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Blood chemistry testing
Porter quiz 2
68
Veterinary Medicine
Undergraduate 2
09/16/2013

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Term
What are the purposes of blood chemistry testing?
Definition
-To evaluate organ systems (#1)
-To identify metabolic problems
-To assist in diagnosis
-To assist in prognosis
-To monitor therapy
Term
What are the methods used for blood chemistries?
Definition
-Dry chemistry testing (#1)
-Wet chemistry testing (Going out)
-single tests
-organ profiles
-general profiles
Term
What is the most important thing to remember about blood chemistries?
Definition
SAMPLE QUALITY
Term
Why should we check the machine manual before running whole blood with anticoagulants?
Definition
Becuase some anticoagulants are incompatible with the machines and can produce incorrect results
Term
Why should you run whole blood samples ASAP?
Definition
Because red cells are still metabolically active in whole blood.
Term
If you can't run the blood immediately, what should you do?
Definition
Label and refridgerate, it will slow the metabolism
Term
Why should you never freeze whole blood?
Definition
because it will rupture the cells
Term
What is the most common source of chemistry testing errors?
Definition
Hemolysis
Term
What are some common causes of hemolyzed samples?
Definition
-Excess pressure during venipuncture
-Mishandling sample..not writing them out, you know what they are
Term
What is lipemia caused by?
Definition
Normally just present when patient is postprandial, but some diseases may cause it
Term
How can you avoid postprandial lipemia?
Definition
Fast patient over night
Term
What are some error sources when running tests?
Definition
-sample probs
-technique errors (pipetting/running test)
-machine errors
-clerical errors
Term
What is a benefit of in-house testing?
Definition
-fast results. patient my be present
Term
What type of blood so you use with screening tests (stix, strips)
Definition
Whole blood.
Term
What are the three main manufacturers of blood chemistry machines?
Definition
-Abaxis
-Idexx
_heska
Term
When is Lactate elevated?
Definition
in shock and acidosis
Term
What does the protein:creatinine ratio assess?
Definition
protein loss
Term
What happens to the blood chemistries when specific organs are effected?
Definition
there will be an increase or decrease in the results.
Term
What are analytes?
Definition
They are measures to evaluate organ/system status.
Term
Name 7 functions of the kidneys
Definition
-removal of nitrogen waste
-regulate salt ions
-regulate acid-base balance
-regulate RBC balance in bone marrow
-regulate blood pressure
-conserve blood glucose and AA
-elimination of drugs/toxic substances
Term
What is azotemia?
Definition
an increase in BUN/creatinine in the blood
Term
What can an increase in BUN/creatinine be caused by?
Definition
-prerenal azotemia (in front of the kidney)
-renal azotemia (in the kidney)
-post-renal azotemia (behind the kidney...blocked cats have post-renal azotemia)
Term
What happens with pre-renal azotemia?
Definition
Kidneys are not getting perfused. Decrease in GFR.
Can cause dehydration, shock, heart disease
Term
What happens with renal azotemia?
Definition
Lose ability to concentrate urine. 75% of nephrons are non-fuctional
Term
What happens with post-renal azotemia?
Definition
Urinary obstruction or post-renal leakage that can be cause by a blocked urethra or ruptured bladder.
Term
What is Blood urea nitrogen also known as?
Definition
Serum urea nitrogen SUN
Term
The GFR is dependant on what?
Definition
renal perfusion
Term
If you have decreased perfusion what happens?
Definition
urea stays in the blood
Term
How is creatinine formed?
Definition
degredation of creatine
Term
What is creatine?
Definition
a muscle energy source
Term
Is there tubular reabsorption of creatinine?
Definition
no, filtered at the glomerulus
Term
What is the prognosis if a patient has creatinine levels of 10 or above?
Definition
poor
Term
If there is a decreased GFR what happens to the phosphorus levels in patients?
Definition
They increase
Term
What does chronic renal failure often present with?
Definition
Non-regenerative anemia
Term
What is hypoalbuminemia due to?
Definition
Loss at the glomerulus
Term
What will we see if patient is hypoalbuminemic?
Definition
Increased proteins in the urine
Term
What is hydronephrosis?
Definition
Fluid (urine) in the kidneys
Term
What different pathologies occur in the liver?
Definition
-cell necrosis
-cholestasis
Term
What is jaundice/icterus due to?
Definition
Increased bilirubin
Term
When you run a bilirubin chemistry can you tell if it's conjugated or unconjugated?
Definition
no
Term
An increase in unconjugated bilirubin can cause what?
Definition
hemolysis
Term
What is the most beneficial test to run for liver disease?
Definition
Bile acids
Term
Are ammonia tests, tests for the liver function?
Definition
no, they are to diagnose liver-brain syndrome and portosystemic shunts
Term
Signs are due to what?
Definition
Increased ammonia from liver not converting it to urea
Term
What are we looking for when we run enzyme tests?
Definition
an increase.
Term
What are enzymes used to evaluate?
Definition
The liver, but are not organ specific
Term
What is sALT?
Definition
a liver specific enzyme in dogs and cats
Term
Where is sAST found?
Definition
Many tissues, especially muscles
Term
When would you see an increase in sAP or GgT?
Definition
Cholestasis (slowing of bile through the liver)
Term
When there is damage to the liver what happens to the sALT?
Definition
Levels go very high. You must wait until the trauma has subsided to get a true value. Can take a couple weeks
Term
What does BSP do?
Definition
evaluate the liver function
Term
When will cholesterol be increased?
Definition
-endocrine abnormalities
-postprandial lipemia
-Hepatic and renal condition
Term
What is the difference between an exocrine and an endocrine gland?
Definition
Exocrine glands secrete through ducts. Endocrine glands have no ducts and go through the bloodstream
Term
What do amylase and lipase do?
Definition
Break down fat
Term
When are amylase and lipase increased?
Definition
in cell necrosis
Term
When would you have a decrease in trypsin?
Definition
With muscle atrophy
Term
What is the serum trypsin -like immunoreactivity test for?
Definition
Exocrine pancreas insufficiency
Term
Where is amylase located?
Definition
The pancreas, duodenum, and (saliva)
Term
What are some reasons of increased amylase?
Definition
-Pancreatic leakage
-REnal failure
-GI disease
-hepatobiliary disease
Term
What anticoagulant should we not use with amylase or lipase samples?
Definition
EDTA
Term
What will falsely elevate amylase?
Definition
Hemolysis
Term
What does amylase do?
Definition
Breaks down starches
Term
What does lipase do?
Definition
Breaks down lipids
Term
Where is lipase located?
Definition
pancreas and gastric mucosa
Term
How is lipase eliminated?
Definition
The kidney
Term
What is creatine kinase?
Definition
a leakage enzyme that has to do with muscle injury
Term
What is the most common chemistry test we run?
Definition
BUN, creatinine
Term
What is the second most common test we run?
Definition
Glucose
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