Blood Chemistry Analysis

Question 0

What type of comparison does a blood chemistry analysis involve?

Answer 0

The comparison of measurable blood components of a patient to the normal values of the general population.

Question 1

What does a blood chemistry analysis do?

Answer 1

Substantiates clinical signs.

Detects sub clinical abnormalities.

Question 2

What are Reference Ranges?

Answer 2

The normal values.

Question 3

How are the normal values derived?

Answer 3

By measuring the blood chemistry components of clinically normal animals.

Question 4

How do reference ranges vary?

Answer 4

By species, breed, sex, age, nutrition, and geographic region.

Question 5

What are enzymes?

Answer 5

Proteins found inside cells that increase the rate of biochemical reactions.

Question 6

Very low levels of enzymes are normally present in what?

Answer 6

The blood

Question 7

Increased levels of enzymes in blood are usually seen if…

Answer 7

Cells are damaged.

Question 8

Enzymes cannot be _____ so _____________ must be done.

Answer 8

Cannot be measured directly but must be made to catalyze a chemical reaction whose product can be measured.

Question 9

How are enzyme concentrations measured?

Answer 9

In international units (IU or U) = amount of enzyme necessary to convert 1 micro mole of substrate to product in one minute.

Question 10

What are the factors influencing enzyme activity?

Answer 10

Temperature
Dehydration
Ultraviolet light
pH extremes
Organic solvents
Heavy metal solvents

Question 11

Enzyme names usually end with what?

Answer 11

With the suffix -ase

Question 12

What might an enzyme’s name indicate?

Answer 12

It’s substrate or the type of chemical reaction it facilitates.

Question 13

The liver is…

Answer 13

The largest internal organ with many vital functions.

Question 14

What are the livers vital functions?

Answer 14

Metabolism of carbohydrates, fats
Synthesis of albumin, clotting factors
Secretion of bilirubin
Metabolism and elimination of toxins, drugs

Question 15

What are three enzymes associated with hepatocellular injury?

Answer 15

1. Alanine aminotransferase (ALT)
2. Aspartate aminotransferase (AST)
3. Sorbitol dehydrogenase

Question 16

Alanine aminotransferase (ALT) is liver specific is liver in what and not liver specific in what?

Answer 16

Liver specific in dogs and cats. Not liver specific in horses, cattle, and swine.

Question 17

Increased levels of alanine aminotransferase (ALT) may also be due to what?

Answer 17

Drug administration (glucocorticoids, anticonvulsants)

Question 18

What are Aspartate aminotransferase (AST) not?

Answer 18

Not liver specific.

Question 19

Increased levels of Aspartate aminotransferase (AST) are often seen with what?

Answer 19

Muscle Inflammation, hemolysis of blood sample.

Question 20

Sodium dehydrogenase is what and not routinely what?

Answer 20

Is liver specific in all species and is not routinely measured.

Question 21

What are two enzymes associated with obstruction of bile flow?

Answer 21

1. Alkaline phosphate (Alk Phos., AP)

2. Gamma glutamyltranspeptidase/glutamyltransferase (GGT)

Question 22

Alkaline phosphate is not what?

Answer 22

Not liver specific.

Question 23

Alkaline phosphate is useful in what and not useful in what?

Answer 23

Useful in dogs and cats.

Not useful in horses and cattle.

Question 24

Increased levels of alkaline phosphate often seen with what?

Answer 24

Bone injury, rapidly growing animals, and use of glucocorticoids and anticonvulsants.

Question 25

What is the primary source for GGT?

Answer 25

Liver

Question 26

GGT works well in what?

Answer 26

Small, large animals.

Question 27

What may increase levels of GGT?

Answer 27

Use of glucocorticoids and anticonvulsants.

Question 28

What is bilirubin derived from?

Answer 28

Hemoglobin released by lysed RBCs.

Question 29

What are increased levels of bilirubin associated with?

Answer 29

Increased RBC destruction or liver disease.

Question 30

What should be avoided when testing a blood sample for bilirubin?

Answer 30

Avoid exposure of blood sample to light.

Question 31

What might lead to falsely elevated readings of bilirubin in a blood sample?

Answer 31

Lipemia and hemolysis of blood sample.

Question 32

What are bile acids and what do they do?

Answer 32

They are substances produced by the liver and secreted in bile to promote the digestion and absorption of fat from the small intestine.

Question 33

How are bile acids removed from circulation?

Answer 33

They are reabsorbed from the SI and removed from circulation by the liver.

Question 34

When might bile acids be increased?

Answer 34

In portosystemic shunts and chronic liver disease.

Question 35

What are the functions of the kidneys?

Answer 35

Eliminates metabolic wastes Maintains normal homeostasis (regulates electrolyte, essential organic molecule levels) Produces important hormones

Question 36

What does BUN stand for?

Answer 36

Blood Urea Nitrogen

Question 37

What is urea?

Answer 37

A metabolic waste that results from amino acid breakdown.

Question 38

Where is urea freely filtered?

Answer 38

At the glomerulus.

Question 39

Increased BUN (i.e. azotemia) May be due to what?

Answer 39

Prerenal Abnormalities Renal Abnormalities Postrenal Abnormalities

Question 40

BUN false positives may occur how?

Answer 40

If the animal ingests a high protein meal prior to test.

Question 41

What is creatinine?

Answer 41

A nitrogen-containing molecule released from muscle at a constant rate.

Question 42

Creatinine is freely filtered by what?

Answer 42

The kidney at a frequent rate.

Question 43

Increased levels of creatinine are due to what?

