Lab Tech Exam 2 Flashcards Preview

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Flashcards in Lab Tech Exam 2 Deck (316):
1

Total protein =

albumin + globulins

2

Albumin makes up __-__% of total plasma protein in most animals

35-50%

3

What organ is albumin produced by?

liver

4

This protein binds to & transports many substances

Albumin

5

Albumin accounts for about ___% of osmotic activity

75%

6

Too little albumin in the blood

hypoalbuminemia

7

What can cause hypoalbuminemia?

Hepatic disease, malnutrition, intestinal malabsorption, renal disease, blood/plasma loss

8

Too much albumin in the blood

Hyperalbuminemia

9

Hyperalbuminemia is _______; decreased plasma water content due to dehydration.

relative

10

All proteins other than albumin are collectively called ________. This includes fibrinogen.

globulins

11

What tube must you use to measure fibrinogen?

purple top

12

Globulins vary in size, structure, function & charge. Most are produced in the _____ and ____ tissue.

liver
lymphoid

13

Immunoglobulins aka

antibodies

14

Globulins are normally estimated by determining the difference between what?

total protein TP - ALB (albumin)

15

What are some causes of hypoglobulinemia?

liver disease, malnutrition, intestinal malabsorption, renal disease, blood/plasma loss, failure of passive transfer (from dam to neonate)

16

What are some causes of hyperglobulinemia?

Relative (decreased plasma water content due to dehydration); inflammation (infectious & noninfectious); lymphoid neoplasms; plasma cell myeloma

17

What does hepatobiliary refer to?

Liver enzymes and other substances made by the liver

18

Enzymes found _____ in the cytoplasm of the cell that leak out when the cell is injured.

free

19

The hepatocyte can be injured by what 2 broad categories?

Primary liver disease
Secondary

20

These are examples of what type of liver problem: toxins, medications; inflammatory reaction; direct trauma; cholestasis (due to toxicity of bile salts and bilirubin)

Primary liver disease

21

These are examples of what type of liver problem: leakage of pancreatic enzymes due to anatomical location; GI disease; hypoxia from anemia or poor circulation

Secondary liver disease

22

Magnitude of elevation of these leakage enzymes is dependent on the ______ of cells being affected, not on the ____ of the injury to these cells.

Number
Severity

23

Enzyme involved in biosynthesis of alanine.
Liver specific in dogs, cats & primates (major source is hepatocyte).

Alanine aminotransferase (ALT)

24

An increase in ALT is usually seen within ___ hours of hepatocyte damage.
Peak levels seen in __-___ hours.
Levels return to normal in a few weeks unless chronic insult is present.

12 hours
24-48 hours

25

Moderate increases in ALT can occur by overproduction produced by what 2 medications?

Glucocorticoids and anticonvulsants

26

This enzyme is involved in the synthesis of aspartate.
Not liver specific

Aspartate aminotransferase (AST)

27

This enzyme has a short half life in dogs and cats. There is no advantage over ALT in these species.

AST

28

AST has a longer half life in horses & cows. However, it is also a _____ enzyme so must be interpreted in light of _____ ______.

Muscle
Creatine kinase (CK)

29

This enzyme is liver specific in large animals but is difficult to run because it is relatively unstable. Extremely short half life, may return to normal by time animal is presented.

Sorbitol Dehydrogenase (SDH)

30

This enzyme is found in high concentrations in hepatocytes of cattle, sheep, goats, and birds. No standardized test method has been developed for use in veterinary practice.

Glutamate Dehydrogenase (GLDH)

31

What are the Hepatocellular Leakage Enzymes? (4)

Alanine aminotransferase (ALT)
Aspartate aminotransferase (AST)
Sorbitol Dehydrogenase (SDH)
Glutamate Dehydrogenase (GLDH)

32

This type of liver enzyme is present within the cell, bound to membranes, and does not leak out of cells when there is damage.

Inducible (Overproduction)

33

Elevations of inducible liver enzymes are induced by an ____ in the rate of synthesis. Some escape the cell into systemic circulation.

increase

34

A group of enzymes present in many tissues. Ex: Alkaline Phosphatase

Isoenzymes

35

High concentrations of this enzyme is found in the liver, bone, intestinal mucosa, kidney and placenta.

Alkaline Phosphatase
(ALKP, ALP, AP)

36

The half life of ALP in the intestines, kidneys and placenta is ____ (____) compared to bone and liver.

short (hours)

37

What drugs can cause an increase in ALP? This only occurs in dogs. Do not necessarily indicate liver pathology.

