard” for assessing total body iron stores?

A

bone marrow iron

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7
Q

What are the characteristics of absolute iron deficiency?

A

-decreased total body stores of iron
-occurs through chronic external blood loss

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8
Q

Why is it difficult to correct absolute iron deficiency with oral replacement therapy?

A

only a small amount of iron is absorbed from the GI tract in veterinary species

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9
Q

What are the characteristics of anemia of inflammatory disease?

A

-hepcidin binds to ferroportin and causes its internalization and degradation
-reduced export of dietary iron into circulation
-sequestration of storage forms of iron occurs in macrophages

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10
Q

How does absolute iron deficiency present on different iron tests?

A

-decreased serum iron
-normal to increased total iron binding capacity
-decreased % saturation
-decreased ferritin
-decreased bone marrow iron

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11
Q

How does functional iron deficiency/inflammatory iron deficiency present on different iron tests?

A

-decreased serum iron
-normal to decreased total iron binding capacity
-normal to decreased % saturation
-increased ferritin
-increased bone marrow iron

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12
Q

What are the characteristics of hepatic insufficiency and portosystemic shunts?

A

-approximately 50% of dogs with PSS have low serum iron and decreased total iron binding capacity
-mechanism is unknown but presumed to be iron sequestration
-ferritin is normal to increased

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13
Q

What can lead to an iron overload?

A

-hemolytic disease**
-chronic blood transfusions
-excess dietary or parenteral iron administration

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14
Q

Where is PTH sourced from?

A

parathyroid gland

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15
Q

What are the target organs of PTH?

A

-bone
-kidney
-intestine

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16
Q

What is the net hormone effect of PTH on plasma conc.?

A

-increased calcium
-decreased phosphate

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17
Q

Where is vitamin D sourced from?

A

-GI absorption
-skin metabolism

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18
Q

What are the target organs of vitamin D?

A

-bone
-kidney
-intestine

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19
Q

What is the net hormone effect of vitamin D on plasma conc.?

A

-increased calcium
-increased phosphate

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20
Q

Where is calcitonin sourced from?

A

C-cells of the thyroid gland

21
Q

What are the target organs of calcitonin?

A

-bone
-kidney
-intestine

22
Q

What is the net hormone effect of calcitonin on plasma conc.?

A

-decreased calcium
-decreased phosphate

23
Q

Where is FGF23-Klotho sourced from?

A

bone

24
Q

What is the target organ of FGF23-Klotho?

A

kidney

25
Q

What is the net hormone effect of FGF23-Klotho on plasma conc.?

A

decreased phosphate

26
Q

What are the characteristics of free/unbound Ca2+?

A

-ionized calcium
-physiologically active fraction
-regulated fraction in health
-contributes to pathologic states

27
Q

What are the characteristics of protein-bound Ca2+?

A

-80% bound to albumin
-20% bound to globulins
-acts as a storage/buffer pool
-influenced by body pH

28
Q

What are the characteristics of complexed Ca2+?

A

-bound to non-protein anions
-anions include citrate, lactate, and phosphate

29
Q

Which factors affect plasma Ca2+?

A

-young age
-body protein status
-intestinal absorption
-resorption from bones
-urinary excretion

30
Q

Which hormones affect plasma Ca2+, and in which direction?

A

-PTH; increase
-vitamin D; increase
-calcitonin; decrease

31
Q

What are the causes of hypercalcemia?

A

-hyperparathyroidism
-osteolysis
-granulomatous disease
-spurious/analytical error
-idiopathic
-neoplasia
-young animals
-Addison’s disease
-renal failure
-vitamin D excess

32
Q

What are the characteristics of primary hyperparathyroidism?

A

-occurs due to hyperplasia or neoplasia of parathyroid glands
-increased fCa2+
-increased or within reference interval PTH

33
Q

What are the characteristics of hypercalcemia of malignancy?

A

-PTH related protein (PTHrp) behaves like PTH and has similar biologic effects
-PTHrp is secreted by neoplasms such as T cell lymphoma or apocrine gland of the anal sac carcinoma

34
Q

How does hypoproteinemia lead to hypocalcemia?

A

-fCa2+ is tightly regulated by hormones
-if protein decreases, calcium is excreted by kidneys or removed to storage pools; it does not shift to fCa2+

35
Q

What are the characteristics of direct fCa2+ measurement?

A

-done on blood gas instrument
-use heparinized whole blood
-maintain anaerobic conditions
-measure sample right away

36
Q

What are the characteristics of primary hypoparathyroidism?

A

-due to low production of PTH
-low fCa2+
-low or within lower reference interval PTH
-increased or within upper reference interval PO4
-uncommon in vet med

37
Q

What are the characteristics of hypovitaminosis D/secondary hyperparathyroidism?

A

-most commonly occurs in CKD patients
-can be seen with nutritional deficiency or chronic GI disease
-low or within lower reference interval fCa2+
-PTH increased or within upper reference interval

38
Q

What are the characteristics of total calcium measurement?

A

-done on chem. analyzer
-serum or heparinized plasma sample
-avoid EDTA and citrate anticoagulants

39
Q

What are the fractions of PO4?

A

-free; 55%
-protein-bound; 10%
-complexed; 35%

40
Q

What are the factors that affect plasma PO4?

A

-young age
-intestinal absorption
-resorption from bones
-urinary excretion
-shifting between compartments

41
Q

Which hormones affect plasma PO4, and in which direction?

A

-PTH; decrease
-vitamin D; increase
-calcitonin; decrease
-FGF23-Klotho; decrease

42
Q

What are the characteristics of phosphate measurement?

A

-done on chem. analyzer
-serum or heparinized plasma sample
-avoid hemolysis; RBCs contain phosphate, can artifactually increase readout

43
Q

Why is it important to evaluate calcium and phosphate together?

A

-sustained hypercalcemia can result in metastatic calcification
-[Ca2+]x[PO4] greater than 70 indicates increased risk of metastatic dysfunction
-concern for renal dysfunction

44
Q

What are the characteristics of magnesium?

A

-majority of Mg2+ is intracellular
-1-2% of Mg2+ is in plasma
-fMg2+ is the active fraction

45
Q

What is the breakdown of Mg2+ plasma distribution?

A

-55-60% fMg2+
-30-40% protein-bound Mg2+
-4-6% complexed Mg2+

46
Q

What factors affect plasma Mg2+?

A

-body protein status
-intestinal absorption
-urinary excretion
-shifting between compartments

47
Q

Which hormones impact plasma Mg2+, and in which direction?

A

-PTH; increased
-aldosterone; decreased
-thyroxine; decreased

48
Q

What are the characteristics of total magnesium measurement?

A

-done on chem. analyzer
-serum or heparinized plasma sample
-avoid EDTA and citrate anticoagulants

49
Q

What are the characteristics of free magnesium measurement?

A

-done on blood gas instrument
-heparinized whole blood sample
-quick, anaerobic handling
-measure sample as soon as possible

FA2 Clinical Pathology (21 decks)

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