Serum Chemistry

Question 1

Glucose D7

Answer 1

Artifact

neonatal/juvenile

Liver failure/dz

Sepsis

Insulinoma

Addison’s

Toxin (xylitol)

Question 2

glucose i5

Answer 2

Stress

DM

Pancreatitis

Cushing’s

Drugs (glucocorticoids)

Question 3

Creatinine d2 (2 things cause false decrease)

Answer 3

Decreased muscle mass

Hyperthyroidism

Question 4

creatinine i3

Answer 4

Pre-renal (dehydration, hypovolemia, addison’s)

Renal (CKD, inflam/infectious, neoplasia, ischemic, neoplasia, amyloidosis)

Post-renal (obstruction, rupture)

Question 5

BUN d4

Answer 5

Low protein diet

PU/PD (DM, Cushing’s)

Liver dz (PSS, cirrhosis)

Drugs (corticosteroids -> diuresis)

Question 6

BUN i5

Answer 6

Recent high protein meal

GI bleeding (digested blood is source of BUN)

Pre-renal

Renal

Post-renal

Question 7

phosphorus d4

Answer 7

Artifact (icterus)

Increased urinary excretion (DM, hyperparathyroidism, hypercalcemia of malignancy)

Translocation (insulin, bicarb)

Defective bone mobilization (eclampsia)

Question 8

phosphorus i4

Answer 8

Artifact (hemolysis in vitro)

Decreased GFR

Growing animals

Hypoparathyroidism

Question 9

calcium d6

Answer 9

Low albumin

CKD

Acute pancreatitis

Hypoparathyroidism

Eclampsia

Ethylene glycol toxicity

Question 10

calcium i7

Answer 10

Idiopathic (cat)

Neoplasia (lymphoma, MM, anal gland, thymoma)

Primary hyperparathyroidism

Kidney disease (uncommon)

Addison’s

Granulomatous inflammation (fungal)

Toxin (vitamin D rodenticide)

Question 11

sodium d4

Answer 11

GI loss (diarrhea, vomiting)

Renal loss (diuretics)

DM

Addison’s

Question 12

sodium i3

Answer 12

GI water loss (vomiting, diarrhea)

Pure water loss (fever, panting, hyperventilation, hyperthermia)

Decreased water intake

Question 13

potassium d5

Answer 13

Decreased intake

CKD (cats)

Renal loss (diuresis, post-obstructive diuresis)

GI loss (vomiting, diarrhea)

Translocation (insulin/glucose)

Question 14

potassium i4

Answer 14

artifact (delayed serum separation)

AKI

Urinary obstruction/rupture

Addison’s

Question 15

TP d6

Answer 15

malabsorption/nutrition

Liver failure

Hemorrhage

PLN

PLE

EPI

Question 16

TP i4

Answer 16

Dehydration

Chronic inflammation

Infection (viral (FIP), rickettsial (ehrlichiosis), chronic bacterial)

Neoplasia (MM, some lymphoma)

Question 17

albumin d10

Answer 17

Liver disease

maldigestion(EPI)

Malabsorption (IBD, neoplasia, lymphangiectasia)

Malnutrition

Inflammation (negative acute phase)

Hemorrhage

PLN

PLE

Addison’s

Excessive IV fluids

Question 18

albumin i1

Answer 18

hemoconcentration

Question 19

globulin d4

Answer 19

Hemorrhage

PLE

malabsorption

EPI

Question 20

globulin i4

Answer 20

Hemoconcentration

Inflammation

Infection (bacterial, viral (FIP), fungal, rickettsial (ehrlichiosis), protozoal)

Neoplasia (MM, some lymphomas)

Question 21

ALT/AST di

Answer 21

Rarely clinically significant

End stage liver disease

Question 22

ALT/AST i7broad

Answer 22

Inflammatory (chronic hepatitis, cirrhosis, pancreatitis)

Infectious (cholangiohepatitis, lepto, FIP, histo, infectious canine hepatitis)

Toxic (NSAIDS, phenobarb, steroids, methimazole)

Liver hypoxia (anemia, CHF, shock)

Metabolic (hyperT4, hepatic lipidosis, cushing’s, DKA/DM)

Neoplasia

Trauma

Question 23

bilirubin d not significant

Question 24

bilirubin i3

Answer 24

Pre-hepatic (hemolysis: IMHA, zinc/onion, parasites)

Hepatic: same as ALT basically

Post-hepatic (cholestatic): same as ALP basically

Question 25

cholesterol d4

Answer 25

Decreased production (cirrhosis, PSS)

Decreased absorption (low fat diet, severe SI dz)

Increased loss (lymphangiectasia)

Addison’s

Question 26

cholesterol i5

Answer 26

Post-prandial

Metabolic: hypothyroidism, DM, cushing’s

Pancreatitis

Nephrotic syndrome/PLN

Drugs: steroids