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Laboratory Diagnostics > Biochemistry > Flashcards

Biochemistry Flashcards

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1
Q

What is biochemistry?

A
  • Measurement of concentration or activity of important biological substances in bodily fluids
  • Measure ions and molecules
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2
Q

What are the positives of in house testing?

A
  • Results same day
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3
Q

What are the positives of commercial lab testing?

A
  • Can test wide range parameters
  • Gold standard testing
  • Cheaper per parameter
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4
Q

What are the negatives for in house testing?

A
  • Equipment to buy
  • Consumables to buy
  • Staff training
  • Staff time
  • Not all parameters measurable
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5
Q

What are the negatives for commercial lab testing?

A
  • Wait for result
  • Abnormal results
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6
Q

What is the difference between plasma and serum?

A
  • Plasma is from unclotted blood and serum is from clotted blood
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7
Q

When would you use an orange top tube (heparin anticoagulant)?

A
  • Plasma
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8
Q

When would you use a white top tube (no anticoagulant)?

A
  • Serum
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9
Q

When would you use a brown top tube (no anticoagulant, has gel)?

A
  • Serum
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10
Q

What does biochemistry measure?

A
  • Electrolytes
  • Total protein
  • Kidney parameters
  • Liver parameters
  • Pancreas parameters
  • Hormones
  • Other muscle and heart parameters
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11
Q

What are electrolytes in biochemistry?

A
  • Major cations (sodium and potassium)
  • Major anions (chloride and bicarbonate)
  • Also measures calcium and phosphate
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12
Q

What do changes in sodium (cation) show?

A
  • Increase: dehydration
  • Decrease: over-hydration
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13
Q

What do changes in potassium (cation) show?

A
  • Increase: Cell lysis, hypoadrenocorticism and renal insufficiency
  • Decrease: Diabetic ketoacidosis
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14
Q

What do changes in bicarbonate (anion) show?

A
  • Increase: alkalosis
  • Decrease: acidosis
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15
Q

What do changes in calcium show?

A
  • Increase: issues with parathyroid or neoplasia
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16
Q

What do changes in phosphate show?

A
  • Increase: Diet or decrease in renal function
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17
Q

What does an increase of lactate show?

A
  • Suggest lactic acidosis, which can show an issue with oxygen saturation in tissues
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18
Q

What does the liver make when metabolising?

A
  • Protein
  • Albumin
  • Cholesterol
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19
Q

What happens when the liver detoxifies product?

A
  • Converts ammonia into urea
  • Excretes bilirubin into bile
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20
Q

When is liver function lost?

A
  • When 70% of tissue is non-functional
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21
Q

How does liver damage occur via bile stasis/cholestasis?

A
  • If bile not flowing due to inflammation/obstruction, ALP and GGT increase in blood
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22
Q

How does liver damage occur via cell death?

A
  • ALT and AST get released whrn hepatocytes burst
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23
Q

What are the secondary factors that increase liver enzymes?

A
  • Increase in corticosteroids/cushings disease
  • Hyperthyroidism
  • Daibetes mellitus
  • Pancreatitis
  • Obesity
  • Starvation
  • Various drugs
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24
Q

How does the liver function with the circulation of bile acids?

