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Clinical Pathology2 > Ch.22Smith.ClinicalChemistry > Flashcards

Ch.22Smith.ClinicalChemistry Flashcards

1
Q

Fasting increases what form of bilirubin?

A

unconjugated bilirubin

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2
Q

Why are there variations in PCV with splenic contraction?

A

pain

excitement

catecholamine release

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3
Q

With blood loss usually see a decrase in both PCV/TP in what time frame?

A

24 to 48 hours

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4
Q

Extracellular fluid volume is determined by what electrolyte?

A

ECF: sodium

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5
Q

Intracellular fluid volume is determined by which electrolyte?

A

intracellular fluid potassium

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6
Q

Definition of hypertonic dehydration

A

water loss > loss of Na and K

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7
Q

What are examples of hypertonic dehydration?

A

hyeprnatremia

free water loss

feed/water deprivation

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8
Q

Define isotonic dehydraiton

A

water loss = loss of Na and K

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9
Q

Isotonic dehydration is caused by:

A

heavily sweating endurance horses

acute/ealry dairrhea

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10
Q

Define hypotonic dehydration

A

water loss less than loss of Na and K

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11
Q

Hypotonic dehydration causes

A

chronic diarrhea with access to fresh water

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12
Q

Intracellular fluid volume is what percentage of body weight?

A

40%

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13
Q

Extracellular fluid volume is what percentage of body weight?

A

20% BW

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14
Q

Sodium depletion occurs in what disease processes

A

vomiting

diarrhea

excessive sweating

adrenal insufficiency

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15
Q

What diseases of that lead to third spacing can cause hyponatremia?

A

peritonitis

ascites

bladder rupture

colon/viscus torsion

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16
Q

At what level are progressive neurologic signs seen with hyponatremia?

A

sodium <115 mEq/L

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17
Q

At what level does hyponatremia is severe/ can cause death?

A

sodium <100 mEq/L

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18
Q

What can cause falsely decreased sodium values?

A

marked hyperlipidemia or

hyperproteinemia

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19
Q

Common causes of hyponatremia

A

Relative water excess:

  • Loss of sodium containing fluid (dec effective circulating vol)
  • diarrhea
  • excessive sweating
  • blood loss
  • fluid drainage: high-volume gastric reflux, high-volume pleural drainage

adrenal insufficiency

sequestration of fluid (third-space problems)

  • peritonitis
  • ascites
  • pleuritis
  • ruptured bladder
  • torsion or volvulus of hte gut

False hponatremia: hyperlipidemia, hyperproteinemia, hyperglycemia

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20
Q

Uncommon causes of hyponatremia:

A

Water retention with normal effective circulating volume:

  • psychogenic polydipsia
  • renal disease
  • inappropriate antidiuretic hormoen secretion
  • use of diuretics
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21
Q

Common causes of hypernatremia

A
  • pure water losses: panting, water deprivation
  • sodium excess (wate restriction): salt poisoning, feeding only electrolytes, no free water
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22
Q

Uncommon causes of hypernatremia

A

water loss exceeds electorlyte oss:

  • vomiting
  • diarrhea
  • burns
  • intrinsic renal disease
  • diuretics
  • disbetes insipius: central neprhogenic
  • hypertonic saline or sodium bicarbonate administraiotn
  • mineralocorticoid excess
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23
Q

What percentage of potassium is in muscle cells and bone?

A

60-75% total body potassium

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24
Q

Where do herbivores receive potassium?

A

Herbivores have net intake of K that is regulated by kidneys

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25
Q

In Hypokaelmia, increased resting membrane potential leads to what clinical signs?

A

muscle weakness

impaire durien concentrating ability

arrhythmias

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26
Q

What are causes of depletion of total body potassium stores:

A
  • Decreased intake and/or latered absorption
  • INC GIT losses
    • vagal indigestion, torsion of abomasum, ileus, diarrhea
  • INC renal losses
    • RTA (horses), diuretics, excess mineralocorticoid
  • Early postpartum dairy cow
    • anorexia and INC K losses
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27
Q

What will cause redistribution of potassium from ECF to ICF?

A

acute alkalosis

insulin or glucose amdinsitration

aggressive, rapid sodium bicarb administration–> alkalosis & profound hypoK

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28
Q

What is a cause of pseudohypokalemia?