Glucocorticoids and anticonvulsants

38

Increased ALP can also be caused by ______. Accelerated production of ALP is induced by increased pressure in the bile ducts during blockage of bile flow.

Cholestasis

39

Cholestasis may be from ______ or _____ causes.

intrahepatic or extrahepatic

40

Intrahepatic cholestasis can occur secondary to a wide variety of conditions that affect the biliary tree in the liver, including:

inflammation or infection, hepatocyte swelling, and neoplasia

41

Extrahepatic cholestasis results from occlusion of the ______, which may be caused by similar conditions affecting the gall bladder, bile duct itselt, or the area of the duodenum where the bile duct empties.

common bile duct

42

Pancreatitis or pancreatic neoplasia may sometimes cause

extrahepatic bile duct obstruction

43

Cat's livers are capable of less ALP production than dogs, consequently an increase of only _-_ X the URL in cats in clinically significant

2-3X

44

ALP is considered an inducible enzyme, but mild increases (<5X URL) have been noted following _____ - probably because of release of membrane fragments containing ALP.

acute hepatic necrosis

45

Is it possible to differentiate the isoforms of ALP?

Yes: bone (BALP); corticosteriod-induced (CALP); liver cholestasis (LALP)

46

Increased osteoblastic activity of ALP can be due to what?

Young growing animals
Hyperparathyroidism
Fracture healing
Osteosarcoma

47

ALP is not use in what 2 species because there are wide fluctuations in normal blood ALP levels.

Cattle & Sheep

48

ALP increases are usually ____ with osteoblastic activity, fracture healing, etc.

mild

49

This enzyme is found in many tissues but the primary source is the liver. Blood ___ level is elevated with liver disease, especially w/obstructive liver disease.

Gamma glutamyltransferase (GGT)

50

Cattle, horses, sheep, goats, and birds have ___ (higher or lower) blood GGT activity than dogs and cats.

higher

51

This enzyme is synthesized in the highest amounts in the kidneys, pancreas & liver.

GGT

52

Why is the blood GGT specific to the liver?

GGT from renal tubules is excreted in urine.
GGT from the pancreas in excreted into the GI tract.
GGT present in the serum originates from the liver.

53

Increased GGT occurs with what pathologically?

Cholestasis
Biliary hyperplasia

54

Similar to ALP, GGT can be induced in dogs receiving what?

Corticosteriods and anticonvulsants

55

Because ALP is not very sensitive in large animals, what liver enzyme would you use to test for cholestasis?

GGT

56

Neonates of several species have markedly increased GGT due to ingestion of

colostrum

57

We can measure many substances that are taken up, modified, produced, and/or secreted by the liver - these are not enzymes. What are these tests called collectively?

Hepatocyte Function tests

58

2 general types of tests for what?
Those that test uptake, metabolism, and clearance of a substance from the blood.
Those that test the synthetic capabilities of the liver.

Hepatic Function tests

59

Bilirubin is a breakdown product of what?

hemoglobin

60

Aged RBCs are destroyed by macrophages in the

spleen

61

What portion of hemoglobin is converted to bilirubin?

Heme

62

The protein-bound (mainly albumin) bilirubin is called

unconjugated bilirubin

63

Inside the hepatocyte, bilirubine attaches first to a binding protein (ligandin), which helps keep it from refluxing back into the blood. Bilirubin is then ______ (usually to glucuronic acid), making it water soluble and excreted in the bile.

conjugated

64

Conjuaged bilirubin is also called

direct bilirubin

65

Some conjugated bilirubin may become protein-bound, termed

delta bilirubin

66

Protein-bound bilirubin, whether conjugated or unconjugated, does not pass through the normal glomerulus, and so is not usually present in

urine.

67

Conjugated bilirubin that is secreted in bile ends up in the intestine, where it is converted to ____ and excreted in feces.

Urobilinogen

68

In health, most serum bilirubin is ______, and a small amount is ______.

Most: unconjugated
small: conjugated

69

Conjugated bilirubin (which is _____ soluble) is excreted as a bile pigment into intestines.

Water

70

Conjugated bilirubin can be converted into urobilinogen by ______ in the intestines.

bacteria

71

Some urobilinogen is converted to stercobilinogen and excreted in stool as

stercobilin

72

Total bilirubin =

conjugated + unconjugated

73

When there is hyperbilirubinemia to a sufficient degree, the serum will be

icteric.

