Clin Path- Mineral Protein Lipid Anion Gap and Blood Gases Evaluation.txt

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Clin Path- Mineral Protein Lipid Anion Gap and Blood Gases Evaluation.txt
2014-11-24 20:46:07
clin path mineral protein lipid aniongap blood gas

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  1. Parathyroid hormone (PTH) is produced primarily in response to __________, and its net effect is increased _________ and _________ and decreased __________. It also stimulates ________ production.
    hypocalcemia; serum calcium; renal excretion of phosphorous; serum phosphorous; vitamin D
  2. Vitamin D production is stimulated by _________; vitamin D increases ___________.
    PTH; serum calcium
  3. The principal regulator of blood calcium levels.
    parathyroid hormone (PTH)
  4. How does vitamin D increase serum calcium levels?
    it increases the GI absorption of calcium
  5. Samples must be analyzed promptly to get accurate free Ca2+ measurements because these levels are dependent upon _______.
    pH, which changes with exposure to air
  6. Measured serum calcium will be decreased if __________ is decreased.
    serum albumin
  7. What are the most common causes for hypocalcemia? (5)
    hypoalbuminemia, critical care patients, CKD, milk fever, pancreatitis
  8. Most common causes of hypercalcemia? (5)
    neoplasia, bone growth/remodeling (young animal or animal with fracture/broken bone), renal disease and Addison's disease (decreased urinary excretion), dehydration
  9. Hypophosphatemia can cause ____________.
    hemolytic anemia
  10. 3 main causes of hypophosphatemia.
    increased excretion (hyperparahtyroidism), alkalosis (shift from ECF to ICF), decreased absorption/mobilization
  11. 4 main causes for hyperphosphatemia.
    decreased renal excretion (decreased GFR, rupture), acidosis (shift from ICF to ECF), increased absorption/ mobilization, bone growth
  12. Serum magnesium depends on __________; decreased Mg is associated with... (6)
    intake; insufficient intake, critical illness, diabetes mellitus, lactation, enteropathy, hypoparathyroidism
  13. Hyperalbuminemia is always associated with _________.
  14. Causes of hypoalbuminemia. (6)
    decreased production (liver disease, malabsorption, compensatory), increased loss (renal loss, enteropathy, blood loss)
  15. Causes of hyperglobulinemia. (3)
    inflammation, neoplasia (plasma cell neoplasia (myeloma), lymphocytic leukemia)
  16. Causes of hypoglobulinemia. (2)
    FTPI, congenital immunodeficiency (SCID)
  17. Increased fibrinogen can be due to... (2)
    dehydration or inflammation
  18. A PP:fibrinogen ratio of >15 indicates...
  19. A PP: fibrinogen ratio of <10 indicates...
  20. A PP: fibrinogen ratio between 10-15 indicates...
    combination? need to consider other data and clinical signs
  21. 5 common causes of hypercholesterolemia.
    postprandial, nephrotic syndrome (protein is lost and cholesterol increases to maintain oncotic pressure), hypothyroidism, diabetes mellitus, cholestasis
  22. 3 causes of hypocholesteroliemia.
    portosystemic shunts/vascular anomalies, protein-losing enteropathy, hypoadrenocorticism
  23. 7 Causes of hypertriglyeridemia.
    postprandial, hypothyroidism, nephrotic syndrome, acute pancreatitis, diabetes mellitus, Cushing's disease, diet
  24. Total body water in normally about ______ of body weight.
  25. Decreased total body water indicates ________.
  26. TBW is divided into two categories:
    extracellular fluid (ECF= blood, intercellular fluid, GI tract, and transcellular fluid) and intracellular fluid (ICF)
  27. The number of solute particles per unit weight of a solution.
    serum osmolality
  28. In normal animals, _________ is the primary driver of osmolality.
  29. An increase osmo gap indicates the presence of...
    small unmeasured molecules, such as exogenous toxins
  30. Hyperosmolality induces shift from ______ to ______, and rapid correction of this may cause __________.
    ICF to ECF; cellular edema
  31. Loss of ICF results in _______; shift to ECF may mask _______; both are associated with ________.
    cell shrinkage; dehydration; hyperosmolality
  32. Hypoosmolality induces shift from ______ to ______, which can compound ____________.
    ECF to ICF; dehydration
  33. Increase ICF results in ________, which may cause _________; this is associated with _________.
    cell swelling; intravascular hemolysis; hypoosmolality
  34. ECF has high levels of _____ and _____, but low levels of _______ [electrolytes].
    Na+; Cl-; K+
  35. Bicarbonate is generated in the ________, ________, and _______.
    lungs (primarily); gastric mucosa; RBCs
  36. Causes of hypernatremia (increased sodium). (6)
    water deficit, water loss greater than sodium loss (GI osmotic shifts, renal excessive urine production), sodium excess (iatrogenic or salt poisoning), artifact
  37. Causes of hyponatermia (reduced sodium). (9)
    pseudohyponatermia (lipemic samples), sodium deficit (vomiting, diarrhea, renal loss (hypoadrenocorticism), sweating in horses, salivary loss, uroabdomen), water excess
  38. 4 causes for hyperchloremia.
    hypernatremia (same differentials), potassium bromide therapy, excessive loss, chloride retention (renal acidosis)
  39. If chloride is low and sodium is normal or the decrease in chloride is greater than the decrease in sodium, consider... (4)
    vomiting, displaced abomasum, obstruction, bovine renal failure
  40. Hyperkalemia can be caused by the following 3 general mechanisms:
    shifting K+ from ICF to ECF, increased total body K+, pseudohyperkalemia
  41. Shifting K+ from ICF to ECF occurs with ________.
    metabolic alkalosis
  42. Increased total body K+ occurs with... (3)
    acute renal failure, urinary tract obstruction or leakage, addison's disease
  43. Pseudohyperkalemia occurs with... (3)
    thrombocytosis, hemolysis, marked leukocytosis
  44. Hypokalemis has the following 3 general causes (mechanisms):
    decreased intake, increased loss/excretion, shifting from ECF to ICF
  45. Increased loss/ excretion of K+ occurs with... (5)
    vomiting/diarrhea, CKD, diuresis, diabetic ketoacidosis, cutaneous loss (sweating in horses)
  46. Shifting of K+ from ECF to ICF occurs with _______.
    mild alkalemia
  47. Na/K ratio is used to help diagnose ____________
    hypoadrencorticism (Addison's disease) [reduced Na/K]
  48. Increased bicarbonate concentrations is usually associated with _______________; it is usually due to... (4)
    metabolic alkalosis; gastric loss/vomiting, gastric sequestration of HCl, renal loss, compensation for chronic respiratory acidosis
  49. Decreased bicarbonate concentrations are usually associated with ___________; they can be caused by... (6)
    metabolic acidosis; [with increased anion gap] ketoacidosis, lactic acidosis, renal insufficiency, uroabdomen/rupture, [with normal anion gap] diarrhea/vomiting, saliva
  50. Most changes in the anion gap are due to ____________________.
    increased unmeasured anions
  51. 5 causes of increased anion gap.
    delayed sample analysis, renal insufficiency/failure, diabetes mellitus ketoacidosis, toxicity (ethylene glycol, salicylates)

