Clin Lab Final review Flashcards
Whole blood is comprised of ___ and ___
Fluid and cells
The fluid component of blood is comprised of _____
Plasma
The cellular component is comprised of ____, ____, and ____
RBCs, WBCs, platelets
If it is a heparin plasma sample that has been stored overnight in the refrigerator it should be _____to remove any possible _____
respun to remove fibrin strands
Plasma from which fibrinogen has been removed
Serum
During clotting process, soluble fibrinogen is plasma is converted to what?
An insoluble fibrin clot
Used to run chemical assays
Anticoagulated blood (plasma)
Serum
What is the preferred anticoagulant for chemistry tests?
Heparin
May cause falsely increased inorganic phosphate levels in the blood
Heparin
May interfere with lactate dehydrogenase activity
Heparin
Should not be used if plasma samples are needed for chemistries
EDTA
Interferes with color development in some alkaline phosphate tests
EDTA
Binds metallic ions that may be necessary for enzyme activity, and binds calcium unavailable for assays
EDTA
Alters the makeup of serum/plasma
Hemolysis
Assays should be done ideally within ____ hr(s)
1 hours
Total Protein, Albumin, Globulin, Albumin/Globulin Ratio, Fibrinogen are all examples of _____ assays
Protein assays
Help form cells, organ, tissues, maintain osmotic pressure, act as buffers in acid-base balance, serve as hormons, function in blood coagulation, defend body against pathogenic microorganisms
Functions of Plasma in the body
Serve as transport/carrier molecules for most constituents of plasma
Function of protein in the body
Total plamsa protein include _____
Fibrinogen
Total serum proteins do not include _____
Fibrinogen
Total protein may be affected by alatered hepatic synthesis, altered protein distribution, breakdown/excretion, and _____ or _____
Dehydration or overhydration
Dehydration causes _____ total protein concentration
elevated
Overhydration causes ______ total protein concentration
Decreased
What are two methods in measuring TP?
Refractrometer, Biuret
Important protein in plasma/serum
Albumin
Makes up 35-50% of total plasma protein
Albumin
Responsible for maintaining osmotic pressure of plasma
Albumin
Albumin is made by ____
Hepatocytes
What may cause decrease in albumin synthesis
Liver disease, renal disease, dietary intake, intestinal protein absorption
What may increase albumin levels?
Hemolysis
Globulin estimate is equal to the difference between what?
TP and albumin
Complex group of proteins made in the liver
Globulins
Primarily transport and bind proteins
Globulin
Make up 3-6% of the total plasma protein made by hepatocytes
*Important in horses
Fibrinogen
Elevated by acute inflammatory/tissue damage
Plasma fibrinogen
There is no fibrinogen in ____
Serum
What are the 4 most common liver assays?
Alanine/Aspartate Aminotransferase
Sorbitol/Glutamate Dehydrogenase
Species in which hepatocytes are a major source of ALT
Dogs, cats, primates
In horses, ruminants, pigs, and birds hepatocytes do not contain enough ____ and are not a good indicator of disease
ALT
Renal cells, cardiac cells, skeletal muscles and pancreas are all sources for ____
ALT
Most accurate indicator of liver disease in small animals
Alanine Aminotransferase (ALT)
True or false, ALT is specific enough to identify specific liver disease
False
Hemolysis and lipemia can artifically ______ ALT levels
Increase
Only found in cases of severe liver disease
Aspartate Aminotransferase (AST)
AST is found where?
RBC, cardiac muscles, skeletal muscles, kidneys, and pancreas
Liver disease, hemolysis, strenuous exercise and IM injection may all result in elevated ___
AST
Primary source of Sorbitol Dehydrogenase (SDH)
Liver cells
Useful in determining liver damage in large animals
SDH
SDH is unstable in ____
Serum
Plasma level of SDH rise with _____ damage/necrosis
Hepatocellular
Liver specific in all species
Glutamate Dehydrogenase (GLDH)
GLDH has increased concentration in what species hepatocytes
cattle, sheep, and goat
Ideal choice for measuring liver function in large animals and exotics
GLDH
Sensitive and specific indicator of liver disease
GLDH
Increased levels of GLDH indicate _____ damage and necrosis
Liver damage
Alkaline Phosphatase and GGT are enzymes associated with _____
Cholestasis
Isoenzyme present in cells within hepatobiliary system, osteoblasts, and chondroblasts
Alkaline Phosphatase (AP, ALKP)
Most often used to detect Cholesasis in dogs and cats
Alkaline Phosphatase
Primary source of GGT or GT
Liver
Higher levels of ____ are found in cattle, horses, sheep, and goats
GGT
Elevated levels are seen in liver disease, especially obstructive liver disease
GGT
Bile Acid tests are more specific _____ function test
liver function
Bile acids have a _______ function
Hepatobiliary
Bile acid is made from _____ in the liver cells
Cholesterol
Bile acids are stored in the _____ until they move into the duodenum and aid in fat storage
gall bladder
Serum level is normally low in ____ ____
Bile acids
Liver removes 75-90%
Bile acids
Hemolysis and lipemia may falsely _____ bile acid measurements
Decrease
Elevated bile acids may indicate what?
