Clin Path: CBC

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Clin Path: CBC
2011-02-14 17:07:06
CBC blood work blood compisition

CBC contents, levels of normal, disease assosiated
Show Answers:

  1. What is the blue test tube? –
  2. Citrate for coagulation testing
  3. What is the grey test tube? –
    Sodium fluoride which preserves glucose
  4. What is the green test tube? –
    Heparin-lithium~ interferes the least with chemistries, bicarb, and blood gases
  5. When running blood what is the clot time with the blood tubes? -
    20-30 minutes
  6. What does a CBC consist of? –
    PCV, Plasma Protein, and total WBC count
  7. Purpose of a blood smear? –
    WBC differential, RBC morphology, platelet estimate, and evaluation of other blood content
  8. Automated CBC also give what? –
    Hemoglobin concentration, MCV, and platlet count
  9. AST: Aspartate aminotransferace
    • -Produced in liver
    • -Liver specific in dogs, cats, and lab animals
    • -Evaluation- Liver Disease/ infection, neoplasia, bile duct obstruction, trauma.
    • -Muscle disease in large animal
  10. AST: Aspartate aminotransferace
  11. -Liver, but not specificily
    • -Muscle is #1 source
    • -Evaluation- Any muscle trauma, difficult blood pull and/ or restraint, Physical Trauma (High activity in Horses), Heart attack, Hemolysis, Liver Disease
  12. ALK PHOS (AP): Alkaline Phosphatase
    • -Liver and Cholestasis
    • -Not Specific but really good indicator of Cholestasis in dogs and cats
    • -Elevation- Normal Young animals, Bone Disease, pancreatitis, Biliary obstruction
    • -Disease may include; Cushing’s Hepatic Neoplasia, Hepatic Lipidosis
  13. SD/ SDH: Sorbital Dehydrogenase
  14. -*Large Animal
    • -LIVER; this is the specific liver test of choice in large animal!
    • -Not readily available
    • -Elevation- Liver disease in Large Animal, Possible Severe Inflammatory GI Disease in Horses
  15. GD: Glutamate Dehydrogenase
    • -*Large Animal
    • -LIVER- good potential as excellent diagnostic test
    • -Not widely available or standardized
  16. GGT: Gamma Glutamyltranspeptidase
    • -LIVER- Considered Liver Specific
    • -Elevation- Liver disease, Newborn~ indicates passive transfer-drugs
  17. Bile Acid:
    • -Liver Function Test!!!
    • -Specific and more useful than just enzymes
    • -Made in liver from cholesterol
    • -Stored in Gall Bladder
    • -Released to aid in fat digestion and then brought back to liver
    • -Liver either reuses or removes
    • -Elevation- Indicates a dysfunction in liver but not the disease
  18. Bilirubin:
    • -From normal breakdown of Heme
    • -Brought to liver bound to Albumin for transfer
    • -Conjugated with sugars and eliminated through feces
    • -Elevation- High conjugated bilirubin~ Liver Damage, High Un-Conjugated bilirubin~ RBC destruction
  19. BUN: Blood Urea Nitrogen
    • -Generally viewed with
    • -Creatinine, phosphorus, and SG
    • -Comes from protein catabolism
    • -Urea made in liver and excreted by Kidney
    • ->75% of nephrons must be damaged before you see elevation
    • -Low BUN~ Liver disease or significant protein intake reduction
    • -Not as Kidney specific as Creatinine
    • -Not as helpful in Equine and Bovine
    • -Elevation- Azoteimia, catabolism, recent high protein meal, Upper GI Bleed
  20. Creatinine
    • -Waste Produced from the muscle
    • -More Kidney Specific than BUN
    • -Less sensitive then BUN
    • -Directly indicates reduced GFR
    • -Assesses for Glomerular disease by quantifying protein leakage in GF
  21. Urine Protein/ Creatinine:
    • -Generally send out 10-15 mls of urine collected by cysto