74

By the time the serum bilirubin reaches ___mg/dL, icterus can also be detected in the mucous membranes & sclera.

3 mg/dL

75

What are the three general causes of hyperbilirubinemia?

Pre-hepatic
Hepatic
Post-hepatic

76

Excess extravascular hemolysis red blood cell breakdown. One cause of hyperbilirubinemia.

Pre-hepatic

77

Liver disease that prevents liver from conjugating the normal amount of unconjugated bilirubin presented to it. One cause of hyperbilirubinemia.

Hepatic

78

Bile duct obstruction so that the conjugated bilirubin can't be passed with bile into the intestines and backs up into the bloodstream and into the tissues. One cause of hyperbilirubinemia.

Post-hepatic

79

The enzymes induced by cholestasis (___ & ____) are generally more sensitive indicators of cholestasis than is increased serum bilirubin (particularly true in dogs & cattle, doesn't always hold true for cats & horses).

ALP & GGT

80

The combination of increased induction enzymes (ALP & GGT) plus increased serum bilirubin supports

Cholestasis

81

Combination of regenerative anemia (typical of hemolysis) and increased serum bilirubin suggests a

pre-hepatic icterus

82

Leakage enzymes (ALT, AST) may be increased (indicating hepatocellular injury) from hepatic causes of icterus, but also from ______ because bile is an irritating substance that can solubilize membranes and cause hepatocyte injury.

post-hepatic causes

83

_____ and ______ causes of icterus cannot be reliably differentiated based on laboratory data. Additional diagnostic tests such as ultrasound, liver biopsy, or sx are usually required.

Hepatic and post-hepatic

84

Bilirubin in these 2 species is only elevated if significant liver disease is present.

Dog and cat

85

Increased bilirubin in this species can be seen in non-hepatic conditions such as anorexia.

Horse

86

Increased bilirubin in this species can be elevated in a variety of diseases. Increase due to liver disease is less than other species.

Cattle

87

Bile acids are synthesized by ______ from cholesterol.

hepatocytes

88

Bile acids are secreted in the ____ and stored in the _____.

bile
gallbladder

89

Bile acids are released into the ____ following a meal.

duodenum

90

Bile acids aid in ____ absorption.

fat

91

Bile acids get transported back to the _____ via portal circulation.

liver

92

Normally, there is a ____ level of bile acids in systemic circulation.

very low

93

What are 3 reasons for an elevation in bile acids?

Decreased hepatic function
Portosystemic shunt
Cholestatic disease

94

An elevation in bile acids because they are not effectively cleared from the blood is caused by what?

decreased hepatic function

95

When blood bypasses the liver and enters systemic circulation, this is called a

portosystemic shunt

96

Bile acids that get regurgitated to the liver and enter systemic circulation is caused by what?

cholestatic disease

97

These are techniques for what test: fast patient for 12 hours; draw blood sample; feed patient; draw blood sample 2 hours later; only fasting sample is taken in animals without a gallbladder.

Bile acids test

98

These 4 tests evaluate hepatic synthetic function.

Albumin, glucose, BUN, cholesterol

99

Albumin is synthesized in the ____, so hepatic insufficiency can result in hypoalbuminemia.

liver

100

Albumin has a long serum half-life (7-10 days), and so decreases are associated with ______ liver disease.

chronic

101

There are other causes besides chronic liver disease for hypoalbuminemia such as

urinary loss, blood loss, intestinal loss

102

The ____ is central to glucose metabolism, converting glucose to glycogen for storage, releasing stored glucose via glycogenolysis, and synthesizing glucose via gluconeogenesis.

Liver

103

Because of the liver's reserve capacity, __-__% of hepatic function must be lost before glucose abnormalities and low albumin levels are seen.

60-80%

104

Typically, we think of hepatic insufficiency as causing hypoglycemia, but a prolonged ______ following a meal is also possible due to decreased glucose uptake by hepatocytes.

hyperglycemia

105

Urea is synthesized from ____ in the liver.

ammonia

106

Markedly decreased hepatic mass is result in ____ (increased or decreased) urea synthesis and therefore a _____ serum BUN, while blood ammonia levels increase.

decreased
decreased

107

Cholesterol is synthesized in the ____ and undergoes enterohepatic circulation via the bile.

liver

108

Cholesterol my be normal, decreased, or increased with liver disease, depending upon the balance between ____ and ____ ______.

cholestasis
hepatic insufficiency

109

What are 3 exocrine pancreatic enzymes?

