final exam
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| show | No, because bicarbonate will be excessively reabsorbed when chloride is depleted.
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| show | 1. bicarbonate system
2. red cell hemoglobin
3. plasma and intracellular proteins
4. organic and inorganic phosphates
5. bone carbonate
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| Respiratory component of bicarbonate buffer system | show 🗑
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| Metabolic component of bicarbonate buffer system | show 🗑
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| Analytes in a standard blood gas | show 🗑
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| What is necessary to determine if a patient is acidemic or alkalemic? | show 🗑
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| show | -increased pCO2
-caused by hypoventilation
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| show | -decreased pCO2
-caused by hyperventilation
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| Metabolic acidosis is characterized by ____, which is caused by _____. | show 🗑
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| Metabolic alkalosis is characterized by ____, which is caused by ____. | show 🗑
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| show | the mEq/L of strong base or acid added to the sample that would produce a neutral pH
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| Positive base excess indicates... | show 🗑
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| Negative base excess indicates... | show 🗑
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| show | -hypoventilation (usually hypercapnic, too)
-low concentration of inspired O2
-ventilation/perfusion mismatch
-impaired alveolar gas diffusion
-R to L shunting (does not respond to O2 therapy)
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| show | -dissolved CO2
-H2CO3
-HCO3 ion
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| show | (Na + K) - (HCO3 + Cl)
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| show | -negatively charged proteins
-phosphates and sulfates (renal acids)
-lactic acid
-ketoacids
-exogenous acids (ethylene glycol)
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| show | 1. accumulation of acids (increased anion gap)
2. loss of bicarb (normal AG and hyperchloremia)
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| 5 ways acids accumulate | show 🗑
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| show | -loss of bicarb from the GI or kidneys creates an acidosis, and the kidneys must reabsorb Na with Cl
-results in hyperchloremia and normal AG
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| show | -usually occurs during inorganic or mineral acidosis due to renal failure or loss of bicarb in diarrhea
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| show | 1. loss of H ion: vomiting, abomasal displacement, Cl-losing diarrhea
2. enhanced HCO3 resorption: volume loss, Cl or K depletion (diuretics)
3. secondary to respiratory acidosis
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| show | IT DOESN'T CHANGE!
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| How is metabolic alkalosis self-perpetuating? | show 🗑
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| Describe the primary mechanisms that create paradoxical aciduria | show 🗑
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| show | 1. widespread pulmonary dz, causing decreased CO2 loss by the lungs
2. intrathoracic lesions
3. lesions or drugs affecting the CNS respiratory center
4. poor ventilation during anesthesia
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| How does the body try to compensate for a respiratory acidosis? | show 🗑
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| Common causes of respiratory alkalosis | show 🗑
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| show | Renal excretion of HCO3 (metabolic acidosis)
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| show | -azotemia (increased AG and metabolic acidosis) with vomiting (metabolic alkalosis)
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| 3 fractions that comprise Ca concentration on chem panel | show 🗑
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| show | 1. PTH
2. vitamin D (calcitriol)
3. calcitonin
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| show | PTH and calcitonin
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| show | 1. PTH (ALSO INCREASES PO4)
2. Vitamin D
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| Which hormone causes hypocalcemia? | show 🗑
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| What pre-analytical error can cause falsely low calcium values? | show 🗑
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| show | 1. age
2. protein status
3. gut absorption
4. bone resorption/deposition
5. kidney resorption
6. acid-base status
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| How does acid/base status affect total calcium concentration? | show 🗑
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| show | Because low protein may cause low TOTAL calcium concentration, but the animal may have a NORMAL free calcium concentration. (To supplement or not to supplement)
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| Things that cause hypercalcemia | show 🗑
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| When is an animal at risk for metastatic mineralization? | show 🗑
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| Common causes of hypocalcemia | show 🗑
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| show | inorganic phosphorous
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| 3 fractions comprising total phosphate concentration | show 🗑
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| Serum/plasma phosphate can be artifactually increased by... | show 🗑
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| Factors affecting phosphate concentration | show 🗑
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| show | RBC hemolysis!! (<1.0 mg/dL)
