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95 Cards in this Set
- Front
- Back
A urine protein: creatinine (UP:UC) of 2 would suggest what kind of proteinuria? |
Tubular (usually between 1-5 |
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What kind of UP:UC would you expect with a pathologic proteinuria? |
>1 |
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A dog has severe glomerular disease due to amyloidosis. What kind of UP:UC reading would be expected? |
>5 (minimum >2) |
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What is the major end product of nitrogen metabolism (urination) in birds? |
uric acid |
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What is the best indicator of renal disease in avian species? |
hyperkalemia. Hyperuricemia (uric acid) is not specific for renal disease, BUN is usually more of an indicator of dehydration, and creatinine is of poor diagnostic value in birds. |
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What are possible causes of hypernatremia (hypotonic)? |
- dehydration - sodium poisoning - loss through panting, fever, hyperventilation |
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What are causes of hyponatremia (hypertonic)? |
- GI loss - renal loss - edematous disorders - hyperglycemia |
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What are the two main reasons for hyperkalemia? |
- increased total body K+ (decreased excretion, hypoadrenocorticism) - shifts from ICF to ECF (metabolic acidosis) |
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What are reasons for hypokalemia? |
- decreased total body K+ (decreased oral intake, increased GI, urinary, cutaneous loss) - shifts from ECF to ICF (metabolic alkalosis) |
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Metabolic acidosis (low HCO3-) would cause: hyper/hypokalemia, hypo/hyperchloremia |
hyperkalemia and hyperchloremia |
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Metabolic alkalosis would cause: hyper/hypokalemia, hypo/hyperchloremia |
hypokalemia and hypochloremia |
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At what point would a Na+:K+ suggest Addison's disease (hypoadrenocorticism)? |
<27:1 (when <23:1 = Addison's on top of list) |
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Changes in Cl- often parallel changes in which other mineral? |
Na+ |
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What are potential causes of hyperchloremia? |
- water deprivation - loss thru panting, sweating, etc - metabolic acidosis |
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What kind of symptom would metabolic alkalosis correlate to?
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vomiting |
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What kind of symptom would metabolic acidosis correlate to? |
secretory diarrhea |
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What kind of calcium is bioavailable? |
free ionized Ca++ |
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A serum chemistry panel would give you which Ca++ values? |
ALL 3: - free ionized calcium - anion-bound - complex Ca++ |
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What would you expect the albumin levels to be if you have low total Ca++? |
low |
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What are three causes for hypercalcemia? |
- body releasing Ca++ from bone (hyperparathyroidism, malignancy) - body retaining more Ca++ - renal diseases |
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If an animal has a neoplasm that is producing PTHrp, would would you expect to happen to phosphorous and PTH levels? |
decreased P PTH WRI |
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What would you expect the PTH and P levels to be in a dog with hypocalcemia? |
decreased PTH and increased P |
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What are 3 causes of hypervitaminosis D? |
1. hypercalcemia 2. hyperphosphatemia 3. excessive dietary Vit D Rodenticides can cause this! |
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What is the most common cause of hypocalcemia? |
Hypoalbuminemia ( which is caused by decreased production - liver, inflammation; increased loss - proteinuria) |
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What is metabolic alkalosis with paradoxical aciduria? What can cause it? |
Metabolic alkalosis (high HCO3) + low Cl- + low K+ + acidic urine pH upper GI stasis, rumen atony, DA |
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If an animal is hypocalcemic due to decreased PTH activity, what are underlying issues possibly causing this? |
- Primary Hypoparathyroidism - hypomagnesemia (grass tetany) |
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What are the 5 main causes of hypocalcemia? |
- secondary to hypoalbuminemia - decreased PTH activity - inadequate Ca+ mobilization or absorption - pregnancy/lactation - excessive urinary loss of Ca+ |
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Which conditions might lead to inadequate calcium mobilization or absorption? |
- exocrine pancreatic insufficiency (low digestive enzymes) - Chronic renal disease - protein-losing enteropathy - hypercalcitonism - oxalate toxicity (rhubarb) |
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Ethylene glycol toxicosis causes hypo/hypercalcemia |
Hypocalcemia - metabolites bind to Ca++ in filtrate --> hypercalcuria |
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What are three main causes of hyperphosphatemia? |
- decreased urinary excretion - increased intestinal absorption - shifts from ICF to ECF (myopathies, acute tumor lysis syndrome) |
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What would you expect from GFR and [PTH] if an animal hyperphosphatemic? |
decreased GFR (not getting rid of enough P) and decreased PTH (which would increase Ca++ levels - antagonistic with P) |
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Hypophosphatemia could be caused by which 4 main things? |
- increased urinary excretion (ex Fanconi) - decreased intestinal absorption (ex anorexia) - Shift from ECF to ICF (ex resp alkalosis) - inadequate mobilization from bone (milk fever) |
