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Right to know Law Requirements for the communication of information regarding the safe handling of hazardous substances present in Michigan workplaces Secondary Label Label on a non-original container, name of product and the diamond (flammability, re-activity, and health hazards) Antiseptic cleaner used to prep animal for surgery or injection Disinfectant cleaner used to clean inanimate objects Fomite inanimate object-Thermometer, stethoscope, Carrier Rabies attire Gloves(double gloving), Nose and mouth mask, gown, and goggles 3 Layers of a PCV tube Plasma, Buffy Coat *Packed WBC*, Packed RBC Total magnification formula obj. lense X eyepiece = Total Magnification Icterus, Lipemic, Hemolytic characteristics of plasma color (yellow, white, or red) always use mild, moderate or marked Purple, Red, Tiger, Blue, Green Vacutanors EDTA/Plasma, None/Serum, Gel/Serum, Sodium Citrate/Plasma, Lithium Heprin/Plasma Blue causes cell distortion-used for coaggulation tests Red sterile, used for shipment of samples Tiger allow to sit for 20 min before running test Light source adjustment light source switch, and adjust diaphragm distance IgE allergic, or parasitic reaction-immunoglobin IgG Secondary immune response (humoral immunity), can pass through placenta, most abundant, neutralizes microbes and toxins IgA Passed via colostrum, mucosal immunity, IgM produced by b-cells, largest of all anitbodies, appear in early course of infection. Activation of complement IgD Unknown, signals b-cells for activation Granulocytes Eosinophils, Neutrophils, and Basophils Agranulocytes Monocyte, lymphocyte Purpose of hemoglobin Hemoglobin carries oxygen and it is found in erythrocytes (RBC) Microcytic and Macrocytic Large RBC, Small RBC Polychromasia RBC that has a bluish color to it Anisocytosis variety of sizes to the erythrocytes within the monolayer-prevalent in bovine Rouleaux stacked coins, prevalent in equine Feline RBC small central palor or none at all Canine RBC large central palor nRBC immature RBC, mistaken for Lymphocytes MCV Mean Corpuscular Volume-Average size of the RBC Femtoliters (fl) MCH Mean Corpuscular Hemoglobin-average weight/volume of hemoglobin within cell Picograms (pg) MCHC Mean Corpuscular Hemoglobin Concentration-average percent of RBC composed of hemoglobin Grams/desiliter (g/dl) ELISA antigen test Tests for specific antibody *Snap test ELISA antibody test Test for specific antigen Immunoglobulins Antibodies False positive on an immunoassay Test showing positive for a disease when the animal does not have the disease. Endoparasite Internal parasite (clinical signs: vomit, anorexia, diarrhea, emaciation, lethargy etc.) Found in Feces, blood and urine Parasite-geographically dependent Intermediate host a host that harbors the immature parasite EXAMPLE:Mosquito Specific Gravity and Leakocytes Urinalysis and found on refractometer and a microscope Dehydration (Specific Gravity) High specific gravity PH Indicates Hydrogen concentration (acidity) Alkalotic PH=>7 Acidic PH=<6 Normal is 6-6.5 Urine Chem Strips Stored in a cool, dry and dark area Free catch urine should be caught during... Midstream Increase in ketones indicates excessive fat metabolism High protein in urine Influenced by diet, amount of exercise and fever Cystocentesis Collection of urine via sterile needle puncture into bladder-contraindications: pyometra suspect, blocked, and/or bleeding disorder suspect (Von Wildebrans) Most sterile sample-used for culture and sensitivity Owner complaints indicating UA acts like straining to urinate, constipation, blood in urine, odor in urine Glucose and Ketones indicates Diabetes (found during urinalysis) Alkalotic Urine herbivoires, due to diet Acidic Urine Omnivores and Carnivores also nursing animals UA Urine must at room temp before analyzing, best analyzed immidiately Pollakuria Frequent Urination Polyuria large amounts being urinated Dysuria difficulty urinating Direct Fecal Smear placing a sample of fecal material on a slide and allow it