Amylase, lipase & trypsin

110

What 2 pancreatic enzymes are measured directly?

amylase & lipase

111

_____ is an exocrine pancreatic enzyme that is measured using antibodies to detect it.

trypsin

112

What are the 2 endocrine pancreas tests?

Glucose
Fructosamine

113

Inflammation of the pancreas. The result of activation of the digestive enzymes (amylase, lipase & proteases) within the pancreas instead of activation in the intestine.

Pancreatitis

114

CSX of what disease?
vomiting, abdominal pain, systemic inflammation (leukocytosis, fever). Occurs in dogs and cats

Pancreatitis

115

The result of an absolute or relative lack of insulin production.

Diabetes mellitus (DM)

116

CSX of what disease?
polydipsia, polyuria, polyphagia & weight loss. Dogs: sudden blindness due to cataract formation can occur. Cats: decreased interaction, unkempt hair, rear limb weakness

Diabetes mellitus (DM)

117

____ and _____ are used to aid in the diagnosis of pancreatitis. Not useful for detection of pancreatic insufficiency because they are produced in other places.

Amylase and lipase

118

Pancreatitis occurs much more commonly in the ___ than other species.

dog

119

Pancreatitis occurs in ____ but is more difficult to diagnose.

cats

120

Pancreatitis is rarely diagnosed in ____ and ____.

horses & cattle

121

The primary source of ____ is the pancreas, but it is also produced in the salivary glands and small intestine.

Amylase

122

This enzyme breaks down starches and glycogen.

Amylase

123

Pancreatic duct ____ results in a backup of digestive enzymes into peripheral circulations.

inflammation

124

Amylase rises rapidly (w/in 12-48) with ____ and remains elevated for more than one ____.

pancreatitis
week

125

Normal amylase and lipase does not rule out _______

pancreatitis

126

Renal tubular cells normally degrade ______. Renal failure may cause elevations in _______.

Amylase

127

Some ____ and ____ diseases may cause elevations in amylase.

liver and intestinal

128

Manipulation of the ____ during sx may also cause elevations in amylase.

pancreas

129

In general, the higher the amylase, the more likely it is to indicate ______.

pancreatitis

130

The degree of amylase activity is not directly ____ to the severity of pancreatitis.

proportional

131

Nearly all serum lipase is derived from the ______.

pancreas

132

This enzyme breaks down the long-chain fatty acids of lipids.

Lipase

133

Interpretation of lipase is similar to that of ______

amylase

134

Lipase activity usually does not increase in ____ patients with pancreatitis and is not a reliable indicator.

feline

135

Lipase may be elevated in non-pancreatic disesases such as:

renal disease, hepatic disease, exploratory sx, corticosteroids (unlike amylase)

136

What test is species specific for an enzyme produced by the pancreas?

Species-specific pancreatic-lipase immunoreactivity (PLI)

137

Limited to the _____ cells (exocrine portion) of the pancreas, and thus is a specific marker indicating damage to the pancreas.

acinar

138

Abdominal ultrasonography is also a useful aid in the diagnosis of the canine _____

pancreatitis

139

This test uses antibodies to detect trypsin and trypsinogen. It is species specific. A 12 hour fasted serum sample is sent to a reference lab on gel ice pack

Serum trypsinlike immunoreactivity

140

This disease is hereditary in German Shepherds. It is secondary to reccurent bouts of pancreatitis.

Exocrine Pancreatic Insufficiency (EPI)

141

Which test is most often used to detect exocrine pancreatic insufficiency (EPI)?

Trypsin-like immunoreactivity (TLI)

142

This disease is a lack of digestive enzymes resulting in malassimilation of ingested food (food is not transformed to absorbable forms). Intestinal bacteria overgrowth often occurs in dogs. Secondary changes occur in intestinal mucosa.

Exocrine Pancreatic Insufficiency

143

Csx of what disease? Chronic diarrhea, weight loss or failure to gain weight, pica & coprophagia may occur.

EPI

144

These cells in the pancreas release glucagon in response to hypoglycemia.

Alpha cells

145

These cells in the pancreas release insulin in response to hyerpglycemia.

