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Clin path lab exam

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pbhati17's version from 2016-11-16 12:35

Section 1

Question Answer
What are some causes of a prerenal azotemia?↑[UN] ↑[CRT] due to ↓renal blood flow -dehydration -shock ↑protein degredation / increased urea prodx -internal hemorrhage ↑[UN] --[CRT]
What are some causes of renal azotemia?↑[UN] ↑[CRT] Acute/chronic renal insuff/failure due to
renal ischeamia/hypoxia
Toxic nephroses
Inflammation
Amyloidosis
Often oliguria/anuria present
What are some causes of post-renal azotemia?An obstruction causes ↓GFR↑[UN] ↑[CRT] Urine leakage would cause ↑[UN] ↑[CRT] but no change in GFR -Urea diffuses faster than Crt
What are some reasons for hypoproteinemia?1)Protein-loss - Hemorrhage -PLN(selective)/PLE/PLD -Parasitism 2)Extravasation of plasma proteins 3)Decreased protein produx - Heptatic insuff(selective) -malabsorption/ maldigestion -Cachectic states
What are some reasons for Hyperproteinemia?Relative -Hemoconcentration Absolute -Inflammation -NeoplasmsL B cell neoplasia/plasma cell myeoloma Multiple myeloma (hyperglobinemia is hallmark)
What are some major causes of Hypoalbuminemia?1)↓ Albumin production by the liver 2)↑ Albumin loss
When we refer to 1)↓ Albumin production by the liver in ref to hypoalbuminemia- what do we mean?↓ Albumin production by the liver - Inflammation - Hepatic insuff - Malabsorption/maldigestion Cachectic states
When we refer to 1))↑ Albumin loss in ref to hypoalbuminemia- what do we mean?↑ Albumin loss - Blood loss - Protein-losing nephropathy - Protein-losing enteropathy Protein-losing dermopathy
What are some causes of Hyperalbunemia?1)Hemoconcentration/dehydration 2)↑ Albumin synthesis 3)steroid tx
When we refer to 1)↑ Albumin synthesis in ref to hyperalbuminemia- what do we mean?False increase due to BCG dye binding
What are some causes of Hypoglobinemia?1)↑ loss from vessels 2)↓ production by liver
What are some general notes about hypoglobinemia?Typically decrease in more than one globulin(nonselective) Decrease in IgG due to Failure of Passive Transfer
What are some causes of Hyperglobinemia?1)Hemoconcentration 2)Inflammation 3)B-lymphocyte neoplasia
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Section 2

Question Answer
What are some broad reasons for Hyponatremia?1)Edematous Disorders 2)Na+losing 3)3rd space loss 4)H20 shift due to hyperglycemia
Some edematous disorders that lead to hyponatremia?Heart failure Cirrhosis
Some Na+ losing condx leading to Hyponatremia?Renal intoxication,
Hypoadrenocorticism - Less aldosterone==>less Na+ conservation,
Diuretics,
Diarrhea
Vomitting,
Intx sequestration
What condx would lead to 3rd space loss and consequently hyponatremia?Uroperitoneum
What are 3 broad reasons for Hypernatremia?1)↓ H2O intake 2)↑ free H2O loss 3)H2O loss>Na+ loss
What are some reasons for↓ H2O intake which lead to Hypernatremia?Restricted access Defective thirst
What are some reasons for ↑ free H2O loss which lead to HypernatremiaDiabetes insipidus Water vapor
What are some causes of Hypokalemia?1)Metabolic alkalosis
2)Prolonged anorexia
3)K+ loss disorders
4)Shift into cells
What are some types of K+ loss disorders that lead to Hypokalemia?Renal
Intestinal
Ketonuria,lactaturia,
HCO3-
Cutaneous loss via sweat(horse)
What are some things that cause K+ to shift into cells and thus, cause hypokalemia?Insulin stimulation
What are some broad causes of Hyperkalemia?1)Metabolic acidosis 2)↓ renal ecretion 3)Pseudohyperkalemia
What are some causes of metabolic acidosis that could lead to hyperkalemia?Inorganic to renal
What are some causes of ↓ renal excretion that lead to hyperkalemia?Oliguric states
renal failure
Urinary obstruction
Uroperitoneum
Addison's
What are some reasons for Psuedohyperkalemia?Hemolysis
Thrombocytosis
memorize

