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Blood work interpretation Flashcards

1
Q

Why may haematocrit (HCT) or RBC be increased?

A

Artifact
Concentration - Dehydration (common), splenic contraction (horses commonly)
Absolute increase in RBC mass - Polycythaemia or inappropriate erythropoietin secretion

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2
Q

Why may haematocrit (HCT) or RBC be decreased?

A

Artifact
Concentration - IV fluid dilution or splenic relaxation (anaesthetics/tranquilizers)
Anaemia - Haemorrhage, haemolysis, decreased production

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3
Q

Why may haemoglobin be increased?

A

Artifacts
Iatrogenic - Oxyglobin therapy
Concentration - Dehydration, splenic contraction
Anaemia

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4
Q

Why may haemoglobin be decreased?

A

Concentration - Iv fluid dilution, splenic relaxation
Anaemia

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5
Q

Why may mean cell volume (MCV) increase?

A

Artifact
Breed - Greyhounds, Miniature and Toy Poodles
Regenerative anaemia
Folate and Vitamin B12 deficiency
Hyperthyroidism (in some cats)

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6
Q

Why may mean cell volume (MCV) decrease

A

Artifact - excess EDTA, hyponatremia
Age - young
Breed - Akitas, Shiba Inu, Shar pei, Husky
Iatrogenic - chloramphenicol, lead
Iron deficiency/ excess zinc
Portosystemic shunts

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7
Q

Why may MCHC decrease

A

Anaemia - regenerative, iron deficiency
Portosystemic shunts
Lead poisoning, vitamin B6 or copper deficiency (uncommon)
RBC swelling

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8
Q

Why may nRBC increase?

A

Bone marrow injury - sepsis, heat stroke, endotoxemia
Dyserythropoeisis - Neoplasia, macrocytosis
Splenic dysfunction - Hemangiosarcoma, exogenous corticosteroids, post-splenectomy
Heat stroke

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9
Q

Why may reticulocytes be increased?

A

Regenerative anaemia
Compensated haemolytic anaemia
Absolute polycythaemia

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10
Q

Why may neutrophils be increased

A

Can increase in stress and inflammation.

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11
Q

When do neutrophil levels decrease

A

Acute endotoxaemia
Decreased bone marrow production
Increased tissue migration
Increased destruction

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12
Q

Why does left shift occur?

A

Severe/acute inflammation where bone marrow can’t keep up with production of WBCs to tackle pathology, This causes the release of immature neutrophils and causes ‘left shift’.

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13
Q

What causes variation in lymphocyte numbers?

A

Most common is physiologic or age-related lymphocytosis. In adults, consider leukaemia and lymphoma. Causes can be iatrogenic e.g corticosteroids

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14
Q

Why may platelet levels increase

A

Reactive or neoplastic thrombocytosis causes.

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15
Q

What causes a rise in sodium

A

Artifact
Iatrogenic - hypertonic IVFT
Water deficit
Salt gain - intake or retention

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16
Q

What causes a decrease in sodium

A

Artifact
Iatrogenic - hypotonic IVFT
Volume overload - CHF, hepatic disease, renal failure
Hypovolaemic hyponatremia

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17
Q

What causes an increase in potassium

A

Artifacts
Iatrogenic - IVFT or K+ supplementation
Transcellular shift
Decreased renal excretion

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18
Q

What causes a decrease in potassium

A

Artifact
Decreased intake - anorexia
transcellular shift - metabolic alkalosis etc.
Increased loss - V+, stasis, torsion, renal

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19
Q

What causes an increase in chloride

A

Artifact
Iatrogenic - Hypertonic IVFT
Metabolic acidosis
Bicarbonate loss - hyperchloremic metabolic acidosis

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20
Q

What causes a decrease in chlorine

A

Iatrogenic - loop diuretics, sodium-rich fluids
Loss of Cl- rich fluid

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21
Q

What are the causes of hyperglycaemia

A

Physiologic
Iatrogenic - Drugs inducing insulin resistance
Sustained - Lack of insulin, diabetes, hyperadrenocorticism, acromegaly

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22
Q

What are causes of hypoglycaemia

A

Artifact
Iatrogenic - insulin administration
Decreased production - Glycogen storage disease, juvenile hypoglycaemia, hepatic insufficiency
Decreased intake
Increased use
Increased insulin secretion

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23
Q

What are causes of increased urea nitrogen?

A

Increased protein catabolism
Increased protein digestion
Decreased GFR

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24
Q

What are causes of decreased urea nitrogen

A

Decreased protein intake - diet, young animals
Decreased production - Hepatic disease
Increased excretion - Causes of polyuria
Increased GFR - Portosystemic shunts

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25
Q

What are causes of increased Creatinine?

A

Artifact
Physiologic
Decreased GFR

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26
Q

What are caused of decreased creatinine?