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If an animal is hypermagnesemic, what would you expect its PTH to be? GFR? |
increased - often due to milk fever Decreased GFR |
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What are common causes of hypomagnesemia? |
- hypoproteinemia - prolonged anorexia - grass tetany - enteric dz - renal loss - blister beetle toxicity |
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If an animal appears to be in an acute phase of inflammation, what should you expect from its albumin levels? |
they should be decreased (it's a neg acute phase protein) |
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What is the most common type of alpha 1 globulin? |
serum amyloid A |
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What is the most common type of alpha 2 globulin? |
haptoglobin |
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What is the most common type of beta 1 globulin? |
transferrin (iron transport) |
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What is the are the most common types of beta 2 globulin? |
Fibrinogen, IgM, C-reactive protein |
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Gamma globulins are also called ___________ and are made in the __________ |
immunoglobulins - B lymphocytes and plasma cells |
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A plasma protein:fibrinogen in a cow with dehydration would be: |
>15 |
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A plasma protein:fibrinogen in a cow with inflammation would be: |
<10 |
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A plasma protein:fibrinogen in a horse with dehydration would be: |
>20 |
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A plasma protein:fibrinogen in a horse with inflammation would be: |
<15 |
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What are the 3 most common acute phase proteins? |
- serum amyloid A - C-reactive protein - Fibrinogen |
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What are components of nephrotic syndrome? |
Occurs with protein-losing nephropathy - marked hypoalbuminemia - marked proteinuria - edema - hypercholesterolemia |
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What is the underlying cause of a polyclonal gammopathy? |
Chronic antigenic stimulation |
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What are potential causes of a monoclonal gammopathy? |
- neoplasia (usually multiple myeloma), ehrlichiosis, amyloidosis, FIP, heartworm Dz |
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If a hypoproteinemia is a result of decreased production, what are two possible causes? |
- hepatic insufficiency - acute phase response (inflammation) |
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Highest density lipoproteins have the (most/least) protein and the (most/least) lipid. |
Highest density lipoproteins have mostprotein & least lipid |
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Triglyceride levels are highest in which lipoprotein classes? |
Chylomicrons and VLDL (main carrier of TGs in fasting state) |
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Cholesterol measurements are mainly looking at which lipoprotein classes? |
LDL (highest % cholesterol for all lipoprotein classes) and HDL |
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Why is it important to fast a patient for 12 hours if you want to measure plasma lipids? |
the post-prandial state will affect cholesterol and TG values |
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What are potential causes of hypercholesterolemia? |
- post-prandial - endocrine dz: hypothyroidism, Cushing's - acute pancreatitis - nephrotic syndrome - cholestasis |
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What are potential causes of hypocholesterolemia? |
- malabsorption/maldigestion - decreased functional hepatic mass - protein-losing enteropathy - Addison's (hypoadrenocorticism) |
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What are potential causes for hypertriglyceridemia? |
Same as for hypercholesterolemia: - postprandial - hypothyroidism - nephrotic syndrome - acute pancreatitis - diabetes mellitus |
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How are NEFAs formed? What stimulates their formation? What inhibits it? |
hydrolysis of TGs in adipose, liver, and mammary gland + = epinephrine and glucagon - = insulin |
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What does a high NEFA level suggest? |
negative energy balance, increased fat breakdown, downstream dz (DA, metritis, mastitis) |
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What are ketones? |
they are produced in the liver from NEFAs in periods of low calorie intake/high energy demand |
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Excess ketones in the urine, blood, or milk, would happen in (respiratory/metabolic acidosis/alkalosis). |
Titrational metabolic acidosis
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In an acute phase response, would you expect the albumin level to increase or decrease? |
Decrease |
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Where is albumin made? What is its role? |
- made in liver - carrier protein |
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Would you expect alpha/beta globulin levels to increase or decrease in an acute phase inflammatory response? |
increase |
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What are two potential causes of hyperproteinemia? |
- dehydration - increased production |
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What are possible causes for hyperfibrinogemia in a cow? |
- increased production due to inflammation (plasma protein:fibrinogen <10) - dehydration |
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What are characteristics of nephrotic syndrome? |
- ascites - marked peripheral edema in limbs - marked decrease in albumin levels - increased risk of thrombosis - hypercholesterolemia |
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With which protein abnormalities might you see nephrotic syndrome?