Beta cells

146

We can measure _____ to help assess the beta cell function of the pancreas.

glucose

147

Diabetes mellitus, stress, and glucocorticoids are causes of what?

Hyperglycemia

148

Insulinoma, fasting, liver disease, and artifact are causes of what?

hypoglycemia

149

This represents the irreversible reaction of glucose bound to protein, particularly albumin.

Fructosamine

150

When glucose is persistently elevated, fructosamine is ______

elevated

151

Half-life of albumin in dogs & cats is 1-2 weeks. Therefore, _____ provides an indication of the average serum glucose over that period.

fructosamine

152

Production of these hormones increases with exposure to cold and then increases metabolic rate to generate more heat.

thyroid hormones

153

These hormones affect metabolism of proteins, carbohydrates, and lipids much.

Thyroid hormones

154

These hormones encourage synthesis of proteins if there are adequate energy sources.

Thyroid hormones

155

Thyroid hormones ____(encourage or discourage) the breakdown of lipids for energy

encourage

156

Thyroid hormones ______ (encourage or discourage) using carbs as energy source.

discourage

157

Deficiency of thyroid hormone

hypothyroidism

158

Lethargy, weight gain, cold intolerance, alopecia are clinical signs of

hypothyroidism

159

Diagnostic tests for hypothyroidsim

Free T4 by ED, T4, TSH

160

Tx for hypothyroidism

thyroid hormone supplement

161

Excessive thyroid hormone

hyperthyroidism

162

Etiology for what disease? lymphocytic throiditis & idiopathic atrophy of the thyroid gland

Hypothyroidism

163

Etiology for what disease? hyperplasia or neoplasia of thyroid gland typically in middle aged to older cats

Hyperthyroidism

164

Clinical signs of what diease? PU/PD, polyphagia, weight loss, v/d, tachycardia, hyperactive

Hyperthyroidism

165

Diagnostic tests for hyperthyroidism

T4, free T4 by ED

166

TX for hyperthyroidism

antithyroid drugs, sx, radioactive iodine

167

This thyroid assay monitors hypothyroid & hyperthyroid patients; aids in diagnosis of hyper & hypothyroidism

Total T4

168

___% of T4 is protein bound

99

169

Total T4 thyroid assay is affected by (2 things). "Euthyroid-sick"

Drugs and non-thyroid illnesses

170

This thyroid assay is more accurate than T4. It measures unbound, biologically active T4.

Free T4 by Equilibrium Dialysis

171

Free T4 by ED should be interpreted in conjunction with (2 things)

TSH & clinical signs

172

This thyroid assay differentiates primary hypothyroidism from secondary/tertiary.

TSH

173

TSH should be interpreted in conjunction with

T4 or free T4 and clinical signs

174

Total T4 should be interpreted in conjunction with (3 things)

TSH, free T4 by ED & clinical signs.

175

Total T4 assay uses what?

serum or plasma

176

If monitoring total T4, draw sample _-_ hours post pill.

4-6

177

Can Total T4 be sent out or run in house?

Both

178

Can Free T4 by ED be sent out or run in house?

Sent out

179

Can TSH be sent out or run in house?

sent out

180

When should a UA be performed? (time of day)

morning

181

increased urine production

Polyuria

182

frequent urination

pollakiuria

183

decrease in daily urine output

oliguria

184

absence of urine

anuria

185

painful urination

dysuria

186

High WBC count in urine

pyuria

187

RBC in urine

hematuria

188

hemoglobin in urine

hemogloinuria

189

4 methods of urine collection

free-catch, manual expression, cystocentesis, catheterization

190

What collection method? Urine collected in clean container free of disinfectants. Mid-stream sample preferred.

Free-catch

191

Disadvantages of free catch method?

WBC, bacteria & protein can be added as contaminants from distal urethra, genital tract & external skin

192

Free catch samples that are negative for WBC, bacteria & protein are ____ results.

valid

193

Free catch samples that are positive for WBC, bacteria, protein will necessitate sampling via

cystocentesis

194

This method of urine collection is cleaner than samples collected by free catch, but urine sample may still contain contaminants.

Catheterization

195

What should be done before cathing an animal for a UA?

External area is generally cleaned w/a surgical skin method

196

When cathing, there is the possibility of causing an ____ UTI.

iatrogenic (secondary)

197

This method of urine collection is likely to add RBC's & transitional cells to the urine sample. This is due to mild trauma to the urethra.

