BioMed 4100/7100

Veterinary Clinical Chemistry

COURSE PROFILE

Course DescriptionThis course of Veterinary Clinical Chemistry is designed to hone the skills of the practicing Veterinary Technician, Veterinary Student or Veterinarian and assumes some basic knowledge of normal chemistry and urinalysis results. The review of normal will be minimal and emphasis will be placed on clinical chemistry and urinalysis findings associated with diseases. Higher level course will include discussion of ancillary tests and more extensive case interpretations.

InstructorAngela Royal, DVM, MS, Diplomate ACVP (Clinical Pathology)

A344 Clydesdale

(573) 882-0086

Tamara Hancock, DVM, MS

Linda M. Berent, DVM, PhD, Diplomate ACVP (Clinical and Anatomic Pathology)

203 Vet Med Building

(573) 884-6774

Major Objectives

  1. Explore the common types of instrumentation used to assess blood chemistry in domestic mammals.
  2. Discover potential sources of error in blood chemistry and blood gas analysis and learn how to minimize these risks.
  3. Investigate quality control guidelines for in-house chemistry analyzers.
  4. Learn what analytes are typically included on complete chemistry panels, “liver panels”, and “renal panels” in small and large domestic mammals.
  5. Learn how to perform a complete urinalysis.
  6. Interpret chemistry panel, urinalysis, and blood gas data to evaluate the hepatobiliary system, gastrointestinal tract, kidneys, and lower urinary tract of domestic mammals.
  7. Understand the major differences in chemistry analysis of exotics and avian species as compared to domestic mammals.

7100 level students will explore weekly topics in more detail and will be provided more opportunities for case interpretation.

Prerequisites4100 level - An AAS or equivalent degree in veterinary technology from an American Veterinary Medical Association-accredited program. Undergraduate level physiology course focused on mammals required (AnSci 3254, BioSc 3700, or similar). Biomed 3200 (Comparative Hematology) is highly recommended. Medical terminology course recommended.

7100 level – DVM degree or equivalent

DeliveryStudents are not required to attend class at regular times; however, it is important that they follow the attendance/participation guidelines and meet due dates and deadlines for readings, assignments, discussions, quizzes, and exams. Communications will be through the discussion board, announcements, and emails. Real time video conferencing is possible on request. Course delivery strategies may include: reading from required textbook(s), reading resources linked to the internet, brief audio or audio/video lectures, assigned projects, use of the discussion board, use of the internet, and e-mails.

OrganizationCourse materials are located under the left-hand tab in the course Blackboard site under “Units”. “Sessions” are found under “Units” and “Modules” under “Sessions”. Further directions are provided in Blackboard.

Required Materials 4100 level: Clinical Pathology for the Veterinary Team. Rosenfeld and Dial. Wiley-Blackwell 2010.

7100 level: Stockham and Scott, Fundamentals of Veterinary Clinical Pathology. 2nd edition, 2008

EVALUATION OF

STUDENT

PERFORMANCE

Satisfactory

PerformanceUndergraduate Students (4100): Points will be earned via weekly participation in discussions, blogs, and assignments. Assignments will focus on application of weekly concepts to veterinary nursing and other “real world” scenarios, including basic interpretation of chemistry panel and urine analysis data. There will be several proctored exams andun-proctored timed quizzes. Students will be allowed to drop their lowest exam score.

Graduate Students (7100): Points will be earned via weekly participation in discussions, blogs, and assignments. Weekly topics will follow the same pattern as for the 4100 level of the course; however graduate students will be presented with more advanced aspects of these topics and will have more in-depth reading assignments. As such, graded assignments will also require more in-depth analysis and interpretation of weekly concepts. Advanced chemistry panel and urine analysis interpretation will be assessed through some of the weekly assignments and via a writing-intensive case interpretation project completed by the last week of the course. There will be several proctored exams andun-proctored timed quizzes; frequency of these assessments will be the same in both the 4100 and 7100 level, but material tested in the graduate level course will be accordingly more advanced.

Exams and QuizzesExams are available only under the supervision of a proctor. Fifty minutes will be allowed for exams.

A quiz is not proctored, but you are expected to complete the quiz by yourself. The quiz is timed so that you will not have time to rely on reference materials, i.e. they are not open-book quizzes.

If you take more time than the quiz or exam allows, your score will be deducted the points of one question each minute in overtime.

You may take a quiz or exam only once. You must complete the exam or quiz once you start it. You may NOT come back to the quiz later. If you are disconnected during an exam, contact the instructor immediately and then send an e-mail to with your name, username, course name, title of the quiz or exam, and a description of the problem. To ensure your answers are logged, click “Save” at the bottom of the page every 2 to 3 questions. Click “Submit” after you have reviewed your answers to have the quiz or exam graded.

Undergraduate students (4100 level) will have their lowest exam score omitted when calculating their course grade; only three exam scores will be included in the total points for BioMed 4100. All four exams will be included in the total points for BioMed 7100.

