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305 Cards in this Set
- Front
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What are the importances of microscopic examination of urine sediment? |
*recognizing diseases of urinary tract *aid in diagnosis of systemic disease |
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Why is the first morning sample best for collection? |
It's more concentrated so chance of finding formed elements are increased |
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What are the best collection techniques for microscopic examination? |
Cystocentesis |
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When should urine be examined microscopically? |
when fresh or within the first 1 hour |
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Minimize bacterial growth in the sample by... |
*if cannot examine within 1 hour, should be refrigerated or preserved *bacteria multiplies if allowed to sit @ room temperature |
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What stain is used during a urinalysis? |
Sternheimer-Malbin Stain (Sedi-Stain) |
|
What are some things seen in a normal urine sediment? |
*epithelial cells *few WBCs & RBCs *mucus & sperm *few hyaline & granular casts *crystals *fat droplets *bacteria |
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How are RBCs, WBCs, and epithelial cells reported when seen in a urinalysis? |
*avg # per high powered field |
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What is the normal WBC cound /hpf in urine? |
< 5 /hpf |
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What is the normal RBC cound /hpf in urine? |
< 5/hpf |
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Describe WBCs in a urinalysis |
*larger than RBCs & smaller than renal epithelial cells *spherical *dull-gray or greenish-yellow color *ID'd by characteristic granules or lobulation of nucleus *Few seen without urinary or genital tract disease |
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What do WBC's do in concentrated urine? |
Shrink |
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What do WBC's do in dilute urine? |
Swell |
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Define Pyuria |
excessive WBC in urine |
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What are some causes of pyuria? |
*inflammatory or infectious disease *nephritis *pyelonephritis *cystitis *urethritis *ureteritis |
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What should be done to urine with pyruia? |
It should be cultured for bacteria |
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What do RBC's indicate in a urinalysis |
*indicate bleeding somewhere in urogenital tract or genital system |
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Describe RBC's in a urinalysis |
*smaller than WBC, larger than yeast *small, round, smooth, somewhat refractile, & orange/yellow but may be colorless if HgB has diffused while standing *Smooth concave disc shape |
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What do RBC's do in concentrated urine? |
shrink & crenate |
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Describe RBC's in dilute or alkaline urine |
*may swell or lyse *smooth edges & pale *may appear as colorless rings *often dissolves |
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RBC's can be confused with... |
fat globules varying in size but color allows for differentiation |
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Describe Epithelial Cells |
*few = normal; result of normal sloughing of old cells |
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Where do Squamous Epithelial Cells derive from?
|
distal urethra, vagina, vulva, or prepuce
|
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Describe Squamous Epithelial Cells |
*insignificant *flat, thin, homogeneous *Largest cells in urine sediment *often straight edges and distinct corners that sometimes curl or fold *Small round nucleus *Sometimes fold on each other *Not found in samples by cysto or catheter |
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Where to Transitional Epithelial Cells derive? |
Bladder, ureters, renal pelvis, & proximal urethra |
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Describe Transitional Epithelial Cells
|
*usually round but can be pear or caudate *granular, small nuclei, larger than WBC's *rare find *High #'s indicate cystitis or pyelonephritis *Also see high #'s in catheter sample |
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Where do Renal Epithelial Cells derive from? |
Renal Tubules |
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Describe Renal Epithelial Cells |
*smallest in urine *slightly larger than WBC *rare find *High # = diseases of kidney parenchyma |
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Describe Bacteria in urine |
*may be contaminated by epithelium of vagina, vulva, or prepuce during urination *Cysto and catheter should be free of bacteria *large #'s w/ WBC's = infection &/or inflammation of urinary tract or genital tract |
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Describe yeast in urine |
*often confused with RBC's or lipid droplets but have budding & maybe double refractile walls *Rare; contaminants |
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Describe Fungi in urine |
*filamentous & branching *uncommon but very serious if found |
