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Lab D > Lab 1 Homeostasis > Flashcards

Lab 1 Homeostasis Flashcards

1
Q

What anticoagulant is generally used for hematology and how does it work?

A

EDTA

Irreversibly chelates Ca2+

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2
Q

How are most blood biochemistry parameters evaluated?

A 
In serum (blood is clotted)
or heparinized plasma
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3
Q

How does heparin work on plasma?

A

Enhanced the binding of coagulation factors to antithrombin III which blocks the conversion of fibrinogen to fibrin

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4
Q

What type of heparin is used for electrolyte measurements?

A

Lyophilized, calcium equilibrated heparin

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5
Q

Which anticoagulant is used for the testing of blood clotting parameters and how does it work?

A

Na2-Citrate 3.8%
Reversibly chelates Ca2+
Also suitable for blood smear (low damage in blood cell metabolism)

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6
Q

Give the three water compartments in the body

A

Extracellular
Intracellular
Transcellular

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7
Q

What is the fluid in the water compartments influenced by?

A

Lungs, kidneys, skin, GI tract

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8
Q

Give total water content of the body

A

600-650 ml/BWkg

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9
Q

What two kinds of volume disturbances can be distinguished?

A

Perfusion and hydration disorders

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10
Q

How can you measure the water volume of each compartment in the body?

A

Not possible, but can be estimated based on some measurable parameters

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11
Q

What does a decrease of tissue perfusion mean?

A

Volume deficit in intravascular space

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12
Q

5 clinical signs to evaluate perfusion:

circulatory problems

A 
Capillary refill time (CRT)
Mucous membrane color
Strength of pulse
Heart rate
Blood pressure (central venous pressure)
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13
Q

7 clinical signs to evaluate hydration

interstitial/intracellular water supply

A

Skin turgor (elasticity)
Mucous membranes
Sunken eyes, prolapse of third eyelid (cats
Eye turgor
Skin around oral cavity or anus
Body weight changes
Urine production, specific gravity of urine

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14
Q

What blood parameters can be used to evaluate volume disturbances?

A

PCV, Ht
Hb concentration
TP or Alb conc
Change in MCV of RBC (osmotic)

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15
Q

What happens at 5-15% loss of total blood volume?

A

No change in blood pressure

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16
Q

What happens at 15-25% loss of total blood volume?

A

Tachycardia, peripheral vasoconstriction, increased BP

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17
Q

What happens at 35-45% loss of total blood volume?

A

Severe BP decrease, oliguria and peripheral vasodilation - shock

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18
Q

What happens at 50% loss of total blood volume?

A

Death

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19
Q

What does Packed Cell Volume give information about?

A

The ratio of whole blood volume to the volume of red blood cells

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20
Q

What can be detected by PCV

A

Fluid volume changes and quantitative changes of RBCs

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21
Q

Give three methods to measure PCV

A

Microhematokrit/microcapillary method
Automated cell counter
Handheld HCT meter

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22
Q

Microhematokrit/microcapillary method

A

Blood into microcapillary, centrifuge, read result on Ht scale

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23
Q

Automated cell counter

A

ACC measure MCV and the number of RBCs

The machine automatically calculates the PCV

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24
Q

Handheld HCT meter

A

Measures Ht and total Hgb in whole blood
Species chip and test strip inserted into meter
Uses optical reflectance