to air dry, stain and then examine Quantifies bacteria and differentiate bacteria Fibrinogen test Centrifuge sample, heat 56 c-5 min or 58 c-3 min, then re-centrifuge PCV and then read again (PCV fibrinogen level) Identifies dehydration and RBC count. Parasite with highest specific gravity Tapeworm Paratenic Host Parasite needs this host for developement, yet the parasite doesn't harm the host. Ex. birds, rodents, humans To find Giardia within feces use.... Zinc Sulfate MSDS Material Safety Data Sheets-contains all chemicals contents, any precautions that need to be taken and steps to take if a spill occurs, also steps for skin contact. Hazard Triangle, exposure limits and PPE OSHA Occupational Safety and Health Administration, US Gov't agency that protects employees Zoonotic Disease transmissible via humans and animals Vector arthropod that easily transmits diseases and pathogens without being harmed. Asepsis condition of sterility Passive Immunity immunity given by mother-born with it Active Immunity developed or aquired-cell mediated or humoral Antigen Molecule or substance found in blood that is recognized as foreign and creates an immune response Humoral Immunity release of specific antibodies-B cells 1st line of defense Cell Mediated Immunity immunity that recognizes foreign invaders and gets rid of it. Cells act on antigen instead of using an antibody 2nd line of defense Macrophage phagocytic cell, derived from monocyte Phagocytosis Cell eating ImmunoAssay test that uses interactions between antibody and antigen, produces results ELISA Enzyme Linked Immunosorbent Assay, immunologic test (Heart worm, feline leukemia, Foal IgG test) ICT Immunochromotography, rapid immunomigration Agglutination Test RBC Clumping, use Blue/Turquois vacutaner (Sodium Citrate) COOMBS test Autoimmune disorders of tissue, destroys own RBC (IMHA) Hematology study of all blood cells Plasma fluid portion of blood, 90% water and 10% protiens, carbs, vit, horomones, etc. Serum Plasma without fibrinogen (removed) Anemia Decreased numbers of circulating RBC: total protein will be higher as well as PCV because there is less fluid within plasma. Iron deficiency, blood loss, immune reaction, illness, internal bleeding, etc. Polycythemia Increased numbers of circulating RBC Fibrinogen Plasma protien, clotting factor, inflammation... Hemocytometer Blood cell counting chamber, number of cells per microliter-oldest method. Regenerative Anemia body responding to blood loss, creating more RBC, may spit out nRBC, bone marrow responding Non-regenerative Anemia body not responding to blood loss. Reticulocyte Large immature, anucleated (containing organelles) RBC. Punctated Spotted RBC, marked with tiny punch holes Aggregate chains of blue granules, common in cats Thrombocyte, cytopenia, cytosis Platelet, Decreased number of circulating platelets, increased number of circulating platelets Leukopenia decreased numbers of circulating WBC Leukocytosis Increased numbers of circulating WBC Prepatent Period period in which the initial infection began and when the ova can be detected and clinical signs are visible Definitive Host host of mature parasites Method of feces collection Free catch-plastic cup, rubber glove, baggy Fecal loop Fecal sleeve (large animals) Pooled sample-from large herd of animals Fresh and must be refrigerated Parasites Specific Gravity (generally) 1.1-1.2 g/ml Sodium Nitrate most common fecal solution, forms crystals Sugar Solution high specific gravity-for larger eggs, inexpensive Zinc Sulfate common, used for protozoal organisms Sodium Chloride bad solution, low specific gravity. Sedimentation settling of large parasites at bottom of sample container, example: fluke eggs and equine parasites Tape Prep detects pinworms (tape on a stick and apply to anus area) stain used for direct smear Lugols Iodine Operculum a lid or flap covering an opening Carry microscope by... arm, base and neck Formalin Ratio 1:10/tissue:formalin Shipping a CBC unstained blood smear and sample of blood in anticoaggulant blood tube. Never