A

severe lipemia

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29
Q

Causes of false hyperkalemia

A
  • in vitro hemolysis
  • prolonged storage of blodo (over 6 hours) w/o separation of serum or plasma
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30
Q

Common causes of hyperkalemia

A
  • altered external balance
    • hypovolemia w/ renal shutdown
  • alterered internal balance
    • metabolic acidosis
    • virgorous exercise
  • Uroperitoneum
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31
Q

Trimethoprim can cause hpyerkalemia through what mechanism?

A

Inhibits normal sodium reabsorption in cortical collecting duct

Alters transmembrane voltage–> impairs K secretion

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32
Q

Uncommon causes of hyperkalemia due to altered internal balance

A
  • Hyperkalemic periodic paralysis in Quarter horses
  • Diabetes mellitus
  • tissue necrosis
  • Renal disease
  • Addison disease
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33
Q

Hyeprchloremic metabolic acidosis can occur in what disease in horses?

A

renal tubular acidosis

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34
Q

Disproportionate increases in chloride (in relation to sodium)

A

normal to low AG hyperchloremic met acidosis

compensation of primary resp alkalosis

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35
Q

Disproportionate decrease in chloride (in relation to sodium)

A

metabolic alkalosis

compensation for chronic primary respiratory acidosis

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36
Q

Hypochloremic metbaolic alkalosis,

loss or sequestration of chloride rich fluids occurs in what diseases?

A

displasced abomasum

reflux

diarrhea (Cl- absorbed in ileum, colon in horse)

heavy sweating in horses

diuertic use in horses

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37
Q

What is isotonic osmolality in healthy animals?

A

ECF ~300 mOsm

(280-310 mOsm in healthy animals)

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38
Q

Where does calcium live within the body and percentages?

A

99% total body Ca: teeth/bones

  1. 9% in cell membranes and endoplasmic reticulum
  2. 1% in serum
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39
Q

Serum calcium roles/function

A
  • maintenance of neuromuscular exictability
  • permeability of cell membranes
  • conduction of nerve impulses
  • muscle contraction
  • clotting
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40
Q

Metabolism of calcium is regulated by:

A
  • diet
  • vitamin D + metabolites
  • PTH
  • Calcitonin
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41
Q

Serum Calcium adjusted by:

A
  • intestinal absorption
  • renal excretion (INC in horses)
  • mobilization from bone
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42
Q

Ionized calcium fluctuates in what acid/base abnormalities?

A

DEC in alkalosis

**less H bound to albumin = more Ca bound

INC in acidosis

**excess H compete with Ca fo rnegative sites on albumin

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43
Q

At what level of hypocalcemia do dairy cows become recumbent?

A

<6 mg/dL

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44
Q

Systemic diaphragmatic flutter occurs d/t

A

phrenic nerves that fire synchronously with atrial depolarization

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45
Q

In renal injury what causes decrease in calcium?

A

acute renal tubular damage

**hroses, cattle, sheep

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46
Q

Hypocalcemia causes

A

H: hypoparathyroidism

A: Hypoalbuminemia

R: renal failure (not horses)

P: pancreatitis

I: intestinal malabsorption

S: spurious

A: alkalosis

L: lactation

E: ethylene glycol

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47
Q

Common causes of hypercalcemia:

A

D: Vitamin D toxicosis

R: renal disease

A: Addison’s

G: granulomatous

O: osteolysis

N: Neoplasia

S: spurious

H: primary hyperparathyroidism

I: Idiopathic

T: hypothermia

48
Q

Phosphorus makeup within the body:

A

85%: structural basis of bones/teeth

15%: energy (ATP, ADP, MAP), membrane phospholipids, DNA, intracellular acid base buffering

49
Q

Causes of hypophophatemia

A

primary hyperparathyroidism

hypovitaminosis D

alkalosis

starvation– refeeding syndrome

50
Q

When phosphorus drops below <1.5 mg/dL , see clinical signs of:

A

hemolytic anemia

ileus

weakness

ataxia

seizure

51
Q

Hyperphosphatemia can cause:

A

bone resorption:

  • high phospohrus chelates Ca
  • lowers ionized Ca
  • activates PTH secretion
  • increases bone resorption
  • demineralizes bone
  • fibrous osteoydstrophy results
52
Q

When can hyperphosphatemia cause soft tissue mineralization:

A

when Ca x Phos >70

53
Q

Cuases of hyperphosphatemia:

A

acute renal failure

nutritionals econdary hyperparahtyroidism (excessphosphate intake)

endurance exercise in horses

Higher noraml range in neonates

54
Q

Low level of magnesium value:

A

<1.8 mg/dL

55
Q

What is considered severe hypomagnesemia?