Catheterization

198

This is the preferred method of urine collection when evaluating the significance of cells or bacteria in the urine.

Cystocentesis

199

Which method of collection should be used when obtaining urine for culture?

Cystocentesis

200

Mild blood contamination may be seen in ____ obtained sample.

cystocentesis

201

What are the 4 UA assays?

Gross examination
Specific gravity (USG)
Chemical analysis
Sediment

202

Analyzing urine sample should be done in what time frame?

15-30 min

203

Why should urine be analyzed within 30 min?

Dissolution of casts & deterioration of cells present in urine.
Increase in urine pH due to loss of CO2
Formation of dissolution of crystals depending on type.
Bacteria will overgrow

204

Urine samples sent to an outside lab for cytologic exam are sent in a ____ tube.

EDTA

205

If urine cannot be examined w/in 30 min, it can be refrigerated & sealed to slow rate of artifactual changes. It will be valid for about ___ hours

6

206

Horse urine is normally what turbidity?

cloudy

207

Normal USG for dogs is what if hydration status is normal

1.025

208

Normal USG for cats is what if hydration status is normal

1.030

209

This UA assay indicates renal function in maintaining hydration; can kidneys concentrate urine?

Urine specific gravity

210

No normal results for USG, only appropriate values for a given _____ state.

hydration

211

In health, the pH of urine is dependent on

diet.

212

Diets high in animal protein produce a ____ urine pH.

lower (more acidic)

213

Diets that are plant/vegetable based result in ___ urine pH.

Higher (alkaline)

214

Carnivores/omnivores have more ___ urine.

acidic

215

Herbivores have more ___ urine

alkaline

216

In illness, the urine pH can be affected by the ____ status of the patient.

acid/base

217

An animal with academia should have more ___ urine as the kidneys excrete excess ____.

Acidic
H+

218

An animal with alkalemia should have more ____ urine as the kidneys retain ____.

basic
H+

219

UTI's, with urease positive bacteria (which convert urea to ammonia) may result in an ____ in pH.

increase

220

Increase in urine pH/alkaline urine, WBC & bacteria in urine sediment are indications of

Urinary tract infections

221

The most common cause of an increase in urine pH in small animals is

artifactual, letting it set out for too long

222

Protein is normally present in ___ quantities in the urine.

low

223

The protein pad on the urine stick is influenced by the ___ of the urine

pH

224

Positive protein readings should be re-checked by a separate method, such as

Sulfosalicylic acid turbidity (SSA)

225

This type of urine can occur with stress, temp extremes (envir or fever) or strenuous exercise.

Proteinuria

226

The more common proteinuria is

renal proteinuria

227

____ is normally not present in the urine in quantities detectable on dipsticks. The dipstick pad detects this using the enzyme glucose oxidase.

Glucose

228

This enzyme activity on the urine dipstick glucose pad is limited and outdated strips may give false neg reactions & temp can affect enzyme activity (refrigerated samples should be warmed to room temp before testing).

glucose oxidase

229

_____ will occur with any condition that causes blood glucose levels to exceed the renal threshold for re-absorption.

Glucosuria

230

____ is a common cause of glucosuria due to excessive blood glucose concentrations.

Diabetes mellitus

231

____ are formed during fat metabolism. ____ indicate an excessive shift from carb metabolism to fat metabolism.

Ketones
Ketonuria

232

The occult blood reagent on the urine dipstick measures what 2 things?

myoglobin or hemoglobin

233

Positive occult blood reading is most commonly associated with ____ rather than hemoglobinuria.

Hematuria

234

____ may occur after rhabdomyolysis. Animals will usually have elevations in muscle enzymes & signs of muscle pain.

rhabdomyolysis

235

____ is a breakdown product of hemoglobin.

Bilirubin

236

Which tests on the dipstick are not reliable for animals?

USG, urobilinogen, nitrites, WBCs

237

What should be used to measure USG?

refractometer

238

What should be observed at 40X for microscopic exam of urine sedimentation?

epithelial cells, RBC, WBC, bacteria

239

What should be observed at 10X for microscopic exam of urine sedimentation?

casts, crystals

240

What misc findings can be on the microscopic exam of urine sedimentation?

mucus, fat, sperm, parasites

241

What are the five main types of casts?

Hyaline, cellular, granular, waxy, fatty

242

What are the 2 types of Calcium oxalate crystals and what do they look like?

