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95 Cards in this Set

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A urine protein: creatinine (UP:UC) of 2 would suggest what kind of proteinuria?

Tubular (usually between 1-5

What kind of UP:UC would you expect with a pathologic proteinuria?

>1

A dog has severe glomerular disease due to amyloidosis. What kind of UP:UC reading would be expected?

>5 (minimum >2)

What is the major end product of nitrogen metabolism (urination) in birds?

uric acid

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.

What are possible causes of hypernatremia (hypotonic)?

- dehydration


- sodium poisoning


- loss through panting, fever, hyperventilation

What are causes of hyponatremia (hypertonic)?

- GI loss


- renal loss


- edematous disorders


- hyperglycemia

What are the two main reasons for hyperkalemia?

- increased total body K+ (decreased excretion, hypoadrenocorticism)


- shifts from ICF to ECF (metabolic acidosis)

What are reasons for hypokalemia?

- decreased total body K+ (decreased oral intake, increased GI, urinary, cutaneous loss)


- shifts from ECF to ICF (metabolic alkalosis)

Metabolic acidosis (low HCO3-) would cause: hyper/hypokalemia, hypo/hyperchloremia

hyperkalemia and hyperchloremia

Metabolic alkalosis would cause: hyper/hypokalemia, hypo/hyperchloremia

hypokalemia and hypochloremia

At what point would a Na+:K+ suggest Addison's disease (hypoadrenocorticism)?

<27:1 (when <23:1 = Addison's on top of list)

Changes in Cl- often parallel changes in which other mineral?

Na+

What are potential causes of hyperchloremia?

- water deprivation


- loss thru panting, sweating, etc


- metabolic acidosis

What kind of symptom would metabolic alkalosis correlate to?

vomiting

What kind of symptom would metabolic acidosis correlate to?

secretory diarrhea

What kind of calcium is bioavailable?

free ionized Ca++

A serum chemistry panel would give you which Ca++ values?

ALL 3:


- free ionized calcium


- anion-bound


- complex Ca++

What would you expect the albumin levels to be if you have low total Ca++?

low

What are three causes for hypercalcemia?

- body releasing Ca++ from bone (hyperparathyroidism, malignancy)


- body retaining more Ca++


- renal diseases

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

What would you expect the PTH and P levels to be in a dog with hypocalcemia?

decreased PTH and increased P

What are 3 causes of hypervitaminosis D?

1. hypercalcemia


2. hyperphosphatemia


3. excessive dietary Vit D




Rodenticides can cause this!

What is the most common cause of hypocalcemia?

Hypoalbuminemia ( which is caused by decreased production - liver, inflammation; increased loss - proteinuria)

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

If an animal is hypocalcemic due to decreased PTH activity, what are underlying issues possibly causing this?

- Primary Hypoparathyroidism


- hypomagnesemia (grass tetany)

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+

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)

Ethylene glycol toxicosis causes hypo/hypercalcemia

Hypocalcemia - metabolites bind to Ca++ in filtrate --> hypercalcuria

What are three main causes of hyperphosphatemia?

- decreased urinary excretion


- increased intestinal absorption


- shifts from ICF to ECF (myopathies, acute tumor lysis syndrome)

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)

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)

If an animal is hypermagnesemic, what would you expect its PTH to be? GFR?

increased - often due to milk fever


Decreased GFR

What are common causes of hypomagnesemia?

- hypoproteinemia


- prolonged anorexia


- grass tetany


- enteric dz


- renal loss


- blister beetle toxicity

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)

What is the most common type of alpha 1 globulin?

serum amyloid A

What is the most common type of alpha 2 globulin?

haptoglobin

What is the most common type of beta 1 globulin?

transferrin (iron transport)

What is the are the most common types of beta 2 globulin?

Fibrinogen, IgM, C-reactive protein

Gamma globulins are also called ___________ and are made in the __________

immunoglobulins - B lymphocytes and plasma cells

A plasma protein:fibrinogen in a cow with dehydration would be:

>15

A plasma protein:fibrinogen in a cow with inflammation would be:

<10

A plasma protein:fibrinogen in a horse with dehydration would be:

>20

A plasma protein:fibrinogen in a horse with inflammation would be:

<15

What are the 3 most common acute phase proteins?

- serum amyloid A


- C-reactive protein


- Fibrinogen

What are components of nephrotic syndrome?

Occurs with protein-losing nephropathy


- marked hypoalbuminemia


- marked proteinuria


- edema


- hypercholesterolemia

What is the underlying cause of a polyclonal gammopathy?

Chronic antigenic stimulation

What are potential causes of a monoclonal gammopathy?

- neoplasia (usually multiple myeloma), ehrlichiosis, amyloidosis, FIP, heartworm Dz

If a hypoproteinemia is a result of decreased production, what are two possible causes?

- hepatic insufficiency


- acute phase response (inflammation)

Highest density lipoproteins have the (most/least) protein and the (most/least) lipid.

Highest density lipoproteins have mostprotein & least lipid

Triglyceride levels are highest in which lipoprotein classes?

