Blood Chemistries Flashcards by Dana Dyches

What do blood chemistries evaluate

the various blood levels to help assess the different body functions

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Why should you not freeze whole blood?

causes hemolysis

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What samples can be used to run blood chemistries

serum, plasma, whole blood

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Why is a grey top tube used for glucose determination?

Because it prevents RBCs from metabolizing glucose

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What body system cannot be evaluated well with chemistries?

respiratory system

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Enzyme number is usually _ in blood

low

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If enzyme number is high in serum, cell have:

ruptured and released enzyme into serum or cell increased enzyme production and excess leaked out of cell

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What should be done regarding patients prior to collecting blood for chemistries?

fasting for at least 2 hours

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The following are functions of the _:
-synthesis of plasma proteins
-clotting factors
-macromolecule metabolism
-detox of toxins
-secretion of bile
-is run by enzymatic reactions

liver

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Liver assays- what is hepatocellular damage

hepatocytes are damaged and enzymes leak into blood causing rise in blood levels

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Liver assays-Hepatocellular damage: What is Alanine Aminotransferase (ALT)?

screening test for liver damage. there is no correlation b/w ALT levels and severity of liver damage

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Liver assays-Hepatocellular damage: _ or _ can elevate ALT

corticosteroids or anticonvulsants

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Aspartate Aminotransferase (AST) is not _ specific

liver

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Liver assays-Hepatocellular damage: Sorbitol Dehydrogenase (SD) is primarily from _, is unstable in serum (activity decreases rapidly, samples assayed within 12 hours), and is not common to average vet lab

hepatocyte

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What do indirect enzyme assays measure

enzymatic reaction

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Liver assays- enzymes associated with _ (bile duct obstruction) and hepatocyte metabolic defects

cholestasis

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Liver assays-Choleostasis: Sources of Alkaline Phosphatase (AP) in young and old animals

Young: developing bone (Osteroblasts and Chondroblasts)
Old: hepatobiliary cells

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Alkaline Phosphatase (AP) is used to detect _ in SA

cholestasis

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Why is AP not useful in cattle and sheep?

wide fluctuation are normal in those species

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Liver assays-Choleostasis: Gamma Glutamyltransferase or -peptidase (GGT) primary source is in the liver but is also in the ,,_, and _

kidneys, pancreas, intestine, and muscle

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What can cause GGT to be elevated

liver disease

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Liver function tests

Bilirubin, Bile acids, Dye excretion, cholesterol, albumin, ammonia

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If there is in elevation in AST what test should be run to confirm true liver damage?

Creatine kinase

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_ is a test of hepatic function, in essence the ability of the hepatocyte to take up unconjugated bilirubin in blood, conjugate it, and excrete it into bile where it is broken down in the intestine by bacteria

Bilirubin

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What species is SD usually performed?

large animals

What tests indicate hepatobiliary disease?

AP, ALKP, GGT

Increased conjugated(direct) total bilirubin is caused by what?

Heptocellular damage, bile duct injury/obstruction?

What will you see in with increase direct total bilirubin

bilirubinuria

Increased unconjugated (indirect) total bilirubin is caused by

RBC destruction, defects in transport to liver to be conjugated

The liver does NOT overproduce _ and if high, determines dehydration

albumin

If excess bile acids in circulation what does this mean?

liver did not clear them out, this is usually the test to diagnose a portosystemic shunt

Bile acids aid in

fat digestion

Bile acids increase with

-post prandial -PSS -Chronic hepatitis -Cirrhosis -Cholestasis -Neoplasms

Bile acids are normally low in circulation, why?

b/c liver removes 75%-90% via portal circulation

How many tests should be run for bile acids

2, one fasted and one 2 hours after eating

Kidney functions

-Homeostasis -Remove end products of nitrogen metabolism -Produce (renin, erythropoietin, prostaglandins)

What does BUN stand for

blood urea nitrogen

What is urea

product of AA breakdown in liver (kidneys ability to filter urea (GFR) (sensitively- low- 75% kidney tissue non-functional before elevated) (plasma passively filtered in glomerulus)

What tests measure BUN

azostick and chemical assay

Normal range of BUN on azo-stick

<26mg/dl

The following are causes of _ BUN: -high protein diet; strenuous exercise= increased AA breakdown -bleeding ulcer (high protein meal)

Increased

The following are causes of _ BUN: -sample contamination of urease-producing bacteria (Staph. aureus, Proteus spp., Klebsiella spp)

decreased

Causes of azotemia

-Dehydration -UT obstruction -Renal dz

Creatinine is formed from Creatine Phosphate- found in _ _ _ (splits to provide energy for ADP + P= ATP)

skeletal muscle fiber

Creatinine is found in most body fluid

sweat, vomitus, and feces

Creatinine is an indicator of

glomerular filtration (urinary obstruction)

_% kidney tissue damage before creatinine is elevated

Why is SDMA a better tool for diagnosing and monitoring CKD in thin geriatric animals, especially cats and animals with other diseases that cause muscle wasting?

