Past qs

Question 1

ALT

who is it specific for

where is it found

cause of elevation in plasma

Answer 1

• liver specific in carnivores
• liver cells, RBC, cytoplasm
• small amt in heart- striated muscle cells and kidney
• increase caused by liver
  
  • ​liver cell damage
  • ​hepatic lipidosis
  • chronic active hepatitis, cholangiohepatitis
  • cirrosis
  • bile obstruction
• other: pancreatitis, septicaemis, neoplasm
• drugs: barbiturates, gcc, salicylates, tetracyclines
• cu storage disorders

Question 2

acute pancreatitis

Answer 2

• causes: inflammation, hypoxia, free radicals, cold temp, mechanical trauma -> membrane damage -> enxyme activation
• clinical signs: anorexia, depression, abdominal pain, vomit, exiccosis, diarrhea, heart fail signs, vasculitis, kidney fail, liver fail, dyspnoe, anemia, icterus, peritonitis, paralytic ileus, septicemia, DIC, organ fail, abcess in pancreas
• lab exams:
  
  • haematology: rbc morph, count
  • serum biochem: pancreatic enzymes in plasma, pancreatic function
  • a-amylase: starch digestion test, p-nitrophenol method
  • lipase: turbidimetric method
  • a-amylase/creatinin ratio
  • trypsin like immunoreactivity
  • pancreatic specific lipase
  • cytology, microbiology

Question 3

lab findings in prehepatic jaundice

plasma, urine, faeces

Answer 3

Question 4

causes for blood urea concentration increase

Answer 4

prerenal

• GI:
  
  • increased protein intake
  • increased bacterial production / dysbacteriosis
  • rumen alkalosis / poor energy status
  • internal bleeding
• protein catabolism
  
  • starvation
  • haemolysis
  • hyperthyroidism
  • fever
  • (SIBO)
• perfusion
  
  • strangulation of A. Renalis
  • heart fail
  • dehydration
  • low BP
  • shock

renal

• embolism inside kidney
• CKD - fibrosis
• hypoplasia
• polycystic kidney disease
• amyloidosis
• kidney tumor
• glomerular nephritis
• NSAIDs

postrenal

• obstruction of kidney pelvis, urether, urethra, bladder
• rupture

Question 5

causes of blood urea decrease

Answer 5

• impaired liver function: decreased urea synth, increased NH3 level
• Haemodilution / hyperhydration
• decreased protein intake: starve, anorexia

Question 6

lab findings in posthepatic jaundice

Answer 6

Question 7

water deprevation test

Answer 7

• needed parameters: BW, Ht, creatinine, urea, TP, osmolality
• goal: to find cause of PU/PD - CDI, PDI or PP?
• how:
  
  • empty bladder by catheter, check BW, urine test every hr
  • withold water till 5% dehydration - approx 6 hrs
  • measure SG
• result:
  
  • PP: sg above 1025
  • CDI or PDI: SG 1010 or below
• differentiate CDI and PDI: give ADH and check after 60 min
  
  • if SG increase it was CDI
  • if SG is still below 1010 its PDI
• contraindication: endocrine disturbance, dehydration, azotemia, liver dysfunction, preggo,

Question 8

lab findings in hepatic jaundice

Answer 8

Question 9

tests for tubular function

Answer 9

1. specific gravity
2. urinary sediment analysis
3. fractional electrolyte clearance
4. analysis of enzymuria
5. urinary osmolality
6. (water deprevation test)

Question 10

what is icerus and what causes increased Br in plasma

Answer 10

• icterus=jaundice: visible yellow discoloration
  
  • in plasma, fat, skin and mucous membranes
  • first visible sight is mucous membrane of genital tract
• increased Br in plasma:
  
  • prehepatic jaundice, haemolysis: immune mediated haemolytic anemia, babesiosis
  • hepatic: liver cell damage, damaged intrahepatic structure, cirrosis
  • posthepatic: cholestasis, obstruction, pancreatitis

Question 11

causes of increased Br1 in serum

Answer 11

• excess production of Br1 due to increased RBC destruction
  
  • acute haemolysis
  • absorption of Hgb after massive haemorrhage or haematoma - absorption icterus
  • transfusion of stored blood w/ many dying RBCs
• decreased uptake of Br1 from blood by liver cells
  
  • impaired hepatic function
  • acute haemolysis
• decreased rate of conjugation of Br1 by livercells
  
  • impaired hepatic function

Question 12

increased blood creatinine

Answer 12

prerenal

• muscle
  
  • rhabdomyolysis
  • rhabdomyosarcoma
  • trauma
  • myositis
  • necrosis
• GI: increased protein intake
• perfusion:
  
  • A. Renalis strangle
  • heart fail
  • dehydration, low BP, shock

renal

• embolism inside kidney
• CKD - fibrosis
• hypoplasia
• polycystic kidney disease
• amyloidosis
• kidney tumor
• glomerular nephritis
• NSAIDs

postrenal

• rupture of kidney, urether, bladder, urethra
• (obstruction do not cause!!)