send with formalin, vapors ruin sample by disrupting cells Specimen Label Patient Name, Owner Name, Date, Species and Test to be run Antibody immunoglobulins, protien from b-cells that attack antigens Errors of a PCV High PCV: didn't spin fast enough, not long enough, sample wasn't mixed properly Low PCV: Microclots, not mixing properly, left in centrifuge-angles off 25 g. needle never run blood through twice, can cause hemolysis (too small of a needle) Technicians cannot... Diagnose, Prescribe meds, perform surgeries and/or prognose Three layers of blood slide Feathered edge-look first for clumping Monolayer-counting layer Thick Layer-cells packed together Green top tube is only good for how long? 8-12 hours TP measurement of protein (total solids) within plasma-use refractometer Dehydrated animal will have polycythemia, usually >.8 g/dl WBC count and differential perform when atleast 5 nRBC are seen Number of blood cells>Relative %, Ex: divide individual WBC by total number>Absolute Value # move decimal left two spaces and multiply by total number>no decimals needed... Low hemoglobin low oxygen Howell jolly body Dark pinpoint on RBC nuclear reminant, perfectly round. Left over from cell, pieces, looks like granules in a cell. Dark blue color Ghost cell RBC that has everything lysed, only the cell membrane remains. Why observe feathered edge first? Look for WBC clumping, and parasites. Also look for platelet clumps, any of these will ruin data. nRBC common in what species? Avian and Reptile Normocytic normal sized cell Normochromic normal coloration of the cell Hypochromic decreased staining intensity/low hemoglobin/dark peripheral ring. Hyperchromic Not really possible, too much stain Common errors or artifacts of an immunoassay? Poor sampling, Washing, Incubation, Cross contamination, improper test kit Heart-worm test checks for what? Adult females are the only ones detectable, typically live on the RIGHT side of the heart Marginal Edge cutting all of mass/tumor, that allows for no re-growth Primary shipping container sample in an absorbant material, prevents cross contamination (baggy, vile etc) Secondary shipping container shipping box with address and label Three test detect microflaria, what are they? Direct-drop of blood onto slide, coverslip, will see movement (clear worm, brownian movement) Filter-this piece of tissue, squirt blood on filter, microflaria will get caught on the screen. PCV-Microflaria will pack in buffy coat after centrifugation, squirm out of buffy coat after Examination of feces: Macroscopic-appearance, consistency, blood, color, mucous, parasites (quantity), and/or foreign body Microscopic-identify parasites Monolayer count area, must be 1 10x view or 2 40x views What is waters SG? 1.0g/dl Size of sample needed for fecal analysis? 2-5 grams, enough solution to mix well, centrifuge for 5 minutes on 50 and allow sitting time of 10 minutes, use sugar-fecalyzer sits for 10 minutes, use salt Label feces container Owner name, patient name, species, time of collection and date Direct sedimentation suspend a small amount of feces with saline or water, unstained or stained-lugols iodine(good for giardia). used to fine trophozoites and if you add a fushion stain, cryptosporidia may be seen. Dirofilaria Immitis Heart worm (people can get HW) Microfilaria-218-329 um long Test for antigen of FEMALE Adults-12-14 inches long must be female to detect Righ side of the heart and pulmonary arteries PP: 6 months Mosquito>bites>dog/cat Signs: dyspnea, respiratory problems, coughing Toxocara (Ascarid/Round worm) Ova: 90x75 um Adults: 3-18 cm lt. brown with thick protien coat, pitted/usually coiled "spaghetti" PS-Small Intestine PP-4/5 weeks post ingestion PH-rodents and some birds RI-TM, TP and PO (orally) Coughed up and swallowed (transtracheal) unthrifty, pot bellied, abdominal pain, diarrhea and vomiting Toxascaris (Ascarid/Round worm) Ova: 75x85 um/ lt. brown with smooth outer shell, ground glass center PS: small intestine PP: 48-72 days (6-9 weeks) PH: rodents RI-PO TM TP