Section 3

Question Answer
What are some broad reasons for Hypochloremia?1)w/↓ [Na] 2)w/↑ [HCO3-] 3)w/↑ [A-]
What are some reasons for w/↓ [Na] that ultimately lead to hypochloremia?Edematous disorders Na+/ Cl- loss Uroperitoneum
What are some reasons for w/↑ [HCO3-] that ultimately lead to hypochloremia?Vomiting Abomasal disorders Hypokalemia
What are some reasons for w/↑ [A-] that ultimately lead to hypochloremia?Ketoacidosis Lactic acidosis
What are some broad reasons for Hyperchloremia?1)w/↑ [Na] 2)w/↓ [HCO3-] 3)Bromide
What are some reasons for w/↑ [Na] that ultimately lead to hyperchloremia?↓H2O intake ↑ free H2O loss
What are some reasons for w/↓ [HCO3-] that ultimately lead to hyperchloremia?Diarrhea Renal Tubular Acidosis
What are some reasons for Bromide that ultimately lead to hyperchloremia?False increase in Cl- due to presence of Bromide (the test measures halides but not specific ones)
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Section 4

Question Answer
What are the major mechanisms behind metabolic acidosis?1)↓ renal loss of H+ 2)↑ H+ prodx(hypoxia) 3)↑ [HCO3-] loss
What are some reasons for ↓ renal loss of H+ that would ultimately lead to metabolic acidosis? Renal failure
What are some reasons for ↑ H+ prodx (hypoxia) that would ultimately lead to metabolic acidosis?Lactic acidosis Ketoacidosis
What are some reasons for ↑ [HCO3-] loss that would ultimately lead to metabolic acidosis?Some diarrheas Proximal renal tubular acidosis
What are some broad reasons for Metabolic Alkalosis/ ↑ [HCO3-]?1)Abomasal 2)Vomiting(subs loss Cl-) 3)Hypokalemia
What are some ways in which the abosmasum can cause a metabolic alkalosis? If it's -displaced -torsion 
What are some ways vomiting can cause metabolic alkalosis?Pyloric obx/others
What are some mechanisms for primary respiratory acidosis?1) Impaired gas exchange 2)Decrease respiratory center 3)Upper airway obstruction 4)Decrease in respiratory muscles 5)Mechanical hypoventilation(anx)
What are the causes of impaired gas exchange that can ultimately lead to respiratory acidosis?Pulmonary Restrictive disease
What are the causes of a decreased respiratory center that can ultimately lead to respiratory acidosis?drugs disease alkalemia
What are the causes of idecreased respiratory muscles that can ultimately lead to respiratory acidosis?Drugs Disease
What are some mechanisms for primary respiratory alkalosis?1) increased alveolar ventilation due to -Hypoxia -Pain/anxiety -mechanical hyperventilation -other respiratory stimuli
What are the normal values for respiratory acidosisdecrease in pH Increase in PaCO2 HCO3 is WRI/unchanged
What are the values for respiratory acidosis w/ comp metabolic alkalosis?the pH is decreased/WRI the PaCO2 and HCO3 are both increased
What are the values of metabolic acidosis?Decreased pH PaCO2 WRI Decreased HCO3
What are the values of metabolic acidosis w/ comp resp alkalosisdecrease/WRI pH and decreased PaCO2 decreased HCO3
What are the values for respiratory alkalosisincrease/WRI pH decrease PaCO2 decreased HCO3-
What are the values for metabolic alkalosis?ncreased pH PaCO2 WRI HCO3- Increased
What are the values for metabolic alkalosis w/ resp acidosis?Increase/WRI pH Increased PaCO2 Increased HCO3-
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Section 5

Question Answer
What are some broad causes for Hypocalcemia?1)Hypoalbuminemia/hypoproteinemia 2)Primary Hypoparathyroidism 3)Hypovitaminosis D 4)Increased Urinary excretion 5)Pregnancy, parturient,lactational 6)Other -acute pancreatitis -Urinary tract obx -PO4 enema -Blister beetle poisoning -Myopathies -Rumen overload
What are some ways Hypovitaminosis D might occur- ultimately leading to Hypocalcemia?Chronic renal dz
What are some reasons for increased urinary excretion- ultimately leading to hypocalcemia?Furosemide Anions
What are some broad causes of Hypercalcemia?1)Primary hyperparathyroidism 2)HUmoral Hypercalcemia of Malignancy 3)Hypervitaminosis D
What are some examples of HHM that ultimately lead to Hypercalcemia?PTH-rp usually Neoplasms -Canine lymphoma -canine apocrine gland carcinoma
What are some causes of Hypervitaminosis D that ultimately lead to Hypercalcemia?Exogenous -Vit D supp -Vit D rodenticide Endogenous -granulomatous inflammation
What are some reasons for hyperphosphatemia?High GH decreases the excretion of phosphates
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