A
  • 90% of bile acids reabsorbed from intestine and recycled by the liver
  • If not functioning well, bile acids can’t be reabsorbed
  • Biliary system needs to have free flow of bile or bile backs up into blood
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25
What is a common liver damage test and what is it?
- Bile acid stimulation test - Detects abnormal increase in bile acids; compare fasting blood sample and fed blood sample
26
What other levels can be tested to look for liver damage except bile acids?
- Bilirubin - Albumin - Glucose - Clotting factors - Ammonia
27
What is the function of the kidney?
- Excretes waste products such as urea, creatinine and SDMA - Controls hydration - Balance electrolytes - Produces erythropoietin
28
What is the glomerular filtration rate?
- The volume of filtrate produced in the Bowman's capsule in unit time - Useful measure of kidney function
29
How can the glomerular filtration rate be measured?
- Inject a harmless, freely filtered chemical and measure how much remains in the blood overtime - Estimate GFR using creatinine and SDMA, can stage CKD
30
How can the kidney be investigated?
- Look at GFR - Increase in waste products in the blood - Loss of ability to concentration urine, causing PUPD (when this happens 2/3 of renal function lost)
31
What does an increase in urea show?
- Alone, elevation unlikely to be a renal cause - Related protein metabolism, so affected by diet and liver as well as the kidney
32
What does an increase in creatinine show?
- Alone, elevation unlikely to be renal cause, as creatinine increases at 75% loss of kidney function - Muscle metabolism
33
What does an increase in SDMA show?
- Elevation suggests renal damage (elevate at 40% renal loss)
34
Why is creatinine isn't great to estimate GFR?
- When there is a large change in GFR, there is a little change in creatinine levels in early renal disease and vice versa in advanced renal failure
35
What is azotaemia?
- Abnormal increase in concentrations of non-protein nitrogenous wastes in blood
36
What is uraemia?
- Adverse clinical signs due to severe azotaemia
37
What are the clinical signs in the pre-renal stage?
- Low volume and very concentrated urine - Dehydration - Hypovolaemia
38
What are the clinical signs of renal stage?
- Dilute, large volume urine that may contain protein - PUPD - Hypertension - Anaemia
39
What are the clinical signs at post-renal stage?
- No urine if urethra blocked, concentrated, may contain blood - Dysuria
40
What are the pre-renal insufficiency factors?
- Dehydration - Cardiac failure - Haemorrhage
41
What are the renal insufficiency factors?
- Toxins - Infections - Crystals - Cysts
42
What are the post-renal insufficiency factors?
- Stone - Tumour - Prostate affecting ureter/bladder/urethra
43
What are other renal disease tests other than examination of waste product levels?
- Ultrasonography - Radiography - Blood pressure assessment - Proteinuria - Urine specific gravity
44
What are the two types of dynamic tests?
- Stimulation test - Suppression test
45
What do stimulation tests do?
- Gives exogenous form of stimulating hormone and measures level of hormone in response; should expect an increase
46
What do suppression tests do?
- Gives exogenous form of hormone and measures level of endogenous hormone in response; should expect a decrease
47
What are the thyroid hormones?
- T3: active form - T4: thyroid secretes most as T4
48
What do thyroid hormones do?
- Increases metabolic rate - Helps cope with period of low-calorie intake by increasing blood glucose and use of body fat and body protein - Increases heart rate and force - Affects NT's in brain and mood
49
What is the thyroid disease in dogs?
- Hypothyroidism - Immune destruction or caused by a chronic illness which decreases T4 levels - Increases cholesterol and triglycerides
50
What is the thyroid disease in cats?
- Hyperthyroidism - Thyroid hyperplasia or caused by thyroid tumour - Increases T4 levels - Causes liver and kidney damage
51
What does cortisol do in the adrenal cortex?
- Increases blood glucose - Anti-inflammatory - Decreases immunity - Controlled by ACTH
52
What does aldosterone do in the adrenal cortex?
- Increases blood sodium and BP - Decreases potassium - Controlled by RAAS, an increase in potassium and ACTH
53
What happens in hyperadrenocorticism/hypercortisolism (Cushing's disease)?
- Protein breakdown - Increased blood glucose - Lipid and calcium breakdown and redistribution - Increases BP
54
What are the clinical signs of hyperadrenocorticism/hypercortisolism (Cushing's disease)?
- Alopecia - PUPD - Decreased inflammatory and immune responses
55
What are the causes of Cushing's disease?
- Pituitary tumour - Adrenal gland tumour - Treatment with corticosteroids
56
What are the biochem, haematoloy and urinalysis findings of a Cushing's disease patient?
- Increased liver enzymes - Hyperglycaemia - Increased triglycerides and cholesterol - Dilute urine - Neutrophilia
57
What is the ACTH stimulation test and what results should be expected?
- Administration of exogenous adrenocorticotropic hormone IV or IM and measure the effect on cortisol production - Cushings = normally high pre and post - Iatrogneic cushings = low pre and post
58
What happens in Hypoadrenocorticism (Addison's disease)?
- Decreased aldosterone and/or cortisol
59
What are the biochem, haematology and urinalysis findings in an Addison's patient?
- Increased potassium - Decreased sodium - Dehydration - Urine concentrated
60
What are the functions of the pancreas?
- Endocrine: releases insulin - Exocrine: releases lipase, amylase and trypsin
61
What happens in an endocrine pancreatic disease (diabetes mellitus)?
- Elevated glucose and possibly ketones in blood and urine - Liver damage - Elevated urea if dehydrated - Use glucose curve or CGM
62
What is a continuous glucose monitor (CGM)?
- Measures glucose in interstitial tissue - Slight delay (5-10min) compared with blood glucose curve - Monitor 24 hours for 2 weeks
63
What are the reproductive hormones?
- Testosterone and oestrogen - Progesterone - Relaxin
64
What are the effects of haemolysis?
- False reduction in bilirubin
65
What is icterus (jaundice) caused by?
- Caused by an increase production of bilirubin from haemolysis - A decrease in excretion of bilirubin from liver disease or cholestasis
66
What is lipaemia (fatty blood)?
- Excess fat in blood plasma; centrifuged sample looks creamy - Caused by hyperlipidaemia - Causes haemolysis
67
What does contamination from the K EDTA blood tube cause?
- Biochem contaminated from K EDTA can cause reduced calcium, increased potassium and decreased ALP and ALT
68
What can fear stress cause on blood results?
- Hyperglycaemia due to adrenaline and cortisol - Triglycerides, cholesterol, and liver enzymes increase from cortisol
69
When may you need to fast before a blood sample?
- If measuring urea, glucose, triglycerides, cholesterol, pancreatic enzymes, bile acids and liver enzymes

Laboratory Diagnostics (11 decks)

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