unthrifty, pot bellied, diarrhea Eggs passed in feces Trichuris Vulpis (Whipworm) Ova: 40-70 um tan, oval shaped with operculum on either end "football" IH:none PS:Cecum and Colon PP:70-90 days (2-3 months) RI: Orally Signs: diarrhea,weight loss, poor hair coat Females lay eggs intermittently(fecal not always pos.) Taenia (Tapeworm) Ova: 43-53 um Striated shell with 6 "hooks" (Hexacanth embryo) Verry Small Round PS: small intestine PP: 2 months IH: Rabbits and mice RI: PO can cause intestinal blockage/develops into a cysticercus forms proglottids in small intestine Dipylidium (Tapeworm) Egg packets: 25-30 um PP: 2 weeks Extremely small Round PS: Small intestine IH: Fleas and Lice RI: PO Develops into a cystercoid during life cycle Ancylostoma (Hookworms) Ova: 40x60um oval or elliptical shape, thin wall, cluster of cells within shell. PH: Rodents PP: 14-20d (2-4w) PS: Small intestine (eat blood) RI:PO, percutaneous, TM *Migrates beneath skin Anemia, melena (tarry stool), weight loss, resp. signs. Transtracheal migration. Blood in stool (bites intestine walls) Uncinaria (Hookworm) Ova: 45x75um PP: 28 days PS: Small intestine PH: Rodents RI: PO (transtracheal) Matures to adult in small intestine. Anemia, melenic diarrhea Less serious than ancylostoma Isospora (coccidia/Protozoa) Ova: 30x38um very small PP: varies PS: sm. Intestine epi PH: Rodents RI: PO Likes sm intestine-abundant with nutrients watery diarrhea Giardia (Protozoa) cyst: 8x14um: trophozoite 18um long 5x10 wide (flagella 8) PP: 1wk PS: small intestine IH:none RI: PO ignested>asexual repro. Loose stool (large fat content and appear mucoid) Iatrogenic veterinarian caused issue/illness/disease micturate to urinate (Micturation-the act of urinating) Anuria without urination Hematuria Blood in the urine Stranguria Straining to urinate Cystitis inflammation of the bladder Cystotomy Surgical entry into the bladder, usually for the removal of uroliths Clinical signs, indicating a UA Anuria, hematuria, licking abdomen/genitalia, innappropriate urination, dysuria/stranguria Reasons for Urinary issues ascending bacteria, PH change, Yeast, compromised immunity (most common) Urinary Stasis urine stays within bladder, bladder is shriveled and the animal cannot feel the pressure or sensation of urine Free catch/voided Midstream, not sterile, must handle properly Manual Expression Constant pressure on bladder, compress to extract or encourage release of urine. Can cause irritation, RBC may be present and patients don't like. Don't perform on suspect blockage. Intact females can alter data Catheterization Sterility is important, culture and sensitivity, do if bladder atony, or chronic obstruction. Bacteria may be present and trauma. Gross Examination Color (brownish red) Clarity, odor, and volume (ml/cc) also use mild, moderate, or marked SG Purpose indicator of the concentration of dissolved materials in the urine and provides as an indicator of kidney disease Isosthenuria SG is not either greater or less than the protien/Kidney failure Biochemical strips Not used for SG or WBC Impregnated with reagents Glucose detects presence of sugar in urine Normal renal threshold-170/180mg/dl Ketones Source of energy, indicates excessive fat metabolism Bilirubin Bile pigments, only found in urine. Indicates hemolytic anemia, liver disease, bile duct Myoglobinuria protein found in muscles, severe muscle trauma causes myoglib to leak into blood, pass through glomeruli and is excreted into urine. dip stick test for what in regards to blood? hematuria and hemoglobinuria. differentiate by centrifugation and sediment analysis. Hgb will be floating like plasma and RBC pack to bottom after centrifugation. Hemoglobinuria hemoglobin in the urine, free floating hematuria blood in urine, RBC pack to bottom Nitrite presence of bacteria, some reduce nitrate. Sediment examination morning sample is best (less concentration) helps recognize diseases of the urinary tract 3 types of epithelial cells found in urine Squamous: Free catch, large angular cells Transitional: any form, small nucleus, round Renal: Any, small with large nucleus and round. If renal cells appear on UA indicates? Neoplasia RBC on a UA colorless to yellowish, small, biconcave. WBC on a UA Bigger that RBC, typically round, often see nucleus. Pyuria-WBC in urine (infection) 4 main types of Casts Hyaline, Granular, Waxy, and Cellular Fatty. 