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| Causes of hyperphosphatemia | show 🗑
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| 3 fractions that comprise total magnesium concentration | show 🗑
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| show | -bones, soft tissue, and ECF
-primarily an intracellular ion (cytosol of RBC's, except in cattle)
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| show | -using a chelator tube (EDTA, citrate, oxalate)
-delayed separation of serum from clot will falsely increase Mg, except in cattle
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| How is magnesium measured post-mortem? | show 🗑
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| Factors affecting magnesium concentration | show 🗑
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| What are 2 major functions of magnesium in the body? | show 🗑
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| Hypomagnesemia may be accompanied by ___ and ___. | show 🗑
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| show | -milk fever (increased PTH results in increased gut absorption)
-decreased urinary excretion
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| Common causes of hypomagnesemia | show 🗑
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| Common causes of hypophosphatemia and hypocalcemia | show 🗑
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| show | -decreased dietary intake
-hyperinsulinemia
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| show | -hyperparathyroidism
-equine renal disease
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| show | -hypoalbuminemia
-acute pancreatitis in dogs
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| show | -neoplasia (HHM)
-Addison's disease
-granulomatous disease
-idiopathic in cats
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| show | -hypoparathyroidism
-ethylene glycol toxicicosis
-phosphate enema
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| Hyperphosphatemia with normocalcemia | show 🗑
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| Hypophosphatemia with hypercalcemia | show 🗑
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| What information is needed to categorize fluid? | show 🗑
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| What kind of tubes should be used or fluid cytology? For culture? | show 🗑
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| What are transudates the result of? | show 🗑
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| 3 ways that fluids become deranged | show 🗑
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| show | protein-poor (pure) and protein-rich (modified)
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| What determines protein-poor versus protein-rich transudate? | show 🗑
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| Presence of a protein-rich (modified) transudate in the abdomen should make you think about... | show 🗑
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| show | -abdomen OR thorax!
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| Exudates form as a result of... | show 🗑
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| Pathophysiology of exudate formation | show 🗑
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| show | 1. congestive heart failure (protein rich in abdomen, either in thorax)
2. generalized dz process affecting both cavities: disseminated cancer, FIP, coagulopathy
3. defects in diaphragm
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| show | -chyle
-bile
-urine
-blood
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| show | -initially causes a transudate
-over time will cause an exudate
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| show | -exudate
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| How can a hemorrhagic effusion be differentiated from blood? | show 🗑
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| How are urine and plasma different on a chem panel? | show 🗑
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| [Cr]fluid > 2x[Cr]plasma | show 🗑
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| show | Suspicious for uroabdomen, should measure [K]
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| show | Supports dx of uroabdomen, higher ratio is more supportive
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| [Cr]fluid > [Cr]plasma AND [K]fluid < [K]plasma | show 🗑
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| show | DOES NOT SUPPORT dx of uroabdomen
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| If fluid amylase/lipase activity > plasma/serum activity... | show 🗑
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| If fluid [triglyceride] > plasma, but fluid [cholesterol] is < plasma... | show 🗑
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| If fluid [bili] is > plasma... | show 🗑
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| If fluid [glucose] < plasma, and [lactate] in fluid is > plasma... | show 🗑
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| If fluid [lactate] is > plasma | show 🗑
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| show | 1. altered dietary intake or absorption
2. altered gluconeogenesis
3. altered glycogenolysis
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| show | 1. insulin (pancreas): lowers
2. glucagon (pancreas): increases
3. growth hormones (pituitary): increases
4. catecholamines and cortisol: increase
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| How do ruminants generate glucose when fasting? | show 🗑
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| show | -animals with prolonged anorexia/starvation (glycogen stores depleted)
-neonates (lack enzymes for gluconeogenesis)
-end stage liver dz
-glycogen storage dz
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| When can hypoglycemia occur without fasting? | show 🗑
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| show | lipemia, icterus, hemolysis
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| show | 200 mg/dL
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| show | -delayed sample separation
