Clin Path Final - Kubuusu TS Flashcards
0
Q
How much of the kidney must be damaged for creatinine to show up in blood?
A
80%
1
Q
How much of the kidney must be damaged for Urea to show up in blood?
A
75%
2
Q
Term for raised urea OR creatinine OR both and is likely caused by dehydration
A
Azotemia
3
Q
Term for raised urea and creatnine plus clinical signs
A
Uremia
4
Q
What is the molecule used for measuring renal failure in birds?
A
uric acid
5
Q
Which molecules most significantly influence specific gravity of urine?
A
salts/electrolytes
6
Q
What term is used to describe specific gravity of urine that is lover than glomerular filtrate?
A
hyposthenuria
7
Q
What are some causes of hyposthenuria?
A
overhydration, pyometra, renal failure
8
Q
What term is used for urine having a fixed low SG?
A
isosthenuria
9
Q
What are the ranges for isosthenuria?
A
1.008 - 1.012
10
Q
What percent of the kidney is damaged before they lose their ability to concentrate urine effectively?
A
loss of 60-65%, early indicator
11
Q
What are some causes of hypersthenuria?
A
dehydration, hypovolemia, heart disease
12
Q
What is pre-renal uremia a result of?
A
decreased renal perfusion
13
Q
How is pre-renal uremia presented in tests?
A
mild to moderate raised urea and creatinine, SG is high
14
Q
How does renal uremia present in tests?
A
Urea is moderate to marked, so is creatinine, and isosthenuria
15
Q
What can cause post renal uremia?
A
urinary tract obstruction from urolithiasis or rupture
16
Q
How does post renal uremia present clinically?
A
creatinine is markedly raised, specific gravity is variable
17
Q
What chemicals on reagent strips are NOT accurate for animals?
A
nitrates, urobilinogen, specific gravity, leukocytes
18
Q
What conditions cause aciduria?
A
carnivores, protein catabolism (pregnant, exercise)
19
Q
What conditions lead to alkalinuria?
A
herbivores, stale urine, UTI/cystitis
20
Q
What test can be used to confirm a positive protein on a urine strip?
A
sulphosalicylic acid test
21
Q
What are some causes of trace positive readings for protein on a urine strip?
A
strenuous exercise, fever, convulsions, colostrum
22
Q
What are some causes of true proteinuria?
A
hemoglobinuria, hemorrhage, inflammation, protein losing neuropathies
23
Q
Why must you interpret the protein finding in urine with the SG?
A
the lower the SG, the more significant is the finding of a positive protein result
24
What rare congenital disease can cause glycosuria?
congential fanconi's syndrome, a tubular disease
25
What tests can be used to confirm glucose in the urine?
Fehlings or Benedicts test
26
What can cause glycosuria besides DM?
marked stress in cats, admin of ketamine or xylazine
27
What are the RELIABLE tests on a urine strip for animals?
pH, protein, glucose, ketones, blood, bilirubin
28
What number and type of cells indicate active urine sediment?
trace rbcs (5-8) or higher
trace WBCs or higher
high numbers of epithelial cells
29
What conditions usually lead to high RBCs in urine?
estrus, UT inflammation/trauma, urogenital neoplasm, some coagulopathies
30
What are the most consistent and reliable hallmarks of urinary tract inflammation?
WBC and protein
31
What are the urinanalysis hallmarks of cystitis/pyelonephritis?
4+ WBC, 4+ RBC, strong protein, bacteria
32
What size are tubular epithelial cells of the urinary tract?
same as WBC size
33
What does dysplastic epithelial cellls in the urine point to?
chronic inflammation
34
What do really high numbers of epithelial cells in urine without any WBC or RBCs indicate?
neoplasm
35
What 3 minerals make up struvite?
mg, ammonium, phosphate
36
What kind of crystal looks like a wagon wheel or dumbell shaped?
calcium carbonates
37
What kind of crystal looks like a coffin lid or brick shaped?
struvite
38
What conditions do struvite crystals tend to accumulate?