2 main types of crystals Struvite and Calcium Oxilate Other artifacts within the urine sediment Sperm, parasites, mucous threads, microorganisms, cocci, rods, and yeast Bladder worm Capillaria Plica appearance similar to whipworm Otodectes Parasite Ear Mites Malassezia yeast commonly found in ears matastisized neoplasia spreading to other organs Tissue Biopsy sampling of a piece of tissue for cytology and histologic exams. Skin, liver, kidneys etc. Either surgical or localized: depends on location Tissue sample no bigger than 1cm wide Exfoliative cytology cells shed from body surfaces samples from CSF, semen, milk, synovial fluid etc. 3 methods of collection: imprint, swab, aspiration Imprints external lesions or tissues removed during surgery. more contamination. Swab test used for cytology, microbial overgrowth and parasitic growth. apply slide to area and use pressure, heat fix and stain. OR Use a cotton swab and roll sample onto microscope slide heat and stain Aspirate Biopsies used for cytologic and bacteriologic. Evaluates a mass or lymph node with min. restraint. Aid in determining course of action Bleeding may occur benign neglect ignored tumor, none invasive FNA Supplies 1" to 1 1/2" 25-gauge needle. 1" 22gauge most common. 3-6 ml syringe and clean glass slides Be sure to immobilize mass before sticking, redirect to get more sample and aspirate several times. Neg. pressure. Remove syringe, draw back air and apply syringe to needle and blow contents onto slide. Staple technique needle without syringe...making several punctures so cells are in barrel of needle. alopecia hair loss-patches or large clumps exudate >3 fluid filled outside of normal circulation, high protein and cells. transudate <2.5 or 3 Fluid that is outside of the normal circulation and low in protein and cells Vaginal Cytology determine stage of estrous and/or rule out vaginitis supplies: cleansing material, cotton swab, microscope slide and stain. Insert swab, rotate, apply to slide and stain Demodicosis infestation of mites (demodex) Dermatophytosis Infection of hair, skin, or nails caused by any one of the dermatophytes (fungus) Dysplasia abnormal tissue development Dystrophy Progressive changes that result from defective nutrition of a tissue or organ (sometimes muscle) Coat brushing important: parasitic, crusting, scaling, follicular. look for alopecia diseases. flea comb or coat brush (brush back hair) Hair plucks test for what? Follicular diseases, demidicosis, dermatophytosis, distrophy/dysplasia. need hemostats, slide and immersion oil ear cytologies look for: yeast(peanut shaped), bacteria, inflammatory cells cornified squamous cells and label L&R sides! Menengitis inflammation of brain DTM Dermatophyte test medium (intray) Skin Scrapings Parasitic diseases, abnormal lesions. Enables both the full thickness of the epidermis and the contents of the hair follicles to be sampled. Several sites Supplies: broad blade, immersion oil and slides Pinch and scrape, apply to slide. Tape Strips Parasitic diseases, microbial overgrowth and cytology. CSF Analysis Idiopathic seizures, inflammatory CNS diseases, neoplasia, undefined spinal disorders. 