    LUKES (lactic, ketones, ethylene glycol, salicylates)
  52. In lactic acidosis, you would expect to see a decrease in ___________ and an increase in _________.
    bicarbonate; anion gap
  53. Increased lactate occurs with... (3)
    decreased O2 delivery due to hypoxia/hypoperfusion, altered carbohydrate metabolism (liver, kidney, hyperthyroid, diabetes, neoplasia, sepsis, drugs/toxins), bacterial fermentation
  54. 2 causes of decrease anion gap.
    decrease unmeasured anions= hypoalbuminemia and hemodilution, increased unmeasured cations= hypercalcemia and hypergammaglobulinemia (myeloma)
  55. Corrected calcium = ?
    Ca + (3.5- Albumin)
  56. Blood gas pH that is decreased indicated.
  57. Blood gas pH that is increased indicated...
  58. Measure of alveolar ventilation and is used to determine respiratory contribution to acid-base homeostasis.
  59. Decrease pCO2.
    respiratory alkalosis
  60. Increased pCO2.
    respiratory acidosis
  61. Measure of the non-respiratory contribution to acid-base homeostasis.
  62. Decreased bicarb (HO3).
    metabolic acidosis
  63. Increased bicarb (HCO3).
    metabolic alkalosis
  64. Metabolic acidosis is indicated by decreased _________ and the expected respiratory compensation is...
    plasma HCO3 (bicarb); hyperventilation to exhale CO2
  65. When loss of bicarb is the cause for metabolic acidosis, there is a(n) _________ anion gap and _______ chloride; 3 causes for this...
    normal; increased or high normal; saliva of ruminants, diarrhea, renal tubular acidosis
  66. When bicarb consumption is the cause for metabolic acidosis, there will be a(n) ______ anion gap and ______ chloride; causes for this include...
    high; normal; LUKES-lactic acid, uremic acids, ketones, ethylene glycol, salicylates
  67. Metabolic alkalosis is indicated by increased ________; its expected respiratory compensation is...
    bicarb; hypoventilation to retain CO2
  68. When metabolic alkalosis is caused by HCL loss or sequestration, differentials include... (7)
    vomiting, gastric tube, gastric obstruction, displaced abomasum, torsion, renal disease, GI stasis (hypocalcemia)
  69. Metabolic acidosis caused by paradoxical aciduria is associated with...
    hypovolemia, hypochloridemia, and totally body loss of K+
  70. With mixed metabolic acidosis and alkalosis, there is _______ HCO3, ______ serum Cl-, and _______ anion gap.
    normal to increased; decreased; increased
  71. 2 mechanisms for mixed metabolic acidosis and alkalosis.
    gastric torsion (vomiting, decreased intake, HCl sequestered), organic acidosis (diabetic ketoacidosis or renal failure)
  72. Respiratory acidosis is associated with increased _______, and the expected metabolic compensation is...
    pCO2 (hypoventilation); increased resorption of HCO3 (may take days)
  73. Causes of respiratory acidosis. (5)
    moss of neurogenic control (anesthesia, head trauma), failure of breathing mechanics (pneumothorax), marked pulmonary abnormalities (pneumonia, pulmonary edema)
  74. Respiratory alkalosis is associated with ____________, and the expected metabolic compensation is...
    decreased pCO2 (hyperventilation); increased excretion of HCO3 (requires several days)
  75. Causes of respiratory alkalosis. (5)
    altered respiratory control (excessive panting, convulsions, encephalopathy), mechanical ventilation, hypoxemia due to hypotension or pulmonary shunts