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Clin Path Review
Final Review
| Question | Answer |
|---|---|
| liver values | ALT, AST, SDH, GDH, ALP/SAP, GGT, bile acids, bilirubin |
| EXOCRINE pancreas values | lipase, amylase, trypsin |
| ENDOCRINE pancreas values | blood glucose |
| kidney values | BUN, creatinine, SDMA, urinalysis |
| muscle values | creatine kinase (CK), AST, LDH |
| electrolyte values | sodium, chloride, potassium, bicarbonate (only non-routine) |
| minerals | calcium, phosphorous, magnesium |
| types of blood sample mostly used for clinical chemistries | serum (RED), plasma (GREEN) |
| lavender top tube | EDTA additive, WHOLE BLOOD collected, used for CBC and blood smears |
| blue top tube | CITRATE additive, WHOLE BLOOD collected, used to test clotting factors |
| green top tube | HEPARIN additive, PLASMA or WHOLE BLOOD collected, used for blood chemistries |
| red top tube | NO additive or SERUM SEPARATOR, SERUM collected, used for blood chemistries and antibody studies |
| two major causes of ELEVATED enzymes | leakage from affected cells, induction of enzyme synthesis by affected cells; GENERALLY INDICATES tissue injury |
| hyperthyroidism LAB tests | affects THYROID gland; total T4, free T4, TSH (thyroid stimulating hormone) |
| hyperthyroidism lab values consistent with DIAGNOSIS | elevated TOTAL T4, elevated fT4 |
| hyperthyroidism MONITORING tests | recheck total T4 in 3-4 weeks, check CBC/chem; METHIAMAZOLE for treatment |
| hypothyroidism LAB tests | TOTAL T4, fT4, TSH |
| hypothyroidism lab values consistent with DIAGNOSIS | decreased total T4, decreased free T4 |
| hypothyroidism MONITORING tests | recheck total T4 in 3-4 weeks, blood draw 4-6 HOURS post-medication |
| hyperadrenocorticism LAB tests | ACTH Stimulation Test, plasma cortisol (not very helpful), Low Dose Dexamethasone Suppression test |
| hyperadrenocorticism lab values consistent with DIAGNOSIS | u-shaped LDDS test graph results |
| hyperadrenocorticism MONITORING tests | ACTH stimulation test at 10, 30 and 90 days; 4 HRS post-TRILOSTANE dosing |
| hypoadrenocorticism LAB tests | ACTH stimulation test |
| hypoadrenocorticism lab values consistent with DIAGNOSIS | low Na/K ratio (<27), abnormal graph results |
| hypoadrenocorticism MONITORING tests | check kidney values and electrolytes every 1-2 weeks for 1st month or until stable |
| hyperparathyroidism LAB tests (primary) | ionized calcium, parathyroid hormone (PTH) |
| hyperparathyroidism lab values consistent with DIAGNOSIS | elevated normal PTH with HYPERCALCEMIA |
| hyperparathyroidism MONITORING tests | serial ionized calcium levels |
| ionized calcium | free Ca in the blood, MUCH more accurate measure of calcium; use serum or heparinized plasma for this test |
| clinical sign associated with elevated bilirubin | ICTERUS, jaundice |
| hypercalcemia causes/diseases | cancer, kidney failure, primary hyperparathyroidism |
| hypocalcemia causes/diseases | pregnancy/lactation, hypoalbuminemia |
| hyperphosphatemia causes/diseases | decreased GFR (glomerular filtration rate)/AZOTEMIA |
| hypophosphatemia causes/diseases | pregnancy, lactation, Ricketts |
| hypermagnesemia causes/diseases | muscle paresis/paralysis (RARE) |
| hypomagnesemia causes/diseases | GRASS TETANY |
| sample used to measure blood gas | arterial blood |
| sensitive test | rule OUT, SNOUT |
| specific test | rule IN, SPIN |
| serum collection procedure | NEED blood to clot |
| plasma collection procedure | DO NOT want blood to clot, have to centrifuge it down |
| milk fever in cattle | HYPOcalcemia |
| causes of hypercalcemia in cats and dogs | cancer, kidney disease, primary hyperparathyroidism |
| eclampsia | hypocalcemia after whelping |
| 5 causes of artifactual or inaccurate chemistry results | inappropriate coagulation use, hemolysis, linearity, discoloration of plasma, delayed separation of plasma |