Monohydrate: picket fence
Dihydrate: square w/x or back of an envelope

243

Factors that may increase urine pH

sample sits out, UTI, high-fiber diets, certain drugs, alkalosis, urine rentention

244

Factors that may decrease urine pH

high-protein diet, fever, starvation, acidosis, excessive muscular activity, certain drugs

245

What type of bilirubin cannot pass through the glomerulus?

unconjugated, because it is usually bound to albumin

246

Only ____ bilirubin will be excreted in the urine.

conjugated

247

Bilirubinuria & hyperbilirubinemia are caused by the same 3 diseases which are

hemolytic disease
hepatic insufficiency
cholestasis

248

Bilirubinuria should prompt you to look for other evidence of (2 things)

liver disease or hemolysis

249

Dogs, especially males, have a ___ renal threshold for bilirubin.

lower

250

Many normal cattle have ___ amounts of bilirubin in their urine.

small

251

Any amount of ___ in cats, pigs, sheep & horses is significant.

bilirubinuria

251

This type of cast is clear, colorless, and somewhat transparent structures composed only of protein.

Hyaline

252

Increased numbers of this type of cast indicate the mildest form of renal irritation. There numbers are also increased with fever, poor renal perfusion, strenuous exercise, or general anesthesia.

Hyaline

253

This type of cast is a hyaline cast containing granules. It is the most common type of cast seen in animals.

Granular casts

254

This type of cast is seen in large numbers with acute nephritis and indicate more severe kidney damage than do hyaline casts.

Granular casts

255

This type of cast consists of epithelial cells from the renal tubules imbedded in a hyaline matrix

Epithelial casts

256

This type of cast is seen in acute nephritis or other conditions that cause degeneration of the renal tubular epithelium

Epithelial casts

257

This type of cast contains WBC, mostly neutrophils, which indicates inflammation in the renal tubules.

Leukocyte casts

258

This type of cast is deep yellow to orange in color. RBC membranes may or may not be visible.

Erythrocyte casts

259

This type of cast indicates renal bleeding.

Erythrocyte casts

260

This type of cast resembles hyaline casts but are usually wider, with square ends rather than rounded ends and a dull, homogenous, waxy appearance

Waxy casts

261

This type of cast indicates chronic, severe degeneration of the renal tubules.

Waxy casts

262

This type of cast contains many small droplets of fat that appear as refractive bodies.

Fatty casts

263

This type of cast is seen in cats with renal disease, occasionally in dogs with diabetes mellitus. A large number of these casts suggest degeneration of the renal tubules.

Fatty casts

264

This type of crystal is a 6-8 sided prism with tapering sides and ends. Typically described as coffin lids, occasionally they may be fern-leaf shaped.

Struvite crystals

265

This type of crystal is found in alkaline to slightly acidic urine

Struvite

266

This type of crystal is common in alkaline urine and appear as a granular precipitate.

Amorphous phosphate

267

This type of crystal is commonly seen in urine of horses and rabbits. They are round, with many lines radiating from their centers, or appear as large granular masses. They may also have a dumbbell shape. They have no clinical significance.

Calcium carbonate.

268

This type of crystal is similar to Amorphous phosphate crystals in that they appear as granular precipitate. Unlike amorphous phosphate, they are found in acidic urine.

Amorphous urates

269

This type of crystal is found in acidic, neutral, or alkaline urine. They are brown in color and round with long, irregular spicules (thorn apple shaped)

Ammonium biurate

270

This type of crystal is most common is animals with severe liver disease, such as portocaval shunts.

Ammonium biurate

271

Calcium oxalate crystals come in what 2 types?

Dihydrate and monohydrate.

272

This type of crystal generally appears as small squares, containing an X across the the crystal, resembling the back of an envelope.

Calcium oxalate dihydrate

273

This type of crystal may be small and dumbbell shaped or elongated and pointed at each end (picket fence).

Calcium oxalate monohydrate

274

This type of calm oxalate crystal is found in acidic and neutral urine. It is commonly seen in small numbers in dogs and horses

Calcium dihydrate

275

The urine of animals poisoned with ethylene glycol (antifreeze), often contains large numbers of ........., especially which one?

Calcium oxalate crystals
Monohydrate

276

Animals with oxalate urolithiasis may have large numbers of .......... ........ Crystals in their urine, and large numbers of these crystals may indicate predisposition to oxalate urolithiasis.

Calcium oxalate

277

This type of crystal is seen in animals being treated with sulfonamides.