A

<1.0 mg/dL

56
Q

Common causes of hypomagnesemia:

A
  • Grass tetany
  • winter tetany
  • grass staggers
  • calves on a milk only, magnesium defieint diet
  • endurance exercise
  • fatty liver syndrome
57
Q

Temperature impacts what values on blood gas?

A

PO2

PCO2

58
Q

Common causes of metabolic acidosis:

A
  • rumen overload (lactic acidosis)
  • ketosis
  • pregnancy toxemia
  • hypovolemic shock
  • acute diarrhea
  • colic when strangulated bowel
  • strangulating abomasal torsion
  • peritonitis
  • uroperitoneum (ruptured bladder)
  • execise above anaerobic threshold (normal response in horses)
59
Q

Metabolic alkalosis compensation

A

hypoventilation (INC pCO2)

60
Q

What causes paradoxical acid urine with hypochlormeic metbaolic alkalosis?

With Upper GI disease

A

Normal: Dehydration & RAAS activation–>

Na & Cl resorption & K excretion–> alkaline urine

Abnormal: Sodium & bicarb resorption & Hydrogen excretion–>

paradoxical acid urine

61
Q

Common causes of metbaolic alkalosis

A
  • sequestration of fludi n abomasum and ofrestomach in ruminants (internal vomiting fo rabomasal relfux)
  • gastric reflux in hroses with ileus
  • massive sweat loss in horses (endurance)
  • salivary loss of chlorid ein horses with esopahgostomy
  • use of diuretics (esp furosemide)
  • functional pyloric stenosis
62
Q

Compensation for respiratory acidosis

A

renal bicarb retention

** takes days.. only in chonri crespriaotyr acidosis

63
Q

Common causes of respiratory acidosis:

A

Primary pulmonary disease

  • obstruction of upper airway, laryngeal dema, aspiraotn pneumonia, pneumothorax, chornic obstructive pulmonary dz

Depression of respiratory center in CNS

  • gneral anesthsia w/ inappropriately assited ventilation
  • drugs: opiates, anesthetics, tranquilizers
  • CNS dz
64
Q

What is included in anion gap calculation?

A

anion gap=

(Na + K) - (Cl + HCO3)

65
Q

normal anion gap

A

12 - 16 mmol/L

66
Q

Causes of decreased anion gap:

A
  • hypoproteinemia
  • hyperchloremic metabolic acidosis (usu hypokalemic)
  • overhydration
67
Q

Causes of increased anion gap:

A
  • lactic acidosis (D and L)
  • ketoacidosis
  • uremic acidosis
  • ethylene glycol
  • assoc with dehydration & contraction alkalosis
68
Q

what percent of bicarb accounts for the CO2 in blood?

A

95% of CO2

69
Q

bicarb calculation (adult)

A

base deficit mEq x BW (kg) X 0.3

70
Q

blood gas normal bicarb?

A

24 mEq/L

71
Q

Increase SDH

A

hepatocellular damage & leakage of enzymes

**liver insult secondary to absorption of bacteria from poral circulation

72
Q

creatine kinase (CK) is found where in body?

A

cardiac & skeletal muscles

**most commonly assoc with rhabdomyolysis

73
Q

What is the half life of creatine kinase in horses and cattle?

A

horses: 2 hours
cattle: 4 hours

74
Q

When does activity of creatine kinase (CK) peak at?

A

6 to 12 hours

**can normalized within 2 4hours

75
Q

a persistant increase in creatine kinase indicates:

A

pactive and continuing mm damage

76
Q

what value of creatine kinase give a guarded prognosis in downer cows?

A

downer cows >3,500 IU/L

77
Q

aspartate aminotransferase (AST) is found in:

A

skeletal mm

cardiac mm

rbc

liver

kidneys

78
Q

What is the half life of AST?

A

>2 days in LA spp

79
Q

How long can AST remain elevated in following myonecrosis or liver damage?