Question 13

ALKP

Answer 13

• location: every cell membrane, placenta, bone, liver, biliary epithelial cells, intestines, kidney tubular cells
• only hepatic and bone ALKP in blood
• tubular cell damage cause increase in urine
• liver ALKP heat stable, bone ALKP heat labile
• SIAP: steroid induced alkaline phosphatase, from liver
• bile duct obstruction enzyme
• pH optimum 10
• phosphotransferase: ex: P from alchohol to another

Question 14

local and general consequences of distal ileus

Answer 14

Question 15

causes of increased ALKP

Answer 15

• bone originated
  
  • young dogs, newborn, preggo
  • bone tumors: osteosarcoma
  • osteomyelitis
  • bone fractures, healing of fractures
• paraneoplastic: lymphoid, lung, hepatic tumours
• liver originated
  
  • cholestasis, intra/extra hepatic bile obstruction
  • bile acids
  • acute hepatic necrosis
  • liver cirrhosis
  • cholangitis
  • hepatic lipidosis
• drugs: barbiturates, salicylates
• increased SIAP: hyperadrenocorticism, chronic stress

Question 16

causes of decreased urine pH

Answer 16

• metabolic and respiratory acidosis: increased h excretion
• vomiting: Na+ reabsorbed wih HCO3, less hco3 in urine
• hypokalaemia: increased h excretion (na/k)
• acidic drugs
• distalis renalis tubularis acidosis: low hco3 excretion
• abomasal displacement
• toxicosis with acidifying agents

Question 17

inorganic compounds in urine

example of why they are in urine

Answer 17

alkaline urine

• struvite: urease + bacteria - UTI
• calcium-carbonate and calcium-phosphate: hypercalcuria - hyperparathyroidism
• amorphous phosphate: meat and grain diet
• ammonium-ureate/biurate: impaired hepatic function - PSS, dalmatian dog

acidic urine

• calcium oxalate: cat eating toxic plant
• uric acid: dalamtian dog
• cystine, tyrosine, leucine: metabolic disease
• bilirubin crystals: prehepatic and hepatic jaundice
• sulphonamides: sulphonamide therapy

Question 18

bile acid measurements

Answer 18

• HPLC
• TBA: total bile acids, specific!
• spectrophotometric
• only blood serum!
• either after 12 hr straving
• or postprandial

Question 19

causes of increased alpha amylase

Answer 19

• acute pancreatitis
• acute/subacute kidney fail
• FIP, other immune mediated diseases
• lymphoma, myeloma
• DM
• ileus
• gastric or intestinal perforation
• parotitis
• chronic enteritis

Question 20

Rivalta test

Answer 20

• add 1-2 drops of native sample to 3% acetic acid solution
• coagulation, smoky appearance: exudate, coag of labile protein fibrinogen, globulin
• no coagulation, sample dissolved: transudate, stable proteins, albumin
• drops remain in reagent: sample has high amt of globulin, FIP
  
  • globulins on surface of drop coagulates, making sample stay in a drop
• note!! urinanalysis need 20% salisylic acid, this coagulates all protein

Question 21

EPI - what is it, causes, lab tests,

Answer 21

• decreased production of digestive enzymes or obstruction of the pancreatic duct
• causes:
  
  • chronic necrotic or atrophic damage
    
    • chronic inflammation, fibrosis
  • inherited pancreatic acinar atrophy
• lab tests
  
  • TLI-concentration: trypsinogen
  • BT-PABA test: chymotrypsin
  • dyed agar gel digestion and schwachmann film test
    
    • chymotrypsine, elastase
  • lipid absorption test: malabsorption/maldigestion
  • faecal elastase test: elastase
  • faecal smear: check undigested material in faeces

Question 22

transudate fluid

Answer 22

Question 23

parameters from body cavity fluids

Answer 23

• physical parameters: color, odour, consistency
• rivalta test
• coagulation ability
• specific gravity
• pH
• RBC count
• nucleated cell count
• TP concentration
• albumin/globulin ratio
• creatinine, ure concentration
• alpha amylase, lipase activity
• LDH activity
• triglycerol, cholesterol concentration
• cytology

Question 24

types of body cavity fluids

Answer 24

• transudate(hydro-)
• exudate (pyo-)
• modified transudate
• blood
• chylus - lymph
• ( cavities: abdominal/peritoneal, thoracic/pleural, mediastinum included, pericardial cavity)

