Clinc Chem Panel

Question 1

3 ways of detecting metabolic acidosis w/o blood gas

Answer 1

1. Decreased TCO2
2. Anion gap
3. Chloride –should always follow Na (if not, Acid-Base disturbance)

Question 2

Explain difference btwn Secretional & Titrational Metabolic acidosis
-& how do you differentiate on lab data

Answer 2

Titrational = Consumed
- HIGH anion gap
Secretional = Lost
- Cl doesn’t follow Na (running from TCO2)

Question 3

How does blood pH affect K+ levels?

Answer 3

acidosis –> hyperkalemia

Question 4

What causes changes in CHLORIDE

Answer 4

1. Follows Na
   - - w/in 3 units from center of Ref Ranges
2. Runs from Bicarb
   
   • Increase Cl (relative to Na) –decrease TCO2 (acidosis)

Question 5

How do you ID Paradoxical aciduria form lab data?

Answer 5

Alkalemia w/ aciduria

– shifts in urine pH should follow closely with blood pH!

Question 6

What leads to paradoxical acuduria

2 driving forces/ 2 contributing factors

Answer 6

Driving forces
**1. Need for Na+ reabsorption
(dehydration, hyponatremia)
2. Alkalosis

Contributing factors

1. HYPO-chloremia
2. HYPO-kalemia

will see a generalized decrease in Na,Cl,K simultaneously

Question 7

What does an increased anion gap w/o decrease TCO2 signify?

Answer 7

Mixed Metabolic Alkalosis &
Titrational Metabolic Acidosis 
- Vomiting w/ hypovolemia
- Renal azotemia & 2ndary vomiting
- Diabetic ketoacidosis & 2ndary vomiting

** AG, TCO2, Cl- may all be involved

Question 8

What action should you take, if you see the following blood work:
-Hypokalemia + metabolic acidosis

Answer 8

• **IMMEDIATE K+ injection required!

- cells have run out of K+ to secrete

Question 9

What action should you take, if you see the following blood work:
-Hypokalemia + unregulated Diabetes Mellitus

Answer 9

• *treat with K+ injection first!
• Lack of insulin –> lack of Glucose & K+ ability to enter cells –> polyuria –> Hypokalemia
• If you just give insulin right away, the animal will become SEVERELY hypokalemic!!

Question 10

What factors can affect the urine pH?

Answer 10

1. Blood pH
2. Diet –alkaline tide
3. Post renal factors –bacteria & sample handling