alkaline urine of dogs and cats, UTI, especially in urease bacteria,
39
What species most commonly have calcium carbonate crystals?
horses and rabbits
40
What urine crystal looks like an envelope or maltese cross?
calcium oxalate dihydrate
41
Where do calcium oxalate dihydrate crystals occur?
acid urine in dogs
42
What crystals look like a picket fence or spindle shape?
calcium oxalate monohydrate
43
What conditions cause calcium oxalate monohydrate crystals to occur?
ethylene glycol poisoning (along with hypocalcemia)
44
What crystals look like a thorn apple?
ammonium (bi)urate
45
What breeds may have naturally occuring ammonium biurate crystals?
dalmatians and english bulldogs
46
What are the pathological causes of ammonium biurate crystals?
portocaval shunts, chronic severe liver dz
47
What is seen in bird and reptile urine?
urates
48
What do cysteine crystals look like?
large clear hexagons
49
What crystal looks like brown needles or tufts?What do large numbers indicate?
billirubin crystals
| hemoytic or hepatic dz
50
What crystals are consistent with adulterated pet food?
melamine-cyanuric
51
What crystals look like sheaf of wheat and indicate congenital hepatic problem?
leucine and tyrosine
52
What doe hyaline casts indicate in a urinanalysis?
proteinuria --> mild renal disease
53
What do granular casts indicate?
moderate renal dz
54
What do cellular casts of RBC or WBC indicate?
severe renal disease
55
Is the following casts acute or chronic? Hyaline, cell, granular.
Hyaline -chronic
| cell/granular - acute
56
What is the sensitivity/specificity for ALP enzyme in dog and cat seperately?
Dog - good sensitivity, fair specificity
| Cat - poor sensitivity, mild increases are significant
57
What conditions can lead to an increase in ALP enzyme?
growing animals, osteosarcoma, corticosteroids (dogs only), may or may not be elevated in chronic liver dz
58
What is ALP enzyme always interpreted with?
ALT enzyme
59
What is the specificity and sensitivity of ALT enzyme?
excellent sensitivity and specificity
60
What is the half life of ALT for dogs and cats?
dogs - 2 days
| cats - 4 hours
61
What can cause an increase in ALT enzyme?
primary hepatocyte injury - hepatitis, hepatocellular carcinoma
62
What liver enzyme is fairly sensitive in large animas but increases in myocyte injury in all species?
AST
63
What enzyme is paired with AST to interpret results?
GGT
64
What could be some causes of increased AST enzyme?
liver dz, muscle dz, hemolysis (found in RBCs)
65
What enzyme increases are induced mostly by cholestasis?
GGT (gamma glutamyl transferase)
66
What is the sensitivity and specificity for GGT?
good sensitivity, fair specificity
67
What enzyme is just as good as GGT in measuring liver disease in small animals?
ALP
68
What liver enzyme is the best indicator of chronic liver problems?
GGT
69
What should be suspected if a cat has an increased ALP but GGT is within RI?
hepatic lipidosis
70
What should be suspected if there is a significant increase in cALP but mild increase in other liver enzymes in a dog?
cushings
71
What liver enzymes would indicate bone disease?
raised bALP, hx of trauma, lameness
72
What liver enzymes would be elevated in muscle disease?
AST, CPK
73
What is the sensitivity and specificity for CPK for muscle injury?
very sensitive, very specific
74
What other enzyme is muscle specific and offers no advantages over CPK?
aldolase
75
What would be seen in the clinical pathology of a horse with rhabdomyolysis?
inflammatory hemogram, acidosis, dehydration, low Na, high K, myoglobinnuria
76
What is the gold standard to test for myoglobinuria?
immunoelectrophoresis
77
What are the drugs that can have an effect on liver enzymes?
corticosteroids, NSAIds, antineoplastics, anticonvulsants, antimicrobials
78
What may a mild bilirubin level indicate?(3)
starvation (horses), septicemia, toxemia
79
What are the 2 causes of prehepativ hyperbillirubinemia?
hemolysis or decreased uptake of Bu
80
What is the major cause of hyperbilirubin in cattle? What about horses?
cattle - decreased uptake of Bu
| horses - starvation
81
What bilirubin pattern indicates hepatocellular hyperbilirubinemia?