Chronic hepatitis, cirrhosis, cholestasis, neoplasms
Considered a waste material, carried to liver bound to albumin
Bilirubin (TBIL)
Bilirubin is insoluble in water until taken to ____
liver
Bilirubin becomes water soluble after being conjugated with _____
sugars
Sensitive to light and must be stored in the dark
Bilirubin
Plasma lipoprotein produced primarily in the liver as well as ingested food
Cholesterol
Seen in inherited diseases, diabetes mellitus, hypothyroidism, cholestais and in the case of some drugs.
Hypercholesterolemia
Abnormally low cholesterol values could be due to decreased absorption, production and altered _____
metabolism
BUN, serum creatinine, urine protein/ creatinine ratio and SDMA are all ____ assays
Kidney assays
Used to evaluate kidney function based on its ability to remove nitrogenous wase from blood
BUN
This test is not very sensitive and only detects kidney failure at 75%
BUN and Creatinine
When the kidney is not functioning properly, ____ is not being removed
Urea
______ _____ diets may increase BUN
High protein diets
BUN may also be elevated due to ________
Dehydration
Diffuses out of muscle cell and into body fluids
Creatinine
Creatinine is eliminated in _____
Urine
Used to evaluate renal function
Creatinine
Azotemia is when BUN and creatinine are _____
Elevated
Measures urinary protein loss
Urine protein/Creatinine ratio
Used to screen for early renal disease, monitor the course of renal disease, and assess therapeutic response
Urine protein/creatinine
In healthy dogs, the protein/creatinine ratio should be ___
Less than 1
Ratio indicating pre renal or functional origin
1-5
Ratio that indicates renal disease
>5
Protein/Creatinine ratio may be falsely elevated due to what?
Fever, exercise, change in temperature
Methylated arginine amino acid
SDMA (Symmetric dimethylarginine)
SDMA is excreted by _____
kidneys
SDMA is specific for kidney disease and increases earlier than creatnine allowing detection as early as ____% loss to ____ % loss
25%-40% loss
As ____ decreases, SDMA increases
GFR
True or false, SDMA is NOT affected by other non-kidney diseases
True
Lean muscle mass impacts creatinine but not ____
SDMA
Reduced urine SG typically occurs when there is on average a _____ loss of GFR
67%
Trypsin, Amylase, Lipase are all ____ assays
Pancreas assay
Proteolytic enzyme
Trypsin
Trypsin is more readily detected in ___ than in blood
Feces
True of false, absence of trypsin in feces is abnormal
True
Two fecal tests used for Trypsin
Test tube method utilizing Knox Gelatin
X-Ray Film Test
Using the test tube method, failure to gel indicates _____
presence of trypsin
Primary source for Amylase
Pancreas (exocrine)
Increased levels of ______ indicate acute pancreatitis, flare ups of chronic pancreatitis, and obstruction of pancreatic ducts
Amylase
Primary source of Lipase
Pancreas (exocrine)
Functions to break down long chain fatty acids of lipids
Lipase
Lipase assays are more sensitive to pancreatitis than ____
amylase
Other pancreas tests include endocrine function of ____ and ____
Glucose and Fructosamine
Utilization of glucose depends on the amount of ____ and ____ produced by the pancreas
insulin and glucagon
For glucose tests what should be separated from serum/plasma immediately after collection
RBCs
What happens if plasma is left in contact with RBCs at room temperature?
Glucose levels may drop 10%/hr
What pancreas test is not effected by hemolysis
Glucose
More specific indicator of pancreatic endocrine activity than glucose
Fructosamine
Fructosamine represents binding between glucose and ____ ____
serum protein
Provides an indication of the average glucose levels over the life span of the protein (1-2 weeks)
Fructosamine
Fructosamine is not affected by ____
stress
Increased levels of Fructosamine indicate what?