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Where are casts formed at in urine? |
*Loop of Henle, distal & collecting tubules where concentration and acidity of urine are greatest |
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Why is fresh urine best for casts? |
*they dissolve rapidly; shaking also breaks them down |
|
Tamm-Horsfall mucoprotein |
*secreted protein
*precipitates in acidic conditions & forms casts shaped like the tubules they form |
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Plasma and mucoprotein are secreted by |
renal tubules |
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What are normal cast findings in urine? |
hyaline, epithelial, or cellular |
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how does centrifugation effect bacteria
|
not effected at low speeds |
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Describe sightings of hyaline casts |
*few may be seen *large #'s indicate lesion of renal tubules *# of casts seen unreliable in severity of disease |
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Describe Hyaline casts |
*clear, colorless, & somewhat transparent *composed of protein *difficult to see unless in dim light *cylindrical w/ parallel sides & round ends *easier to ID in stained |
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What are some causes of high #'s of hyaline casts? |
renal irritation, fever, poor renal diffusion, strenuous exercise, or general anesthesia |
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Describe Granular casts |
*hyalines w/ granules *former WBC or form of coarse or fine granulars *renal epithelial cast *those gone through degeneration *most commonly seen |
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Large #'s of Granular casts are seen with what and indicate what? |
Seen w/ acute nephritis & indicate more severe kidney damage |
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Describe Epithelial Casts |
*have epithelial cells from renal tubules that become embedded in hyaline matrix |
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What are Epithelial Casts seen with? |
acute nephritis and other conditions causing degeneration of renal tubular epithelium |
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Describe WBC casts |
have WBC's; presence: inflammation of renal tubules |
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Describe RBC casts |
deep yellow to orange; have RBC's & form when RBC's aggregate within lumen of tubule |
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What are some causes for RBC casts? |
Hemorrhage from trauma or bleeding disorders or part of inflammation lesion |
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Describe Waxy Casts |
*resemble hyaline but usually wider w/ square ends & dull, homogenous waxy appearance *colorless or grey & highly refractile |
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What do Waxy casts indicate? |
*chronic & severe degeneration of renal tubules |
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Describe Fatty Casts |
*small droplets of fat appearing as refractile bodies |
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When are Fatty Casts seen? |
*frequent in cats w/ renal disease because cats have lipids in their renal parenchyma *seen in dogs w/ diabetes mellitus |
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What do large #'s of fatty casts suggest?
|
degeneration of renal tubules |
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What helps with viewing fatty casts? |
*Seti-stain |
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Cylindroids |
*misc. *similar to hyaline cast but longer w/ tapered end |
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Mucous Threads |
*often confused with casts *twisted ribbon shape *large amount present in horses b/c they have mucous glands in renal pelvis & ureters |
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What do mucous threads indicate? |
urethral irritation or contamination of sample with genital secretions |
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Spermatozoa |
*Intact males *no clinical significance *may also be seen in recently bred females *large amounts may produce false positive for protein tests |
|
Capillaria plica |
Stomach worm of the dog |
|
Dioctophyma renale |
kidney worm of dogs |
|
Steohenurus dentatus |
kidney worm of pig |
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Fat droplets in urine |
*light green tinge *highly refractile *spherical bodies of various sizes *small, round structures under a coverslip *Seti-Stain orange/red when stained *from catheter lubricants or oily surfaces may contaminate urine *noncellular material not derived from body cells |
|
Describe Lipureia
|
seen in most cats
*seen w/ obesity, diabetes mellitus, hypothyroidism, and rarely after a high-fat meal |
|
Describe Crystalluria |
*crystals in urine *types formed depending on pH, concentration, temp., & solubility *noted as few, moderate, occasional |
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List the common crystals seen in acidic urine |
*Ammonium biurate *Amorphous urates *Bilirubin *Calcium Oxalate *Triple phostate or struvite *Cystine *leucine *tryosine *uric acid |
|
Ammonium Biurate |
*brown in color *round, long, irregular spicules *"thorn apple" shape *severe liver disease |
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Amorphous urates
|
*Amphorus crystal *appear as granular precipitate |
