1 – Introduction

Question 1

What is the minimum database?

Answer 1

BCB
Biochemistry panel
urinalysis

Question 2

What are the 4 components of a CBC?

Answer 2

Erythrogram, Leukogram, Thrombogram, Smear evaluation
*run on anti-coagulated blood

Question 3

What is a biochemistry panel?

Answer 3

• Usually run on serum
• panel of >20 tests
  o Measured analyte or enzyme activity
  o Calculate value
  o Organized in body systems approach
• *evaluate organ function/damage, homeostasis

Question 4

Urinalysis

Answer 4

Physical: gross and USG
Dipstick: chemical constituents
Microscopic: presence of crystals, cells, organisms

Question 5

What is hemostasis?

Answer 5

-Ability of blood to clot when needed
- Platelets: primary and platelet count part of CBC
- Coagulation testing: secondary (PT, PTT), inhibitors of hemostasis and global hemostasis

Question 6

What is cytology?

Answer 6

Microscopic evaluation of cells obtained via fine needle aspiration, impression smears or in fluids
- Can shorten the differential list or even make a definitive diagnosis

Question 7

What are reference interval limitations?

Answer 7

• 5% chance normal animal will fall outside RI but not clinically relevant
  o If panel with 20 tests, 64% chance one result will be outside reference interval
• *breed and age related differences
• Healthy and non-healthy animals can overlap (‘false negatives and false positives’)
• *panel is also only a snap shot in time

Question 8

What is total protein divided into?

Answer 8

Albumin + ‘globulins’

Question 9

Where are most proteins produced?

Answer 9

Liver, except immunoglobulins

Question 10

What is the difference between plasma and serum?

Answer 10

Plasma: contains fibrinogen
Serum: does NOT contain fibrinogen

Question 11

Plasma total protein (CBC)

Answer 11

Measured by refractometry
-fibrinogen reported in large animals

Question 12

TP and albumin are measured values: but globulin and A:G ratio are calculated values

Answer 12

• Globulin=total protein – albumin
• A:G ratio: albumin divided by globulin
  o Helps to ID cause of change in serum protein

Question 13

What is panhyperproteinemia?

Answer 13

• Increased albumin and globulin
  o Normal A:G ratio
• Ex. dehydration

Question 14

What is panhypoproteinemia?

Answer 14

• Decreased albumin and globulin
  o Normal A:G ratio
• Ex. acute blood loss
• Ex. overzealous fluid therapy
• Ex. non-selective protein-loss
• Ex. Cavitary effusions

Question 15

What is selective hypoalbuminemia (+/- hypoproteinemia)?

Answer 15

• Decreased albumin, normal globulin
  o Decreased A:G ratio
• Ex. protein losing nephropathy
• Ex. starvation (wildlife)
• Ex. cachexia
• *rare to see low albumin with low protein intake (unless starvation)

Question 16

What is acute inflammation in regards to A:G ratio?

Answer 16

• Decreased albumin, increased globulin
  o Decreased A:G ratio
• increased albumin: decreased hepatic synthesis (negative APP)
• increased globulins: increased synthesis of positive APP

Question 17

What is selective (marked) hyperglobulinemia?

Answer 17

• Normal albumin, markedly elevated globulin, decreased A:G ratio
• Usually results in increased total protein (hyperproteinemia)
• Ex. chronic antigenic stimulation
• Ex. neoplasia
• *serum protein electrophoresis can be used to differentiate

Question 18

What is selective hypoglobulinemia (+/- hypoproteinemia)?

Answer 18

• Normal albumin, decreased globulin, increased A:G raio
• Adults: NOT clinically significant
• Young animals:
  o Mild: lack of antigenic stimulation
  o Marked: acquired or inherited immunodeficiency

Question 19

What is hepatic dysfunction/failure and A:G ratio?

Answer 19

• Decreased albumin, variable globulin and AG ratio
• Ex. low albumin from decreased hepatic synthesis
• Ex. concurrent inflammation may increase Ig synthesis and mask a decrease in globulins or even result in high globulins

Question 20

What are the steps to interpreting serum proteins?

Answer 20

1. Describe the protein values: hypo, hyper or normal
2. ID the protein pattern
3. Identify most likely differential(s)
4. Does it make sense with the clinical picture?