Bu and Bc but Bc predominates
82
What bilirubin pattern is comprised of neither Bu or Bc predominating?
posthepatic/extrahepatic
| in long notes says Bc is the only one present but ppt says neither predominate
83
Which species has a low renal threshold for Bc, therefore making it easier to detect in urine?
dog
84
Where is Bc easiest to detect in cats?
blood
85
How great is the damage to the liver if ammonia is present in the blood?
>85%
86
What diseases cause hyperammonemia?
portal vascular shunts, advanced liver failure
87
What indicates a disease when post prandial blood ammonia is compared to pre prandial blood ammonia?
post prandial is 3x the base value
88
What is probably the most sensitive liver test?
Serum bile acids
89
What diseases do increased serum bile acids indicate?
cholestasis, hepatitis, fatty infiltration, necrosis, steroids, vascular shunt, cirrhosis
90
Why are serum bile acids the test of choice for portal vein shunts?
because serum bile acids will be taken up even in chronic liver failure but wont be if there is a shunt
91
What can increase the sensitivity and specificity for serum bile acids in detecting hepatic insufficiency?
pre and post analysis (before and after eating)
92
What cells make gamma globulins?
lymphoid cells
93
What is the most accurate and quantitative method for protein measurement?
electrophoresis
94
What term is used for "an abnormal condition of proteins"?
protein dyscrasia
95
What term is used for "abnormal concentrations of protein in blood"?
dysproteinemia
96
What 2 conditions cause an absolute hyperproteinemia?
inflammation
| B-cell neoplasia
97
What i it called when refractometer measures greater than 0.3g/dl difference between plasma and serum?
pseudohypoproteinemia (due to high glucose, urea, etc)
98
Which 2 conditions are true hypoproteinemia is also a selective dysproteinemia?
failure of passive transfer of maternal immunoglobulins
hypoalbuminemia from renal problem
all others are non-selective
99
What are the only 2 causes of hyperalbuminemia?
hemoconcentration
| dehydration
100
What is the specificity and sensitivity for albumin to indicate dehydration?
high specificity, lower sensitivity (some dehydrated animals have it WRI)
101
What are the 3 acute phase proteins?
serum amyloid A
Hatoglobin
ceruloplasmin
102
What are the 3 beta globulins?
fibrinogen
C reactive protein
transferrin
103
When can acute phase proteins first be detected?
within several hours to days after the onset of inflammation
104
When does the concentration of negative phase proteins such as albumin and transferrin decrease?
within weeks
105
What can cause polyclonal gammopathies?
chronic inflammation, liver dz, FIP, parasites, ehrlichia, IM dz, lymphoma
106
What can cause monoclonal gammopathies?
multiple myeloma
107
What 3 conditions can cause the body to lose more albumin than globulins and therefore lower the AG ratio?
protein losing nephropathy, enteropathy, dermatopathy
108
What may a high A/G ratio indicate?
rare - immunodeficiency or in neonates before suckling
109
What is important to determine in large animals when they have a high concentration of fibrinogen?
can be inflammation or dehydration
| must do plasma protein: fibrinogen ratio (TPP:F)
110
What is the equation for the TPP:F ratio in large animals?
TPP-Fibrinogen
| divided by fibrinogen
111
What TPP:F ratio indicates active inflammation in cattle? horses?
cattle: <15
112
What does a ratio of 10-15 for TPP:F indicate in cattle?
non-diagnostic
113
What TPP:F ratio indicates dehydration in cattle? horses?
cattle: >15
Horses: >20
114
How can you check the globulin content in mares colostrum?
