What three minerals can you test for?
calcium, phosphorus, magnesium
Calcium: 99% _____ and 1% _____
bones, neuromuscular tone
What are the 3 functions of calcium?
facilitates blood coagulation, ion transfer across cell membranes, maintains enzyme activity
What is hypercalcemia?
increase of calcium in the blood
What is the medical term for an increase of calcium in the blood?
What is hypercalcemia caused primarily by? (2 things)
malignancy, primary hyperthyroidism
Malignancy and primary hyperthyroidism are the primary causes of _____
What is hypocalcemia?
decreased calcium in the blood
What is the medical term for a decrease of calcium in the blood?
What are the primary causes of hypocalcemia? (2 things)
post-whelping tetany (eclampsia), hypoalbuminemia
Post-whelping tetany (eclampsia) and hypoalbuminemia are the primary causes of _____
Hypocalcemia is usually seen on a (routine/emergency) basis?
What is the proper calcium:phosphorus ratio?
1.2:1 - 1.2(calcium):1(phosphorus)
Calcium is (directly/inversely) proportional to phosphorus
When calcium levels increase, phosphorus levels _____?
What are the functions of calcium? (3 things)
carbohydrate metabolism, part of nucleic acids and phospholipids, energy storage,release, and transfer
Phosphorus is found 80% in _____
Phosphorus levels are normally higher in _____
What are the 2 forms of phosphorus and where are they found?
organic - in RBC, inorganic - plasma and serum
Where is organic phosphorus found?
Where is inorganic phosphorus found?
in plasma and serum
Which form of phosphorus can be measured?
Magnesium is an _____ mineral.
Where is magnesium found?
in all body tissues
More than 50% of magnesium is found in _____
What is the function of magnesium?
production of acetylcholine
What should be avoided when dealing with all mineral samples?
What are electrolytes?
ionic substances in body fluids
What is the function of electrolytes?
acid-base and osmotic balance
What tube color (and additive if present) is required for a electrolyte sample?
green top heparin sample, red top or SST
What are the units of measurement for electrolytes?
What are the 4 major electrolytes?
sodium, potassium, chloride, bicarbonate
What is the primary extracellular fluid cation?
What is the primary intracellular fluid cation?
What is the primary extracellular anion?
What regulates the blood pH (buffer)?
What are the 4 ways to measure electrolytes?
chemical, ion-specific, blood sample, blood gases
What forms of electrolytes can the chemical method measure?
What forms of electrolytes can the ion-specific method measure? What specifically does it measure?
active forms, measures the change in electrical potentials
Where are plasma proteins primarily produced?
Where are plasma proteins?
liver, immune system (plasma cells and lymphoid tissue)
What are 7 functions of proteins
structural matrix of cells, organs and tissues; maintain oncotic pressure; enzymes for biochemical reactions; buffers in acid-base balance; hormones; blood coagulation; defense against pathogenic carrier molecules
What is the primary circulating plasma protein?
What are the three plasma proteins and their significance?
albumin - primary circulating plasma protein; globulins - antibodies; fibrinogen - clotting
What is the most abundant plasma protein in serum and how much (%)?
Albumin is synthesized by _____
Which plasma protein is a major transport protein in blood? What does it transport?
albumin; hormones, bilirubin, drugs, etc.
Where is globulin synthesized?
What is the primary function of globulin?
transport and binds proteins
Globulin forms the building blocks of _____, _____, and _____.
immunoglobulins, coagulation factors, hemoglobin
Total protein - albumin = _____
_____ - albumin = globulin
Total protein - _____ = globulin
What is the 1st indication of protein abnormality?
albumin:globulin ratio (A:G)
What is the abnormal A:G ratio in dogs and equine?
What is the abnormal A:G ratio in cats, cattle, and pigs?
Where is fibrinogen synthesized?
Fibrinogen is the precursor of _____ that forms the matrix of a blood clot.
What is the precursor of fibrin?
What could cause an increase in fibrinogen?
acute inflammation or tissue damage
Total PP (plasma protein) (includes/excludes) fibrinogen? What is used for this test?
includes, PCV tube
Serum TP (total protein) (includes/excludes) fibrinogen? What is used for this test?
excludes, chem analyzer
The heat precipitation test is used to analyze _____
What is the medical term for an increase of sodium (Na+)?
