JR Clinical biochemistry Flashcards
(114 cards)
1
Q
What is a pink sample tube for?
A
EDTA - Haematology (cytology) - cells in fluid sample
2
Q
What is a red sample tube for?
A
Plain serum biochemistry - no anticoagulant
3
Q
What is an orange sample tube for?
A
Biochemistry with heparin - anticoagulant
4
Q
What is a yellow tube for?
A
Oxalate fluoride
5
Q
What is oxalate fluoride sample tube for?
A
Glucose analysis
6
Q
What is a green sample tube for?
A
PT/aPTT - shows blood clotting times
7
Q
What is a serum tube required for?
A
Bile acids
Haptoglobin
Serum protein electrophoresis
8
Q
How does stress affect biochemistry samples?
A
Increased glucose in cats
Increased WBCs
Splenic contraction - increased PCV, HCT
9
Q
What three things cause interference with spectrophotometric assays?
A
Haemolysis - red
Lipaema - turbidity/less clear
Icterus - yellow
10
Q
What does spectrophotometry do (graph at bottom of blood results)?
A
Measures how much of an analyte there is in a sample
11
Q
What two things make up total protein?
A
Albumin and globulin
12
Q
What is used to estimate total protein?
A
Refractometer - measures total solids
13
Q
Where is albumin synthesised?
A
Liver
14
Q
What is albumins primary job?
A
Maintaining colloid oncotic pressure
15
Q
What is commonly bound to albumin?
A
Calcium
16
Q
What does acute phase proteins mean?
A
Proteins thats levels are affected by inflammation - some increase and some decrease
17
Q
What type of acute phase protein is albumin?
A
Negative acute phase protein
18
Q
What can cause hypoalbuminaemia?
A
Reduced production - liver dysfunction
GI disease - protein losing enteropathy
Kidney disease - protein losing nephropathy
19
Q
What is panhypoproteinaemia?
A
When both albumin and globulin are low
20
Q
What can cause panhypoproteinaemia?
A
Haemorrhage
Exudative disease eg. burns
21
Q
What are globulins synthesised by?
A
Plasma B cells
22
Q
What can cause hypoglobulinaemia?
A
Immune incompetence
Protein loss from haemorrhage etc.
23
Q
What is more common - hypo or hyperglobulinaemia?
A
Hyperglobulinaemia
24
Q
What is used to analyse hyperglobulinaemia?
A
Serum protein electrophoresis
25
What does a broad peak on serum protein electrophoresis mean?
Inflammatory response
26
What does a massive increase in gamma globulin normally mean on serum protein electrophoresis?
Neoplastic proliferation of plasma cells
27
What is a positive acute phase protein in dogs?
C reactive protein
28
What is a positive acute phase protein in cats?
AGP
29
What is a positive acute phase protein in horses?
Serum amyloid A
30
What can cause hypoglycaemia?
Severe sepsis
Hepatic dysfunction - cant synthesise
Excess insulin - insulinoma neoplasma
Addisons (hypoadrenocorticism)
Iatrogenic
31
How do you tell the difference between transient and persistent hyperglycaemia?
Urine glucose
| Frucosamine - glucose bound to albumin
32
What is the most common ketone?
Beta-hydroxybutyric acid (BHB)
33
How are ketones measured?
Dipstix - but not BHB
34
What ketones do dipstix measure?
Acetone and acetoacetate, not BHB
35
What are markers of lipolysis?
Non-esterified fatty acids
36
What can cause hyperlipidaemia?
Diet - obesity
Increased production/metabolism eg. diabetes increasing fat breakdown
Cholestasis
37
What are the main types of triglycerides?
Enterocytes - diet
Adipocytes - fat
Hepatocytes
38
What are some specific signs of liver disease?
Icterus
Coagulopathy
Ascites - fluid accumulation
Hepatic encephalopathy
39
What are the hepatocellular enzymes that indicate liver damage in dogs and cats?
```
Alanine aminotransferase (ALT)
Aspartate aminotransferase (AST)
```
40
Where is ALT found?
Liver cytoplasm only
41
Where is AST found?
Mitochondrial - liver and muscles
42
What are the hepatocellular enzymes that indicate liver damage in large animals?
```
Sorbitol dehydrogenase (SDH)
Glutamate dehydrogenase (GLDH)
```
43
What are the two different reasons for elevated hepatocellular enzymes?
Primary liver disease
| Secondary/reactive liver disease - inflammation elsewhere in body
44
What is cholestasis?
Impaired bile flow
45
What are the two cholestatic enzymes?
```
Alkaline phosphatase (ALP)
Gamma glutamyl transferase (GGT)
```
46
Which cholestatic enzyme is more sensitive in large animals?
Gamma glutamyl transferase (GGT)
47
What can affect cholestatic enzyme levels?
Cholestatic isoenzymes
48
What can cause cholestatic enzyme elevations?
Disease of biliary tree
Endocrine diseases causing liver swelling
Steroids
49
What are isoenzymes?
Enzymes that catalyse the same reaction but come from a different origin
50
What produces bilirubin?
RBC breakdown
51
What causes prehepatic jaundice?
Haemolysis
52
What causes hepatic jaundice?
Liver damage, cant conjugate bilirubin
53
What causes post-hepatic jaundice?
Cholestasis
54
What is the main cause of jaundice in cattle?
Haemolysis
## Footnote
eg.babesia
55
How can you tell if it is prehepatic jaundice?