Question 25

Talk about bile

Answer 25

• primary bile acids: cholic acid, chenodeoxycholic acid
  
  • synthesized in liver from cholesterol
  • stored and concentrated in gall bladder
  • released to duodenum via bile duct
• primary bile acids are deconjugated by bacteria in intestines, form secondary bile acids
  
  • litho-cholic acid, deoxy-cholic acid
• 90% of conjugated bile acids reabsorbed at terminal ileum
  
  • transported back to liver via portal circulation
• 2-5% faecal loss
• function: detergent effect, key role in micelle formation and lipid digestion and anti-endotoxin effect
  
  • emulgating big fat droplet to smaller drops with more surface
  • neutralize effect of gram- bacteria toxins
• concentration in plasma increased after eating
• release is mediated by cholecystokinin-pancreozymin and secretin

Question 26

specific gravity

methods

interpretation

Answer 26

methods

• urinometer: most accurate at 21 degrees, easy, cheap, but need alot of urine
• refractometer: easy, one drop urine is enough, not reliable if urine sample is not transparent
• test strip: not usefull

interpretation

• normal: up to 1030 g/l - large variation
• hyposthenuria: below 1008
  
  • hyperadrenocorticism, decreased ADH prod, ADH resistance, renal tubular damage, PP
  • may also be seen in: hypoadrenocorticism, liver disease, prolonged fluid therapy
  • medullary washout
• isosthenuria: 1008-10012 g/l
  
  • tubules cant concentrate/dilute filtrate
  • severe tubular damage
  • also in case of: medullary washout, CDI, PDI, PP
• hypersthenuria: above 1012 g/l (physiologic)
  
  • decreased water intake, water loss, acute kidney failiure
  • also in DM (rare)

always measure more than once as large variation is normal

Question 27

glomerular function tests

Answer 27

• blood urea concentration in blood plasma
• creatinine concentration in blood plasma
• plasma urea / plasmacreatinine ratio
• creatinine clearance
• urinary total protein concentration
• urinary TP / creatinine ratio
• SDMA

Question 28

what parameters change in portosystemic shunt and why

Answer 28

• decreased hepatic perfusion
  
  • the shunt redirect part of the blood flow away from liver
• increased bile acids in blood
  
  • absorbed bile acids bypass liver tissue
• decreased urea concentration in blood
  
  • nh3 dont reach liver, no urea synthesis
• increased NH3 in blood
• microcytosis, hyperchromasia
  
  • decreased MCV, decreased MCHC

Question 29

how to measure TP/total creatinine ratio

what are the causes

Question 30

list sampling and analysis of CSF

Answer 30

• sampling:
  
  • Na K EDTA tubes!!
  • check speed of dripping - intra cranial pressure
  • important to check intracranial pressure first
    
    • retina observation
  • lumbosacral zona: more protein and cells
  • optical zona
• physical examination
  
  • color:
    
    • red: fresh bleeding
    • yellow: bleeding in the past
    • opaque: highly inflamed/ neoplastic disease
  • turbidity:
    
    • slight: cell count 100-300
    • severe: cell count 2000-3000
  • coagulation: coagulative in highly inflammatory processes
• cell count
  
  • total cell count: native sample
  • normal count: 5-10 micro litre
• cytology
• protein content
• glucose concentration
• lactate concentration
• enzyme activity

Question 31

body cavity fluids and causes for accumulation

Answer 31

• types of fluids: transudate, modified transudate, exudate, chylus, blood
• cause of accumulation
  
  • increased vessel permeability - non inflammatory
    
    • increased hydrostatic pressure
      
      • right sided heart fail
      • liver hypertension, failiure, cirrosis
      • blockage of a blood vessel
      • renal fibrosis
    • decreased plasma coloid oncotic pressure
      
      • decrease of plasma albumin
        
        • protein intake
        • malabsorption, maldigestion
        • epi
        • liver failiure: no synthesis
        • high utilisation
        • loss: ple, pln, gnp
    • impended lymph flow
    • hormonal effect
      
      • aldosterone, ADH
  • increased permeability of vessels - inflammatory
    
    • bacterial toxin
    • viral effect
    • parasitic toxins
    • inflammatory mediators

Question 32

evaluation of bile acids

Answer 32

• determination (spectrophotometric)
  
  • HPLC: test every single acids, separate
  • TBA: total bile acid, specific
  • RIA
• sample: SERUM only!
• normal range: 20micromol/l fasting, 40 after eating
• 12hrs after starving or 2 hrs after feeding
• increase
  
  • liver injury, damage
  • bile duct obstruction, biliary stasis
  • portosystemic shunt