4- Evaluation of a biochemical panel- part 2

Question 1

What indicator shows cardiac damage vs cardiac dysfunction?

Answer 1

Damage = troponin I - released when myocytes are damaged

Dysfunction = NT-proBNP - released when muscles cells are stretched - cardiac enlargement

Question 2

What indicator shows damaged liver & Liver dysfunction?

Answer 2

Damage = ALKP, ALT, AST, CK
Dysfunction = Bile acid, ammonia, albumin, glucose, bilirubin

Question 3

What indicator shows damaged vs dysfunction of the pancreas?

Answer 3

Damage= Lipase, PLI
Dysfunction= TLI (pancreatic function)

Question 4

What indicator shows damaged vs dysfunction thyroid?

Answer 4

Damaged= TgAA
Dysfunction= T4, TSH

Question 5

What indicator shows damaged vs dysfunction renal system?

Answer 5

damaged= casts
Dysfunction= creatinine, USG, proteinuria

Question 6

T/F ALT is completely liver-specific in dogs & cats (not large animals)

Answer 6

True

Question 7

Why is it more worrying If cats liver enzymes (ALT/ALKP) are out of reference?

Answer 7

Cats’ enzymes half-life is a lot shorter than dogs a lot more worrying if you have high - continued liver injury

Question 8

What induces Alkaline phosphatase (ALKP)?

Answer 8

Impaired biliary flow & medications

Question 9

T/F ALKP is liver specific

Answer 9

False - bone, intestinal
very susceptible to non-hepatic disease

Question 10

T/F serum GGT is more biliary specific than ALKP

Answer 10

True

Question 11

Elevated urea & normal creatinine suggest what?

Answer 11

pre-renal effects:
- Reduced renal perfusion (dehydration)

Question 12

What do unusually high blood urea and normal creatinine suggest

Answer 12

GI bleeding

Question 13

What is important to look at to determine if high glucose levels significant

Answer 13

Fructosamine will help determine the significance of higher glucose levels

Question 14

T/F Horses excrete excess calcium through the kidney

Answer 14

True

Question 15

If AST is high what does this mean

Answer 15

AST- can be released from both hepatocytes and monocytes- so need to compare with another muscle or liver enzyme to see if it is definitely a liver/ muscle problem

Question 16

What can or should I do about elevated liver enzymes?

Answer 16

rule out therapies- as steroids can cause increase
rule out systemic, pancreatic, GI disease
Multiple enzyme abnormalities, very high results +/- bilirubin – can’t ignore- this is when you would think liver straight away

Question 17

what is the alternative to urea which excreted in uricotelic species

Answer 17

uric acid

Question 18

Describe the importance of elevated bilirubin in horses and cattle

Answer 18

Elevated in anorexic horses and cattle with normal hepatic function- not always pathological often physiologic in these species

Question 19

what do you need to look at to evaluate calcium in egg laying species

Answer 19

Egg laying species will generate high tCa (increase in protein bound fraction – ovalbumin) but normal iCa- so if we want to know about the physiological calcium status in an egg laying species have to look at the iCa level

Question 20

What electrolyte imbalance is common in large animal diarrhoea

Answer 20

low Na, Cl
elevated K