1 1/2 in 20g needle Aseptic ALWAYS need 1-2 ml Insert sterile spinal needle into subarachnoid area. What recumbancy for CSF Analysis? Lateral recumbancy, pending on which hand is being used. What are the two major land marks for CSF Analysis? External Occipital protuberance which is midline point Cranial Edge of wings of the atlas-vertical landmark What tube is the CSF transferred too? An EDTA (cells to be observed) or plain RTT (culture) xanthochmia yellowish CSF: normal is clear Abdominocentesis passage into abdomen for the purpose of removing fluid for analysis ascites fluid build up in the peritoneal cavity Peritoneal Fluid Analysis Straw yellow, but clear is normal. aseptically insert sterile needle. Don't puncture bowel or spleen, may iatrogenically cause peritonitis. Standing or Left Lateral (less organs) If odor is maloderous... idicate necrotic bowel or free contents of bowel TP refractometer SG: <2.5 or 3 Technique clip and clean area (2-3 cm caudal of umbilicus and 2-3 cm right of midline. Lateral-go straight in. Run needle perpendicular to body wall, aspirate intermittently. Use closed system, so to not allow air into abdomen EDTA Tube and/or RTT EDTA: Nucleated cell count, cytologic RTT: TP measurements, chemistry analysis or culture Thoracocentesis/Thoracentesis Fluid from pleural cavity. "chest tap" passage into pleural cavity for the purpose of removing fluid or air. Pleural Effusion thoracic fluid, accumulation of fluid in the pleural cavity Chylothorax lymph thats milky from emulsified fats, lymph fluid in the thorax Pyothorax infected fluids within chest wall (pus) Hemothorax collection of blood in pleaural cavity Pneumothorax collection of air or gas in pleural cavity Supplies for a Thoracocentesis 19-21 g. 1 1/2 in butterfly catheter, pending on animal size. 3 way stopcock system Where is the needle for a thoracocentesis injected? 7-8th or 8-9th intercostal space, and puncture should be into the thorax and on the cranial aspect of the rib. Arthrocentesis insertion of needle into joint space Synovial fluid should be..... Straw yellow color, clear and non turbid, have a sticky feel (viscosity) Supplies for Synovial Fluid Analysis Local or GA, surgically scrub and prep area. 20-22 g. 1.5 in needle. 3cc syringe Pre-cleaned slides EDTA tubes and culturettes Briefly describe the process for collection of synovial fluid. Proper restraint, local or GA as indicated by doctor, prep site for injection, be sure joint space is open for insertion of needle, advance needle into joint and apply negative pressure to allow back flow of Synovial fluid. Remove needle and apple pressure to punctured area, make smears Purpose of a tracheal wash to diagnose chronic respiratory tract disorders usually undefined etiology and non-responsive to symptomatic therapy Where are sample obtained from during a tracheal wash? Tracheal or bronchial lumens orotracheal animal is anesthetized and sample is obtained through a catheter and an endotracheal tube nasotracheal tracheal wash via the nasal passages transtracheal a tracheal wash that is through the skin and directly into the trachea most invasive but produces minimal contamination Supplies for a tracheal wash Sedation may be required, local anesthetic to block the area 16 gauge IV catheter, large bore hypodermic needle (stylet) and a polypropylene catheter 12 cc syringe, Saline (sterile) solution, Slides When inserting the needle into the trachea, what will you be penetrating? cricothyriod membrane and directly into the trachea, coughing is normal How much saline is injected? 1-3 cc are bolused, allowing the patient to cough up brochial secretions/exudates and the solution is then re-aspirated typically only .5 to 1cc of solution is recovered after several injections Aqueous Humor analysis Aspriated from the anterior chamber of the eye patient is either deceased or anesthetized The fluid of this analysis is generally? low in protein and cellularity Postmorteum harvest can tell you what? the BUN and electrolytes before death typically CA and MG Where is CSF obtained from? The Subarchanoid mebrane What is quality judged by for an automated cell counter? Accuracy, precision, and reliability Enzymes Induce chemical change in other substances, they increase rate of biochemical reaction and all function intracellularly. Can leak out of damaged cells Usually named after what they act upon Liver absorbs nutrients, secretion of bilirubin and bile filters and metabolizes amino acids, carbohydrates, and lipids synthesize albumin, chelesterol and plasma proteins ALT Primary source is hepatocyte (liver specific