Quiz 5 the kidney, proteins, liver and endocrine system

Question 1

The primary functions of the kidney:

Answer 1

• Removal of metabolic wastes and toxic substances.
• Regulation of fluid compartment volume and composition of body fluids.
• Maintenance of acid/base balance—electrolyte movement.
• Maintenance of blood pressure—renin/angiotensin.
• Maintenance of RBC levels—erythropoietin.
• Maintenance of bone matrix and blood calcium levels—vitamin D activation.

Question 2

The ____________ is the kidney’s primary functional unit.

Answer 2

nephron

Question 3

glomerulus

Answer 3

filtering system in nephron

Question 4

define glomerular filtration rate

Answer 4

the rate at which the kidneys form filtrate is the glomerular filtration rate (GFR). It depends upon the blood pressure, amount of resorption at the level of the kidney, and rate of urine output.

Question 5

Why is SDMA a more appropriate test to identify early kidney disease than BUN

Answer 5

SDMA is a more sensitive earlier marker to identify renal disease than BUN or creatinine.

Question 6

SDMA

Answer 6

SDMA is produced by all nucleated cells at a constant rate.

An elevation in our SDMA on a biochemical profile is an indicator of impaired GFR and early renal disease.

Question 7

BUN

Answer 7

urea (BUN) is synthesized in the liver from ammonia (the main waste product of protein catabolism). For these reasons, BUN can be mildly increased for several reasons other than renal disease:

Increased protein catabolism (starvation).

High protein diet.

Bleeding into the gastrointestinal tract (GIT)—Digested blood is broken down into protein which is broken down into urea in the liver.

Question 8

how urine-specific gravity and a complete urinalysis allow for a better understanding of renal function

Answer 8

If renal disease is present, there will be a reduction in the urine-specific gravity (more dilute urine). For example, if normal for that animal is a urine-specific gravity of 1.040, then a 1.015 would be a dilute urine.

Question 9

chronic vs acute renal failure

Answer 9

Acute - Acute renal failure occurs when there is an abrupt decrease in renal function sufficient to result in retention of nitrogenous wastes.animals with acute kidney failure may die despite intensive immediate therapy. Those who recover, if the damage is significant, can transition to develop a permanent change to the kidney and the onset of chronic renal failure.

Chronic- gradual decline in renal function where the damage to the kidney is no longer reversible. In chronic renal failure, the stage of disease is often performed to provide guidance for diagnosing, treating, and managing chronic kidney disease.

Question 10

biochemical profile includes:

Answer 10

Blood urea nitrogen (aka urea, BUN)

Creatinine

SDMA-symmetric dimethylarginine

BUN: Creatinine ratio

Urinalysis (will be discussed in greater detail next semester)

Urine protein: Creatinine (UPCR)

Question 11

Filtration is ____________Essential nutrients, as well as wastes, will end up in the filtrate

Answer 11

non selective

Question 12

azotemia

Answer 12

Azotemia is the accumulation of nitrogenous wastes in the serum. The primary nitrogen-containing waste products are urea and creatinine.

Question 13

prerenal, renal, vs post renal

Answer 13

-prerenal- result of decreased blood flow/blood pressure to kidneys
- Renal—direct damage to the kidneys
- Postrenal—damage or blockage of urine outflow along the urinary tract after the kidneys (ureters, bladder, urethra)

Question 14

what common tests are used to evaluate renal function:

Answer 14

Blood urea nitrogen (aka urea, BUN)

Creatinine

SDMA-symmetric dimethylarginine

BUN: Creatinine ratio

Urinalysis (will be discussed in greater detail next semester)

Urine protein: Creatinine (UPCR)

Question 15

up to _____ of urea is excreted in the urine

Answer 15

40%

Question 16

BUN is dependent on:

Answer 16

Prerenal—result of decreased blood flow/blood pressure to kidneys

Renal—direct damage to the kidney

Postrenal—blockage of urine outflow

Question 17

an elevation in BUN often cannot be seen on your bloodwork biochemical profile until approximately _________of the nephrons are nonfunctional. For this reason, BUN is not a sensitive indicator of renal disease.

Answer 17

2/3

Question 18

creatinine vs creatine

Answer 18

• Creatine (not creatinine) is synthesized in the liver as an energy source for muscle contraction.
• The waste product is creatinine and is excreted into the blood at a constant rate and filtered in the kidney.

Question 19

Discuss why creatine is a better indicator than BUN

Answer 19

due to the fact that muscle mass and the rate of creatinine production are stable from day to day and also not affected by diet like BUN, creatinine is a much more specific indicator of renal disease than BUN.

Question 20

UPCR

Answer 20

Should be very small amount of protein in urine but lots of creatinine (waste product!)

Ratio should be <1.0—If ratio increases, may indicate increased loss of albumin due to glomerular disease.

Early indicator—often before azotemia!

Question 21

Mild increases in _____________can be fatal—stop the heart!

Answer 21

Potassium

Question 22

How is anemia involved in kidney failure:

Answer 22

The kidney is the site where erythropoietin is produced in the body. With chronic renal impairment, the ability of the kidney to produce erythropoietin effectively is reduced, leading to a reduced signal to the bone marrow to produce more RBCs when required.