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Calcium oxalate |
*small squares *have "X" on back resembling an envelope *dumb-bell shapes or elongated and pointed at each end *common small #'s in dogs and horses |
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Triple phosphate or struvite |
*6-8 sided prisms w/ tapering sides & ends *resemble coffin lids *sometimes fern-leaf shape esp. when urine has high concentration of ammonia |
|
Cystine |
*6-sided, flat, colorless, thin *renal tubular dysfunction or cystine urolithiasis |
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Leucine |
*"wheel" or "pincushion" shape *yellow or brown color *liver disease |
|
Tryosine |
*dark, needlelike projections *highly refractile *small clusters *liver disease *not common in K9 or feline |
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Uric Acid |
*usually diamond or rhomboid shape *yellow or yellow-brown *not common in cats and dogs except for Dalmations |
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What are common Alkaline crystals? |
*Ammonium biurate
*Amorphous phosphate *Calcium carbonate *Calcium oxalate *Triple Phosphate |
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Calcium carbonate |
*common in horses & rabbits *round, many lines from center *dumb bell shape *no clinical significance |
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What are common neutral crystals? |
*Ammoniu biurate *Amorphous phosphate *amorphous urates *Calcium carbonate *calcium oxalate *triple phosphate |
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Urolithiasis |
*stones composed of various minerals found in urinary tract *send to stone laboratory |
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Composition of uroliths |
*calcium, magnesium, and ammoinium carbonate OR *calcium, magnesium, and ammonium phosphate |
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Describe Endocrine |
*V-shaped gland of 2 lobes joined by body *Right lobe is mesoduodenum next to greater omentum, along dorsal duodenum near stomach *Internal secretion pertaining to gland that secretes directly into blood stream |
|
islets of Langerhans
|
interspersed within the exocrine pancreatic tissue are arrangements of cells that that on the appearance of "islands" of lighter-staining tissue
|
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What does the production and secretion of insulin depend on? |
blood glucose levels |
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Define insulin |
*principle hormone effecting blood glucose *lowers blood glucose levels *body will quit sometimes causing creation of glucose |
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Define Glucagon |
*elevates blood glucose levels by stimulating conversions of glucose from its storage form of glycogen found in liver |
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What are the functions of Insulin? |
*prevents blood glucose concentration from exceeding the renal threshold and spilling glucose into the urine |
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What does the blood glucose level indicate in the body? |
*carbohydrate metabolism |
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What can blood glucose levels be used to measure? |
endocrine function of the pancreas |
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Blood glucose reflects the balance of what? |
blood insulin and glucagon levels |
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As insulin levels increase... |
rate of glucose increases and blood glucose levels decrease |
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What is the role of Glucagon?
|
acts as stabilizer to prevent blood glucose levels from becoming too low
|
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As insulin levels decrease... |
glucose use decreases and blood glucose concentration increases |
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What must be separated from RBCs immediately after collection? |
*serum and plasma |
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Describe glucose levels in a sample of plasma left in contact with RBCs at room temperature |
The levels drop 10% per hour |
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What is used as a glucose preservative even if another anti-coagulant is used? |
Sodium fluoride |
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What can be done to the collection sample to slow glucose use by RBCs |
refrigeration |
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What is the function of Carbohydrate metabolism? |
*source of fuel for the body |
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Where do digestion of carbs occur |
small intestine |
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Describe the digestion of carbohydrates |
begins in the mouth with secretion of enzymes from salivary glands such as Amylase; they change to monosaccharides (simple sugars) in a form of galactose, glucose, and fructose then it is absorbed into the blood through mucosa and stored in the liver |
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2 forms of sugar and where they are formed |
*glucose - only form stored in blood *glycogen - stored in liver |
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What 2 organs are internal storages for glucose? |
liver and kidneys |
