Term
| Mnemonic for the causes of hypercalcemia |
|
Definition
Hyperparathyroidism
Osteolysis
Granulomatous disease
Spurious (usually an artifact of lipemia)
Idiopathic (cats)
Neoplasias (lymphosarcoma or anal sac adenocarcinoma)
Young animals
Addison's disease
Renal failure (horses)
hypervitaminosis D |
|
|
Term
| Seven common causes of hypocalcemia |
|
Definition
Hypoparathyroidism
Hypovitaminosis D
Milk fever
Ovine pregnancy toxemia
Acute pancreatitis
Ethylene glycol toxicosis
Chronic renal disease
Idiopathic in dogs |
|
|
Term
| Why does chronic renal disease produce hypocalcemia? |
|
Definition
|
|
Term
| Is ionized calcium higher or lower in acidemia? |
|
Definition
| Higher! Ca++ and H+ compete for space on proteins, so acidemia lowers the protein-bound Ca++ fraction. |
|
|
Term
| Insulin's impact on phosphate |
|
Definition
| Insulin shifts phosphate into cells, which may cause hemolysis if severe |
|
|
Term
| How is hemoglobin A1c measured? |
|
Definition
|
|
Term
| How is fructosamine measured? |
|
Definition
|
|
Term
| 2 causes of low PO4 & normal Ca++ |
|
Definition
Decreased dietary phosphate
Hyperinsulinemia |
|
|
Term
| 2 causes of low PO4 & low Ca++ |
|
Definition
Hypovitaminosis D
Milk fever |
|
|
Term
| Other than ileal malabsorption, what may cause a cobalamin deficiency in cattle? |
|
Definition
| Nutritional COBALT deficiency |
|
|
Term
| 3 causes of low Ca++ and normal PO4 |
|
Definition
Hypoalbuminemia
Acute pancreatitis
Ethylene glycol toxicosis |
|
|
Term
| THREE test results with a protein-losing enteropathy |
|
Definition
HIGH fecal α1-PI (measured in feces)
Low albumin
Low globulin |
|
|
Term
| What happens to Ca++ and Mg in a citrated or EDTA blood collection tube? |
|
Definition
| Both Ca++ and Mg are artifactually lowered |
|
|
Term
| Four causes of high NEFAs |
|
Definition
Hepatic lipidosis (fatty change!!)
Diabetes mellitus
poor nutrition
Obesity |
|
|
Term
|
Definition
| CRH from the hypothalamus |
|
|
Term
| These two processes depend on Mg |
|
Definition
PTH release and function
Renal K+ retention
**Mg loss will result in low Ca and K, and efforts to correct either will be fruitless without magnesium |
|
|
Term
| Calcification of soft tissue may occur when how much of what minerals is high? |
|
Definition
|
|
Term
| 3 common causes of hypomagnesemia |
|
Definition
Low protein (affects protein-bound fraction)
Low dietary intake (eg grass tetany in cattle)
High renal loss (osmotic diuresis) |
|
|
Term
| 2 causes of hypermagnesemia |
|
Definition
Milk fever
Low renal excretion |
|
|
Term
| Proper name for milk fever |
|
Definition
|
|
Term
| Decreased bicarb and chloride indicates what A/B disturbance? |
|
Definition
Metabolic alkalosis
Metabolic acidosis (usu renal)
(AKA a mixed A/B disturbance!) |
|
|
Term
| What are the unmeasured anions in renal metabolic acidosis? |
|
Definition
|
|
Term
| Why might there be an increased anion gap if bicarb is normal? |
|
Definition
| A mixed metabolic acidosis/alkalosis |
|
|
Term
| Four causes of an increased Ca++ with normal phosphate |
|
Definition
Neoplasia (humoral hypercalcemia of malignancy)
Addison's
Granulomatous disease
Idiopathic (cats) |
|
|
Term
| 3 hormones that increase blood glucose |
|
Definition
cortisol & epinephrine
glucagon
growth hormones |
|
|
Term
| 4 reasons the liver can't maintain euglycemia in the face of fasting? |
|
Definition
starvation
hepatic lipidosis / liver disease
cachexia
neonates (piglets, toy breed puppies) |
|
|
Term
| 5 causes of fasting hyperlipedmia |
|
Definition
1. obesity (metabolic syndrome)
2. diabetes mellitus
3. Cushing's
4. hypothyroidism
5. Schnauzer |
|
|
Term
What causes a transudate?
What causes an exudate? |
|
Definition
Transuates are caused by disturbances of circulation.