Chylomicrons and VLDL (main carrier of TGs in fasting state)

Cholesterol measurements are mainly looking at which lipoprotein classes?

LDL (highest % cholesterol for all lipoprotein classes) and HDL

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

What are potential causes of hypercholesterolemia?

- post-prandial


- endocrine dz: hypothyroidism, Cushing's


- acute pancreatitis


- nephrotic syndrome


- cholestasis

What are potential causes of hypocholesterolemia?

- malabsorption/maldigestion


- decreased functional hepatic mass


- protein-losing enteropathy


- Addison's (hypoadrenocorticism)

What are potential causes for hypertriglyceridemia?

Same as for hypercholesterolemia:


- postprandial


- hypothyroidism


- nephrotic syndrome


- acute pancreatitis


- diabetes mellitus

How are NEFAs formed? What stimulates their formation? What inhibits it?

hydrolysis of TGs in adipose, liver, and mammary gland




+ = epinephrine and glucagon


- = insulin

What does a high NEFA level suggest?

negative energy balance, increased fat breakdown, downstream dz (DA, metritis, mastitis)

What are ketones?

they are produced in the liver from NEFAs in periods of low calorie intake/high energy demand

Excess ketones in the urine, blood, or milk, would happen in (respiratory/metabolic acidosis/alkalosis).

Titrational metabolic acidosis

In an acute phase response, would you expect the albumin level to increase or decrease?

Decrease

Where is albumin made? What is its role?

- made in liver


- carrier protein

Would you expect alpha/beta globulin levels to increase or decrease in an acute phase inflammatory response?

increase

What are two potential causes of hyperproteinemia?

- dehydration


- increased production

What are possible causes for hyperfibrinogemia in a cow?

- increased production due to inflammation (plasma protein:fibrinogen <10)


- dehydration

What are characteristics of nephrotic syndrome?

- ascites


- marked peripheral edema in limbs


- marked decrease in albumin levels


- increased risk of thrombosis


- hypercholesterolemia

With which protein abnormalities might you see nephrotic syndrome?

- hyperglobulinemia


- hypercholesterolemia


- hypertriglyceridemia

What might cause hyperglobulinemia?

- acute inflammation


- nephrotic syndrome

What are potential causes behind a monoclonal gammopathy?

- mutiple myeloma


- ehrlichiosis


- amyloidosis


- FIP

What is hyperviscosity syndrome?

a condition in which sluggish blood flow thru capillary beds --> poor perfusion




seen with increased IgM

What are the possible causes of hypoalbuminemia?

1. Decreased production (hepatic insufficiency, inflammation)


2. Increased loss (proteinuria, protein-losing enteropathy)


- acute blood loss

If a foal is hypoglobulinemic at 3 days, what is the possible reason?

failure of passive transfer

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

There is an increased risk of what with nephrotic syndrome?

thrombosis

What does an increased CK level mean?

muscle damage

What does an increase in AST mean?

Cellular damage - hepatocytes, skeletal muscle, RBC

How would serum phosphate and potassium be affected by severe muscle damage?

both would increase

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

What are the important components of bile?

- water


- bild acids


- conjugated bilirubin


- cholesterol and fatty acids


- electrolytes


- water-soluble wastes

The liver gets blood from which sources?

Portal vein and hepatic artery

What are the common leakage enzymes and what do they suggest?

- ALT (sm animals)


- AST


- ID/SDH (lg animals)




suggest hepatocellular injury

Increases in AST indicate what?

NOT specific for liver:


- hepatocyte damage


- muscle damage


- hemolysis

What are the common inducible enzymes and what do they indicate?

- ALP (sm animals)


- GGT (lg animals)




suggestive of cholestasis



What are reasons for increases in ALP?

- cholestasis


- hormonal/drug effect


- feline hyperthyroidism


- increased osteoblastic activity

What are reasons for increases in GGT in large animals?

- neonate recently takien in colostru


- cholestasis*


- drugs/hormones

What is bilirubin? In what form does it predominantly exist?

a pigment derived from heme degradation - mostly in the unconjugated form

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

What is the most likely cause of pre-hepatic hyperbilirubinemia?

extravascular or intravascular hemolysis

What are the most likely causes of hepatic hyperbilirubinemia?

- in HORSES/CATTLE: anorexia


- sepsis

Which lab analytes would be out of reference interval with pre-hepatic hyperbilirubinemia?

- Bu>Bc


- anemia


- hemoglobinuria



What are possible causes for post-hepatic hyperbilirubinemia?

-cholestasis*


- hepatocyte swelling


- steroid hepatopathy


- inflammation


- cholelithiasis

Which lab abnormalities are consistent with cholestasis?

- hypercholesterolemia


- hyperbilirubinemia


- increased ALP, GGT (inducible)


- increased ALT, AST, ID/SDH (leakage)

What does plasma have that serum does not?

fibrinogen & clotting factors V and VII

What is plasma?

liquid portion of blood PRIOR to clotting

What is serum?

liquid portion of blood AFTER clotting