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What is the role of the liver for carbohydrate metabolism? |
*can remove and contribute glucose to blood by 2 different conversion processes *glucogenesis *glycogenolysis |
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Glucogenesis |
conversion of glucose to glycogen in liver |
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Glycogenolysis |
conversion of glycogen to glucose in liver |
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What is the role of the kidney in carbohydrate metabolism? |
filter &/or absorb back into the blood stream |
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Who should be fasted prior to blood glucose testing and for how long? |
*non ruminants or young ruminants that are nursing *12-18 hours prior |
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Which is preferred for blood glucose testing? |
serum over plasma |
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When should blood glucose be tested? |
if suspect pancreatitis or diabetes between last meal |
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Normal glucose levels for dog |
76-120 mg/dL |
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Normal glucose levels for cats |
58-120 mg/dL |
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Normal glucose levels for horse |
62-127 mg/dL |
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Normal glucose levels for cow |
37-79 mg/dL |
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Define hyperglycemia |
*increase *imbalance of liver output of glucose & uptake of glucose by peripheral tissues *too much glucose output and body cannot absorb it all |
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What are some causes of hyperglycemia? |
disturbance of endocrine function of pancreas with secretion of insulin and glucagon |
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Define hypoglycemia |
*decrease plasma glucose level *# of imbalances between liver's conversion of glycogen to glucose and actual tissue utilization of glucose |
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What are some causes of hypoglycemia? |
*hyperinsulinism *malnutrition *starvation *overdose of insulin *ketosis *severe exertion *glycogen storage disease (liver disease) |
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What are the 2 forms of hyperglycemia? |
*diabetes - which is pathological *transitory - which is nonpathological |
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Describe diabetes mellitus |
*true disease causing hyperglycemia *7200 mg/dL = diabetic |
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What are some causes of diabetes? |
*lack of insulin *other hormone producing organs whose abnormal functions affects blood glucose levels i.e. pituitary gland, thyroid gland, and adrenal cortex |
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Describe Transitory hyperglycemia |
result of treatment or secondary to another condition |
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What are examples of transitory hyperglycemia? |
*digestion *cold temp. *drugs *IV fluids *ingest carbs *excitement |
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Describe hyperinsulinism
|
*when endocrine tissue of pancreas produces overabundance of insulin which in turn lowers blood glucose |
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Describe glycogen storage disease
|
*liver disorders where excess levels of glucose are converted to glycogen |
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Define Diabetes Mellitus |
chronic disorder of carbohydrate metabolism due to an insulin deficiency |
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Etiology of Diabetes Mellitus |
*caused by damage to insulin producing cells of Islets of Langerhan's *caused by disorders like chronic pancreatitis *most cases of diabetes happen in dogs over 5 years - more common in females and overweight dogs *Common breed: Schnauzers |
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Clinical signs of Diabetes mellitus |
*PUPD *polyphagia *weight loss *weakness |
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Clinical signs of advanced diabetes mellitus |
*sweet acetone odor to breath and skin *ketones in urine *vomiting or diabetic coma in severe cases |
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Lab results for diabetes mellitus |
*glucosuria *blood glucose levels exceed renal threshold: 175-220 mg/dL *fasting levels *accompanied by ketosis |
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Diagnosis of diabetes mellitus |
*fasting, blood test, hyperglycemia, ketonemia, ketonuria *SpGr will increase indicated diabetes despide PUPD |
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Tx of diabetes mellitus
|
*mild controlled by diet *otherwise insulin is required |
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Describe the pancreas |
*actually 2 organs, endocrine & exocrine, held together is one stroma |
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Where is the pancreas located? |
*long, flat abdominal organ located near duodenum |
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Exocrine portion of pancreas
|
*AKA acinar cells
*greatest portion of organ |
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What are the functions of the exocrine portion? |
*external secretion production and secretes enzyme - rich juice that contains enzymes necessary for digestion in small intestine |
