Urology Clin Path

Question 1

Haematology

Answer 1

RBCs, WBCs, platelets
may incl haemostasis

Question 2

Biochemistry may include

Answer 2

endocrinological & urinalysis

Question 3

Immunological testing

Answer 3

lymphs, globulins

Question 4

Inflammatory markers in clinpath profile?

Answer 4

WBCs
globulins
CRP/SAA

Question 5

Endocrinological tests

Answer 5

GLC
Lipid
K
Fructosamine
T4
Cortisol
Electrolytes
etc.

Question 6

Metabolic test

Answer 6

GLC
Cholesterol
Triglyceride
Fructosamine

Question 7

Markers for malassimilation?

Answer 7

B12, folate, TLI, glucose tolerance

Question 8

Markers for anorexia?

Answer 8

K, Mg, Urea, Lipids, albumin

Question 9

Markers for mineral balance?

Answer 9

Ca, Mg, Pi

Question 10

markers of colostrum intake?

Answer 10

TP, globulin, GGT

Question 11

Markers of toxins

Answer 11

anion gap
osmolal gap
organ injury

Question 12

markers indicating cancer

Answer 12

leukaemia
lymphoma
metastasis

Question 13

Acid base markers

Answer 13

TCO2, blood gases, beta hydroxybutyrate, electrolytes

Question 14

stress markers

Answer 14

glucose, cortisol, leucon, ALP in dog

Question 15

Genetic markers can affect…

Answer 15

all markers

Question 16

Hepatobiliary injury markers

Answer 16

GLD (most specific)
ALT, AST, ALP, TB, BA, cholesterol, urea, albumin

Question 17

kidney function biomarkers

Answer 17

Ur, Cr, SDMA, amylase, electrolytes, acid-base

Question 18

Muscle injury markers

Answer 18

CK, AST/ALT

Question 19

muscle wasting markers

Answer 19

Cr, CK

Question 20

muscle exertion markers

Answer 20

lactate, CK, AST (ALT), salt, acid-base

Question 21

Pancreas biomarkers

Answer 21

Lipase, amylase, TLI

Question 22

Gastrointestinal biomarkers change for

Answer 22

colic, dehydration

Question 23

Bone biomarkers

Answer 23

rapid growth in ALP

Question 24

Cardiac biomarker

Answer 24

cTnI

Question 25

GFR biomarkers

Answer 25

Ur, Cr, SDMA, cystatin

Question 26

Electrolyte biomarkers related to primary renal dz

Answer 26

NaCl & bicarb loss

Question 27

Hydration biomarkers affected in primary renal dz

Answer 27

water loss

Question 28

acid-base biomarker related to primary renal dz

Answer 28

bicarb loss

Question 29

protein loss biomarker due to primary renal dz

Answer 29

albumin, globulins, cholesterol

Question 30

Muscle markers affected by primary renal dz

Answer 30

Cr, CK, AST

Question 31

erythron affected by primary renal dz

Answer 31

EPO

Question 32

blood biomarkers affected in primary renal dz

Answer 32

GFR, electrolytes, hydration, acid-base, protein, muscle, erythron, leukon

Question 33

Urine parameters affected in primary renal dz

Answer 33

gross, USG, glucose, protein, pH, crystals, casts, RBCs, WBCs

Question 34

Renal dz or dysfxn is often secondary to..

Answer 34

dz elsewhere

Question 35

Top 10 biomarker facts

Answer 35

1. biomarker increases indicate severity of tissue pathology
2. biomarkers may be increased rather than decreased
3. biomarkers may indicate leakage or dysfxn
4. there is biomarker redundancy in profiles
5. most biomarkers are not tissue-specific but report for 2+ tissues
6. Only rare biomarkers are tissue specific
7. some parameters are specific for multiple pathological processes
8. biomarker tissue-specificity may be species (breed, age, gender) dependent
9. Biomarker kinetics is tissue & species dependent
10. derived data that compares 1 specific parameter change to another

Question 36

How do you approach a clin path profile for a renal case?

Answer 36

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

Question 37

What are some causes of renal dz?

Answer 37

• diabetes
• ageing
• urinary obstruction
• glomerular dz
• ischaemia
• toxicity
• infection
• cancer
• hepato-renal synrome
• genetic