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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
Q

Septic Exudate

Gross appearance, concentrations, micro exam, pathenogenesis, etiology

A

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
Q

Sterile Exudate

Gross appearance, concentrations, micro exam, pathenogenesis, etiology

A

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
Q

Hemorrhagic Effusion

Gross appearance, concentrations, micro exam, pathenogenesis, etiology

A

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
Q

Chylous Effusion

Gross appearance, concentrations, micro exam, pathenogenesis, etiology

A

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
Q

Uroperitoneum/Uroabdomen

Gross appearance, concentrations, micro exam, pathenogenesis, etiology

A

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
Q

Bilious Effusion

Gross appearance, concentrations, micro exam, pathenogenesis, etiology

A

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
Q

neoplastic Effusion

Gross appearance, concentrations, micro exam

A

Gross appearance
* Clarity variable
* Color variable

Measured concentrations
* TP variable (≥ 2.0 g/dL)
* TNCC variable (> 5,000 /μL)

Microscopic examination
* Neoplastic cells

32
Q

round cells

A

Individualized
Round
non inflammatory

33
Q

epithelial cells

A

non inflammatory
Cell-to-Cell
Individualized
Round
Polygonal

34
Q

mesenchymal cells

A

non inflammatory
Matrix
Individualized
Spindle
Stellate

35
Q

naked nuclei cells

A

non inflammatory
Fragile cells
Invisible borders
Round nuclei
Uniform nuclei

36
Q

anisokaryosis

A

different sizes

37
Q

pleomorphism

A

different shapes

38
Q

high N:C

A

high nucleus: cytoplasm

39
Q

criteria for malignancy

A
40
Q

enzymes in chemistry

A

Measure “activity”
Induced or “leakage”
Tissue and species specificity
Only worried about increased activity

41
Q

lipase measurement

A

Olympus AU400
* Colometric method
* Spectrophotometer
* Beer’s law ;)

42
Q

enzymology assumptions

A

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
Q

explanations for increased enzyme activity

A

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
Q

creatine kinase (CK)

A

Leakage = “Cell injury”
Muscle (skeletal, cardiac and smooth)
hemolysis (artifact)
Half life just few hours (2-3h) FAST Response
CK ≠ Creatinine

45
Q

AST

A

leakage =“Cell injury”
Liver & muscle
hemolysis (artifact)
* >1 test to interpret (ALT, SDH, CK, etc.)

**Small & large animals **

46
Q

SDH

A

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
Q

ALT

A

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
Q

GGT

A

Induced
Hepatobiliary
Cholestasis -> Decreased Bile Flow
small and Large animal

49
Q

ALP

A

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
Q

cALP

A

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
Q

ALP interpretation in dogs

A

< 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
Q

LPS

A

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
Q

PLI

A

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
Q

AMS

A

“Cell injury”
Exocrine pancreases (pancreatitis) and many other tissue types

55
Q

SDH

A

“Cell injury”
Liver
Replaces ALT for LARGE animal

DWT exam 3 (14 decks)

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