-marked leukocytosis
-erythrocytosis
**RBC and WBC don't need insulin to use glucose!
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| show | -physiologic rxn
-diabetes mellitus (insulin deficiency or resistance)
-drugs
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| Conditions causing hypoglycemia (11) | show 🗑
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| show | -promoted by glucagon
-inhibited by insulin
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| show | 1. acetoacetate
2. acetone
3. beta hydroxybutyrate
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| show | -screening for diabetes mellitus
-screening dairy cows
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| 2 ketoamines | show 🗑
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| show | -prolonged and consistent hyperglycemia (NOT stress)
-fructosamine: 2-3 wks
-Hb a1c: 60 days
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| When is insulin concentration most commonly measured? | show 🗑
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| show | [insulin] x 100/[glucose]
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| 2 fx of lipids in body | show 🗑
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| 4 body lipids (measured) | show 🗑
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| Lipoproteins: least to most dense | show 🗑
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| show | -luminal surface of capillary endothelial cells
-catalyzed by lipoprotein lipase, which needs insulin to work
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| show | -activates LPL and hepatic lipoprotein lipase
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| show | -thyroxine
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| show | -chylomicrons or VLDL (triglycerides)
-NOT cholesterol
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| show | 1. increased production by hepatocytes (PLN)
2. increased production by enterocytes (post-prandial)
3. hypothyroidism
4. acute pancreatitis
5. cholestasis
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| show | 1. PSS
2. PLE
3. hypoadrenocorticism
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| show | 1. equine hyperlipemia
2. post-prandial
3. hypothyroidism
4. nephrotic syndrome
5. acute pancreatitis
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| show | -serum sample after 12 hr fast
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| show | -chylomicron test
-total triglyceride measurement
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| How do FFA get outside of lipoprotein molecules? | show 🗑
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| show | -commonly measured in dairy cattle to assess energy balance
-increase associated with negative energy balance
-also increase with diabetes mellitus, hepatic lipidosis, obesity, food deprivation, after exercise
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| Pancreatic leakage enzymes | show 🗑
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| show | -pancreatic acinar damage
-decreased GFR (prerenal, renal, postrenal)
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| show | -pancreatic acinar damage
-decreased GFR
-dexamethasone treatment
-pancreatic/hepatic neoplasia
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| Laboratory test of choice for pancreatitis | show 🗑
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| What test is used to diagnose EPI in dogs and cats? | show 🗑
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| show | 1. pancreatitis
2. decreased GFR
3. dexamethasone tx
4. horses w/ strangulating obstruction and endotoxic shock
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| Conditions caused by chronic pancreatitis | show 🗑
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| show | -exocrine pancreatic insufficiency
-loss of acinar tissue
-deficiency of digestive enzymes and secretions (HCO3)
-leads to maldigestion of food
-usually seen in German Shepherd, Rough Coated Collie, Greyhound
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| show | -chronic weight loss
-accumulation of osmotically active particles w/in GI > movement of H2O into tract > osmotic diarrhea
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| show | -increased amylase, lipase, PLI, and TLI
-possible hypocalcemia, hypercholesterolemia, metabolic alkalosis, azotemia, cholestasis, DIC, hyperglycemia, abdominal effusions
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| show | -decreased TLI
-possible decreased cobalamin and increased folate
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| show | -the ileum
-decreased Cbl = distal intestinal dz
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| Causes of increased Cbl | show 🗑
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| show | 1. ileal mucosal dz
2. small intestinal bacterial overgrowth (SIBO)
3. EPI
4. Cobalt deficiency in cattle
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| show | -increased numbers of enteric bacteria consume more Cbl, and it is not absorbed in the ileum
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| How does EPI cause decreased Cbl? | show 🗑
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| How does cobalt deficiency cause decreased Cbl? | show 🗑
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| Where is folate absorbed? | show 🗑
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| show | 1. SIBO (xs produced by bacteria, seen with EPI)
2. low intestinal pH (also seen with EPI)
3. xs dietary folate
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| What is fecal alpha-PI used to diagnose? | show 🗑
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| Tests for intestinal permeability | show 🗑
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caldrid3