    • -P:C <1~ normal
    • -P:C 1-5~ fever, high activity, hemoglobinemia
    • -P:C >5~ Renal Disease
  22. What are the 4 things we think of with Pancreas? –
    Amylase, Lipase, Glucose, Trypsin
  23. Amylase
    • -Primary organ is Pancreas- involved in carbohydrate digestion
    • -Not as specific as Lipace
    • -Atleast 2-3 x normal before we think pancreatitis
    • -Often does not raise in cats with pancreatitis
    • -Elevation-Pancreatitis/ disease, renal failure, intestinal disease
  24. Lipase:
    • -Pancreas- involved in fat digestion
    • -More specific than amylase but still need 2-3x elevation to think pancreatitis
    • -Elavation- Pancreatitis/ Disease, Severe GI Disease, Decreased GFR
  25. Glucose:
    • -Indirect measure of pancreatic (endocrine) function
    • -Easier to measure than insulin
    • -FASTED SAMPLE!! And collect in Grey top to prevent breakdown
    • -Decrease- Malnourishment, Insulinoma, young small puppy, Addison’s, Megadoses of Vit C
    • Elevation- Non-fatsed smaple, Diabetes Melitus, Stress/ Epinephrine (SP cows and cats), Cushing’s
  26. What is GFR?
    Glomular Filtration Rate
  27. Fructosamine-
    Becoming standard for diabetes testing
  28. Trypsin
    • -Fecal sample, not blood
    • -Helps Digest Protein
    • -Test: Mix fresh sample with Knox gelatin solution. If present (which it should be) will not set. Will set as gelatin in absent
  29. Electrolytes-
    Carry electrical charge; Cations or anions
  30. Sodium (NA+):
    • -Stabilize Osmotic Pressure
    • -Both high and low extremes can cause neurologic signs and death!
  31. Hyponatremia:
    Dilution, CHF, Liver Disease, Kidney Disease, Addison’s
  32. Hypernatremia:
    Dehydration, ADH deficiency
  33. Potassium (K+):
    • -Proper cardiac function
    • -Nerve muscle function
    • -Resting Membrane Potential
    • -Intracelluar cation
    • -Most in muscle
    • -Either extreme is life-threatening
  34. Hypokalemia:
    Dilution, Polyuria, Diuretic Therepy, CRF, <2.5 à sign of muscle weakness
  35. Hyperkalemia:
    Cellular damage, Insulin deficiency (need to move into cell), ARF, Post-Renal Azotemia, Addison’s, >7.5 àsevere cardiac disturbance
  36. Chloride (Cl-):
    • -Follows Sodium
    • -Major plasma anion
    • -Usually assessed in relation to Na+
  37. Bicarbonate:
    • -Anion
    • -Major Buffer
    • -Key in CO2 transport to lungs
  38. Metabolic Alkalosis=
    Increase in Bicarb
  39. Metabolic Acidosis=
    Decrease in Bicarb
  40. Calcium:
    • -Technically a mineral- 99% housed in bones
    • -# major functions- hemostasis, Structure, and Neuromuscular activity
    • -Calcium and phosphorous usually have inverse relationship
  41. Serum Calcium:
    • -50/50 free vs; protein bound
    • -Albumin concentration can total calcium but not frre
    • -FREE calcium is the only ACTIVE
    • -Only a change in free ionized calcium with show signs
    • -pH will alter how much calcium is free
    • -increase in pHà decrease in Ca++
    • -Decrease in pHà increase Ca++
  42. What does Calitonin do?
  43. Hypocalcemia:
    Hypothyroidism, Vit D dif, Milk fever, CRF
  44. Hypercalcemia:
    Neoplasia(think Lymphoid tumor), toxicity, bone destruction, Hyperthyroidism
  45. Phosphorus:
    • -Typically changes inversely to calcium
    • -80-90% in bones
    • -Major Intracellular anion
    • -Integral to ATP
  46. Hypophosphatemia:
    Increase loss d/t diuretics, Complication of insulin, Hemolysis if severeà CNS signs, ataxia, seizure
  47. Hyperphosphatemia:
    Renal failureà decrease excreation, hyperthyroidism in some cats, hypoparathyroidismà increase phosphate, decrease Calcium