What is the medical term for a decrease in sodium (Na+)?
What is the medical term for an increase in potassium?
What is the medical term for a decrease in potassium?
What conditions are sensitive to TP (total protein) changes? (7 things)
edema and ascites, diarrhea, weight loss, renal or liver disease, blood clotting problems
What is the medical term for an increase in total protein? What is a major cause?
What is the medical term for a decrease in total protein? What is a major cause?
hypoproteinemia, liver disease
Tests of adrenocortical function requires a _____ sample
Tests of thyroid function requires a _____ sample
What is the medical term for increased ACTH? What disease is this?
hyperadrenocorticism, Cushing's disease
What is the medical term for decreased ACTH? What disease is this?
hypoadrenocorticism, Addision's disease
What tests evaluate adrenocortical function? (3 things)
ACTH stimulation test, low/high dose dexamethasone suppression test, plasma cortisol
What do thyroid panels test for?
T3, T4, free T3 and T4, autoantibodies
What tests evaluate thyroid function? (3 things)
thyroid stimulation test (TSH response test), thyroid-releasing hormone stimulation test (TRH), thyroid panels
What is the largest internal organ?
The liver is in charge of the metabolism of _____, _____, and _____
amino acids, carbohydrates, lipids
The liver synthesizes ______, _____, _____, and _____
albumin, cholesterol, plasma proteins, clotting factors
The liver is responsible for the digestion and absorption of _____ (_____ formation)
The liver eliminates _____ and _____ _____
toxins, certain drugs
_____ are a group of enzymes that transfer amine groups from animo acids to ketoacids to produce a new amino acid
Transferases are formed in tissues with _____ rates of _____ metabolism. Give 3 places.
high, protein, kidney, liver, muscle
ALT stands for...
alanine amino transferase
aspartate amino transferase
ALT is a _____-specific enzyme in _____, _____, and _____ (types of animals). What kind of animals are the exception?
liver, dogs, cats, primates, farm animals
What is the primary source of ALT? What are the other sources? Can a disease of one of these organs affect ALT?
liver hepatocytes, kidney, cardiac, skeletal muscle, pancreas, yes
A liver disease screening cannot determine the _____ or _____ of the disease.
Give an example of a liver-specific enzyme. Give an example of a liver-nonspecific enzyme.
ALT is liver-specific. AST is liver-nonspecific.
ALT is a liver (specific/nonspecific) enzyme. AST is a liver (specific/nonspecific) enzyme.
What are the 2 primary sources of AST? What are the other sources? (5 things)
hepatocytes and muscle cells, RBCs, cardiac and skeletal muscle, kidney, pancreas
Excercise, IM injections, liver disease, muscle disease, hemolysis, and lipemia are causes of (ALT/AST) increases.
_____ are a group of enzymes responsible for transferring hydrogen groups.
Dehydrogenases play a role in _____.
LDH stands for
SDH stands for
GLDH stands for
Dehydrogenases: What is the preferred assay to evaluate equine/large animal liver function?
SDH (sorbitol dehydrogenase)
Dehydrogenases: What is the preferred assay to evaluate cattle and avian liver function?
T or F. You are able to detect small elevations in liver disease using GLDH.
Cholestatic enzymes: SAP stands for
serum alkaline phosphate
SAP is used to determine ___________
what moves through the liver
SAP is formed in _____, _____, _____, and _____.
liver, bone, kidney, intestine
What animals may have increased SAP? What causes it?
young, growing bones
A significant increase in SAP is caused by __________ (_-_x normal) or __________ (_-_x) from _____
liver disease (2-3x normal), obstructive disease (10-15x normal), cholestasis
An increase in SAP without an increase in ALT is usually caused by _____.
Transpeptidases: GGT stands for
What is the primary source for GGT? Where else is it found?
liver, many tissues
GGT is used to evaluate _____ and _____ (what kinds of animals)?
GGT is more sensitive and specific for _____ _____ disease in _____ than _____ especially in combination with _____. This excludes _____ _____.
hepatic obstructive, cats, dogs, SAP, hepatic lipidosis
How is GGT measured?
