Week 6 notes Flashcards
What are several uses of a clinical chemistry profile?
Screen for disease, assess pre-surgical risk, distinguish between DDX, assess severity of existing disease, monitor progression/response to therapy and identify patterns that suggest dysfunction
What are some factors that can affect quality of test results?
Collection procedure: use correct needle size, fill tubes in correct order, store correctlyLabeling, handling and shippingPatient variablesEquipment difficulties
What are some analytical factors that can affect tests?
Analyzer, other equipment, test methods and components, quality control, and operating and maintenance procedures
How do we have QC and accurate results from chemistry analyzers?
Proper calibration, routine maintenance, running daily controls, blanking methods, monitor for deterioration of reagents, monitor condition of analyzer
What are the sample types we use for chemistry panels?
Serum, heparinized whole blood, and heparinized plasma
What are the functions of plasma proteins?
Structural component of cells, organs, and tissues, osmotic pressure, enzymes, buffers, hormones, clotting, defense, and transport molecules
Total plasma proteins includes what?
All proteins and fibrinogen
Total serum proteins includes what?
All proteins excluding clotting factors
Protein concentrations are affected by?
Hepatic synthesis, altered protein breakdown or excretion, and dehydration or over hydration
Albumin is what % of total protein?
35-50%
What are the 2 different globulins and where do they come from?
Alpha- from the liverGamma- from antibodies
How do you get globulin concentration?
TP - Albumin = concentration
What is the first indication of protein abnormality?
Albumin to globulin ration A:G
Fibrinogen is how much of TP?
3-6%
What are some hepatobiliary assays we do?
ALT, AST, AP, bilirubin, cholesterol, sorbitol dehydrogenase, glutamate dehydrogenase, and gamma glutamyltranspeptidase
What are some renal assays we do?
BUN, serum creatinine, and BUN/ creatinine ratio
What are some exocrine pancreatic assays we do?
Amylase, lipase, trypsin, serum TLI, and serum PLI
What are some electrolyte assays we do?
Calcium, inorganic phosphorus, sodium, potassium, magnesium, chloride, and bicarbonate.
What are 2 miscellaneous tests we might do?
Creatine kinase, and lactate
What are some endocrine pancreatic assays we do?
Glucose, fructosamine, glycosylated hemoglobin, beta-hydroxy-butyrate, glucose tolerance, and insulin tolerance
What are some adrenocortical function tests we do?
ACTH stimulation, dexmethasone suppression
What are some thyroid assays we do?
T4 and cholesterol, TSH response, TRH response, T3 suppression,
What are some pituitary function assays we do?
GH (growth hormone)
What other test do you perform with AST?
ALT
If your ALT and AST are high what assay do you perform and why?
CK to differentiate between wether it is the liver or skeletal muscle that has been damged.
Bilirubin tests help to determine what?
Cause of jaundice, hepatocellular damage, bile ducts injury/ obstruction, or erythrocyte destruction
Cholesterol can be used to screen for what?
Hypothyroidism, hyperadrenocorticism, diabetes mellitus, or nephrotic syndrome
Concentration of AP can be used to detect what in dogs and cats?
Cholestasis
What can cause a disproportionate increase in BUN?
Dehydration, dietary treatment failure, owner non-compliance with treatment
How do we normally test for trypsin?
Fecal
Calcium is inversely related to what?
Inorganic phosphorus
You see an increase in potassium in what type of patients?
Hyperkalemic
How much % of glucose do you loose every hour it goes untested?
10%
Why would you do an ACTH test?
Suspected hypo- or hyperadrenocorticism
A low-dose dexmethasone test confirms what?
Hyperadrenocorticism
A high-dose dexmethasone tests differentiates what?
Pituitary from adrenal causes