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Describe Trypsin |
*pancreatic enzyme that aids digestion by catalyzing the reaction that breaks down proteins of ingested food |
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Testing methods of trypsin |
*more readibly detected in feces than in blood but can be seen in both *more trypsinanalyses performed on fecal samples *normally found in feces *absence in feces is abnormal *variety of tests in reference lab |
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Pancreatic test |
Serum pancreatic lypase immunoreactivity - detects pancreatitis in dogs & cats |
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Where do trypsin enzymes empty into? |
duodenum by pancreatic duct |
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TLI |
Serum trypsinlikeimmuno test |
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Describe TLI test |
*radio immunoassay used to detect antibodies to Trypsin which are species specific *used to diagnose exocrine pancreatic insuff. in k-9 *fast animal prior to testing |
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Gelatin Soln. Test |
*Knox unflavored gelatin is a source of protein; mix fresh feces with warm 7.5% gelatin solution tests for presence; not quantity |
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Gelatin Film Test |
*utilizes gelatin coating on undeveloped X-ray film; use bicarbonate solution and mix w/ fresh feces and place strip of X-ray film on it and incubate *if present the coating will strip off *it absent the film will be unchanged |
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Define Amylase |
*primary source: pancreas *also produced in salivary glands & small intestines |
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What is the function of Amylase |
breakdown of starches and glycogen in sugars |
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2 test methods for amylase |
*saccharogenic *amyloclastic |
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Saccharogenic test |
*measures production of reducing sugars as amylase catalyzes break down of starch |
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Amyloclastic test |
*measures disappearance of starch as it is broken down to reduce sugars through amylase activity |
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Why should EDTA not be used when collecting samples for Amylase and Lipase testing? |
Because amylase and lipase require calcium |
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What should be used in place of EDTA to collect for Amylase and Lipase? |
Lithium heparin - green top tubes |
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What 2 issues will effect amylase and lipase results? |
*hemolysis and lipemia |
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Elevated amylase doesn't always mean what and why? |
Pancreatitis because it is produced in tissues other than pancreas
|
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Amylase testing results
/meanings |
*elevated amylase doesn't always mean pancreatitis b/c it is produced in tissues other than pancreas
*less sensitive indicator of pancreatic function than lipase because lipase is only produced in the pancreas *typically amylase is run with lipase for pancreatic function testing |
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What are some causes of increased Amylase? |
*acute pancreatitis, flare-ups of chronic pancreatitis, obstruction of pancreatic ducts, enteritis, intestinal obstruction, intestinal perforation, or decrease in glomerular filtration |
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Describe Lipase and its function |
*majority derived from pancreas *break down the long-chain fatty acids of lipids (triglycerides) *with chronic progressive pancreatic disease, damaged pancreatic cells are replaced w/ connective tissue that can't produce enzymes causing a gradual decrease in both amylase and lipase levels |
|
Test methods for lipase |
usually based on hydrolysis of olive oil emulsion into fatty acids by lipase present in patient serum |
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What are increased lipase levels seen with? |
renal and hepatic dysfunctions; also steroid administration |
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Describe acute pancreatitis |
*enzymes escape into tissue paraenchyma resulting in autolysis and hemorrhage |
|
What is exocrine pancreatic insufficiency? |
*disturbance of exocrine function of pancreas causing insufficient secretions of pancreatic enzymes *advanced stages may show signs of diabetes |
|
What are some causes of exocrine pancreatic insufficiency? |
chronic inflammation |
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What can exocrine pancreatic insufficiency result in? |
serious digestive disorders including maldigestion, malabsorption
|
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What are symptoms of exocrine pancreatic insufficiency?
|
diarrhea, steatorrhea, polyphagia, and weight loss |
|
Define neoplasia |
tumor of pancreas |
|
What are signs of neoplasia? |
epigastric pain, jaundice, chronic weight loss, V/D |
|
Define hepatocyte |
liver cell |
|
Kupffer cell |
macrophage of the liver |
|
Hepatic portal circulation |
blood vessel system that transports blood from capillaries in intestines to hepatic capillaries |
|
Bile Canaluculi |