_____ is the metabolite from breakdown of hemoglobin in the spleen.
_____ is a waste product when RBCs die.
How is bilirubin primarily removed from plasma?
liver, carried back to liver bound by albumin
_____ bilirubin (indirect)
_____ bilirubin (direct)
unconjugated bilirubin (_____)
conjugated bilirubin (_____)
What happens to unconjugated bilirubin?
bound to albumin
What happens to conjugated bilirubin?
converted to urobilinogen and eliminated in feces and through kidney
Total bilirubin is ?/? unconjugated and ?/? conjugated.
Bilirubin function tests are used to determine the cause of _____ (condition)?
A high bilirubin indicates the possibility of _____ disease.
The PCV of a patient with a high bilirubin will show _____, _____, and an abnormal _____ _____
hemolysis, jauncice, plasma layer
Signs of a high bilirubin include... (4 things)
anemia, icterus, lethargy, low CRT (capillary refill time)
What will the blood smear possibly show on a patient with a high bilirubin? (2 things)
Conjugated (direct) bilirubin tests evaluate (2 things)
liver, patency of bile duct
Unconjugated (indirect) bilirubin tests evaluate
increase in RBC destruction (autoimmune hemolytic anemias)
What reagent is used to test bilirubin? What is the visible sign?
diazo reagent (sodium nitrate or HCl), color change
What factors affect results of a bilirubin test?
hemolysis (decrease), lipemia, light sensitive (store sample in dark)
(Serum) Bile acids are produced from __________. They are secreted into bile by _____. They are stored in _____.
cholesterol in liver cells, hepatocytes, gall bladder (horses do not have a gall bladder)
What do serum bile acids do?
aid in digestion of lipids
T or F. Low levels of serum bile acids in the blood signals a disease.
F. High levels are part of a disease.
_____ is a good test to rule out extrahepatic disorder
serum bile acids
What kind of preparation is required for a serum bile sample?
fasted sample. cannot have food in the room
T or F. Serum cholesterol is the primary test for liver dysfunction.
F. ALT, AST, SAP, and bilirubin are better indicators and the combination of the above can produce a positive trend.
_____ is a plasma lipoprotein produced primarily in the liver. It is also from ingested food.
Cholestasis causes an increase in _____
_____ is usually secondary to other conditions such as diabetes, hepatic lipidosis, hypothyroidism, Cushing's, exogenous corticosteroid use, etc.
What is the function of the kidney?
What organ is a major elimination route?
What 2 things should not leave the kidney?
A damaged liver _____ regenerate. A damaged kidney _____ regenerate.
T or F. The kidney causes an increase of elimination of water and electrolytes when it is in a positive balance.
A normal kidney _____ water and nutrients and keeps _____ in balance.
Kidneys remove waste products of __________
BUN stands for what? What is it?
blood urea nitrogen, nitrogenous waste
What organ produces renin, erythropoietin, and prostoglandins?
The kidney is responsible for the _____ of vitamin _____
BUN evaluates the _____. Why?
kidney, that is what is responsible for its elimination
What is the product of amino acid breakdown in the liver (not avian)?
What is the major nitrogenous waste in birds?
How does BUN evaluate kidney function? What happens in a diseased kidney?
ability to remove urea from the blood. in kidney disease, urea would be reabsorbed by the kidney tubules.
__% of the kidney is nonfunctional before you see a change in BUN.
What is azotemia?
What would you run if your patient is azotemic? Why?
UA (urine assay/urinalysis), evaluate specific gravity to determine cause
Pre-renal causes of azotemia include (3 things)
dehydration, cardiac, shock
Renal causes of azotemia include
What is the urine specific gravity for an azotemic patient with renal causes? What does this mean?
1.008-1.012, the kidney is unable to concentrate the urine
Post-renal causes of azotemia include (2 things)
obstructions, elevated creatanine
Decreases in BUN are caused by (3 things)
liver disease, anorexia, kidney tubular injury
What sample is preferred for BUN? What is used to run the test?
serum, chem analyzer
BUN: Azostix require a _____ sample.
What kind of diet may cause an increase in BUN? Why?
high protein, increased amino acid breakdown. need fasted sample
T or F. Hydration levels do not affect BUN.
F. Dehydration causes increase in BUN
T or F. Exercise, fever, steroids, and lipemia affect BUN.