SG should be > 1.060, also can use electrophoresis or radial immunodiffusion
115
What test can be used to measure globulin content in neonate serum?
turbidity test - serum is turbid if globulin present
116
What are some causes of acute exocrine disease?
acute pancreatitis, pancreatic necrosis, pancreatic neoplasia
117
What is an example of chronic exocrine disease?
exocrine pancreatic insufficiency - EPI
118
What is the sensitivity and specificity for amylase and lipase to detect acute pancreatic disease?
sensitivity is good, but specificity is poor to moderate
119
What could also increase amylase or lipase besides pancreatic disease?
renal failure, gastroenteritis, hyperadrenocorticocism, stress
120
What is used to diagnose pancreatic disease in cats?
feline pancreatic lipase immunoreactivity or ultrasound
121
What clinical abnormalities are seen in a dog with pancreatic disease?
inflammatory CBC, increased globulin
increase in amylase and lipase in blood and peritoneal fluid
moderate liver increases
increased TLI, cPLI, and TAP
122
What is the only definitive test for exocrine pancreatic insufficiency?
a low serum TLI
123
What should be checked in older cats that have diarrhea?
blood T4 levels
124
Where is vitamin B12 absorbed in the gut? what about folate?
Vit B12 - distal small intestine
| Folate - proximal small intestine
125
What would low folate with normal B12 suggest?
upper small intestine problem
126
What would high folate and normal or low B12 suggest?
small intestinal bacterial overgrowth (SIBO)
127
What may low folate and low B12 suggest?
diffuse small intestinal problem
128
What medium should blood be taken in to analyze for absorption test for GI tract?
fluoride oxalate ( establish blood glucose)
129
What will rumenal fluid look like in grain overload or rumenal atony?
gray and maladorous
130
When does normal sedimentation take place in normal rumen fluid?
< 8 minutes
131
What is the normal pH of rumen fluid?
5.5 - 7
132
How long does a methylene blue reaction take in a normal rumen fluid sample?
6 minutes
133
What is the major cation intracellularly?
K+
134
What is the major cation extracellulary? anion?
cation - Na
| anion - Cl
135
What are the 5 conditions that could cause abnormal electrolyte results?
1. inc/dec in water or electrolyte uptake
2. shift from ICF
3. renal retention
4. loss thru gut, kidney,skin, resp
5. acid base disturbance
136
When may an animal get hypotonic dehydration?
just replenishes water, not salt lost
| horse - sweating
137
What are some causes of hyperkalemia?
IV destruction of RBC +platelets
| renal failure, iatrogenic, hypoadrenocorticocism,metabolic acidosis
138
What happens to K in inorganic acidosis?
only H+ enters cells, with K+ going into ECF
139
What are some causes of hypokalemia?
anorexia (cats), increased renal excretion, increased loss thru the gut, metabolic alkalosis, iatrogenic insulin
140
What organ regulates the HCO3- concentration?
kidneys
141
What ions does TCO2 consist of?
bicarbonate (HCO3-), carbonic acid (H2CO3), and CO2
142
What is the bicarbonate-carbonic acid buffer equation?
HCO3- + H+ H2CO3 H2O + CO2
143
What is tCO2 a indirect measure of?
HCO3- (TQ!)
144
What is HCO3- inversely related with?
Cl
145
Metabolic acidosis will be an increase or decrease in sodium?
hypernatremia
| alkalosis - hyponatremia
146
How can you determine a selective loss of Cl-?
Na - Cl > 42-45
147
What can cause a selective loss of chloride ions?
vomiting, obstruction at pylorus, abomasal displacement
148
What does loss of NaHCO3 rich fluid in intestinal secretions lead to in regards to chlorine and sodium?
hyperchloremia, but NOT hyperanetremia
149
What does a Na:K ratio of less than 15:1 indicate?
semi diagnostic for hypoadrenocorticocism
150
What does a increased anion gap indicate?
metabolic acidosis or increase in unmeasured ions (ketones, uremic acids, ethylene glycol, lactic, and salicyclic acid
151
What does a positive BE (base excess) indicate? negative BE?
```
+ = metabolic alkalosis
- = metabolic acidosis
```