test) Catabolism of drugs avoid hemolysis and lipemia of samples other sources: renal cells, cardiac muscle, skelatal muscle, and pacreas. Liver Test ALP or ALKP found in cells involved in the production of bone and hepatocytes high results- young growing, fractures, periodontal disease, bone cancer and degenerative joint disease non-Liver specific Test AST/SGOT increase indicates enzyme leakage due to muscle cell distruction muscle soreness after extreme exercise Present in hepatocytes and skelatal, pancreatic, and kidneys, they release with the breakdown of amino acids Liver Test GGT primary source is the liver but lower levels in dog and cat used mostly in large animals, this is a liver enzyme non-liver specific test Bile Acids aid in fat digestion in the duodenum. reabsorbed and carried back to liver usually elevated after a meal Test: fasting blood draw, feeding a meal and 2 hours later post prandial blood draw. Place in a RTT non-liver specific test Bilirubin Waste material from breakdown of RBC's, specifically hgb portion. Hyperbillirubinemia, uncongugated and congugated are typically read together. non-liver specific test Kidney tests Kidneys conserve or eliminate water/electrolytes as needed. Works to maintain homeostasis Elimination of soluble metabolic wastes Azotemia increased BUN and Creatinine Uremia increased BUN and Creatinine with toxic signs 75% of kidneys damaged before clinical signs are visible Blood Urea Nitrogen (BUN) waste bi-product of protein metabolism, filtered at renal glomeruli Kidney test BUN and Creatinine Biproducts of enzymes both kidney tests Creatinine is a waste biproduct of muscle, phosphocreatine breakdown filtered at glomeruli Pancreas has two functions: Secrete insulin (edocrine) enzyme rich juice that contains enzymes that are necessary for function (exocrine) tests are lipase, amylase and glucose Lipase acts on lipids and fats Amylase Breaks down starches and glycogen in sugars Glucose Used to measure carbohydrate metabolism and endocrine function of the pancreas. Working balance between dietary intake and glucagon, helps maintain normal levels of glucose. Fibrinogen in buffy coat With an increased buffy coat it is significant because excess WBC mean that there is inflammation going on. CK produced in striated skelatal muscle, used to break down creatinine and phosphocreatine. muscle damage cause leakage of CK unstable outside of body Chol Breakdown controlled by thyroid horomone hypothyroidism Important handling techniques The longer the blood sample sets the lower glucose levels will be. Drawn typically during dietary fasting and run immidiately Plasma protein tests produced mainly outside of liver and immune system there are many functions in the body and only specific ones are useful for diagnostics Albumin, fibrinogen, and globulins Total protein serum TP does not include fibrinogen and helps in determining dehydration status-high total protein means there are not enough fluids within the plasma. Hypo or hyperproteinemia Hemolysis affects total protein results, they will be increased Albumin makes up 35-50% of total protein Responsible for maintaining osmotic pressure of plasma and is synthesized by the liver. Electrolytes maintain fluid balance, osmotic pressure, normal muscular and nervous functions. Electrolytes- Calcium (CA+), Phosphorul (Phos), Potassium (K+), Sodium (Na+), Chloride (Cl-) and Magnesium (Mg+) Calcium maintenance of inorganic ion transfer across cell membrane, functions in the maintenance of neuromuscular excitability and tone. Hypocalcemia can cause muscular tetany Inversely related to inorganic (plasma serum) concentrations Why dont you use EDTA for calcium? EDTA binds with calcium and artificially lowers a RTT should be used or a Lithium heprin Phosphorus found in majority (80%) in the bones, the rest has major functions-store energy, release and transfer Carbohydrate metabolism, majority is organic and found in RBC Remainder is found in serum and plasma inorganic phosphorus<--this is what is tested for Hyper or hyponatremia