_____ and _____ are used to evaluate the kidney with urine specific gravity.
Creatinine is a metabolite of _____ which stores energy in muscles
Creatinine is __________ and excreted in _____
filtered through glomeruli, urine
T or F. Creatinine is a very sensitive test. It detects kidney disease early.
F. 75% kidney damage before you see increase in blood levels
What sample is needed to test creatinine?
plasma or serum
What happens during water deprivation testing?
hospitalized patient is gradually deprived of water until release of ADH
What is the key factor in determining the right time to test during the water deprivation test?
5% weight loss
What happens after the key factor in water deprivation testing?
Water deprivation test: what signals a problem?
abnormal USG, failure to concentrate urine
What does a normal USG signal in water deprivation testing?
ADH (antidiuretic hormone) is functioning normally
What 2 types of animals do you never perform a water deprivation test one?
What are chemistry screens?
tests that measure chemical components of blood
What do chemistry screens measure?
dissolved substances in blood that are either there normally or from damaged or released from cells
Photometric analysis is
spectrophotometer that measures amount of light transmitted through a solution
Electrochemical analysis is? What is it used for?
ions diffuse across area separated by membrane. difference in voltage (electrical potential) between the two sides of membrane is measured). evaluates electrolytes and ionic compounds
What 4 factors affect chemistry screen results? Why?
hemolysis - moist syringe, mixed vigorously, forced through needle, frozen whole blood, excess alcohol used to clean skin, improper labeling - date, time, patient and clinic ID, improper sample handling - use within 1 hour of collection, collect samples before treatment, patient influences - fasted sample
_____ assay - photometric analyzers. requires a standard (nonbiologic solution of analyte with known concentration)
_____ assay - enzyme assays or when reagent is enzyme-based. determines enzyme concentrations, measure rate of formation of product of enzymatic reaction. does not reach a stable endpoint. IU or SI units
_____ pancreas - production of digestive enzymes by acinar cells
Exocrine pancreas - production of _____ by _____
digestive enzymes, acinar
_____ pancreas - production of insulin and glucagon by islet cells
Endocrine pancreas - production of _____ and _____ by _____
insulin, glucagon, islet cells
What tests the exocrine pancreas? (3 things)
amylase, lipase, trypsin
_____ is the catalyst in the breakdown of starch and glycogen
The primary source of amylase is the _____. It is also produced in the _____ and _____
pancreas, salivary glands, small intestine
What are the 2 methods of measurement for amylase?
saccharogenic and amyloclastic
_____ is the catalyst in the breakdown of triglycerides.
What is the method of measurement for lipase?
What is the primary source of lipase?
What does PLI stand for and what is it?
pancreatic lipase immunoreactivity, specific test for pancreatitis in cats
_____ is the catalyst in the breakdown of proteins.
What are the 2 tests for trypsin?
fecal, TLI (trypsin like immunoreactivity) tests insufficiency (EPI)
What tests the endocrine pancreas? (2 things)
glucose (BG), fructosamine
_____ indicates carbohydrate metabolism and endocrine function of pancreas.
What 3 test methods are there for BG? What sample for each.
benedict copper reduction test - serum, dipstick, glucometer - whole blood
What is a glucose preservative?
Na+ fluoride with EDTA
What is the medical term for an increase in blood glucose?
What is the medical term for a decrease in blood glucose?
What is the medical term for glucose in the urine?
What is the medical term for hypofunction of insulin in the endocrine pancreas?
What is the medical term for hyperfunction of insulin in endocrine pancreas?
What is the normal serum BG range (dogs)?
What is the renal threshold of BG (dogs)?
How should a BG sample be handled?
fasted, stress in cats may cause transient increase
_____ is an irreversible reaction of glucose to protein (albumin)
What do increased fructosamine levels indicate?
Average serum glucose over time period represented by the half-life of that species serum protein is used to monitor _____ in _____
diabetes mellitus, cats
What additives cannot be in a serum calcium sample tube?
EDTA, oxalate because they bind calcium
What test for total plasma proteins? Does it include fibrinogen?
What test for serum total proteins? Does it include fibrinogen?
chem analyzer, no
What is primarily used to determine liver damage in large animals?
Lactate (lactic acid) requires a _____ tube.