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95 Cards in this Set

  • Front
  • Back
Substances with ____MW have more particles?
What are the 3 ions in the extracellular compartment?

EC= Na, Cl, HCO3

IC = K, Mg, HPO4
The ICF composes what percent?
Hypernatremia always = what?
What is lab evidence of hypernatremia dehydration?
Increased Hct, TP, BUN/Creatinine, Na, Cl, AG, hypersthenuria
What are causes of hypernatremia + dehydration?
1 - adpsia due to lack of water (concentrated urine, thirsty)
2 - adipsia due to abnormal thirst mechanism (concentrated urine, not thirsty)
3 - diabetes insipidus with lack of water (dilute - hyposthenuria with thirst)
Is central or nephrogenic diabetes insipidus responsive to ADH?
What is the value for isothenuria?
What is an appropriate renal response in dehydration?
What are causes of hypernatreimia + normal hydration (normovolemia)?
-salt poisoning
-consumption of sea water
-primary hypernatremia (don't want to drink)
-increase in Na and CL only
What are causes of hypernatremia + normal hydration (hypovolemia - increased ICF)?
Osmotic agents
What is the formula for estimating osmolality?
2 (Na + K) + (Glucose/18) + (BUN/2.8)

-significant if greater than 10-15 of measured value
If an osmolar gap is identified, what could be possible active substances?
-lactate, ketones, ethylene glycol , drugs

-will not be anything that is in the formula
What is a cause of normonatremic dehydration?
(Na and water are lost in equal proportions)
What are some important causes of Hyponatremic dehydration?
Na loss> water loss
-due to disease
-renal loss
-GI (foals)
-lactating dairy cow
-horses sweating
-muscle damage
What is a major cause of relative hypokalemia? (shifting from ECF to ICF)
-alkalosis - vomiting

-insulin Rx
What are caused of absolute hypokalemia?
-decreased intake
-increased loss - renal (diuresis, ketonuria, metabolic alkalosis)
-GI - vomiting, diarrhea, sequestration, saliva loss, sweat
What can happen with hyperkalemia?
cardiac arrest
What are causes of relative/spurious increases in K? (5)
-oriental breeds
-massive tissue necrosis
What are causes of absolute increase in K?
-decreased renal excretion (ruptured urinary bladder, acute renal failure, post renal obstructive disease)
What are other signs of hypoaldosteronism?
-hyponatremia and hypochloridemia
-Na/K ratio<23
-inappropriately concentrated urine with azotemia
-looks like renal failure
When is hypochloridemia seen without hyponatremia?
vomiting of pure stomach contents - because gastric fluids are rich in HCl
What values are see with a urinary bladder rupture?
decreased Na and Cl
increased K, BUN and Creatinine

-plasma values look like urine values
What does plasma look like?
increased Na and Cl
decreased K, BUN and Creatinine
What are the arterial pH limits?
7.36 - 7.44
What 3 ways does the body control pH?
-buffer system (weak acid and salt of its conjugated base)
-lungs (works fast)
-kidneys (slowest, but do most of the work)
What types of buffer systems are there is the body?
bicarb buffer system
-phosphate (can't be manipulated by the lungs)
-protein (can't be manipulated by the lungs)
What is the hydration equation?
CO2 +H2O <--> H2CO3 <--> H(+) + CO3(-)
How does the kidney restore balance in an acidosis condition?
-gets rid of H+ (acidic urine)
-keeps HCO3-
What makes a carnivore's pee acid?
methionine and cystein
What makes an herbivores pee alkaline?
malate in plant materials
How do the lung keep balance in an acidosis condition?

-in an alkalotic condition?
shift to left and blows of CO2 (H+ decreases)

-shift to the right and conserve CO2 (hold breath) (H+ increases)
What does hypoventilation, or pneumonia cause?
respiratroy acidosis
-drives equation to the right
What does hyperventilation or panic attack cause?
respiratory alkalosis
-drives equation to the left
What two types of metabolic acidosis are there?

-what do you see with each?
titration acidosis (associated with a increased AG - KLUE)

secretion acidosis = diarrhea, salivation in ruminants
What are causes of metabolic alkalosis?
-loss of H+ (gastric vomiting, abomasal reflux)

-gain base (ammonia/urea toxicant; bicarb fluids)
What are the steps to determining acid base problems?
-whatever agrees with pH is the primary problem with compensation in the other direction
What does total CO2 tell you?
BE or HCO3-

-does not always indicate a primary change therefore must use with clinical data to differentiate
What types of acid base disturbances are there?
What are 4 predisposing factors to paradoxical aciduria?
1 - metabolic alkalosis (increased HCO3-)
2 - hypovolemia (often due to dehydration so therefore have hyponatremia)
3 - severe hypochloremia (vomiting)
4 - hypokalemia
What is the formula for anion gap?

(Na + K) - (Cl + HCO3-)
What are the unmeasured anions and cations in an anion gap?
anions - phosphate, sulfates, albumin, lactate

cations - Ca, Mg, gammaglobulins
What are caused of increased anion gap and decreased AG?
increased - KLUE

decreased - hypoalbuminemia, hypercalcemia, hypermagnesemia
What two things are needed to diagnose a mixed acid base disturbance?
-increased AG
-increased or normal HCO3

(metabolic acidosis (titration acidosis like dehydration, renal failure, diabetic ketoacidosis) with metabolic alkalosis - vomiting)
Does Cl increase or decrease with secretion acidosis?
What are the four main markers of cellular leakage?

