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DWT exam 3 > clin path > Flashcards

clin path Flashcards

1
Q

serum vs plasma protein

A

serum protein is a little less than plasma protein

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2
Q

albumin

A

Low molecular weight protein
* Little bit bigger than pores separating blood and urine (glomerulus)
* smaller than globulin

Production: Liver
Function
* Oncotic pressure (pull interstitial fluid into vessel)
* Insoluble > Soluble (transport)
* more albumins than globuilns (more oncotic pressure)

Clearance
Metabolically active tissues

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3
Q

globulins

A

Proteins not albumin
* Immunoglobulins
* Complement proteins
* Coagulation proteins
* Haptoglobin
* Transferrin

Production
* B lymphocytes, plasma cells
* Liver

Function
* Lots!…but mostly inflammation

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4
Q

Acute phase proteins

A

Positive APPs
* go UP with inflammation
* Most globulins
* alpha and beta globulins (complement, fibrinogen, etc)

negative APP
* go DOWN with inflammation
* albumins

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5
Q

delayed response proteins

A

Positive DRPs
* Immunoglobulins

Negative DRPs
* Not really a thing

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6
Q

How to measure proteins

A

Refractometer
* Light refraction
* Total protein (total solids)
* simple, easy
* Lipemia interferes with refractions

Chemistry
* Chemical reaction > Color
* Albumin, globulins
* more accurate

Electrophoresis
* Proteins migrate through gel
* Electrical charge, mass, shape
* Albumin, α-, β-, γ-globulins

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7
Q

panhypoproteinemia causes

A

Hemorrhage
Protein-losing enteropathy (PLE)
* protein lost in GI
* lymphangiectasia

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8
Q

Selective hypoalbuminemia

A

Inflammation
Protein-losing nephropathy (PLN)
* protein lost through glomerulus
* also losing antithrombin III (pro thrombotic)

Liver failure

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9
Q

albumin amount to loose oncotic pressure

A

< 1-1.5 g/dl
causes edemas

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10
Q

Selective hypoglobulinemia

A

Failure of passive transfer (FPT)
young animals that do not receive colostrum

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11
Q

Panhyperproteinemia

A

dehydration

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12
Q

Selective hyperalbuminemia

A

rare
maybe dehydration

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13
Q

Selective hyperglobulinemia

A

Inflammation (mild)
B cell lymphoma (very high values)
Plasma cell neoplasia (produce antibodies)

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14
Q

polyclonal gamopathy

A

many polyclonal antibodies produced
broad increased hump
increased total protein, globulins
inflammation, immune response

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15
Q

monoclonal gammopathy

A

increased clone of single neoplastic B cell that produces antibodies
increased total protein, globulins
neoplasia

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16
Q

tube for fluid analysis and cytology

A

EDTA purple

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17
Q

tube culture, biochem testing

A

red no additive

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18
Q

gross appearence fluid analysis

A

Color
Clarity

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19
Q

Measured concentrations fluid analysis

A

Total protein
Total nucleated cell count
RBC count

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20
Q

Microscopic examination fluid analysis

A

Cell identification
Infectious agents
Acellular material (bile, digesta)
can use smear from fluid or sediment (centrifuged)

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21
Q

how to send fluid to reference lab

A

Fluid + Ice packs
Unstained smears
Overnight shipping
No formalin submissions in the same box

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22
Q

hypo/hypervolemia

A

decreased/increased blood volume

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23
Q

Pure (Protein-Poor) Transudate

Gross appearance, concentrations, micro exam, pathenogenesis, etiology

A

Gross appearance
* Clear
* Colorless, light yellow

Measured concentrations
* Total Protein < 2.0 g/dL
* TNCC < 1,500 /μL

Microscopic examination
* Variable, usually mononuclear

Pathogenesis
* Decreased oncotic pressure
* Increased capillary hydrostatic pressure
* Decreased lymphatic drainage

Etiologies
* Protein-losing nephropathy
* Protein-losing enteropathy
* Liver failure

