chemistryl Word Scramble

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Question	Answer
Nitrogenous waste that is excreted by the kidney via	glomerular filtration.
Tubule reabsorption occurs	40-60percent, depending on flow rate.
Urea	important for renal medullary concentration gradient (Na too).
BUN primarily used as	an indicator of GFR.
Azotemia	(increased circulating nitrogenous waste, BUN.
Pre-renal	reduced renal perfusion.
Renal	primary kidney disease.
Post-renal	ureter, bladder, urethral obstruction or rupture
BUN interpreted in light of	urine SG.
Adequate min SG that is consistently	attained in healthy animal when faced with a need for water conservation.
Dog SG	> 1030.
Cat SG	>1035.
Others SG	> 1025.
Increased BUN and adequate SG	Renal tubules are concentrating = pre-renal azotemia,Decreased GFR.
Increased BUN and inadequate SG (isosthenuric1008-1012, concentration of plasma	Primary renal disease suspected.
Low sensitivity and specificity	BUN.
3/4 of both kidneys must be non-functional before BUN will	elevate.
Many other factors influence level of circulating levels of	BUN.
Production of BUN Primary source is	dietary protein.
Ingested protein is converted to	ammonia by bacteria in the gut.
Ammonia diffuses across the gut into	portal circulation and carried to the liver.
Liver converts ammonia to	urea.
Minor elevations of BUN	High protein diet,GI hemorrhage acts as a high protein meal.
Liver disease	Decrease hepatic conversion of ammonia to urea,Low urea and high ammonia seen.
Portosystemic shunt	Ammonia absorbed by the gut is not carried to the liver.
Diuresis	Increased glomerular filtration rate.
Creatinine	By product of muscle metabolism.
Excreted almost exclusively by glomerular filtration	creatinine.
No tubule reabsorption	creatinine.
Like BUN, used to estimate GFR	creatinine.
Less influenced by non-renal factors then BUN	creatinine.
Creatinine levels elevated when BUN is normal	Substances known as non-creatinine chromogens are sometimes present in the blood; false elevated levels.
Creatinine Production related to	muscle metabolism.
Creatinine is degradation product of	creatine energy source of muscle.
Freely diffuses out of muscle cells	creatinine.
Takes creatinine about 4 hours to	equilibrate throughout body BUN about 1,5 hrs.
Specific Gravity Solute concentration Defined	density of urine/density of water.
Measured by refractometer	SG.
SG is a measure of	tubular function.
Adequate concentration min SG that should occur with	need to conserve.
Dog sg	> 1030.
Cat sg	>1035.
Others sg	> 1025.
Isosthenuria	SG = 1008-1012.
SG Solute concentration is similar to	glomerular filtrate.
No tubular function required	sg.
Do not describe SG as low or dilute but as	Unconcentrated.
Hyposthenuria SG = < 1005 Indicates	dilutional function.
Hepatobiliary system Injury Small animal	ALT, AST.
Large animal liver	SDH, AST, GGT.
ALT alanine aminotransferase only	small animal.
increased serum values indicate cell injury cytosolic enzyme	ALT.
Dog and Cat ALT primarily from	hepatocytes, muscle can infrequently contribute.
muscle contains modest amounts of	ALT.
severe muscle injury eg HBC or congenital myopathies may cause increase	ALT.
mild to moderate muscle injurty unlikely to cause significant	ALT changes.
T 1/2 = 2,5 days in dog, 3,5 hours in cat	ALT.
ALT generally magnitude parallels number of cells affected, not	severity or reversibility.
AST aspartate aminotransferase both large and small animal	Increased serum levels indicate cell injury cytosolic and mitochondrial.
AST highest values occur with severe	cellular injury that includes mitochondrial injury.
High activity in liver and muscle	AST.
high serum level can result from injury to either organ	AST.
must be used in combo with other tests ALT, SDH, CK muscle	AST.
also present in RBC hemolyzed samples can contribute to increase values	AST.
T 1/2 = < 24 hours in dog and cat,7-10 days in horse	AST.
