Urology Clin Path Flashcards
Haematology
RBCs, WBCs, platelets
may incl haemostasis
Biochemistry may include
endocrinological & urinalysis
Immunological testing
lymphs, globulins
Inflammatory markers in clinpath profile?
WBCs
globulins
CRP/SAA
Endocrinological tests
GLC
Lipid
K
Fructosamine
T4
Cortisol
Electrolytes
etc.
Metabolic test
GLC
Cholesterol
Triglyceride
Fructosamine
Markers for malassimilation?
B12, folate, TLI, glucose tolerance
Markers for anorexia?
K, Mg, Urea, Lipids, albumin
Markers for mineral balance?
Ca, Mg, Pi
markers of colostrum intake?
TP, globulin, GGT
Markers of toxins
anion gap
osmolal gap
organ injury
markers indicating cancer
leukaemia
lymphoma
metastasis
Acid base markers
TCO2, blood gases, beta hydroxybutyrate, electrolytes
stress markers
glucose, cortisol, leucon, ALP in dog
Genetic markers can affect…
all markers
Hepatobiliary injury markers
GLD (most specific)
ALT, AST, ALP, TB, BA, cholesterol, urea, albumin
kidney function biomarkers
Ur, Cr, SDMA, amylase, electrolytes, acid-base
Muscle injury markers
CK, AST/ALT
muscle wasting markers
Cr, CK
muscle exertion markers
lactate, CK, AST (ALT), salt, acid-base
Pancreas biomarkers
Lipase, amylase, TLI
Gastrointestinal biomarkers change for
colic, dehydration
Bone biomarkers
rapid growth in ALP
Cardiac biomarker
cTnI
GFR biomarkers
Ur, Cr, SDMA, cystatin
Electrolyte biomarkers related to primary renal dz
NaCl & bicarb loss
Hydration biomarkers affected in primary renal dz
water loss
acid-base biomarker related to primary renal dz
bicarb loss
protein loss biomarker due to primary renal dz
albumin, globulins, cholesterol
Muscle markers affected by primary renal dz
Cr, CK, AST
erythron affected by primary renal dz
EPO
blood biomarkers affected in primary renal dz
GFR, electrolytes, hydration, acid-base, protein, muscle, erythron, leukon
Urine parameters affected in primary renal dz
gross, USG, glucose, protein, pH, crystals, casts, RBCs, WBCs
Renal dz or dysfxn is often secondary to..
dz elsewhere
Top 10 biomarker facts
- biomarker increases indicate severity of tissue pathology
- biomarkers may be increased rather than decreased
- biomarkers may indicate leakage or dysfxn
- there is biomarker redundancy in profiles
- most biomarkers are not tissue-specific but report for 2+ tissues
- Only rare biomarkers are tissue specific
- some parameters are specific for multiple pathological processes
- biomarker tissue-specificity may be species (breed, age, gender) dependent
- Biomarker kinetics is tissue & species dependent
- derived data that compares 1 specific parameter change to another
How do you approach a clin path profile for a renal case?
Haematology
anaemia? eg CRD
↓retics? eg CRD
↓lymphs? uraemic
inflammation? M1-2 ↑ neuts / monos esp in cats w/ CRD
Chemistry & U/A
azotemia? urine SG <1.35 cat, <1.25 dog then diagnose renal tubular dz
other ↓GFR biomarkers: Pi, amylase, Mg, K, SDMA, cystatin
if Ur much higher than Cr, then muscle wasting & chronicity
NaCl loss? tubular dz
normal blood glucose but glucosuria – tubular dz
alb loss into urine? =glomerular dz. Edema & hi chol = nephrotic syndrome
↓TCO2- ? likely Na loss more than Cl loss & (± hyperchloremic) metabolic acidosis
↑↑↑AG in some poisonings eg ethylene glycol
Ur crystals? Struvite in FUS
high peritoneal Cr vs blood = ruptured bladder
What are some causes of renal dz?
- diabetes
- ageing
- urinary obstruction
- glomerular dz
- ischaemia
- toxicity
- infection
- cancer
- hepato-renal synrome
- genetic