24
Q

Modified (Protein-Rich) Transudate

Gross appearance, concentrations, micro exam, pathenogenesis, etiology

A

Gross appearance
* Clear, hazy, or cloudy
* Variable, usually yellow

Measured concentrations
* TP ≥ 2.0 g/dL
* TNCC < 5,000 /μL

Microscopic examination
* Variable, usually neutrophils

Pathogenesis
Increased capillary hydrostatic pressure
Decreased lymphatic drainage

Etiologies (anything!)
* Hypertensive disorders
* Local or systemic
* Lymphadenopathy
* Feline infectious peritonitis (FIP)
* Many other causes

25
Septic Exudate | Gross appearance, concentrations, micro exam, pathenogenesis, etiology
Gross appearance * Hazy, cloudy, or flocculent * Yellow, tan, cream, orange Measured concentrations * TP ≥ 2.0 g/dL * TNCC > 5,000 /μL Microscopic examination * **Neutrophils** * **Infectious** agents Pathogenesis * **Increased interendothelial spaces** * Diapedesis of neutrophils Etiologies * Visceral tissue (In > Out) Pleuropneumonia Esophageal perforation GI perforation or necrosis Ruptured bladders * Parietal tissue (Out > In) Penetrating wounds/FB * Hematogenous
26
Sterile Exudate | Gross appearance, concentrations, micro exam, pathenogenesis, etiology
Gross appearance * Hazy, cloudy * Yellow, tan, cream, orange Measured concentrations * TP ≥ 2.0 g/dL * TNCC > 5,000 /μL Microscopic examination * Neutrophils * No infectious agents Pathogenesis * Increased interendothelial spaces * Diapedesis of neutrophils Etiologies * Pancreatitis * Enteritis/Colitis * Displaced organs/tissues * Ruptured bladders * Feline infectious peritonitis (FIP) * Neoplasia | no visible infectious agents
27
Hemorrhagic Effusion | Gross appearance, concentrations, micro exam, pathenogenesis, etiology
Gross appearance * Opaque * Red Measured concentrations * TP ≥ 2.0 g/dL * **RBC > 1,000,000 /μL** Microscopic examination * Blood smear * Erythrophagia, hemosiderin Pathogenesis * **Leakage of blood** Etiology * Trauma * Displaced organs/tissues * Hemorrhaging neoplasms * Coagulation disorders * Idiopathic
28
Chylous Effusion | Gross appearance, concentrations, micro exam, pathenogenesis, etiology
Gross appearance * Hazy, cloudy, opaque * Pinkish white, white Measured concentrations * TP ≥ 2.0 g/dL * TNCC variable Microscopic examination * **Small lymphocytes** Fluid chemistry * **Triglycerides** (>100mg/dL) Pathogenesis * **Leakage of lymphatics** that drain the GI tract Etiology * Idiopathic- dogs * Trauma * **Heart disease- CATS** * Displaced organs/tissues * Lymphadenopathy * Neoplasms
29
Uroperitoneum/Uroabdomen | Gross appearance, concentrations, micro exam, pathenogenesis, etiology
Gross appearance * Clear, hazy, cloudy * Pale yellow, **yellow** Measured concentrations * TP variable * TNCC variable Microscopic examination * Variable Fluid chemistry * Creatinine Pathogenesis * **Ruptured urinary tract** (bladder) Etiologies * Uroliths (stones) * Mucus plugs * Trauma * Neoplasms
30
Bilious Effusion | Gross appearance, concentrations, micro exam, pathenogenesis, etiology
Gross appearance * Hazy, cloudy, flocculent * Yellow, tan, orange, green, brown Measured concentrations * TP ≥ 2.0 g/dL * TNCC > 5,000 /μL Microscopic examination * **Bile** Fluid chemistry * **Bilirubin** Pathogenesis * **Ruptured biliary tract** (bladder) Etiology * Choleliths (gallstones) * Mucocele (mucus plug) * Trauma * Neoplasms
31
neoplastic Effusion | Gross appearance, concentrations, micro exam
Gross appearance * Clarity variable * Color variable Measured concentrations * TP variable (≥ 2.0 g/dL) * TNCC variable (> 5,000 /μL) Microscopic examination * **Neoplastic cells**
32
round cells
Individualized Round non inflammatory
33
epithelial cells