If there is a low PCV due to regenerative anaemia
56
How can you tell if it is hepatic jaundice?
Elevated hepatocellular enzymes
57
How can you tell if it is post hepatic jaunice?
Elevated cholestatic enzymes
58
What are bile acid/salts function?
Fat digestion/absorption
59
What is used to make bile acids?
Cholesterol
60
What amino acid is used to conjugate cholesterol into bile acids?
Taurine
61
What does the bile acid tolerance test evaluate?
Bile acid levels in blood samples taken before and after a meal
62
What are elevated bile acid levels a marker of?
Cholestasis
Hepatic dysfunction
Portosystemic shunt
63
What is a marker of muscle damage?
Creatine kinase
64
What test do you do for pancreatitis?
Pancreatic lipase immunoreactivity
65
What does a negative SNAP PLI test mean?
Definitely doesnt have pancreatitis
66
What does a positive SNAP PLI test mean?
Might have pancreatitis, do spec test to confirm
67
What are B vitamins used to evaluate?
GI tract function
68
Where is folate (vitamin B9) absorbed?
Proximal SI - jejunum
69
Where is cobalamin (vitamin B12) absorbed?
Distal SI - ilium
70
What do you need to absorb cobalamin/vitamin B12?
Intrinsic factor from the pancreas - exocrine pancreatic insufficiency
71
What are some indicators of kidney injury?
PUPD
Metabolic acidosis - lose acid/base regulation
Uraemia/azotemia
Proteinuria
72
What is azotemia?
Increased urea and/or increased creatinine in the blood
73
What is uraemia?
Clinical syndrome arising from azotemia
74
What causes pre renal azotemia?
Reduced renal perfusion - not enough blood pressure to filter in glomerulus
75
What is a sign that it is pre-renal azotemia?
Azotemia with concentrated urine
76
What causes renal azotemia?
Fewer functioning nephrons
77
What is a sign that it is renal azotemia?
Azotemia with dilute urine (not enough nephrons to concentrate it)
78
How many nephrons do the kidneys need to lose to become azotemic?
75% - high functional reserve capacity
79
What causes a post-renal azotemia?
Obstruction or rupture of urinary tract
80
How do you measure glomerular filtration rate in animals?
Urea levels - but can be influenced by diet
| Creatine levels
81
What happens to phosphates and potassium with renal disease?
Hyperphosphataemia and hyperkalaemia - are primarily renally excreted so accumilate
82
What are some non sterile methods of urine collection?
Free catch
Non-absorbable cat litter
Catheterisation
83
What is the only sterile method of urine collection?
Cystocentesis - needle into bladder
84
What does glucosuria with hyperglycaemia mean?
Diabetes mellitus - high in both blood and urine
85
What does glucosuria with normal blood glucose levels mean?
Problem with proximal tubule
86
What does bilirubinuria suggest?
Normal in dogs
| Abnormal in others
87
What does ketonuria mean?
Diabetes mellitus
88
How do you measure urine specific gravity?
Refractometer
89
What does hypersthenuria mean?
Concentrated urine - specific gravity
90
What does haemoglobinuria suggest?
Haemolysis
91
What does heamuria suggest?
Primary urinary tract disease - bleeding
92
What does proteinuria suggest?
Glomerular dysfunction
93
What is abnormal in crystalluria?
Urates
| Casts of tubule
94
What is sodium responsible for in the body?
Preservation of electroneutrality - water retention/loss
95
What is hyponatremia?
Low sodium
96
What can cause hyponatremia?
Los of Na+ - vomiting, renal disease etc.
Gain of water - drink too much etc.
Endogenous shifts - diabetes etc.
97
What can cause hypernatremia?
Gain Na+ - salt from sea etc.
| Loss of water - diabetes, GI losses, burns, not drinking enough
98
What does the body produce in response to chronic sodium disturbance?
Idiogenic osmoles - prevent changes to cell swelling in CNS
99
How do idiogenic osmoles affect treatment of sodium disturbances?
If acute - can treat quickly as havent had a chance to make them yet
If chronic - need to correct Na+ slowly
100
What is chlorines job in the body?
Preserves electroneutrality - follows sodium
101
What causes hyperchloraemic metabolic acidosis?
Loss of other anions so Cl is retained to compensate
102
What can cause hypo/hyperchloraemia?
Hypo/hypernatremia - follows sodium
103
What can cause hypochloraemia without hyponatraemia?
Gain of other anions
Lactic acidosis
Ketoacidosis
Azotemia
104
What can cause hyperchloraemia without hypernatremia?
Loss of other anions eg. bicarbonate
GI losses
Renal losses
105
What effect does hyperkalaemia have on the body?
Cardiac problems - bradycardia, heart attack
106
What effect does hypokalaemia have on the body?
Muscle weakness, lethargy
107
What regulates potassium excretion in the kidney?
Aldosterone
108
What does a low Na:K ratio (<20) indicate?
Addisons disease - hypoadrenocorticism
109
What function does calcium have in the body?
Muscle contraction
| Nerve conduction
110
What electrolyte is linked to calcium?
Phosphates - same hormonal regulation
111
What hormone increases calcium and phosphate levels?
Parathyroid hormone
112
What hormone decreases calcium and phosphate levels?
Calcitonin
113
What can cause an increase in calcium and a decrease in phosphate?
Cancer - produces PTHrp
114
What can cause hypocalcaemia?
Lactation - milk fever
Sepsis
Pancreatitis
