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82 Cards in this Set

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What's the difference b/w serum and plasma?
Plasma: before blood clots, has plasma proteins-fibrinogen, clotting factors
Serum: after blood has clotted, lacks fibrinogen and clotting factors
How are plasma proteins measured? Serum proteins?
Plasma: refractometer
Serum: spectrophotometry
How do you determine serum globulin concentration?
Subtract albumin from total protein
What proteins do we measure? (4)
1) Total
2) Albumin
3) Fibrinogen-large animals
4) Globulins
What does it mean if total protein increases and the PCV increases?
Dehydration
-Albumin and globulins both increase
What does it mean if the total protein decreases and the PCV decreases?
Blood loss
-Albumin and globulins both decrease
Serum protein is _____% albumin.
35-50%
What protein makes up the majority of oncotic pressure?
Albumin
Are globulins larger or smaller than albumin (69000)?
smaller
Where is albumin synthesized?
Liver
What 5 things do globulins include?
1) antibodies
2) Complement
3) Clotting factors
4) Many enzymes
5) Protein carriers-lipids, vitamins, hormones, etc.
How are globulins classified?
Based on how far they migrate in a gel-vary by size
What 2 globulins are produced in the liver?
alpha globulins
betaglobulins
What makes up most of the gamma globulins?
Primarily IgG
What type of globulin are IgM and IgA?
Beta-globulins
What are 3 general causes of hyperproteinemia?
1) Hemocontration
2) Increased globulin synthesis
3) Hyperfibrinogenemia
-Usually inflammation
What is hemoconcentration?
Dehydration causes a proportional increase in both albumin and globulin
What are 2 causes of increased globulin synthesis?
1) Inflammation--> increase both acute phase proteins and Igs and complement
2) B lymphocyte neoplasia
What is the only cause of hyperalbuminemia?
Dehydration
What are acute phase proteins?
Mixed group of factors that are produced by the liver within 24 hours of inflammation, infection, tumors, necrosis, immune-mediated disease or surgery.
What is used to evaluate increased globulins?
Protein electrophoresis:
Polyclonal gammopathy
Monoclonal gammopathy
What kind of gammopathy is this? What could cause it?
Polyclonal gammopathy
Increased IgG produced by a mixed population of B lymphocytes or plasma cells w/ chronic antigenic stimulation
What could cause this pattern?
Monoclonal: IgG production by a clone of B lymphocytes or plasma cells
-Usually neoplastic-lymphoma, plasma cell tumor, or lymphocytic leukemia
Sometimes associated w/ infections such as ehrlichiosis, leishmaniasis, chronic pyoderma
What is the most common cause of an increase in alpha globulins?
Acute inflammation bc most of the acute phase reactants migrate as alpha
What does a polyclonal gammopathy represent?
Increased quantities of immunoglobulins produced by a heterogeneous population of B lymphocytes or plasma cells w/ chronic antigenic stimulation
What does a monoclonal gammopathy represent?
Increased immunoglobulin proudction by a single clone of B lymphocytes or plasma cells
-Most commonly neoplasia: lymphoma, plasma cell tumor, lymphocytic leukemia
What are the 2 general causes of hypoproteinemia?
1) Loss
2) Failure of synthesis
What is the cause of just hypoalbuminemia?
Loss through glomeruli
What are 4 causes of panhypoproteinemia from protein loss?
1) GI loss
2) Intestinal parasitism
3) Hemorrhage
4) Severe effusion
What are 2 causes of failure to synthesize just albumin (just hypoalbuminemia)?
1) Liver failure
2) Prolonged malabsorption/ maldigestion causing malnutrition
What are 2 causes of hypoglobulinemia from a failure of synthesis?
1) Failure of passive transfer
2) Immune-deficiency
What levels mean there is failure of passive transfer in foals? calves?
Foals: < 800 mg/dl
Calves < 1000 mg/dl
What are 2 methods used to test for failure of passive transfer in calves, but NOT foals?
1) Refractometer
2) Sodium sulfite (also ok in crias)
What method is used to detect failure of passive transfer in calves and foals?
Zinc sulfate
What are two methods used to detect failure of passive transfer in foals only?
1) Glutaraldehyde conjugation
2) ELISA
True or false. The ELISA SNAP test is not a quantitative test for failure of passive transfer in foals.
False, semiquantitative test by color change
What is the major force holding fluid in vessels?
Colloid osmotic pressure
What can you do in a patient with a really low colloid osmotic pressure?
Can give synthetic colloids
How is colloid osmotic pressure measured?
Using a colloid osmometer
What do you call increased concentrations of lipids in the blood that may or may not be grossly visible?
Hyperlipidemia
What do you call increased concentrations of lipids in the blood that are grossly visible in serum or plasma?
lipemia
What does post-prandial (physiologic) hyperlipidemia occur in dogs or cats? How long does it take to clear?
About 2-6 after eating
Clears by 8-16 hours
What are 5 causes of fasting/persistent (at least a 12 h fast) hyperlipidemia?