A

up to 10 days

80
Q

Gamma-glutamyltransferase (GGT) is membrane bound specifically to what location:

A

Biliary tract

81
Q

GGT can be found in what other tissues?

A

Pancreas, GIT, kidney, mammary gland & repro tract **do not see serum GGT increase

82
Q

In thoroughbred race horses what liver enzyme is elevated, but responds to rest/decreased work?

A

GGT **unknown pathophysiology

83
Q

Alkaline phophatase is a marker of:

A

Biliary disease

84
Q

What are enzymes that are markers of hepatocellular damage?

A

ALT AST SDH

85
Q

What are markers of cholestatic disease?

A

ALP GGT Tbili Cholesterol

86
Q

What are indirect markers of hepatocellular function?

A

Albumin Glucose BUN Cholesterol

87
Q

What are direct tests of hepatocellular function?

A

Bile acids Provocative bile acids test Ammonia Ammonia tolerance test

88
Q

Common causes of elevated SDH

A

Severe anoxia Acute liver disease Liver abscess Secondary to damaged bowel (strangulating intestinal lesion, acute toxic enteritis) Chronic liver failure

89
Q

LDH is released from what organs?

A

Heart Liver Kidney Muscle

90
Q

Bilirubin is a break down product of:

A

Heme (component of hemoglobin)

91
Q

Direct bilirubin is

A

Conjugated bilirubin

92
Q

Indirect bilirubin is

A

Unconjugated (pre-hepatic), albuminboun

93
Q

Causes of increased indirect bilirubin:

A

Anorexia (in horses) Increased production LIver disease/failure Hepatic uptake decreased Conjugation decrease Hemolytic anemia

94
Q

Increase in conjugated bilirubin causes

A

Intrahepatic cholestasis (cholagniohepatitis) Extrahepatic bile duct obstruction Cholelithiasis Neonatal isoerythrolysis

95
Q

Hypoglycemia common causes

A

Inappetance in newborns Sepsis Pregnancy toxemia Endotoxic shock (late stages) Hepatic failure

96
Q

Hyperglycemia common causes:

A

Acute severe colic in horses Stress and excitement Cushing syndrome Glucocorticoid administration Xylazine administration

97
Q

Why is creatinine more reliable than urea nitrogen (BUN) in ruminants?

A

Because urea can be secreted in saliva and metabolized by rumen microbes

98
Q

Common causes of pre-renal azotemia

A

Reduce renal perfusion Hypovolemia Congestive heart failure Dehydration alter endurance exercise

99
Q

Common causes of renal azotemia

A

Acute renal failure Chronic renal failure

100
Q

Common causes of post renal azotemia

A

Urolithiasis Renal calculi Ureteral calculi Urethral calculi Ruptured bladder

101
Q

Where is urea produced?

A

In liver from ammonia (derived from AA catabolism)

102
Q

Urea is excreted by what organs?

A

Kidneys (glomerular filtration) Intestine Saliva Sweat

103
Q

Why in liver failure do we see decreased BUN?

A

Due decreased production

104
Q

Causes of decreased BUN

A

Liver failure Neonatal animals (BUN normally lower in adult)

105
Q

Hyposthenuria

A

1010

106
Q

Hypersthenuric

A

>1030 -1035

107
Q

Isosthenuric

A

1008-1012

108
Q

Causes of hypothenuria:

A

Altered release of or response to ADH DI and nephrogenic DI Psychogenic polydipsia Medullary washout Chronic liver failure

109
Q

Causes of USG <1020 in the face of dehydration?

A

Primary renal disease Diabetes insipidus Nephrogenic diabetes insipidus Medullary washout

110
Q

Ruminant renal threshold for glucose

A

100-140 mg/dL

111
Q

Equine renal threshold for glucose

A

160-180 mg/dL

112
Q

Glucosuria without hyperglycemia indicates

A

Renal tubular damage

113
Q

Casts in urine are

A

Accumulations of proteins and cellular materials in renal tubules

114
Q

Hyaline casts in urine are caused by:

A

Glomerulonephritis Fever with passive congestion Severe dehydration

115
Q

What ketones are detected in urine?

A

Acetone & acetoacetate **Do not detect beta-hydroxybutyrate

Clinical Pathology2 (7 decks)

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