-what are 2 others

other - LDH and ALT
Which is the most specific indicator for muscle damage?

is there a long or short half life?

-short half life therefore may return to reference level before measured
What does CK do in the body?
it makes ATP available for use in the body and in the process makes creatinine
How is creatinine eliminated and what does this estimate?
via the urine and therefore estimates glomerular filtration
What are conditions that can cause an increase in CK?
-myositis (infectious or immune mediated)
-equine rhabdomyolysis
-strenuous exercise
-maybe secondary to arthritis
What artifacts could cause an increase in CK?
-traumatic venipuncture
How much higher is CK in neonates?
5 x higher
AST is an injury enzyme of what?
skeletal muscle and liver
What are causes of hyperkalemia?
-muscle necrosis
-secondary to rhabdomyolysis
-diabetes mellitus
-oleander toxicity
-obstruction of urine outflow
-addisons disease
What are causes of hypokalemia?
-renal disease
-gereatric cats
-marginal dietary intake
What are the three types of hypokalemic myopathies?
1 - rhabdomyolysis secondary to K depletion (weakness -> increased CK -> necrosis --> myoglobinuria
2 - diabetic animals
3 - bovine post-partum ketosis (downers)
What are three rule outs with a positive occult blood?
1 - hematuria (sediment at bottom)
2 - hemoglobinuria (red plasma)
3 - myoglobinuria (clear plasma)
With myoglobinuria, what does the plasma look like and what does the urine look like?
plasma - clear
urine - brown
Bacteria have urease. This can make the urine....

-produces CO2 (drives equation to the left) and ammonia (combines with free H+ ions)
What are artifacts of alkaline urine?
-causes cells to lyse
-casts to dissolve
-changes crystal formation
-false positive on urine dipstick for protein
If you want to confirm presence of protein on a urine dipstick with alkaline urine, what test do you need?
Bumin test
What happens if a dilute urine sits too long?
cells lyse and it is difficult to determine if there is hemoglobin or RBC
What does light do to bilirubin and urobilinogen?
are degraded by light
How do you describe ketones?
volatile - therefore escape form urine
What could brown urine mean?

hemoglobinuria, myoglobinuria

What does a refractometer measure and what does it infer?
RI --> SG --> osmolality
What two things overestimate osmolality?
glucose and protein
What is the measured bilirubin on a dipstick?

what does it mean?

What is the order of sensitivity of tests for cholestasis in dogs?

ALP>GGT>urinine bili>serum bili

GGT>ALP>serum bili>urine bili
Bilirubin is degraded to what in the large intestine by bacteria?
urobilinogen and sterobilinogen
What does decreased urobilinogen mean?
biliary obstruction
Once protein is detected on a dipstick, what should you evaluate it for?
hematuria or cystitis (look at RBC and WBC)

-if not that, may be glomerular or tubular disease
What does the urine P:C ratio mean?
>3 often means glomerular injury

<3 often means tubular injury
What does glucosuria mean and what is the renal threshold?
-180 for most
-100 more ruminants
When would you see ketones in the urine?
with increased lipolysis (starvation, bovine ketosis, diabetic ketoacidemia, ovine preg. toxicosis)
What is normal for RBC or WBC on sediment on 40x?
5 cells

-greater than this means hematuria or pyuria
What are conditions that increase BUN only?
1 - endogenous protein break down
2 - high protein meal
3- GI bleeding
What are the 2 causes of prerenal azotemia?
-decreased GFR (dehydration and decreased CO)

-increased nitrogen load (where BUN increases without Creatinine)
What are the characteristics of prerenal azotemia?
-decreased GFR
-hypersthenuria (at least 1/3 of nephrons are still functioning)
What is the order of abilities lost with renal failure?
1 - ability to concentrate or dilute urine
2- Ability to eliminate nitrogenous wastes
3- Ability to produce EPO
If the kidneys can't concentrate or dilute urine how many nephrons are lost and what does this reflect function of?
- >2/3 of nephrons are lost (with fixed SG)
- measure of tubular function
Other than isothenuria, what are some other indicators of tubular damage?
-increased fractional excretion of Na
-increased GGT
-increased NAG
-increased retinal binding protein
-P:C ratio is greater than 1-3
-greater than 3 casts/LPF
Once the kidneys have lost the ability to eliminate N wastes, how many functioning nephrons are lost?

What is this a function of
>3/4 are lost

-measure of glomerular function
What is the exception to azotemia appearing before loss of concentrating ability?
cats and primary glomerular disease
With primary glomerular disease, what is seen?
-retain limited ability to concentrate
-urine P:C ratio is >1-3
What are findings of post-renal azotemia?
-lg or ruptured urinary bladder (decreased Na and CL) (increased K, P, BUN, and Creatinine)
-pronounced azotemia
-titration acidosis
What are the species difference of renal failure with horses?
-increased Ca
increased P
What are the species differences of renal failure with ruminants?
-decreased Ca
-decreased Na and Cl
-increased fibrionogen
What is lost with a protein loosing nephropathy?
albumin with hypocalcemia
-metabolic acidosis
What conditions cause PU/PD?
-list 8
-renal failure
-diabetes mellitus (osmotic diuresis)
-liver failure
-Diabetes insipidus
jeder (jedes, jede ...)
each, every
(uses case endings)
After a dehydration, what causes concentrated urine?
thirst center
psycogenic (medullary washout)
hyposthenuria is typically what type of problem?
After a dehydration test, what causes hyposthenuria?
diabetes insipidus
In an animal with Diabetes Insipidus, after administration of ADH, central causes...
concentrated urine