A

Physiologic
Decreased production - starvation, decreased muscle mass
Increased GFR - Portosystemic shunts

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27
Q

Causes of increased uric acid

A

Artifact
Renal disease - decreased GFR, loss of >70% functional renal capacity
Increased deposition - articular gout

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28
Q

What are causes of increased bilirubin?

A

Physiologic
Increased production
Decreased hepatic uptake
Decreased hepatic conjugation
Inherited

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29
Q

What are the causes of increased ALP?

A

Physiologic - young, breed
Iatrogenic - liver injury, anticonvulsants, thyroxine
Hepatobiliary - cholestasis
Endocrine - Hyperthyroidism
Bone - Hyperparathyroidism

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30
Q

What causes increased GGT?

A

Physiologic - neonates
Iatrogenic - Biliary injury or cholestasis, anticonvulsants
Hepatobiliary - hyperplasia, cholestasis

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31
Q

Causes of increased ALT

A

Artifact
Iatrogenic - liver injury from drugs
Hepatic injury - Many causes
Muscle - Severe muscle injury, aortic thromboembolism, myopathies, trauma

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32
Q

What are the causes of increased AST?

A

Artifact
Iatrogenic - liver injury, anticonvulsants
Physiologic
Liver - Injury of any cause
Muscle - Myopathies, trauma, WMD, dystrophy

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33
Q

What causes increases of CK?

A

Artefact
Physiologic - age, post-exercise, anorexia
Iatrogenic - muscle injury, I/M injection, irritant drugs, post-surgery
Muscle injury - nutritional, inherited, toxin

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34
Q

What causes an increase in LDH?

A

Artifact
Physiologic - exercise
Liver injury
Muscle injury
Neoplasia

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35
Q

What causes an increase in total protein?

A

Dehydration
Increased albumin
Increased globulins

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36
Q

What causes a decrease in total protein?

A

Blood loss
Protein-losing enteropathy
Overdilation with fluids
Decreased albumin
Decreased globulins

37
Q

What causes an increase in albumin?

A

Artifact
Physiologic - haemoconcentration
Increased production - hepatocellular carcinoma, corticosteroids

38
Q

What causes a decrease in albumin?

A

Iatrogenic - excessive fluid administration
Decreased production - malnutrition/starvation, hepatic insufficiency
Increased loss - protein-loss, severe haemorrhage etc.

39
Q

What causes an decrease in immunoglobulins?

A

Immunodeficiencies
Failure of passive transfer
Blood loss
Protein-losing enteropathy

40
Q

What are the most common causes of hyercalcaemia?

A

Humoral hypercalcaemia of malignancy
Hypoadrenocorticism

41
Q

What are the most common causes of hypocalcaemia?

A

Low albumin
Renal disease
Pancreatitis
GI disease

42
Q

What are causes of increased phosphate?

A

Artifact
Iatrogenic - phosphate enemas
Physiological - post-prandial, young animals
Increased intake - rodenticides, supplements
Transcellular shift - skeletal muscle injury
Decreased excretion - GFR, hyperthyroidism

43
Q

What are causes of decreased phosphate?

A

Artifact
Iatrogenic - diuretics, steroids, antacids
Decreased intestinal absorption
Transcellular shifts
Increased loss
Hepatic lipidosis

44
Q

What causes an increase in magnesium?

A

Artifact
Iatrogenic - excessive supplementation
Increased absorption
Decreased excretion - GFR, hypocalcaemia
Release from cells - myopathy, soft tissue necrosis
Increased PTH

45
Q

What causes a decrease in Magnesium?

A

Artifact
Physiologic - age
Iatrogenic - administration of Mg-poor fluids
Decreased albumin
Decreased intake - anorexia, high potassium diet
Translocation into cells - insulin, hypothermia
Excess loss

46
Q

What causes an increase in cholesterol

A

Increased production
Decreased lipolysis, abnormal processing
Inherited
Decreased excretion - cholestasis
Endocrine disorders - Diabetes mellitus, pancreatitis, hyperadrenocorticism

47
Q

What are causes of decreased cholesterol

A

Artifact
Decreased absorption
Decreased production - liver disease
Altered metabolism
Increased lipoprotein uptake

48
Q

What are common causes of increased triglycerides?

A

Post-prandial fasting
Diabetes mellitus
Hyperadrenocorticism
Hyperlipidemia

49
Q

What causes increased amylase?

A

Acute pancreatitis
Decreased GFR
Intestinal disease or obstruction

50
Q

What causes increased lipase

A

Corticosteroids
Acute pancreatitis
Peritonitis, gastritis, obstruction, manipulation
Decreased GFR

51
Q

What causes an increase in bile acids?

A

Physiologic
Decreased clearance from the portal circulation
Decreased excretion

52
Q

What causes a decrease in bile acids

A

Physiologic - prolonged fasting
Enterohepatic - malabsorption

53
Q

What parts of the biochemistry panel are used to look at liver health?