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- hyperglobulinemia - hypercholesterolemia - hypertriglyceridemia |
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What might cause hyperglobulinemia? |
- acute inflammation - nephrotic syndrome |
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What are potential causes behind a monoclonal gammopathy? |
- mutiple myeloma - ehrlichiosis - amyloidosis - FIP |
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What is hyperviscosity syndrome? |
a condition in which sluggish blood flow thru capillary beds --> poor perfusion seen with increased IgM |
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What are the possible causes of hypoalbuminemia? |
1. Decreased production (hepatic insufficiency, inflammation) 2. Increased loss (proteinuria, protein-losing enteropathy) - acute blood loss |
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If a foal is hypoglobulinemic at 3 days, what is the possible reason? |
failure of passive transfer |
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You have a bovine patient with a history of ADR, hyperfibrinogemia, and a PP:Fibrino. of 17. What is the best interpretation for the hyperfibrinogenemia based on this result? |
elevation due to dehydration |
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There is an increased risk of what with nephrotic syndrome? |
thrombosis |
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What does an increased CK level mean? |
muscle damage |
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What does an increase in AST mean? |
Cellular damage - hepatocytes, skeletal muscle, RBC |
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How would serum phosphate and potassium be affected by severe muscle damage? |
both would increase |
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What are important functions of the liver? |
- protein - albumin - carbohydrate - gluconeogenesis - lipid metabolism - cholesterol - storage of proteins - detoxification (ammonia --> BUN) - PMN kupffer cells - excretory fxn |
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What are the important components of bile? |
- water - bild acids - conjugated bilirubin - cholesterol and fatty acids - electrolytes - water-soluble wastes |
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The liver gets blood from which sources? |
Portal vein and hepatic artery |
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What are the common leakage enzymes and what do they suggest? |
- ALT (sm animals) - AST - ID/SDH (lg animals) suggest hepatocellular injury |
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Increases in AST indicate what? |
NOT specific for liver: - hepatocyte damage - muscle damage - hemolysis |
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What are the common inducible enzymes and what do they indicate? |
- ALP (sm animals) - GGT (lg animals) suggestive of cholestasis |
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What are reasons for increases in ALP? |
- cholestasis - hormonal/drug effect - feline hyperthyroidism - increased osteoblastic activity |
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What are reasons for increases in GGT in large animals? |
- neonate recently takien in colostru - cholestasis* - drugs/hormones |
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What is bilirubin? In what form does it predominantly exist? |
a pigment derived from heme degradation - mostly in the unconjugated form |
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Where does bilirubin conjugation take place? What does this mean? |
- liver: it undergoes a process to make it water soluble, which is necessary for excretion |
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What is the most likely cause of pre-hepatic hyperbilirubinemia? |
extravascular or intravascular hemolysis |
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What are the most likely causes of hepatic hyperbilirubinemia? |
- in HORSES/CATTLE: anorexia - sepsis |
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Which lab analytes would be out of reference interval with pre-hepatic hyperbilirubinemia? |
- Bu>Bc - anemia - hemoglobinuria |
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What are possible causes for post-hepatic hyperbilirubinemia? |
-cholestasis* - hepatocyte swelling - steroid hepatopathy - inflammation - cholelithiasis |
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Which lab abnormalities are consistent with cholestasis? |
- hypercholesterolemia - hyperbilirubinemia - increased ALP, GGT (inducible) - increased ALT, AST, ID/SDH (leakage) |
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What does plasma have that serum does not? |
fibrinogen & clotting factors V and VII |
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What is plasma? |
liquid portion of blood PRIOR to clotting |
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What is serum? |
liquid portion of blood AFTER clotting |