clin chem test 1

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clin chem test 1
2012-07-05 13:15:07
bel rea clin chem

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  1. functional unit of the kidney?
  2. Functions of the Nephrons
    fltration of substance and reabsorption
  3. Filtration of substances goes from the________to the _________
    Glomerulus to the bowmans capsule
  4. 3 things that affect the degree of filtration
    • 1 blood pressure (hypotension decreases filtration)
    • 2 amt of blood reaching the glomerulus (ie shock causes pools in capillarys decreasing blood to vital organs causing a decrease in filtration)
    • 3 laws off defusion (substances move from a high conc. to a low conc.
  5. Freely filtered substances
    • 1 Water
    • 2 Electrolytes
    • 3 Glucose
    • 4 amino acids
    • 5 Urea & Creatinine (non protein)
  6. urea comes from?
    protein breakdown--->Ammonia--->urea--->urine
  7. Creatinine comes from?
    Muscle metabolism--->creatinine--->urine
  8. Reabsorption
    Renal tubules to the blood stream
  9. what two things can control reabsorption?
    • Hormones
    • Blood levels
  10. how do hormones play a part in reabsorption?
    • ADH: realsed from the pituitary and tells tubules to reabsorb h20
    • Aldosterone: released from the  adrenals  controls sodium reabsorption and potassium excreation
  11. normal blood glucose level in dogs?
  12. Renal threshold?
  13. should there be glucose in a normal pt's urine?
  14. highly concentrated urine increase your chance of seeing?
  15. positive and negatives of a morning sample?
    • +high conc. has better chance of finding crystals
    • -Poor cytology from the sample sitting
  16. Recently formed samples +/-
    • +good cytology
    • -urine is dilute decreasing the chance of seeing abnormalities and dilute urine is a hypotonic solution the can cause cells (rbcs) to swell and rupture
  17. 4 methods of collecting urine
    • Voided
    • Manual expression
    • Catheterization
    • Cystocentesis
  18. Advantages of a voided sample
    • -no iatrogenic trauma/infx
    • -clients can do it
    • -easiest on pt
  19. Disadvantage of Voided sample
    • -animal wont go
    • -poor method for culture due to possible contamination
  20. Advantages of Manual expression
    -convienient b4 sx
  21. disadvantages of manual expression
    • -may require anesthsia
    • -big dogs with tense abdominal muscles are difficult
    • -iatrogenic trauma which causes in increase in RBCs
    • -can rupture the bladder
    • -if pt has cystitus you can drive the bacteria into the Ureters

  22. how to preform manual expression
    • -palpate bladder with finger pressure
    • - apply gental steady pressure
    • be patient so sphincter can open
  23. advantages of catherization
    • -usually an immediate sample
    • -may releive urinary obstruction
    • -if using foley can moniter urinary output
    • -can use for culture
  24. Disadvantages of catheterization
    • -iatrogenic trauma/infx
    • -may require anesthesia
  25. types of catheters
    • cats-tom cat
    • dog-red rubber, polypropylene (stiffer and longer), foley (indwelling) females-bitch
  26. Use of catheters
    • -use smallest that will allow for passage of urine
    • -clean and sterile (cath, lube, gloves) (exception: polypropylene)
    • -measure
    • pinch tubing b4 pulling out
    • -discard the 1st part of the sample to decrease bac. contamin.
  27. Cystocentesis advantages
    • -immediate sample
    • -no anesthesia required
    • -best for urine culture
  28. Disadvantages of Cystocentesis
    -iatrogenic trauma and infx= increased RBC
  29. how to preform cystocentesis
    • -palpate the bladder if possible
    • -Female dogs: dorsal recumb.
    • -22g Ga 1-1.5 inches long
    • -6cc-12cc syringe
    • -may also do in lateral or standing
    • -draw as much urine as you can (bladder will shrink, wall thickens, hole closes)
    • -if you miss, backout with neg. pressure and try again
    • -Never redirect you could hit the colon!
  30. 4 parts of a routine U/A
    • macroscopic evaluation
    • USG
    • Urine Chemistrys
    • microscopic Evaluation
  31. how long can urine sit at room temp?
    30 mins
  32. if standing at room temp what will happen
    bacteria multiply, crystals increase, urine gets cloudy, cells disntegrate, cast breakdown, pH changes (increased due to lost CO2, Urease + bacteria
  33. how long can u refridgerate urine
  34. how do you chem. preserve urine
    • 1gtt of  40% formaldeyde to 1oz of urine
    • --MUST DO CHEMS FIRST (dipsticks)