Question 23

how is protein measured manually?

Answer 23

Refractometry - Estimating plasma protein (including fibrinogen) in EDTA plasma.

Question 24

albumin roles

Answer 24

Albumin is the major plasma protein that we evaluate—50–60% of TP (total protein).
Plays a large contribution to plasma colloid osmotic pressure.

Maintains osmotic gradient and plays a role in keeping water inside the blood vessels.

Albumin is a carrier protein for many substances.

Albumin also plays a role as a nutrient source.

Question 25

hypoalbuminemia and hyperalbuminemia.

Answer 25

hyperalbuminemia: Increased production, Physiologic increase/ hemoconcentration, or laboratory error

Hypoabuminemia: physiologic Hemodilution, Decreased production, increased loss

Question 26

hypoglobulinemia and hyperglobulinemia.

Answer 26

Hypoglobulinemia:
- failure of passive transport

hyperglobulinemia:
- any increase in globulin factors, increase in antibody production

Question 27

most common enzymes evaluated on a biochemical profile for organs

Answer 27

ALT, AST, GGT, ALP, ALKP, AMYL, LIP, LPS, CK

Question 28

proteins are made up of: Amino acids which are

Answer 28

A carboxylic acid (-COOH).

An amino (-NH2) group attached to the same carbon atom.

The R-group, also attached.

Distinguishes one amino acid from another.

R groups give the amino acid its name. The R group includes: glycine, alanine, valine, leucine, cysteine, etc.

Question 29

Essential Amino Acids

Answer 29

amino acids that cannot be produced by the body and must be obtained through nutritional sources, (e.g., dogs and methionine or cats and taurine).

Question 30

Non-Essential Amino Acids

Answer 30

These are amino acids that can be produced by cells in the body (e.g., aspartate).

Question 31

hormones role

Answer 31

Hormones are chemical messengers which interact with other components to produce biochemical changes.

Part of the endocrine system.

Released directly into the bloodstream (e.g., insulin, thyroxine, epinephrine).

Question 32

enzymes

Answer 32

Enzymes are involved in controlling the biochemical and physical reactions of cells.

Question 33

receptors

Answer 33

Receptors receive chemical signals within the body (e.g., neural receptors).

Question 34

antibodies

Answer 34

Antibodies play a large role in the immune response.

Question 35

fibrillar proteins

Answer 35

Keratin found in nails and fur.

Collagen found in bones and cartilage, providing strength and flexibility.

Contractile proteins within muscle (actin and myosin).

Question 36

he ratio of albumin to the amount of globulin in most species is ______

Answer 36

1:1

Question 37

Role of liver

Answer 37

Control of blood glucose levels—storage of glucose as glycogen when needed (the glycogen will be converted back to glucose as an energy source).

Removes toxins from the body: ammonia as well as many others.

Primary site for drug metabolism.

Production of bile (bile will eliminate bilirubin in excess and absorb fats).

Production of cholesterol.

Produces most of the proteins in the body.

Produces many of the clotting factor proteins.

Storage of vitamins, including the fat-soluble vitamins A, D, E, K.

Production of immune factors.

Involved in phagocytosis of bacteria in the bloodstream (like the spleen).

Question 38

Liver enzymes

Answer 38

ALT, AST, GGT, ALP ALKP, SDH

Question 39

Bile is stored in the

Answer 39

gall bladder

Question 40

role of bile

Answer 40

assists in the elimination of bilirubin

Question 41

Cholestasis

Answer 41

occur when bile does not flow appropriately within the biliary system. It can occur from within the biliary ductules system itself due to a concern within the hepatocytes or from an extrahepatic mechanical obstruction to the bile ducts.

Question 42

Jaundice/icterus

Answer 42

Excess bilirubin builds up in a patient

Question 43

Cirrhosis

Answer 43

Cirrhosis is the replacement of damaged liver tissue with fibrous scar tissue, which is an irreversible change to the liver. This can occur secondary to chronic liver disease over time.

Question 44

ALT

Answer 44

Useful in dogs and cats to evaluate if there is any liver cell damage (hepatocyte damage)

Question 45

AST

Answer 45

Useful in cats, dogs, ruminants, and horses to evaluate for liver disease.
other tissue sources may also leak this enzyme

Question 46

GGT

Answer 46

• good indicator for horses of hepatocellular injury and bile duct injury
• additional enzyme evaluated in dogs and cats

Question 47

ALP ALKP

Answer 47

liver disease in dogs, Certain meds can cause leakage such as steroids seizure meds etc, liver disease in cats
- other reasons we can see elevation is endocrine disease, growing puppies, difficult collection, hemolyzed sample

Question 48

SDH

Answer 48

liver disease bovine patients

Question 49

Bilirubin levels in the blood can be:

Answer 49

Total bilirubin.

Direct bilirubin.

Indirect bilirubin is also commonly reported on a biochemical profile.

Question 50

An elevation in liver enzymes __________ indicate liver dysfunction. When we are looking to evaluate liver dysfunction in dogs and cats, a separate bile acids test is required.

Answer 50

does not