Sulfonamide crystals

278

This type of crystal is round, usually dark, with individual crystals radiating from the center. They are less likely to be seen in alkaline urine.

Sulfonamide crystals

279

This type of crystal takes on a variety of shapes but are usually diamond or rhomboid. They appear yellow or yellow-brown and are not commonly found in dog or cat urine except Dalmatians

Uris acid crystals

280

This type of crystal is wheel or pincushion shaped and are yellow or brown in color. Animals with liver disease may have this type of crystal in their urine.

Leucine

281

This type of crystal is dark, with needlelike projections, and are highly refractive. They are often found in small clusters. They are not a common finding in dog and cat urine. Animals with liver disease may have these in their urine.

Tyrosine

282

This type of crystal appears flat and is 6-sided (hexagon) colorless and thin. They can be associated with renal tubular dysfunction or cystine urolithiasis.

Cystine

283

The bladder worm of dogs and cats

Capillaria plica

284

Kidney worm of dogs

Dioctophyma renale

285

What may be seen in the urine sediment of dogs with adult heartworms?

Microfilaria

286

Occurrence of uroliths in the urinary tract

Urolithiasis

287

What are the primary serum chemistry tests for kidney function?

Blood urea nitrogen (BUN)
Creatinine (CREA)

288

Increased concentrations of BUN and/or CREA are referred to as

azotemia

289

During protein catabolism, ____ is formed.

ammonia

290

The liver converts ammonia to

urea

291

Urea is soluble in plasma and is freely filtered through the glomerulus. Some urea is normally reabsorbed through the tubules. There, ___ amount of BUN is maintained.

some

292

Serum creatinine is produced from the breakdown of

phosphocreatine

293

Protein in muscle tissue is referred to as

phosphocreatine

294

The day to day rate of creatinine production is relatively constant in any animal and is dependent on

muscle mass

295

Creatinine is cleared primarily by the

kidney

296

Creatinine is ____ reabsorbed through the tubules.

minimally

297

Even though ___ is the result of breakdown of muscle protein, alterations in muscle metabolism rarely affect it enough to cause elevations above normal.

creatinine

298

What are 2 general causes of azotemia?

Decreased glomerular filtration of blood. (glomerular filtration rate GFR)
Increased rate of protein catabolism

299

This is a characteristic of what cause of azotemia? Decreased number of functioning nephrons.

Decreased GFR (glomerular filtration rate)

300

This is a characteristic of what cause of azotemia? Shut down of filtration due to obstruction causing backpressure into the ureter and kidneys.

Decreased GFR

301

This is a characteristic of what cause of azotemia? Decreased blood flow to the kidneys: 1) reduced blood volume from dehydration, hypotension, 2) reduced circulating volume due to cardiac insufficiency.

Decreased GFR

302

These are characteristics of what cause of azotemia? High protein diet. Increased muscle breakdown.

Increased rate of protein catabolism

303

This is a characteristic of what cause of azotemia? Bleeding in the GI tract (results in digestion of serum proteins).

Increased rate of protein catabolism

304

Pre-renal azotemia can result from the rate of formation of nitrogenous waste _____ and _____ renal clearance.

increases and exceeds

305

Pre-renal azotemia can result from ___ blood flow to the kidneys.

decreased

306

The kidneys are normal but there is reduced blood flow to the kidneys resulting in reduced clearance of waste products. This results in ____ azotemia.

pre-renal

307

With decreased blood flow to the kidneys, the degree of azotemia may be

very high

308

You cannot ever rule out pre-renal azotemia due to poor perfusion simply based on the magnitude of the

azotemia

309

Decreased GFR due to lack of functioning renal tissue (reduced number of functioning nephrons) will result in ____ azotemia.

renal

310

Because of the excess reserve capacity of the kidney, renal azotemia does not occur until approximately __% of the nephrons are nonfuncitonal.

75%

311

Decreased GFR secondary to urinary obstruction is related to

postrenal azotemia

312

Blockage of urine flow eventually causes enough backpressure into the ureters and kidneys to shut down

renal filtration

313

If you can rule out post-renal azotemia based on clincal exam, then ___ can be used to differentiate pre-renal from renal azotemia.

USG

314

If the urine is adequately concentrated, the animal has a ____ azotemia.

pre-renal

315

The ability to concentrate urine is lost when __% of the nephrons are non-functional.

66%