Persistent hypergylcemia - diabetes mellitus
Used to diagnose Addison’s disease (Hypoadrenocorticism) or Cushing’s disease (Hyperadrenocorticism)
ACTH stimulation test
If ACTH results are low, it indicates
Hypoadrenocorticism
If ACTH results are high, it indicates
hyperadrenocorticism
Dexmathasone suppression tests evaluate adrenal glands differently by using the adrenal ______ ____
Feedback loops
Measures and compares levels of cortisol in an animals blood stream before and after it receives an injection of dexamethasone
Dexamethasone suppression test
Confirms or replaces the ACTH test for Cushing’s disease
Dexamethasone suppression test
Measure and compares levels of cortisol in an animal’s bloodstream before and after it receives an injection of dexamethasone
Dexamethasone suppresion test
Post injection, healthy animals show suppressed _____ levels
cortisol
_____ hormones influence metabolic rate, growth, and differentiation of all body cells
Thyroid
Assay that function for the maintenance of water balance
Electrolyte assays
Most commonly analyzed in electrolyte assays
Calcium, inorganic phosphorus, potassium, sodium, chloride, magnesium
Maintenance of neuromuscular excitability and tone as well as activity of many enzymes
Calcium
Functions in facilitation of blood coagulation
Calcium
Calcium is usually ______ related to inorganic phosphorus concentration
inversely
What does hypercalcemia indicate?
Young, growing animals
Renal failure, Addison’s disease, Vitamin D toxicity, and in some cases cancer
What does hypercalcemia indicate?
Muscle tremors, weakness, convulsions
Milk fever, eclampsia
Found 80% in bones
Inorganic phosphorus
Composition of inorganic phosphorus
Nucleic acids, phospholipids
As phosphorus concentration _______, calcium concentration _____
decreases, increases
Hyperphosphatemia may indicate
hemolysis, hyperthyroidism, renal disease
Hypophosphatemia may be indicated due to
Lab error (#1 cause), renal loss, transcellular shifting, decreased absorption
Major cation of plasma and interstitial fluid
Sodium
Sodium is vital in _____ and ______
pH balance, and acid-base balance
What are some causes of Hypernatremia?
PD, CHF, Gi losses, liver disease
What are some causes of hyponatremia?
Excessive water loss, inadequate intake, salt gain
Major intracellular cation
Potassium
What is hypokalemia associated with?
Alkalosis, inadequate intake, and fluid loss
What is hyperkalemia associated with?
renal failure, urinary tract obstruction or rupture, cardiac arrythmia
Found in all body tissues, 50% in bones
Magnesium
Activates enzyme systems and involved in production and decomposition of acetylcholine
Magnesium
What is associated with hypomagnesemia
Decreased intake, GI losses, sweating in endurance horses
What is associated with hypermagnesemia?
Hemolysis, increased intake
Main extracellular anion
Chloride
Important in water distribution, osmotic pressure, and normal anion/cation ratio
Chloride
What is associated with hyperchloremia
Acidosis, chloride retention, and drug administration
What is associated with hypocholemia?
Alkalosis, V/D, fluids, sweating
Aids in transport of carbon dioxide from tissues to lungs
Bicarbonate
Frequently estimated from blood carbon dioxide levels
Bicarbonate
What blood is preffered for Bicarbonate measurement?
Arterial blood
Creatine Kinase (aka creatine phosphokinase (CPK) is primarily produced in _______ muscles and the _____
striated muscles and brain
One of the most organ specific enzymes available
CPK
What does it mean if you aspirate blood during a FNA
Blood vessel was hit, or tumor is extremely vascular
____ cell tumors bleed a lot more
Mast cell
What is seen with suppurative (purulent) inflammation
Primarily neutrophils
What is seen with pyogranulomatous inflammation?
Primarily neutrophils and macrophages
What is een with Eosinophilic inflammation
Eosinophils with neutrophils
Neutrophils are seen in _____ and non _____ inflammation
septic and non-septic
Eosinophils are often seen in the presence of
allergies, forein protein, inflammation
Cells that are round with eccentric nucleus
Mast cells
Benign tumors of the adipocytes
Lipoma
True or false, cells present in neoplasia are of different tissues
False, cells present are of same tissue
Any unusual variation in overall cell size
Anisokaryosis
Variability in size and shape of the same cell
Pleomorphism
Anisokaryosis and pleomorphism are both indicators of what?
