Liver Clin Path

Select all of the markers below that are associated with muscle cell leakage

• LDH

• AST

• Mgb

• CK

• K+ and phosphorus

Which of the following below is the most specific and sensitive indicator of muscle damage?

• Creatine kinase (CK)

• Aspartate transaminase (AST)

• LDH

• Myoglobin (Mgb)

Creatine kinase is found in skeletal muscle, cardiac muscle and the CNS- It also has the ability to cross the BBB.

• True

• False

Answer explanation

Does NOT cross the BBB

Match the following

• 7-8 days

• Creatine kinase half life

• ~2-3 days

• Alanine aminotransferase (ALT)

• ~4 hours

• Aspartate transaminase (AST) half life dog

• <1 day

• Sorbitol dehydrogenase (SDH) half life

• 2-4 hours

• Aspartate transaminase (AST) half life horse

You have a 4 year old patient who you suspect has muscle injury- you note the animal has a high creatine kinase. You ask the tech if the blood draw went okay and she said it was a little difficult and the sample had some hemolysis- what would we be worried about with these results?

• Nothing- start the treatment for muscle injury

• Hemolysis can cause a false positive for CK so we should rerun blood work

• CK is not a specific or sensitive indicator of muscle injury so these results are inconsequential

Select all of the below that are tissue sources for AST:

• hepatocytes

• skeletal muscle

• smooth muscle

• RBC's

• CNS

A 6 year old mare comes into the clinic for weakness and lethargy. You client states she is unsure what is going on she just knows that her horse is acting off. You ask about a history which is unremarkable except that the mare has started seeing a trainer for conditioning this past week and went yesterday. All values are normal except you note a stress leukogram, hyperphosphatemia, hyperkalemia, azotemia and increased AST. What is your top differential?

• Acute kidney injury

• Muscle injury

• Liver insufficiency

• Pancreatitis

In large animals AST is:

• Skeletal muscle leakage enzyme

• Pancreatic leakage enzyme

• Liver leakage enzyme

• orthopedic neoplastic indicator

Answer explanation

AST is a skeletal muscle leakage enzyme in small animals

A 5 year old black lab presents to you for dark urine- the client noticed it after he peed on the sidewalk. On the urine dipstick there is a positive blood reaction and after centrifuging the plasma is red- what is this?

• Myoglobinuria

• Hematuria

• Hemoglobinuria

• Ketonuria

You were sent a sample of dark red urine and it was positive for blood on the urine dipstick- after centrifuge the plasma is clear- what does this indicate?

• Hemoglobinuria

• Hemtaturia

• Myoglobinuria

• Ketonuria