Exudates are caused by infection of pleura/peritoneum. |
|
|
Term
| 4 "special" exudative fluids |
|
Definition
|
|
Term
| 3 ways to derange fluid circulation |
|
Definition
1. decrease oncotic P
2. increase hydrostatic P
3. decrease lymphatic drainage |
|
|
Term
| Where does a protein-poor transudate originate? What about a protein-rich? |
|
Definition
| A protein-rich transudate originates at a site of large capillary fenestrations, like the liver or lungs. Normal capillary bed disturbances produce a protein-poor transudate. |
|
|
Term
| 2 ways a protein-rich transudate occurs in the abdomen |
|
Definition
1. impeded liver drainage (liver disease or venous outflow - abdominal)
2. increased hydrostatic P in liver sinusoids (RSCHF - thoracic) |
|
|
Term
Characterize a:
1. protein-poor transudate
2. protein-rich transudate
3. exudate |
|
Definition
1. TP < 2, TNCC < 1500, mononuclear cells, clear
2. TP < 2, TNCC < 5000, mononuclear cells, light yellow
3. TP > 2, TNCC > 5000, PMN cells, variable |
|
|
Term
| 3 causes of bicavitary effusions |
|
Definition
1. Right-sided CHF
2. Generalized disease (cancer, FIP, coagulopathy)
3. [RARE] tear in diaphragm |
|
|
Term
| Will a diaphragmatic tear cause abdominal fluid to enter the thorax or thoracic fluid to enter the abdomen? |
|
Definition
| Abdominal effusion leaks into the thorax |
|
|
Term
| Character of acute vs. chronic uroabdomen |
|
Definition
Acute uroabdomen is usually transudative
Chronic uroabdomen is usually exudative |
|
|
Term
|
Definition
Chyle is mildly irritating chronically
Bile is very caustic and irritating
Both produce an exudate |
|
|
Term
| Difference between hemorrhagic effusions and blood |
|
Definition
| There are no platelets in hemorrhagic effusions |
|
|
Term
Lipase levels with pancreatitis
(in blood and in the effusion) |
|
Definition
High in blood
Higher in effusion |
|
|
Term
| Characterize a septic effusion |
|
Definition
|
|
Term
| Characterize an effusion due to a strangulating lesion (like in a horse) |
|
Definition
|
|
Term
| 4 causes of high cortisol |
|
Definition
Pituitary- or adrenal-dependent hyperadrenocorticalism
Iatrogenic glucocorticoids
Chronic stress
[RARE] Ectopic ACTH tumor production |
|
|
Term
| 3 mechanisms of low cortisol |
|
Definition
Addision's:
1. pituitary gland destroyed
2. adrenal glands destroyed
3. abrupt cessation of corticosteroids |
|
|
Term
| Lots of NaHCO3 indicates what state? |
|
Definition
| Hypochloremic metabolic alkalosis |
|
|
Term
Components of chyle
Appearance of chyle |
|
Definition
Triglycerides + lymphocytes
Milky white |
|
|
Term
| Interpret the various results of a HDDST |
|
Definition
Suppressed at 4 & 8 hours: PD Cushing's
Suppressed at 4 OR 8 hours: probably PD
Never suppressed: dunno |
|
|
Term
| Interpret possible results of ACTH stim test |
|
Definition
No response: Addison's (highly specific!)