1) Usually hormonal or metabolic
2) Primary hyperlipidemia-genetic
e.g. Schnauzers
3) Drug- induced e.g. glucocorticoids
4) Enterocolitis in horses
5) Acute pancreatitis, hepatopathy
True or false. Hypercholesterolemia is usually associated with atherosclerosis in domestic animals.
False, that's humans
What are the 4 forms of cholesterol?
Very low density lipoproteins (VLDL)
Intermediate-density lipoproteins (IDL)
Low density lipoproteins (LDLs)
High density lipoproteins (HDL)
What are 4 causes of hypercholesteremia?
1) Endocrinopathies
2) Protein-losing glomerulopathy
3) Cholestasis
4) Acute pancreatitis
What are 3 endocrinopathies that cause hypercholesteremia?
1) Diabetes mellitus
2) Hypothyroidism
3) Hyperadrenocorticism
What are 4 causes of hypocholesteremia?
1) Decreased production-hepatopathy
2) Protein-losing enteropathy (e.g. lymphangectasia)
3) Hypoadrenocorticism
4) Severe malnutrition/ maldigestion/ malaborption
What are the causes of hypertriglyceridemia?
Similar to causes of hypercholesteremia:
1) Endocrinopathies
2) Protein-losing glomerulopathy
3) Cholestasis
4) Acute pancreatitis
What causes hypotriglyceridemia?
Nothing clinically significant
When do non-esterified fatty acids (NEFAs) increase in plasma?
When there's a negative energy balance
What are 5 common causes of increased NEFA?
1) Hepatic lipidosis
2) Ketosis
3) Diabetes mellitus
4) Equine "Cushing's"
5) Hyperlipidemia
True or false. Adipokines can not be measured.
True
What are the 3 adipokines?
1) Leptin
2) Adiponectin
3) Resistin
What are adipokines?
Factors produced by adipocytes or macrophages
What are 3 ways that glucose is increased in plasma?
1) Diet
2) Glycogenolysis
3) From amino acids and fats
What 5 things regulate glucose? How does each one impact glucose levels?
1) Insulin--> lower blood levels
2) Glucagon--> increases
3) Glucocorticoids--> increases
4) Catecholamines--> increases
5) Growth hormone--> increases
What are 2 ways to test serum glucose?`
1) Several assay techniques
2) Portable glucometers-usually less accurate at higher glucose concentrations
When is there glucose in the urine?
When blood glucose exceeds the renal threshold
-About 180 mg/dl in dogs,cats, borses
About 100 mg/dl in cattle
What are 2 common causes of hypoglycemia?
1) Increased utilization by tissues
2) Decreased production
OR combination of both
What is the most common cause of hypoglycemia at the lab?
Not separating the cells from the serum promptly
What are 7 other causes of hypoglycemia?
1) Hyperinsulinism (tumor, iatrogenic)
2) Hepatic insufficiency
3) Sepsis
4) Starvation, malabsorption, maldigestion-rare!
5) Hypoadrenocorticism (decreased insulin antagonist)
6) Extreme exertion-"hunting dog hypoglycemia"
7) Glycogen storage diseases
What are 3 physiologic causes of hyperglycemia?
1) Stress
2) Excitement
3) Postprandial
What are 3 pathologic causes of hyperglycemia?
1) Diabetes mellitus
2) Hyperadrenocorticism
3) Pharmacologic (glucocorticoids)
What is the definitive test for hyperinsulinism due to neoplasia?
Serum insulin assay
What is the serum insulin assay based on?
Plasma glucose concentrations should be proportional to plasma glucose concentration
i.e. insulin should be elevated in conjugation with glucose
What is a normal serum insulin assay ratio for dogs?
< 30 is normal for dogs
What do fructosamine and glycated hemoglobin measure?
Assays that estimate average blood glucose over the long-term
What is fructosamine?
Glucose bound to albumin
What is serum fructosamine concentration proportional to?
Blood glucose over last 2-3 weeks
True or false. Fructosamine is affected by physiologic hyperglycemia.
False, not affected by physiologic hyperglycemia
Where is glycated hemoglobin formed?
In erythrocytes as a reaction b/w glucose and hemoglobin
What does glycated hemoglobin reflect?
Average blood glucose over life span of erythrocyte (longer than albumin) e.g. 2-3 months
What are 3 ketones?
Acetoacetate
B-hydroxybutyrate
Acetone
When are ketones formed?
When there is carbohydrate deficiency and increased fat metabolism
What happens when there's excess ketones?
Causes metabolic acidosis
How are ketones detected?
In the urine by a dipstick
What are 7 causes of hyperketonemia?
1) Diabetes mellitus (also hyperglycemia)
2) Bovine ketosis
3) Pregancy toxemia
4) Hepatic lipidosis
5) Starvation
6) Anorexia
7) Low-carb diet
What is different about diabetic hyperketonemic animals compared to other causes of hyperketonemia?
Only one where animal is also hyperglycemic
When is lactate formed?
During anaerobic metabolism- when there is decreased tissue perfusion
What tube do you want to use to measure lactose?
Sodium fluoride-grey top
What are 4 causes of increased lactic acid?
1) Shock
2) Ischemia
3) Grain overload
4) Sustained heavy exercise