A

Leakage enzymes: ALT, AST, SDH, GLDH
Inducible enzymes: ALP, GGT
Bilirubin, Urea nitrogen, glucose, albumin, cholesterol, bile acids, ammonia

54
Q

What parts of the biochemistry panel are used to look at kidney health?

A

Urea
Creatinine
Electrolytes: Sodium, Chloride, Potassium, Calcium, Phosphate, Magnesium

55
Q

What part of the biochemistry panel are used to look at pancreas health?

A

Amylase
Lipase

56
Q

What part of the biochemistry panel is used to look for muscle health?

A

AST, CK and LDH

57
Q

What markers look at carbohydrate metabolism?

A

Glucose and fructosamine

58
Q

What markers can be used for lipid metabolism?

A

Triglyceride
Cholesterol
NEFA (non-esterified fatty acids)
B-hydroxybutyrate (BHB)

59
Q

What is anaemia?

A

Decreased haemocrit/packed cell volume or haemoglobin

60
Q

What are the signs of anaemia?

A

Inadequate perfusion/oxygenation - pale mms, lethargy, exercise intolerance
Tachypnoea/tachycardia
Poor pulse quality, flow heart murmur
Underlying pathology

61
Q

Where does apparent anaemia occur?

A

Young animals, anaesthesia, overhydrated

62
Q

What are some abnormal cell types seen with anaemia?

A

Nucleated RBCs, reticulocytes, basophilic stippling, Howell-Jolly body, Heinz bodies

63
Q

In what condition is neutrophilia and spherocytes seen with anaemia?

A

IMHA

64
Q

What is the most common form of non-regenerative anaemia?

A

Inflammation - normocytic normochromic

65
Q

What type of anaemia is absolute iron deficiency?

A

Microcytic hypochromic

66
Q

What is poikilocytosis?

A

Alteration in cell shape

67
Q

What conditions are seen with acanthocytes (spur cells)? What do they look like?

A

Diffuse liver disease, splenic hemangiosarcoma, portosystemic shunts.
Rounded projections of variable diameter and lenghh

68
Q

What are spherocytes an indicator of? What do they look like?

A

Immune-mediated haemolytic anaemia
Small, densely staining spherical RBCs

69
Q

What are schistocytes?

A

Irregular fragmented erythrocytes through mechanical trauma to circulating erythrocytes

70
Q

What are Heinz bodies indicative of?

A

Oxidative damage - paracetamol and onion toxicity
Associated with diabetes mellitus, lymphoma and hyperthyroidism

71
Q

What is basophilic stippling indicative of?

A

Signs of regeneration. Associated with lead poisoning.

72
Q

What are Howell-Jolly Bodies indicative of?

A

Signs of regeneration. Can be seen with splenectomy or suppressed splenic function

73
Q

What can babesiosis lead to?

A

Haemolytic anaemia
Systemic inflammatory response syndrome (SIRS)
Multiple organ dysfunction syndrome (MODS)

74
Q

What pathologies relate to normocytic normochromic anaemia?

A

Illness, pre-regenerative or occasionally non-regenerative anaemia.

74
Q

What pathologies relate to normocytic normochromic anaemia?

A

Illness, pre-regenerative or occasionally non-regenerative anaemia.

75
Q

What pathologies link to macrocytic hypochromic anaemia?

A

Highly regenerative anaemia

76
Q

What pathologies link to microcytic hypochromic anaemia?

A

Classic iron deficiency, chronic external blood loss.

77
Q

What factors can cause a shift of cells from the marginal to the circulating pool?

A

Epinephrine, glucocorticoids, infection, stress

78
Q

What are causes of neutrophilia?

A

Inflammation
Steroid
Physiological
Chronic neutrophil leukaemia
Paraneoplastic

79
Q

What causes the appearance of foamy cytoplasm?

A

Dispersed organelles

80
Q

What causes the appearance of diffuse cytoplasmic basophilia?

A

Persistent cytoplastic RNA

81
Q

What causes the appearance of Dohle bodies?

A

Focal blue-grey cytoplasmic structures

82
Q

What causes the appearance of asynchronous nuclear maturation?

A

Finely granular nuclear chromatin in segments

83
Q

What are causes of neutropenia?

A

Inflammation
Decreased production
Rare

84
Q

What are the causes of lymphocytosis?

A

Physiological
Chronic inflammation
Young animals and recent vaccination
Lymphoproliferative disorders
Hypoadrenocorticism

85
Q

What are the causes of lymphopenia?

A

Stress/steroids
Acute inflammation
Loss of lymph
Cytotoxic drugs, radiation
Immunodeficiency syndrome
Lymphoma

86
Q

What are the causes of monocytosis?

A

Inflammation
Steroid/stress
Monocytic/myelomonocytic leukemia

87
Q

What are the causes of eosinophilia?

A

Hypersensitivity
Parasitism
Hypoadrenocorticism
Paraneoplastic
Idiopathic eosinophilic syndrome
Eosinophilic leukaemia

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