Biochemistry and Urinalysis

Question 1

Give examples of clinical pathology tests…

Answer 1

Haematology
Clotting profile
Biochemistry
Urinalysis
Cytology

Question 2

What is biochemistry used for?

Answer 2

Evaluating different organ systems

Measuring enzymes, metabolites, electrolytes

Question 3

Why is serum recommended for most biochemical tests rather than plasma?

Answer 3

Anticoagulants in plasma can interfere with some tests

Question 4

What is the difference between serum and plasma?

Answer 4

Plasma contains all clotting factors including fibrogen, where as serum is fluid after clot formation

Question 5

How would you collect serum?

Answer 5

Collect blood intro tubes without anti-coagulatants (brown/red top)

Question 6

How would you separate serum?

Answer 6

Allow blood to clot and remove serum
Centrifuge
Serum separator tube
Separate immediately if possible
Store in fridge at 4deg

Question 7

How would you collect plasma?

Answer 7

Collect from blood into EDTA, heparin or citrate
Blood won’t clot so need to separate plasma via centrifugation
Store at 4 deg

Question 8

What is measured in a biochemical profile?

Answer 8

Total protein
Albumin
Globulins
Bicarbonate
Anion gap
Calcium
Phosphorus
Glucose
Electrolytes
Urea nitrogen
Creatinine
Bilirubin
Cholesterol
Amylase
Lipase
CK
ALT
ALP
SDH
GLDH

Question 9

Why are total protein levels often higher in plasma?

Answer 9

Fibrinogen is included

Question 10

What is total protein made up of?

Answer 10

Albumin

Globulins

Question 11

How is total protein measured?

Answer 11

Using a refractometer

Question 12

What conditions may falsely increase total proteins?

Answer 12

Icterus
Severe haemolysis
Lipemia (blocks light so can appear darker blue)

Question 13

How can you stop dietary lipemia increasing TP measurements?

Answer 13

Starve animal before test

Question 14

What increases TP?

Answer 14

Dehydration
Inflammation
Neoplasia

Question 15

What decreases TP?

Answer 15

Loss
Decreased synthesis
Dilution

Question 16

Why do globulin need to be separated by electrophoresis?

Answer 16

There are different types

Question 17

What can cause an increase in globulins?

Answer 17

Inflammation (polyclonal)

Neoplasia (monoclonal)

Question 18

How can you calculate globulin levels?

Answer 18

Take TP, removed AL and whats left is globulins

Question 19

What is polyclonal gammopathy?

Answer 19

Increase in all types of globulins e.g. FIP

Question 20

What is monoclonal gammopathy?

Answer 20

Increase in a single type of Ig by a single clone of cells e.g. plasma cell tumour

Question 21

What causes an increase in albumin?

Answer 21

Dehydration

Question 22

What causes a decrease in albumin?

Answer 22

Increased loss (renal, GI, haemorrhage)
Decreased synth (liver)
Third spacing (effusions)

Question 23

What does it mean if you are dehydrated and have normal albumin levels?

Answer 23

You had low albumin to start with

Question 24

How would you evaluate liver function?

Answer 24

Enzymes
Metabolites
Function tests

Question 25

What does an increase in liver enzymes mean?

Answer 25

Leak from damaged cells so indicates liver disease

Question 26

How would you evaluate pancreas function?

Answer 26

Amylase and lipase

Question 27

What could an increase in pancreatic enzymes be indicative of?

Answer 27

Leak from damaged cells (pancreatitis) | Renal insufficiency

Question 28

What do you need to look at to evaluate the urinary system?

Answer 28

Serum chemistry | Urine

Question 29

What are good indicators of GFR?

Answer 29

Urea | Creatinine

Question 30

What is low urea indicative of'?

Answer 30

Liver damage

Question 31

What is high urea indicative of?

Answer 31

Kidney damage

Question 32

What is creatinine derived from and what does an increase menan?

Answer 32

Creatine in muscle (influenced by mm) | Increase - kidneys not excreting it properly

Question 33

What is azotemia?

Answer 33

Increase in nitrogenous waste in circulation

Question 34

What can cause azotemia?

Answer 34

Pre-renal (dehydration) Renal (renal disease) Post-renal (obstruction)

Question 35

Describe pre-renal azotemia...

Answer 35

Decreased blood volume + therefore pressure Body responds by increasing HR and constricting vessels Reduces kidney filtration and urea excretion

Question 36

What would you check to analyse the cause of azotemia?

Answer 36

USG | Blood and urine analysis

Question 37

If urea and creatinine are increased what should the urine specific gravity be in... a. Dog b. Cat c. Horse/ruminant What does it mean if the values are less?

Answer 37

a. 1.030 b. 1.035 c. 1.025 Decreased concentrating ability and renal failure is present

Question 38

What species is urea not a reliable indicator of renal disease in? Why? What should be used instead?

Answer 38

Ruminants Urea levels influenced by protein intake , high protein meal, GI bleeding Creatinine

Question 39

Why may you get increased sodium levels?

Answer 39

Increased intake Increased water loss Decrease water intake

Question 40

Why might you get decreased sodium levels?

Answer 40

Increased loss | Increased water intake

Question 41

What is the main ion in ECF?

Answer 41

Sodium

Question 42

What is the main ion in intracellular space?

Answer 42

Potassium

Question 43

What is an increase in potassium associated with?

Answer 43

Renal failure HypoAC Leakage from cells (tissue damage, thombocytosis, leukemia)

Question 44

What is a decrease in potassium associated with?

Answer 44

Loss (renal, vomiting, diarrhoea) | Decreased intake

Question 45

What do changes in chloride usually coincide with?

Answer 45

Changes in sodium

Question 46

What are changes in chloride without sodium associated with?

Answer 46

Alterations in acid-base balance Vomiting Abomasal displacement

Question 47

When you measure total calcium what are you measuring?

Answer 47

Free calcium | Bound calcium

Question 48

What is an increase in phosphorus associated with?

Answer 48

Renal disease | Young growing animals with also evaluated Ca and ALP

Question 49

What do you analyse with urinalysis?

Answer 49

``` Gross appearance Chemical analysis (SG, dipstick) Sediment analysis (cellular elements, crystals, casts) ```