Answer 43

Prerenal Abnormalities Renal Abnormalities Postrenal Abnormalities

Question 44

The pancreas is an important gland involved in what?

Answer 44

Digestion of food and regulation of blood glucose.

Question 45

Digestive enzymes produced by the pancreas include what?

Answer 45

Amylase Lipase Trypsin

Question 46

Where are amylase and lipase commonly measured?

Answer 46

In blood chemistry panels.

Question 47

Where are amylase and lipase found primarily?

Answer 47

In the pancreas but also found in other parts of the GI tract.

Question 48

What are increased levels of amylase and lipase associated with?

Answer 48

Injury to pancreatic cells. Elevations 3x the normal level considered significant.

Question 49

What is Pancreatic Lipase Immunoreactivity (PLI)?

Answer 49

A highly specific test for pancreatitis in both dogs and cats.

Question 50

What can a PLI be used to diagnose?

Answer 50

Exocrine pancreatic insufficiency (EPI)

Question 51

What is the test for Trypsin?

Answer 51

Trypsin-Like Immunoreactivity (TLI)

Question 52

Increased levels of Trypsin is associated with what?

Answer 52

Pancreatitis

Question 53

Decreased levels of Trypsin associated with what?

Answer 53

Exocrine pancreatic insufficiency (EPI)

Question 54

What is utilized by the body tissues for energy?

Answer 54

Glucose

Question 55

Blood glucose level reflects an equilibrium between what?

Answer 55

The amount of glucose entering the bloodstream. The amount of glucose leaving the bloodstream.

Question 56

What helps maintain normal blood glucose levels?

Answer 56

Glucagon and insulin.

Question 57

What is hyperglycemia seen with?

Answer 57

Diabetes mellitus

Question 58

What is hypoglycemia seen with?

Answer 58

Insulinoma Decreased food intake

Question 59

What must be done when testing for glucose?

Answer 59

Fast animals before testing. Separate RBCs from serum after blood collection.

Question 60

How many types of plasma proteins are produced in the body?

Answer 60

Over 200

Question 61

What are some of the many functions of plasma proteins?

Answer 61

Part of the structural matrix of cells Enzymes Hormones Antibodies

Question 62

What are the three most important and largest plasma protein fractions?

Answer 62

Albumin, globulins, and fibrinogen

Question 63

What is total plasma protein?

Answer 63

All plasma proteins added together.

Question 64

Total plasma protein is a good indicator of what?

Answer 64

Overall health

Question 65

Total plasma protein can be high with what and low with what?

Answer 65

High with chronic inflammation or infection. | Low with liver disease.

Question 66

What is Albumin?

Answer 66

An important protein produced by hepatocytes. Makes up 35-50% of total plasma protein level.

Question 67

What is Globulin?

Answer 67

Second largest plasma protein fraction. Produced in the liver and by B-lymphocytes, Has various functions.

Question 68

When are increased levels of globulins seen?

Answer 68

With infection, chronic inflammation, and neoplasia.

Question 69

What is fibrinogen?

Answer 69

Protein produced in the liver. Involved in blood clot formation. Makes up 3-6% of total plasma protein.

Question 70

How is fibrinogen measured in the clinic?

Answer 70

By heating a micro hematocrit tube to precipitate fibrinogen.

Question 71

Increased levels of fibrinogen occur with what?

Answer 71

Inflammation/tissue injury

Question 72

What are electrolytes?

Answer 72

Mineral ions (cations, anions) found in circulating blood.

Question 73

What do electrolytes play an important role in?

Answer 73

Maintenance of water balance. Nervous function. Muscular function.

Question 74

What does potassium play an important role in?

Answer 74

Maintaining normal neuromuscular function.

Question 75

Hypokalemia occurs with what?

Answer 75

Vomiting and chronic renal failure,

Question 76

Where is calcium important?

Answer 76

Muscular function

Question 77

What can calcium not be measured in?

Answer 77

Anticoagulated plasma

Question 78

When is hypocalcemia seen?

Answer 78

Eclampsia/puerperal tetany

Question 79

Phosphorus is important in?

Answer 79

Energy storage, part of normal cell membrane.

Question 80

Hyperphosphatemia is seen in what?

Answer 80

Chronic renal failure.

Question 81

Sodium is important in what?

Answer 81

Maintaining water balance in the body.

Question 82

Hyponatremia occurs with what?

Answer 82

Vomiting and diarrhea

Question 83

Chloride is important in what?

Answer 83

Water balance

Question 84

Hypochloremia occurs with what?

Answer 84

Vomiting

Question 85

Magnesium is important in what?

Answer 85

Neuromuscular function

Question 86

Hypomagnesemia is seen in what?

Answer 86

Grass tetany

Question 87

``` Creatine Kinase (CPK) and Creatine Phosphokinase (CPK) are found chiefly in what? ```

Answer 87

Muscle tissue

Question 88

``` Increased levels of Creatine Kinase (CPK) and Creatine Phosphokinase (CPK) occur with what? ```

Answer 88

Muscle injury, trauma, exercise, surgery, and injection.

Question 89

What is cholesterol?

Answer 89

A type of fat formed inside the body from fatty acids. | Important component of cellular membranes, adrenal and gonadal hormones.

Question 90

Where is cholesterol found?

Answer 90

In many tissues including the liver, adrenal gland, gonads, nerves.

Question 91

Abnormally high levels of cholesterol seen in what?

Answer 91

Diseases with abnormal cholesterol metabolism. Hypothyroidism, Hyperadrenocorticism (Cushing's), diabetes mellitus.