SDH sorbitol dehydrogenase large and small increase indicates	hepatocellular injury cytosolic in all species.
T 1/2 very short minutes to hours	SDH.
use with other injury enzyme AST having a longer half life	SDH.
useful to follow progression	SDH.
helpful to determine if AST is increased because of muscle or liver injury	SDH.
GGT gamma glutamyltransferase large animal increase mainly due to	chlosestasis but may increase with acute, severe hepatic injury.
T 1/2 = 3 days in horse	GGT.
Cholestasis	ALP, GGT, bilirubin, urine bilirubin.
sensitivity of tests dog	ALP > GGT > urine bilirubin > serum bilirubin.
ALP alkaline phosphatase inducible enzyme mostly	bound to hepatocellular membranes less in biliary cells chloestais marker.
T 1/2 dog = 3 days,cat = 6 hours,horse = between dog and cat, but more like cat	ALP.
Not liver specific	ALP.
found in liver	hALP, bone bALP, placenta, intestine, kidney, and leukocytes.
also induced by both endogenous and exogenous corticosteroids	cALP in dog.
Drugs, steroids and anticuvulsants Phenobarbital	ALP.
Interpretation of increased ALP- dog general	< 4X increase is non-specific could be from any of the above sources.
> 4 x increase = cholestasis and/or isoenzyme induction	hALP, cALP.
ALP 4X increase,3 possibilities	pure cholestasis,pure isoenzyme induction corticosteroids, anticonvulsants,both cholestasis & isoenzyme induction.
must interpret ALP with other heptobiliary tests	injury, cholestatis, conjugated bilirubin.
ALP-cat	any increase is significant =cholestasis.
Cat ALP T 1/2 is	short.
Feline liver ALP activity is	3x lower compared to dogs.
GGT gamma glutamyltransferase	inducible enzyme bound to membranes of bile duct epithelial cells and , to a lesser extent hepatocytes.
Dogs and cats increased serum levels are liver specific and indicate chlestasis	GGT.
GGT large animal increase mostly due to	cholestatsis, but may increase with acute, severe injury.
T 1/2 = 3 days in horses probably in dog and cat	GGT.
Bilirubin	less sensitive indicators of cholestasis than ALP, GGT.
Bilirubin Production and excretions produced during	phagocytoses of senescent RBCs.
hemoglobin converted is converted to	heme and globin.
globin a protein degreaded to its	amino acid constituents and recycled.
heme, degraded to free	unconjugated bilirubin.
Unconjugated bilirubin is complexed with	albumin and carried to liver.
conjugated by liver with glucuronic acid and excreted in	bile.
increase in total circulating bilirubin may result from	prehaptic, intrahepatic, or posthepatic causes.
pre-hepatic =	hemolysis increased RBC breakdown, 75 unconjugated.
intrahepatic =	both conjugated and unconjugated bilirubin.
posthepatic =	75 conjugated bilirubin.
urine bilirubin only conjugated bilirubin passes the	glomerulus.
increased urine bilirubin used as indicator for	cholestasis.
dog normally renal threshold for bilirubin is	low any increase is significant.
cat high renal threshold urine bilirubin only present in	severe cases of liver disease.
Decreased Functional Mass loss of functional hepatocytes from severe cirrhosis for example, or from an infiltrative process such as	hepatic lipidosis or neoplasia OR vascular shunt that bypasses hepatocytes.
at least 70-80 of functional liver mass must be lost before signs and/or functional assays are altered	urine bilirubin.
decreased BUN as compared to creatinine which is often unaffected, unless animal has	very low muscle mass or medullary washout from low urea, causing increased GFR & low creatinine.
Can also see Decreased BUN with normal creatinine if	low protein diet or decreased intake, mild anorexia. AMMONIA should be increased along with decreased BUN because of
dec albumin from dec synthesis OTHER DDx	inflammation mild dec neg acute phase protein,renal loss,intestinal loss panhypoproteinemia,sequestration exudates,inc vascular permeability,peritonitis,3rd space dz.

Created by: alljacks

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