Scoring of Assignments

GradingThe grading scale will be A to F, including some pluses and minuses but no A+, C+, C-, D+, or D-. Grades will be based on the following scale:

96-100% = A

91-95% = A-

88-90% = B+

84-87% = B

81-83% = B-

71-80% = C

61-70% = D

60% or less =F

Graduate grading will not include +/-

90-100% = A

80 – 89% = B

70-79% = C

65-69% = D

64% or less =F

Note: A Certificate in Biomedical Technology requires at least a “C” grade in this course, plus a total of 15 crhr BIOMED courses with an average GPA in all BIOMED courses of 3.0.

COURSESCHEDULE

Date / Topics: Undergraduate / Reading Assignments / Assignments/Quizzes/Tests(Points)
Graduate level: (g)
Week 1 /
  1. Syllabus review, black board introduction
  2. Introduction to clinical chemistry
  3. Instrumentation
/ Syllabus
Chapter 1
Tegrity / Assignment/Discussion Board
(g) Advanced instrumentation/methodology / (g) Chapter 1
Week 2 /
  1. Reference intervals - concepts
  1. Creating reference intervals
/ Chapter 1
Tegrity
Journal/web reference / Assignment
Quiz
(g) Reference intervals - advanced / (g)Chapter 1
Journal/web reference
Week 3 /
  1. Sample handling, pre-analytical sources of error
  2. Quality control – concepts
  3. Quality control - implementation
/ Chapter 1
Tegrity
Journal/web reference / QC Assignment
(g) Advanced quality assurance and quality control / (g) Chapter 1
Journal/web reference
Week 4 /
  1. Standard operating procedures
  2. Purchasing instruments – evaluating performance
  3. Purchasing instruments – cost analysis
/ Chapter 1
Tegrity / Cost analysis assignment
(g) Method comparison / (g) Chapter 1
Journal/web reference
Week 5 /
  1. Hepatobiliary enzymes
  2. Muscular and pancreatic enzymes
/ Chapter 6
Tegrity / Exam 1
Case interpretation assignment (enzymes)
(g) Ancillary tests for pancreatitis, advanced interpretation of enzyme alterations / (g) Chapter 12
Journal/web reference
Week 6 /
  1. Bilirubin
  1. Routine liver function parameters on a chemistry panel
  2. Additional options for assessing liver function
/ Chapter 6
Tegrity / Case interpretation assignment
Quiz
(g) Advanced interpretation of liver function / (g) Chapter13
Week 7 /
  1. Glucose
  1. Lipids
ii. Proteins / Chapter 7
Tegrity / Assignment
(g) Advanced diagnostics for diabetes mellitus, exocrine pancreatic insufficiency / (g) Chapter 13,15,16 (select portions)
Week 8 /
  1. Calcium, phosphorus, and magnesium homeostasis in health
  2. Calcium, phosphorus, and magnesium pathology
/ Chapter 8
Tegrity /
  1. Exam #2
  2. Assignment

(g) Advanced interpretation of mineral disorders, PTH, and PTHrp / (g) Chapter 12
Week 9 /
  1. Renal physiology review
  2. BUN, creatinine
  3. Evaluating azotemia
/ Chapter 5
Tegrity / Assignment
Quiz
(g) Additional methods to evaluate GFR, Advanced interpretation of azotemia / (g) Chapter 8
Journal/web reference
Week 10 /
  1. Sodium
  2. Chloride
  3. Potassium
/ Chapter 8
Tegrity / Electrolyte patterns assignment
(g) Advanced electrolyte interpretation / (g) Chapter 9
Journal/web reference
Week 11 /
  1. Bicarbonate, anion gap
  1. Blood gas analysis – procedure
  2. Blood gas analysis - interpretation
/ Chapter 12
Tegrity / Acid/Base assignment
(g) Advanced acid:baseinterpretation / (g) Chapter 9, 10 (select portions)
Journal/web reference
Week 12 /
  1. i. Urine analysis – sample collection, gross properties
  2. Urine analysis – chemical properties
/ Chapter 9, 10
Tegrity / Exam 3
Assignment
(g) Fractional excretion, urinary enzyme interpretation / (g) Chapter 8
Journal/web reference
Week 13 /
  1. Urine analysis – procedure for urine sediment examination
  2. Urine analysis – microscopic evaluation of urine sediment
  3. Urine analysis –ancillary testing
/ Chapter 9, 10
Tegrity / Assignment
Quiz
(g) Uncommon and challenging urine analysis abnormalities / (g) Chapter 8
Journal/web reference
Thanksgiving Break Nov 24-28
Week 14 / i. Exotics clinical chemistry - mammals
ii. Exotics clinical chemistry – avian
iii. Exotics clinical chemistry - others / Tegrity
Journal/web reference(s) / Assignment
(g) Advanced interpretation of clinical chemistry data in exotic species
Week 15 / i Review
ii. Complete chemistry panel and urine analysis interpretation / Tegrity / 4100: Assignment
7100: Written case interpretations
(g) Advanced case interpretation
Finals week / Exam will open Dec 15-17. / Exam #4