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25
Physiological Ht range for most species
0.35-0.45 l/l or 35-45%
26
Interpretation of PCV results
Decrease: oligocythaemia or anaemia Increase: polycythaemia
27
Physiological polycythaemia
Congenital Newborn Physiological long-term hypoxia
28
Relative polycythaemia
Dehydration
29
Absolute polycythaemia | Primary/Secondary
Increased RBC production Primary: no increase in EPO Bone marrow neoplasia, polycyt. absoluta vera ``` Secondary: because of increased EPO True: long term hypoxia (BOAS dogs, RAO, right-left shunt of heart) Not true: no hypoxia EPO producing tumour of kidney/liver ```
30
Complex polycythaemia
Hypervolaemic polycythaemia | Life threathening acute stress or extreme physical exercise - constriction of blood vessels and spleen
31
False polycythaemia
Long sample storage with EDTA
32
False oligocythaemia
Microcytosis
33
Physiological oligocythaemia
Increased plasma volume in the 3rd trimester
34
Relative oligocythaemia
Pathological increase in plasma volume (hyperhydration) | Iatrogen, terminal phase of chronic kidney insufficiency
35
Absolute oligocythaemia
After acute bleeding Decreased RBC production: Bone marrow suppression (Heavy metal poisoning, mycotoxins, viral infections) Deficiencies: Fe, Cu, pyridoxal, cobalamine, folic acid Decreased lifespan in circulation: immune-med hemolytic anemia Sequestration of RBCs in spleen (splenomegaly)
36
Complex oligocythaemia
Hypovolaemic oligocythaemia | Absolute oligocythaemia with vomiting/diarrhea
37
Additional information by examining blood in Ht tubes after centrifuging
Colour change of plasma Buffy coat Microfilaria larvae
38
Mention 4 color changes of plasma
1. Reddish tint: hemolysis 2. White/opaque: alimentary hyperlipidaemia 3. Yellow: hyperbilirubinaemia (horse physiological, cattle b-carotene) 4. Chocolate brown: methaemoglobinaemia
39
Buffy coat in Ht tube
WBCs 1-2 mm Increase/decrease can be seen
40
Mild dehydration
<5% hardly detectable 5-6% skin turgor 6-8% enophtalmos, dry mucosa
41
Moderate dehydration
8-10% longer CRT, dry mucosa, enophtalmos, tachycardia, severe skin turgor
42
Advanced dehydration
10-12% signs of shock, disturbed consciousness weak pulse, tachycardia, low BP, cold extremities 12-15% shock, life threathening
43
Common PCV lab errors
Improper mixing Leak of RBC during centrifuging Anticoagulant effect (clumping or swelling)
44
Serum osmolality
Osmotic pressure of body fluids expressed in kg | Depends on concentration of osmotically active substances: Na/K/Cl and urea, glucose and ketone bodies
45
What sample is used to measure serum osmolality
Heparinised plasma or serum
46
Methods to measure serum osmolality
Mathematical | Osmometer
47
Mathematical measurement of serum osmolality
2 (Na+K) + urea + glucose | Advantage: no additional equipment needed
48
Osmometer
Measures freezing point of sample compared to freezing point of water (0C)
49
Osmolar gap
Difference between calculated and measured osmolarity | Gives information about toxins
50
Hyperosmolarity
>310 mOsm/kg | Concentrated EC fluids
51
Hypoosmolarity
<270 mOsm/kg | Diluted EC space
52
What can happen if we try to decrease blood glucose in advanced DM patients too quickly with exogenous insulin administration?
Rapid change in osmolarity Hypophosphataemia, hypokalaemia Cellular oedema in brain or lungs
53
What can increase osmolar gap?
Ethanol, ethylene-glycol, methyl-alcohol or isopropyl-alcohol in the blood
54
Electrolyte concentration | Sample
Ionogram Heparinised whole blood Ca2+: calcium ion-equilibrated Na- or Li- heparinate
55
Why not use Na/K EDTA for ionogram analysis?
Increases conc of Na/K and decreases Ca to zero
56
Na+ Reference range What does it do Conc depends on
140-150 mmol/l Maintains plasma osmolarity: cannot move freely through biological membranes ``` Depends on intake, per os and IV Excretion: prox tubules: 60% reabsorbed Aldosterone effect Distal tubules Excretion of other osmotically active substances Sweating (horses) ```
57
Causes of hypernatraemia
``` 1. Dehydration Decreased intake Polyuria (diabetes insipidus) Vomiting, diarrhea Hyperthermia, panting ``` 2. Na+ retention in kidneys Primary/secondary hyperaldosteronism 3. Other Hypertonic saline solution overdose Salt poisoning
58
Causes of hyponatraemia
``` 1. Water poisoning Per os (ru) Overdose of IV hypotonic fluid ``` 2. Retention of water Cardiac insufficiency Renal or hepatic insufficiency ``` 3. Na+ loss Diarrhea Renal loss, hypoadrenocorticism Sweating Body cavity sequestration ``` 4. Water efflux from IC to EC