Malignancy
Indications for abdominocentesis
evaluating abdominal disease, obtain fluid sample
For abdominocentesis, introduce the needle into the _____ cavity
Peritoneal
For thoracocentesis, introduce the needle into the ____ cavity
pleural
Indications for transtracheal wash
evaluate respiratory disease
Indication for arthrocentesis
aspiration of joint fluid or injection of medication
Indications for a CSF tap
collection of fluid for diagnostics or to deliver medications
Arthrocentesis samples should be placed in ____
LTT
CSF tap samples should be placed in
RTT
For CSF taps, ____ ml collected for cytological analysis, and ___ ml for bacterial culture
1-5 ml, 0.25 ml
What procedures are used for thick fluids?
Wedge smear, compression smear, line prep, combination prep
Thin fluids should be ____ for 5 minutes at ______ rpm
centrifuged, 1000-2000 rpm
Clear to straw yellow, transparent, odorless, low numbers
Normal body fluids
Transudates, exudates and chylous effusion are all ____ fluids
abnormal
Primarily macrophages, lymphocytes, and mesothelial cells
Transudates
Feline infectious peritonitis, chylothorax, CHF and liver disease are all causes of ______
Transudates
Transudates have very low ____ levels and _____ cell counts
low protein and nucleated cell counts
Exudates often have high numbers of _____
neutrophils
Very high cell counts, high protein levels and may be maldorous
Exudates
Exudates are usually caused by acute or chronic _______
inflammation
Appears milky or like “strawberry milkshake”
Chylous fuid
Chylous fluid is most common in the ____ cavity
Pleural
Chylous fluid may be caused by ____ disease
Heart disease
Chylous fluid contains a predominance of normal, small ____
lymphocytes
Chylous fluid contain ____ _____ which are visible if stained
Fat droplets
What species are seasonal polyestrus
Cats, sheep, goats, and horses
Dogs have what type of cycle?
Nonseasonal monoestrus
What species are induced ovulators?
Cats
Gestation length in cats and dogs
63 days
Gestation length in cows
280 days
Gestation length in cattle
330 days
Gestation length in elephants
22 months
Hormone of the pituitary gland
Oxytocin
Released during parturition and sucking of mammary glands
oxytocin
Oxytocin stimulates ___ let down and ___ of uterus
Milk let down and contractions of uterus
Pregnancy testing at 21 days
ultrasound, hormone testing
Pregnancy testing at 45-48 days, looking for development of bone
radiograph
First stool of newborns that consists of material collected in the intestines of the fetus
Meconium
Thick fluid containing nutrients and antibodies
Colostrum
More reliable test for breeding
Progesterone
Number of microorganisms needed to cause disease
Infective dose
Gram negative bacteria within a cell and are excreted when the cell dies
Endotoxins
Immunizing agents in vaccines; good antigen
Exotoxins
Excreted from bacteria into the surrounding medium or tissues
Exotoxins
Basic unit of measure for bacterial cell morphology
Micrometer or micron (u)
Shape ranging from cocci to rods
Pleomorphic
“Chinese letter” pattern of bacteria
Palisades
Intracellular bodies that are resistant to heat, chemicals and radiation
Endospores
Can survive in the presence of oxygen but their growth is limited
Faculatative anaerobic
Used primarily to detect Mycobacterium and Nocardia species
Acid-Fast Stain
Identified lactose-fermenting organisms and only gram negative bacteria growth
MacConkey agar
Positive simmons citrate is _____, negative is ____
Deep blue, same color (green)
Growth on Triple sugar iron slant and butt indicate fermentable sugar. Acidic is _____, alkaline is ____ and means no fermentation
Yellow, Red
Positive Urea media is _____
pink
Liquid media used to grow anaerobic bacteria to detrmine oxygen tolerance
Thiglycollate
Used to culture for antibiotic susceptibility testing
Tripticase Soy
Tests that differentiate staphs, streps, and coliforms
Catalase test
Used to tell staph aureus from environmental staph
Coagulase test
Used to tell environmental streps from strep agalactiae
CAMP test
Arrowhead formation of this test indicates positive results
CAMP test
Contagious pathogens in milk
S. aureus, S. agalactiae
Gram postive cocci clusters, usually gray/white color with no hemolysis
Environmental staph
Found on infected udder, dirty bedding; appears gray/white, doubgle zone of beta hemolysis; catalase/coagulase positive; Gram positive cocci clusters
Staph aureus
Catalase negative, CAMP test negative; Gram positive cocci chains
Environmental strep