fine tubular channels forming a 3-D network within parenchyma of liver; joins to form bile ducts & hepatic duct; surrounds & collects bile from hepatic cells to small ducts at peripheral of lobules |
|
Bile |
produced by hepatic cells; contains bile acids, bilirubin, & cholesterol; liquid secretions of hepatic cells |
|
Hepatic artery |
Carry oxygenated blood to cells of liver |
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Central vein |
course from center of each liver lobule, receiving blood from sinusoids and carry to hepatic veins; smallest part of hepatic vein |
|
Hepatic vein |
carries deoxygenated blood to heart from liver |
|
Portal Vein
|
large vein carrying nutrient rich blood from stomach, intestines, pancreas, & spleen into liver; detoxifies and filters blood within the sinusoids |
|
Bilirubin |
insoluble molecule derived from break down of hemoglobin by macrophages of the spleen |
|
Biliverdin |
Green bile pigment formed by catabolism of hemaglobin & is converted to bilirubin |
|
Urobilinogen |
A colorless by-product of bilirubin reduction. It is formed in the intestines by bacterial action on bilirubin; usually excreted in the kidneys |
|
Urobilin |
same as urochrome; pigment in urine |
|
Urochrome |
normal yellow pigment in urine |
|
Conjugate |
bilirubin taken into the liver cells and conjugated to form water-soluble compound |
|
Bilirubin Glucoronide |
conjugated form of bilirubin in bilirubin metabolism |
|
What are the functions of the liver? |
*metabolizes *synthesis of plasma protein, cholesterol, clotting factors *digestion & absorption of nutrients *bile *detoxification *catabolism *stores glycogen |
|
Describe metabolism of the liver |
*metabolizes amino acids, carbs, & lipids *filters materials absorbed from GI tract before having a chance to reach systemic circulation |
|
What organ is the largest gland in the body and why? |
Liver because of its complex structure, function, and pathology |
|
What is the liver's primary function? |
*storage site for bile |
|
What do malfunctions of the galbladder and liver result in? |
signs of jaundice, hypoalbuminemia, problems w/ hemostasis, hypoglycemia, hyperlipoproteinemia, and hepatoencephalopathy |
|
Where is the liver located? |
the right side of the body directly behind the diaphragm |
|
Liver lobules |
4 lobes: left, right, caudate, quadrate |
|
Liver plates |
A single layer of hepatic cells that look like plates; radiate outward from central vein to peripheral to liver lobule |
|
Hepatocytes |
Liver cells; 1 layer thick ; radial manner in each lobule structural unit of liver |
|
Sinusoids |
*capillaries that empty into the central vein derive from hepatic arteries & portal vein lined with endothelial cells and kuffper cells |
|
Bilirubin formation
|
*RBC destruction *heme converted to biliverdin *biliverdin reduced to bilirubin *bound to albumin *unconjugated *released in plasma *carried to liver through the blood *joined with glucuronic acid *conjugated |
|
Unconjugated bilirubin |
*floats in blood *free bilirubin *water-insoluble |
|
Conjugated bilirubin is joined what what? |
glucuronic acid |
|
Bilirubin to Urobilinogen |
*bilirubin secreted in bile *enters intestines *reduced to urobilinogen |
|
Route of Urobilinogen |
*in feces *hepatic portal circulation into blood *to kidneys |
|
Urobilinogen in feces |
*most excreted here in oxidation form of urobilin |
|
Urobilinogen in hepatic portal circulation |
*part is reabsorbed back into the hepatic portal circulation and re-excreted in bile |
|
Urobilinogen to the kidneys |
some reabsorbed bypasses the liver and enters general circulation then travels to the kidneys to be filtered and excreted in urine *called urinary urobiligen |
|
What is urobilin? |
brownish pigment that gives stool its color |
|
What is bile? |
bile salts, lecithin, cholesterol, bilirubin, and electrolytes; liquid secretion of liver cells into duct cells of liver from cholesterol |
|
What is the route of bile flow ? |
*hepatocytes to canaliculi to hepatic ducts *send bile out of liver lobules and joins with cystic duct to form bile duct *leaves bile duct and empties into duodenum |
|
Where is bile stored? |
in galbladder |
|
What happens to bile in horses and why? |
goes directly into the intestines because horses don't have a galbladder by the bile duct |
|
Describe bile if it stored in the galbladder |
it becomes concentrated |
|
What controls the bile duct? |
a sphincter |
|
What is the sphincter of the bile duct controlled by? |
Hormones |
|
How do hormones control the sphincter of the bile duct?
|
contraction/relaxation of it |
|
What is the name of sphincter controlling hormone? |
CCK - Chloe Cysto Kinin |
|
Where is CCK produced?
|
by duodenum |
|
CCK is produced in response to what? |
lipids and amino acids in small intestine |
|
What happens to fat in the intestine? |
It gets broken down into smaller fat globules by bile salts |
|
What causes greater digestion of fats? |
Pancreatic lipase
|
|
What is the unit of measurement for enzymology? |
IU or U |
|
What happens to enzymes when the liver is damaged? |
They leak out |
|
What are the functions of bile? |
*helps stimulate peristalsis by GI movement |
|
What are liver function tests used for? |
establish rate of progression or regression of liver damage |
|
What do liver function tests measure? |
level of substances which are produced, modified, or released when liver cells are damaged
|
|
What does ALT stand for? |
Alanine Aminotransferase |
|
What does AST stand for?