it is not impacted by muscle mass

Pancreas endocrine tests

-Insulin (CHO metabolism) -Glucagon (elevated BG levels) -Glucose

_ should always be present in feces, abnormal if not

Trypsin

What is trypsin

a proteolytic enzyme, aids in digestion of proteins

What are the methods of pancreas -exocrine tests for trypsin

-test tube method -x-ray film method

What is the most specific test for diagnosing exocrine pancreatic insufficiency

determination of trypsin-like immunoreactivity (TLI)

How is a TLI done

taking a single fasting blood sample sent to a lab

What does amylase do

breakdown starches and glycogen

Pancreatic exocrine tests

TLI Amylase Lipase

What causes increased levels of amylase

acute pancreatitis, flare ups of chronic pancr., pancreatic duct obstruction

Normal amylase in dogs/cats= _x higher than in humans (important if using human lab)

What does lipase do

break down lipids

_ is required for activity of lipase

calcium

Lipase may be more _ than amylase

sensitive

Level of _/_ not directly proportional to severity of pancreatitis

amylase/lipase

Lipase and amylase have _ sensitive and specificity for pancreatitis

poor

When is creatine kinase elevated

when striated myocytes damaged/destroyed and leak CK out of cell into blood

Creatine kinase is organ-specific and can only tell what

that muscle is damaged, not which muscle, or severity of damage

Where is cholesterol produced

everywhere but primarily liver, adrenal cortex, ovaries, testes, intestinal epithelium

Hypercholesterolemia dx what _

hypothyroidism

_ _ controls synthesis and destruction of cholesterol

Thyroid hormone

Hypercholesterolemia also caused by

hyperadrenocorticism, diabetes mellitus, nephrotoxic syndrome

Plasma prot is produced by _ and _ _

liver and immune system

The following are functions of _: -Structural matrix -Osmotic pressure -Enzymes -Hromones -Blood coag -Body defense -Transport/carrier molecules

TP consists of

albumin + globulin +/- fibrinogen

concentration of TP is affect by

altered formation in the liver, distribution, breakdown, and dehydration or over hydration

TP helps determine _ status

hydration

Plasma contains _

fibrinogen

How is globulin measured

total serum protein - albumin

Hypoproteinemia is usually due to

albumin loss

Hypoalbuminemia is usually due to

any diffuse liver dz (also renal dz, dietary intake, intestinal proteins absorption)

How to calculate albumin:globulin

divide albumin by globulin

normal albumin:globulin in dogs, horse, sheep, goat

>1.00

normal albumin:globulin in cattle, pigs, and cats

<1.00

Elevated fibrinogen indicates

acute inflammation or tissue damage

Heat precipitation test is used to test what

fibrinogen

The following are functions of _: -Maintain water balance, osmotic pressure -Maintain normal muscular function -Maintain normal nervous system -Maintain and activate several enzymes -Acid base regulation

Electrolytes

When testing calcium, never use _ or _ tubes

EDTA or oxalate

Calcium is _% in bones

Function of calcium

neuromuscular excitability and tone, blood coagulation

Calcium is an indicator of

neoplasia, parathyroid dz, bone disease

Inorganic phosphorus is _% in bones and _% in energy storage, release & transfer (ATP), CHO metabolism, make up Nucleic acids and phospholipids

80%, 20%

Sodium is in

plasma and interstitial fluid

Sodium plays a role in

water distribution, osmotic pressure, maintenance

Hemolysis can cause _ levels of sodium

lower

Hyperkalemia

acidosis (exchange for H ion in plasma), cellular damage/necrosis

Hypokalemia

indadequate K intake, fluid loss (V/D)

Functions of potassium

muscular fxn, respiration, cardiac fxn, nerve impulse transmission, CHO metabolism

Magnesium is _% in bones (closely related to P and Ca)

Mg:Ca imbalance causes release of Act=

muscle tetany

Functions of magnesium

activates E systems, production and decomposition of Ach

What test is helpful in diagnosing Addison's disease

Na+:K+

If Na+:K+ <25:1 what test should be run to R/O Addison's disease

ACTH STIM test

Functions of chloride

maintains water distribution, osmotic pressure, normal cation: anion ratio

What sample is best for chloride

serum

Functions of bicarbonate

bicarb/carbonic acid buffer system (blood pH), transport of CO2

Excess bicarb is excreted via

kidneys

What is normal blood pH

7.35-7.45

If blood pH is below 7.3 this is called

acidosis (excess H+)

If blood pH is above 7.4 it is called

alkalosis (low H+)

Both _ and _ systems work to regulate the pH in acid-base imbalance

respiratory and renal

_ acid-base imbalance works within minutes

Respiratory

_ acid-base imbalance works for days to restore balance

renal

What organ plays a major role by actively secreting or resorbing bicarbonate

kidneys

What molecule carries oxygen AND serves as a blood buffer

Hemoglobin

Metabolic acidosis or alkalosis is caused by everything other than the _ system

respiratory

If RR decreases, less CO2 is eliminated, this causes _ and increase in partial pressure CO2

hypercapnia

If RR increases, this causes _ and decrease in PCO2

hypocapnia

_ are produced when glucose metabolism is abnormal

ketones

_ can cause alkalosis

Vomiting

Blood Chemistries Flashcards

(117 cards)