Found on cow’s udder; contagious; beta hemolysis; catalse negative, CAMP positive; gram postive cocci chains
S. agalactiae
Large, gray and round, mucoid, occasional beta hemolysis; round pink colonies with pink precipitate (MacConkey agar); catalase negative; gram negative rods in chains
E. coli
Also known as coliforms; large, gray mucoid, occasional beta hemolysis; Round pink colonies that look like fish eyes (MacConkey agar); catalase negative; gram negative rods in chains
Klebsiella
Not as common pathogens in milk:
Yeast, Prothetica, Mycoplasma bovis (contagious)
Can be caused by penicillin treatment; looks like staph; catalase positive; gram positive buds
yeast
Incubation time of yeast
48 hours
Considered to contaminate; spread through milking procedures; cow’s milk will be “clinical”; look like wax droplets on agar plate; catalase positive; large gram positive ovals
Prototheca
Cows must be isolated for life; source of infection is cows with URIs; requires routine screening of bulk tank and milk strings to identify
M. bovis
Most common bacteria found in bulk tanks
E. coli
Used to identify cows with asymptomatic mastitis
Somatic cell counts
An increase in leukocytes causes elevated ____
SCC
Bulk tank SCC should be between
150,000 cells/ml to 200,000 cells/ml
Causes bumble foot in avians
Staphylococcus
Seen in food poisoning, skin infections and post surgical infections
Staphylococcus
Associated with Lancefield groups. Do not form endospores, aerobic, purple cocci in chains; grow best on blood agars
Streptococcus
Strep pyogenes
sore throat in people
Strep agalactiae
Major cause of bovine mastitis
Srep disgalactiae
Minor cause of mastitis
Strep equi
Strangles in horses
Strep zooepidemicus
Genital infection, wound infection
Strep fecalis, strep equismilis
Urinary infections, Infection in young pigs
Strep duran, strep suis
Diarrhea in foals, cervical lymphadentitis in pigs
It is important NOT to culture this organism due to anthrax
Bacillus
Aerobic, non-motile, gram positive bacilli
Bacillus
Bacillus spore can live up to ____ years
40 years
Anaerobic, gram positive bacilli; spore forming; invasive and noninvasive
Clostridium
Aerobic, motile, gram positive bacilli, transmitted in soil, feces, genital secretions and moldy hay
Listeria
Most prevalent during summer months as it is spread by house flies
Erysipelothrix
Gram Negative Facultative Anaerobic Bacilli
E. coli, Salmonella, Klebsiella, Pasteurella, Hemophilus, Actinobacillus
Ferment lactose with gas production
E. coli
2 forms of Salmonella infections
Enteric and Septic
Stain is concentrated on ends of rods, 2 major species important in vet med
Pasteurella
Two important forms of pasteurella
Pastuerella multocida. hemolytic
Snuffles in rabbits, Fowl cholera, cattle pneumonia, normal flora in cats/dogs mouths
Pasteurella multocida
Shipping fever in cattle, pneumonia, associated with stress
Pasteurella hemolytic
Infection thromboembolic meningoencephalitis in cattle, Glasser’s disease in young pigs
Hemophilus
Wooden tongue in cattle, septicemia, purulent infection of joints and kidneys
Actinobacillus
Slightly curved or straight rods; cigar shaped rods; Blue-green pigment with fruity odor
Pseudomonas
Brucella, Bordetella, Francisella are all what kind of bacteria?
Gram negative aerobic bacilli
Tularemia in rabbits sheep and wild animals spread through wood ticks and contaminated food and water
Francisella
Gram negative cocci responsible for bovine KCS (pink eye)
Moraxella
Bacillus with beaded appearance, calf diptheria, foor rot, liver abcesses
Fusobacterium
Contagious foot rot in sheep
Bacteroides
True venereal disease; slender curved rods or spiral commas; spontaneous abortion in cattle, hemorrhagic enteritis, swine dysentery
Campylobacter
Lumpy jaw in cattle, pleuritis in dogs, mastitis in sows. Yellow sulfer like granules
Actinomyces
Acid fast positive; Gram postive rods; systemic and local infection in dogs and cats and mastitis in cattle
Nocardia
Johne’s disease, chronic disease with lesion in lungs and lymph nodes
Mycobacterium
Mode of transmission may be Congenital via umbilical vein
Mycobacterium
Smallest free living cells
Mycoplasma
Tightly coiled spiral rods, transmitted in urine
Leptospira
Flagella, cause lyme disease and borreliosis in birds
Borrelia
Intracellular bacteria associated with RMSF, Q fever in humans, and mastitis
Rickettsia
Intracellular bacteria causing psittacosis in birds, abortion in ewes, and diarrhea in calves with inadequate colostrum
Chlamydia
All birds entering the US must be quarantines for _____ days due to this disease
30-45 days, Chlamydia