| hypernatremia causes | DEHYDRATION, salt toxicity |
| hyponatremia causes | DIARRHEA, renal disease |
| hyperkalemia causes | kidney disease, azotemia |
| hypokalemia causes | anorexia |
| hyperchloremia causes | DEHYDRATION |
| hypochloremia causes | vomiting |
| most specific AND sensitive test for MUSCLE damage | creatine kinase (CK), found primarily in skeletal muscle |
| 2 chemistry values that can increase with muscle damage | AST, LDH; muscle damage can occur from exertion, myopathies |
| liver enzymes that indicate HEPATOCELLULAR injury | ALT, AST, GGT, ALP/SAP |
| liver enzymes that indicate CHOLESTASIS | GGT, ALP |
| cholestasis | decreased flow of bile |
| most sensitive indicator of cholestasis in DOGS | ALP |
| most specific indicator of cholestasis in ALL SPECIES | GGT |
| blood tests that measure LIVER FUNCTION | bile acids (TEST OF CHOICE), bilirubin |
| causes of elevated bilirubin | hemolysis (pre-hepatic), hepatic neoplasia (hepatic), cholestasis (post-hepatic) |
| bile acid test | tests for LIVER FUNCTION; 1) fasted sample 2) feed fatty meal 3) sample 1-2 hours post-prandial |
| low dose dexamethasone suppression test (LDDS) | tests for HYPERadrenocorticism (Cushing's); 1) baseline serum sample 2) give dexamethasone 3) serum sample 4 AND 8 hours post-dosing |
| ACTH stimulation test | tests for HYPOadrenocorticism (Addison's); 1) baseline serum sample 2) give synthetic ACTH 3) sample 1-2 hours post-dosing |
| three electrolytes commonly measured in-house | sodium, potassium, chloride |
| canine patient with ELEVATED ALP and ELEVATED GGT is most consistent with: | CHOLESTASIS |
| test results that would confirm pancreatitis diagnosis in DOGS | 2-3x increase of lipase and amylase (CPLi test) |
| best test to rule in pancreatitis in a cat | FPLi |
| BUN | blood urea nitrogen, produced in LIVER cells |
| creatinine | kidney enzyme, produced in muscles; more SPECIFIC indicator of kidney function |
| patient with ELEVATED BUN and CREATININE is most consistent with: | AZOTEMIA |
| azotemia causes | dehydration (pre-renal), kidney disease (renal), urinary obstruction (post-renal) |
| SMDA test | symmetric dimethylarginine test; useful in detecting kidney disease much earlier than BUN and creatinine (40% damage) |
| patient with ELEVATED AST and CK but NORMAL ALT is consistent with: | muscle damage or myopathy |
| patient with NORMAL CK and ELEVATED AST and ALT is consistent with: | liver damage or disorder |
| lab test used to diagnose EPI in DOGS | trypsin-like immunoreactivity; values are INCREASED lipase and amylase |
| increased blood glucose | HYPERglycemia; diseases of concern are DIABETES MELLITUS, tests that confirm are fructosamine and urinalysis |
| decreased blood glucose | HYPOglycemia; diseases of concern are insulinoma and iatrogenic; life-threatening |
| normal BG range for DOGS and CATS | 75-120 mg/dL |
| fructosamine tests | persistent hyperglycemia |
| practical uses for fructosamine test | rule IN DM is BG is borderline, rule OUT stress hyperglycemia, evaluate diabetic animals to determine if therapy is effective |
| urinalysis and assessing the diabetic patient | detects KETONES in the urine; if ketones are present in a diabetic patient, diabetes = BAD |
| normal blood pH | 7.4 |
| acidosis | decreased blood pH |
| alkalosis | increased blood pH |
| metabolic acidosis | decreased BICARBONATE |
| metabolic alkalosis | increased BICARBONATE |
| respiratory acidosis | increased pCO2; hypoventilation |
| respiratory alkalosis | decreased pCO2; hyperventilation |
| bicarbonate | HCO3-; metabolic base, major buffer found in the blood |
| pCO2 | respiratory acid |
| calculation of anion gap | (Na + K) - (Cl - HCO3) |
| increased anion gap | metabolic acidosis |
| BNP | measures heart function |
Created by:
mkroon26
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