59
K+ Reference range Conc depends on
3.5-5.5 mmol/l Intake Excretion (90% reabs) increases in presence of aldosterone effect Depends on pH Insulin: cotransport of K+ with glucose into cells
60
7 causes of hypokalaemia
``` Decreased intake Long term polyuria Administration of loop-diuretic drugs Enteral potassium loss Primary/Secondary hyperaldosteronism Alkalosis Insulin ```
61
causes of hyperkalaemia
``` Increased intake Acute kidney failure Urinary bladder rupture Hypoaldosteronism (also hyperadrenocorticism) Acidosis ```
62
Pseudohyperkalaemia
Damage of tissue cells or RBS (necrosis, hemolysis) | ø Dogs
63
Why is the normal range of K+ narrow?
Because substantial change in either direction influences the conduction of neural stimuli Muscle weakness
64
Cl- | Reference range
100-125 mmol/l | Most important anion of plasma (With HCO3)
65
Hyperchloraemia
``` Salt poisoning Decreased secretion (hyperaldosteronism) and other processes with hypernatraemia ```
66
Hypochloraemia
Abomasal displacement, vomiting, diarrhea, sweating and other processes with hyponatraemia
67
Major cations and anions
Cations: Na+, K+ Anions: Cl-, HCO3-
68
Anion gap
Other anions | Proteinate, phosphate, sulphate, lactate, oxalate, salicylate
69
Calcium Role Presence in blood plasma
``` Ionized: Ca2+, Total: tCa Neuromuscular irritability maintenance Muscle contraction initiation Cell membrane permeability regulation Blood clotting processes Bones and teeth ``` 47% bound to albumins 40% free ionized form 13% chelated form (organic acids)
70
Calcium reference range | Egg-laying poultry
2.1-3 mmol/l (Ca2+ half) | Can be doubled (%decrease of ionized fraction)
71
tCa preferred sample | Ca2+ preferred sample
tCa: Serum | Ca2+: heparinized plasma
72
Ca2+ measurement
Ion-selective electrodes
73
tCa measurement
Spectrophotometry | Calcium forms violet complex in high pH with orthocresolphtalein
74
Neuromuscular irritability symptom, calcium test
Test for Ca2+ instead of tCa | Calcium binding substances getting into blood stream and bind ionized Ca2+
75
Hypocalcaemia
Insufficient intake or absorption (vit D) Parathyroid gland hypofunction (Mg deficiency) Lactating animals Calcium binding substance toxicosis Usually both low but: Low Ca2+: caused by alkalosis (bound to albumin)
76
Hypercalcaemia
Excessive Ca/vit D intake Hyper a vitaminosis (cats) Parathormone hyperfunction Causes damage to bones and soft tissue calcification
77
tCa can be influenced by
Plasma proteins
78
Chronic kidney insufficiency compensation
Constant calcium loss: hypocalcaemia Compensation by PTH excretion Secondary renal hyperparathyroidism and hypercalcaemia
79
Magnesium forms Role Reference range
``` tMg, Mg2+ ATP metabolism (bound to Mg IC) Actin-myosin activator Catalysator for more than 300 enzymes Facilitates synthesis and breakdown of ACh ``` 0.8-1.5 mmol/l
80
Preferred samples: tMg Mg2+
tMg: serum or heparinized plasma | Mg2+ heparinised plasma
81
Mg Measurement
Mg2+: ion-selective electrodes (ISE) 70% of total Mg | tMg: Spectrophotometry with xylidine-blue reagent (purple complex)
82
Hypomagnesaemia
Grass tetany Early spring grass, especially lactating Muscle spasms, respiratory distress, death Absorption disturbance Increased excretion (renal/enteral) Hyperthyroidism (also inc IC Mg storage)
83
Hypermagnesaemia
``` Increased intake Decreased excretion: chronic insufficiency milk fever hypothyreosis Hyperadrenocorticism Dehydration ```
84
Inorganic phosphate What does it do Reference range
``` Product, reaction partner and a source of several synthetic, transitional and breakdown processes (ATP, sugar phosphate, glucose-6-P) Plasma buffer systems Eq/Ca: 0.8-1.8 mmol/l Fe/Bo/Ov: 1-2.4 mmol/l Su/Cap: 1-3 mmol/l ```
85
Pi sample and measurement method
Sample: Serum/heparinised plasma Spectrophotometry Acidic: phosphorus reacts with ammonium-molybdate and forms yellow complex
86
PTH effect
Induces phosphate and calcium mobilization from the bones and increased Pi-excretion and Ca-reabsorption through kidneys. Net effect: decreased Pi and increased Ca in plasma
87
Calcitonin effect
Increases calcium and phosphate absorption from intestines and their incorporation into the bones. Net effect is decreased Pi and Ca conc in the blood. Decrease of plasma Ph causes a decrease in Pi-conc and an increase in Ca2+ level (tCa no change)

Lab D (8 decks)

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