non inflammatory Cell-to-Cell Individualized Round Polygonal
34
mesenchymal cells
non inflammatory Matrix Individualized Spindle Stellate
35
naked nuclei cells
non inflammatory Fragile cells Invisible borders Round nuclei Uniform nuclei
36
anisokaryosis
different sizes
37
pleomorphism
different shapes
38
high N:C
high nucleus: cytoplasm
39
criteria for malignancy
40
enzymes in chemistry
**Measure “activity”** **Induced or “leakage”** Tissue and species specificity **Only worried about increased activity**
41
lipase measurement
Olympus AU400 * Colometric method * **Spectrophotometer** * Beer’s law ;)
42
enzymology assumptions
Substrate is in excess **Rate proportional to E** **P proportional to E** More enzyme * Increases ES complex * Increases Product formed * Increases reaction rate * Increased slope
43
explanations for increased enzyme activity
**Injury (leakage)** * Bleb, leak, necrosis (Severity ? Reversible ?) * No parenchyma, no enzyme **Induction** * something induces an enzyme to increase activity Decreased clearance (Renal disease: AMS, LPS) Hyperplasia (L-GGT and B-ALP) Ingestion (Colostrum -> GGT) Xenobiotic or endogenous chemical induction (Glucocorticoids -> ALB (dog))
44
creatine kinase (CK)
Leakage = “Cell injury” **Muscle** (skeletal, cardiac and smooth) **hemolysis** (artifact) Half life just few hours (2-3h) **FAST Response** CK ≠ Creatinine
45
AST
leakage =“Cell injury” **Liver & muscle** hemolysis (artifact) * >1 test to interpret (ALT, SDH, CK, etc.) **Small & large animals **
46
SDH
leakage =“Cell injury” **Liver **= best for liver in **large animals** **Replaces ALT for L animal** T1/2 = few hours Sample handling critical (poor storage stability) | LIVER SPECIFIC LARGE ANIMALS
47
ALT
leakage =“Cell injury” **Mostly liver specific** * (skel musc just a little in dogs) **Small Animals Only** T1/2 = 2.5 days (dog), 3.5 hours (cat) Magnitude: Distribution vs severity?
48
GGT
Induced Hepatobiliary **Cholestasis -> Decreased Bile Flow** small and Large animal
49
ALP
Induced Hepatobiliary **Cholestasis -> Decreased Bile Flow** **Small Animals Only** ISOENZYMES (2 gene products) 1. Tissue Unspecific Isoenzyme **liver (hALP), bone, placenta, renal Isoforms** 2. Intestinal Isoenzyme GI, **K9 c-steroid induced (cALP)** Isoforms | liver and bone= all SA **steroid induced = DOG ONLY**
50
cALP
**Dog only!** Intestinal ALP gene, but in liver. Different T1/2 based on glycosylation. Drug induced production **Corticosteroids, phenobarbital** May also be induced with cholestasis!
51
ALP interpretation in dogs
**< 4x increase = Nonspecific** **> 4x increase = Cholestasis &/or Glucocorticoids, anticonvulsants ** Juveniles (bone ALP) * By ~4 weeks: < 800-900 IU/L * By 6 months: < 200-300 IU/L Neonates (Source unclear- nonpathologic) Values up to 1000-3000 IU/L for 2- 4 weeks
52
LPS
leakage =“Cell injury” **Exocrine pancreases (pancreatitis)** + other Half-life 2 hours (canine) Best used in conjunction with amylase Pancreatitis: increase of 3-8X Pancreatic, liver and intestinal carcinomas : >20X increases Decreased GFR can cause a 2-3X increase Corticosteroids can increase activity up to 5X
53
PLI
Pancreatic Lipase Immunoreactivity “Cell injury” **More specific for exocrine pancreases than LPS** Available for both **dogs & cats **  cPLI Most sensitive and specific test for canine pancreatitis fPLI Improved sensitivity and specificity over TLI in cases of pancreatitis **Chronic pancreatitis and mild pancreatitis may still be missed!! **
54
AMS
“Cell injury” **Exocrine pancreases (pancreatitis**) and **many other tissue types**
55
SDH
“Cell injury” **Liver** Replaces ALT for **LARGE animal**

DWT exam 3 (14 decks)

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