|
Asparte Aminotransferase |
|
What does SDH stand for? |
Sorbitol Dehydrogenase |
|
What does GDH stand for? |
Glutamate Dehydrogenase |
|
What is the function of ALT and AST? |
*catalyze reactions that transfer amino groups from amino acids to keto acids during production of new amino acids |
|
What is the function of GDH and SDH? |
catalyze transfer of hydrogen groups, primarily during glycolysis |
|
Describe ALT |
*in dogs, cats, and primates: liver specific enzyme *horses, ruminants, pigs, & birds are not liver specific |
|
What are some other sources of ALT in horses, ruminants, pigs, & birds? |
renal cells, cardiac muscles, skeletal muscle, and pancreas |
|
Causes of increased ALT |
damage to hepatocytes |
|
Describe AST |
*not liver specific *found in other tissues *usually performed with other tests *can be used to test muscle damage |
|
What other tissues is AST found in? |
RBCs, cardiac muscle, liver, skeletal muscle, kidneys, & pancreas |
|
Describe SDH |
*useful for evaluating liver damage in large animals: cattle, sheep, goat, swine, and horses *present in all common domestic species *tests usually sent to outside labs *unstable |
|
Describe GDH
|
*bound enzyme *high concentrations in liver cells of cattle, sheep, & goats *enzyme of choice for ruminants & avian |
|
Describe Alkaline Phosphate
|
*AP, ALP, or AKLP *isoenzyme *multiple organ sources *4 forms *not tested in house |
|
What are the 4 forms of AP? |
liver, bone, intestinal, and corticosteroid induced specific |
|
Where is AP found? |
osteoblasts, condroblasts, and hepatic cells |
|
How is AP produced in young animals? |
Bone development |
|
How is AP produced in older animals?
|
primarily in liver |
|
What can elevate AP levels? |
bone injury or obstructed liver disease |
|
What should be used when collecting and testing for AP? |
Serum or Lithium heparin plasma |
|
Why not use EDTA and oxylate when testing for AP? |
It can cause lower false AP values |
|
What does GGT stand for? |
Gamma glutamyltransferase |
|
Where is GGT found? |
in many tissues but primary source is liver |
|
What causes GGT to elevate? |
patients with obstructive liver disease |
|
Describe plasma proteins liver function test |
*many diseases can result but frequently in kidney and liver disease
*includes fibrinogen - plasma *serum does not have fibrinogen *green top tube will not clot |
|
Where are plasma proteins produced?
|
primarily in liver and parts of immune system |
|
What can affect the TP concentration of a plasma protein liver test? |
liver disease altering protein synthesis and by other diseases associated with altered protein distribution, break down, or excretion |
|
What causes a false protein alteration? |
Hydration status |
|
Describe BSP Dye test |
*evaluating function of liver to excrete certain waste
*not common in veterinary medicine practice but is available |
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What is the calculated dose of BSP? |
5mg/kg |
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How does the BSP dye test work? |
5mg/kg BSP is given IV through cephalic vein, wait 30 minutes, and draw blood from opposite vein and assay results for amount of dye retained by the body |
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What does BSP stand for |
Bromsulfphialeine |
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What is Jaundice a clinical sign of? |
galbladder, liver, or blood disease |
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What causes jaundice? |
presence of excessive bilirubin, liver disease, bile duct obstruction, or hemolytic jaundice (excessive RBC destruction) |
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What is Cholestasis? |
stoppage/suppression of bile flow which causes hyperbilirubinemia and jaundice |
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What causes Cholestasis? |
bile duct obstruction |
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Why should lipemia be avoided when testing electrolyte assays? |
Because it will alter the results |
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What are the major electrolytes in plasma? |
Calcium, Inorganic Phosphorus, Magnesium, Sodium, Bicarbonate, Potassium, Chloride |
|
What electrolytes are Anions? |
Phosphorus, Chloride, and Bicarbonate |
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What electrolytes are Cations? |
Sodium, Potassium, Calcium, Magnesium, and Hydrogen |
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Where are electrolytes found in the body? |
All body fluids |
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What are the functions of electrolytes?