Normal response: normal
Exaggerated response: Cushing's |
|
|
Term
| What does EPI cause a decrease in? |
|
Definition
|
|
Term
|
Definition
Ca & PO4 absorption into bone
Decreased renal Ca & PO4 resorption |
|
|
Term
| How to test for pancreatitis |
|
Definition
high amylase & lipase
high cPLI or fPLI
[high TLI] |
|
|
Term
| Why do some neoplasias produce high calcium? What is this called? |
|
Definition
PTP-rP
Humoral hypercalcemia of malignancy |
|
|
Term
| This is consistent with insulinoma |
|
Definition
High insulin
High insulin:glucose ratio |
|
|
Term
|
Definition
| Some inflammatory reactions, such as Ehrlichia, produce closely spaced gamma globulins that can look almost monoclonal |
|
|
Term
| Proteins that have been permanently bound to glucose |
|
Definition
Fructosamine
This test differentiates prolonged hyperglycemia from stress spike |
|
|
Term
| 2 endocrine causes of pancreatitis |
|
Definition
Diabetes mellitus
Cushing's |
|
|
Term
| Severe pancreatitis may lead to what 2 things? |
|
Definition
|
|
Term
| How to diagnose exocrine pancreatic insufficiency |
|
Definition
|
|
Term
Low cobalamin
High folate
Low TLI |
|
Definition
|
|
Term
| 2 glycolated protein tests |
|
Definition
Fructosamine
Hemoglobin A1c |
|
|
Term
Low cobalamin
Normal folate
Normal TLI
**TWO causes! |
|
Definition
Ileal malabsorption
[RARE] Congenital cobalamin defect |
|
|
Term
| Lipemia is marked by an excess of one or more of these compounds |
|
Definition
Chylomicrons
Very low density lipoproteins
Intermediate density lipoproteins |
|
|
Term
| What is the cholesterol test a measure of? |
|
Definition
|
|
Term
| Total triglyceride test is a measure of what? |
|
Definition
Chylomicrons, VLDL, & IDL
(these are the biomarkers of LIPEMIA!) |
|
|
Term
| 2 ion changes in metabolic alkalosis |
|
Definition
|
|
Term
Low cobalamin
High folate
Normal TLI |
|
Definition
|
|
Term
2 mechanisms of metabolic acidosis:
1) high anion gap
2) normal anion gap |
|
Definition
1) Increase in unmeasured anions
-lactic acidosis
-renal acidosis
2) Loss of bicarb (with a high Cl) |
|
|
Term
| Machine's formula for the anion gap |
|
Definition
| anion gap = Na + K - Cl - HCO3 |
|
|
Term
| 3 possible things found in the anion gap |
|
Definition
Renal acids (PO4 & SO4)
Organic acids
Exgenous acids |
|
|
Term
|
Definition
1) Cl is lost -> Na+ is resorbed with BICARB instead of Cl- in PCT
2) K+ is lost -> Na+ is exchanged for H+ instead of K+
Therefore in both cases an alkalotic patient has acidic rather than alkalotic pee! |
|
|
Term
| 2 causes of lactic acidosis |
|
Definition
Hypoxia
Massive muscle damage |
|
|
Term
|
Definition
1) diarrhea
2) GI obstruction, ileus, sequestration
3) Excessive salivation (cows)
4) Type II renal tubular acidosis (HCO3 not resorbed) |
|
|
Term
| Consequence of inorganic metabolic acidosis |
|
Definition
| H+ is taken into cells, and K+ is released -> Hyperkalemia |
|
|
Term
| How does ethylene glycol alter acid/base balance? |
|
Definition
Azotemia + acid production
These mechanisms work together to produce a severely high anion gap! |
|
|
Term
| 6 sources for acid accumulation, leading to a metabolic acidosis |
|
Definition
1) lactic acidosis
2) renal acidosis
3) ketosis
4) metabolism of toxins to acid intermediates (e.g. ethylene glycol)
5) hyperalbuminemia
6) type I renal tubular acidosis |
|
|
Term
| Lab findings in pancreatitis (6 categories) |
|
Definition
High amylase, lipase, and PLI
High ALP, CHOL, and T.bili (cholestasis)
Low Ca++
Inflammatory leukogram
Dehydration (high TPP & prerenal azotemia)
Vomiting (hypochloremic metabolic alkalosis) |
|
|
Term
| 4 causes of metabolic alkalosis |
|
Definition
1) vomiting
2) abomasal displacement
3) diuretics (with loss of K+ & Cl-)
4) compensation of respiratory acidosis
5) Cl- losing diarrhea |
|
|
Term
| 3 screening tests for Cushing's disease |
|
Definition
Urinary cortisol:creatinine ratio
ACTH stimulation test
Low dose dexamethasone suppression test |
|
|
Term
| 3 differentiation tests between PDH & ADH |
|
Definition
Endogenous ACTH test
LDDST
HDDST
** imaging also very useful! |
|
|
Term
2 types of Cushing's syndromes
& which is more common? |
|
Definition
Pituitary-dependent hyperadrenocorticalism -more common!
Adrenal-dependent hyperadrenocorticalism |
|
|
Term
| 3 causes of high PO4 & low Ca |
|
Definition
1. hypoparathyroidism
2. phosphate enema
3. rhabdomyolysis |
|
|
Term
| 3 causes of high PO4 and normal Ca |
|
Definition
1. Young, growing animal
2. Low GFR
3. Clotted blood sample |
|
|
Term
| 2 causes of high PO4 and high Ca |
|
Definition
1. 6-24 week-old puppy
2. Hypervitaminosis D |
|
|
Term
| 3 causes of a LOW anion gap |
|
Definition
1. Hypoalbuminemia (decrease in anionic proteins)
2. Monoclonal gammopathy (increase in cationic proteins)
3. Hypercalcemia |
|
|