|
*Water balance *fluid osmotic pressure *Muscular and nervous functions *Acid base regulation |
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How much of calcium is found in the bones? |
99% |
|
Where is the last 1 % of calcium? |
The rest of the body |
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What is the function of calcium? |
Help clotting |
|
How is Calcium related to inorganic phosphorus? |
Inversely |
|
Hypercalcemia |
Too much calcium |
|
Hypocalcemia |
Decreased calcium |
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What anticoagulants should not be used when collecting to test calcium and why? |
EDTA, Oxalate, and Citrate because they bind to calcium |
|
What should be avoided when testing for all electrolytes? |
Hemolysis
|
|
Who most commonly has calcium deficiencies? |
Lactating bitches |
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How much of phosphorus is found in bones? |
80% |
|
How much of phosphorus is found in the body? |
20% |
|
What is the function of phosphorus? |
*energy storage, release, & transfer
*Carbohydrate metabolism |
|
Where is inorganic phosphorus? |
plasma/serum |
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Where is organic phosphorus? |
erythrocytes |
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What is the relationship between calcium and phosphorus? |
Inversely related |
|
Hyperphosphatemia |
Increase in phosphorus |
|
Hypophosphatemia |
Decrease in phosphorus |
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Which electrolyte is the major cation found in plasma and fluids? |
Sodium |
|
What are the functions of sodium? |
*Water distributon *Body fluid osmotic pressure maintenance *Vital role in pH regulation of urine & acid-base balance |
|
Hypernatremia |
Elevated sodium |
|
Hyponatremia |
Decrease level of sodium |
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What anticoagulant should not be used for collection to test sodium and why? |
Sodium heparin because it will falsely elevate results |
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What anticoagulant should be used for collection to test sodium? |
Lithium heparin |
|
What are the functions of potassium? |
*normal muscular function, respiration, cardiac function, nerve impulse transmission, and carbohydrate metabolism |
|
What is preferred to test potassium? |
Plasma |
|
Define Hyperkalemia |
increased potassium levels |
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What causes hyperkalemia? |
cellular damage or necrosis |
|
Define hypokalemia? |
Decrease levels of potassium |
|
What causes hypokalemia? |
Decreased, anorexia, ketonuria, diuresis, fluid loss |
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Where is magnesium found in the body? |
50% in bones and 50% all body tissues |
|
How is magnesium related to calcium and phosphorus? |
imbalance Mg/Ca ratio will result in muscular tetany from release of acetylcholine |
|
What is the function of Magnesium? |
Production and decomposition of acetylcholine |
|
Hypermagnesemia |
Increased magnesium levels |
|
Hypomagnesemia |
Decreased magnesium levels |
|
What are the functions of Chloride? |
maintain water distribution, osmotic pressure, and normal cation/anion ratio |
|
What does chloride have a close relationship with? |
Sodium and bicarbonate |
|
Define Hyperchloremia |
Increased levels of chloride |
|
Define Hypochloremia |
Decreased levels of chloride |
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What should be done to the blood sample to test for chloride? |
It should be separated from the cells |
|
What are the functions of bicarbonate? |
aid in transport of Co2 from tissue to lungs keeping body pH regulated |
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How much of total CO2 is measured from blood CO2 levels? |
95% |
|
What should be done to the blood sample to test for CO2? |
chilled in ice water to prevent altering of acid-base composition |
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Describe Nitrate/Nitrite Poisoning?
|
Heavy fertilized areas |
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What are the 2 rodenticides used?
|
Warfarin and Pindone |
|
Describe Ethylene glycol poisoning
|
antifreeze, calcium oxylate monohydrate crystals, kidney failure and death; can be tested in house |
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Chemicals/HgB |
denature Hgb; methylene blue, red maple leaves, onions leak proof container Everything is important Wash nothing before shipping it out due to it being evidence; fix in 10% formalin |
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Normal Glucose levels for dog |
Neg |
|
Normal Glucose levels for cat |
Neg |
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Normal bilirubin levels for dog |
Neg to trace |
|
Normal Glucose levels for cat |
Neg |