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Fundamentals of Diagnostics Exam 2 > Clin Path > Flashcards

Clin Path Flashcards

1
Q

what is the normal relationship between hemoglobin and HCT? what is going on if the ratio is off?

A

Hgbx3 = HCT ± 1-3
if not, there is hemolysis
in vivo = increased Hgb
otherwise, in vitro

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2
Q

what is the calculation to compare plasma protein with fibrinogen? what do the results mean?

A

(PP-fibrinogen)/fibrinogen
horse: <15 = inflammation. >20 = dehydration
cattle: <10 = inflammation. >15 = dehydration
in between = likely both

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3
Q

what should you look at with changes in Ca

A

albumin
if both are increased or decreased in the same proportions, the change can be blamed on albumin

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4
Q

how do you calculate a corrected Cl

A

(avg Na reference interval)/(measured Na)x(measured Cl)

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5
Q

what does an increase or decrease in Cl mean

A

increase - metabolic acidosis
decrease - metabolic alkalosis

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6
Q

increase in what values indicates liver injury

A

ALT, AST, SDH

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7
Q

increase in what values indicates cholestasis

A

ALP, GGT, bilirubin

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8
Q

what are the differentials with increased lipase, amylase, TLI, PLI

A

acinar (exocrine) pancreas damage or decreased GFR

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9
Q

what are the differentials with decreased TLI and PLI

A

chronic pancreatitis and acinar atrophy

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10
Q

what levels will be changed with exocrine pancreatic insufficiency

A

decreased cobalamin and increased folate

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11
Q

list examples of pre-analytical error

A

inappropriate test request, order entry error, misidentification, label error, inappropriate container or sample, insufficient volume, inadequate transport or storage, sample processing before analysis

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12
Q

list examples of analytical error

A

instrument malfunction, reagents, methodology, operator error
lowest proportion of errors occurs here

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13
Q

list examples of post-analytical error

A

failure in reporting, improper data entry, inappropriate reference interval, incorrect interpretation of results

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14
Q

what values will be affected if your sample is submitted in K3EDTA

A

decreased Ca (chelated), increased K

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15
Q

what will happen if plasma is not harvested from cells

A

glucose consumed by cells, so decreased

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16
Q

what will happen if blood is exposed to air for too long

A

CO2 loss, so decreased bicarb and increased anion gap

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17
Q

what is a red top tube used for? what is in it?

A

serum for chemistry
clot activator or no additive

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18
Q

what is a purple top tube used for? what is in it?

A

plasma for hematology
EDTA

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19
Q

how much blood is in your patient? how much can you steal?

A

have 6-8% of body weight in blood
can safely take 5% of that

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20
Q

what effect with heinz bodies have on your values

A

increased MCH, MCHC, reticulocytes, platelets

21
Q

what effect with EDTA have on your CBC values

A

decreased MCV, HCT

22
Q

what effect will an old blood sample have on your values

A

dohle bodies, decreased WBC, neutrophils, increased bands, increased or decreased lymphocytes

23
Q

what effect will platelet clumping have on your count

A

decreased

24
Q

what effect will organisms have on your platelet count

A

increased

25
Q

what effect will ghost cells have on your platelet count

A

increased

26
Q

what effect will hemolysis have on your values

A

increased MCH, MCHC, platelets, CK, AST, LDH, Mg
decreased PCV, HCT, RBC
increased P in horses, camelids, and asian dog breeds

27
Q

what effect will icterus have on your values

A

decreased creatinine, decreased TP

28
Q

what effect will lipemia have on your values

A

increased platelets, HGB
decreased electrolytes

29
Q

what effect will delayed urinalysis have on your values

A

increased pH, proliferation of microbes, degradation of formed elements (cells and casts), degradation of chemical analytes (bilirubin, ketones), calcium oxide and magnesium ammonium phosphate crystals may develop

30
Q

why do you have to be skeptical of procyte values

A

can misclassify cells in 15% of cases, so must evaluate WBC plat of correctness
straight lines between clouds is a red flag that the machine had trouble differentiating

31
Q

what are the differentials for a moderate normocytic non-regenerative anemia

A
  • anemia of chronic dz (#1 with increased WBCs)
  • pre-regeneration <3-4 days
  • decreased erythropoiesis due to decreased EPO from kidneys or bone marrow damage/myelophthisis (platelets and WBCs will also be reduced if bone marrow cause)
  • inefficient erythropoiesis due to PIMA or neoplasia
32
Q

what does basophilic stippling indicate

A

remnants of RNA or pappenheimer bodies (iron in RBCs)

33
Q

how do you diagnose siderocytosis

A

prussian blue stain binds iron in the cells

34
Q

what are your differentials with siderocytosis

A

-lead tox
-increased iron turnover
-dyserythropoiesis due to myelodysplastic syndrome or acute myeloid leukemia

35
Q

what species can normally have dohle bodies without toxic changes

A

cats

36
Q

what are your differentials for thrombocytosis

A

-reactive/inflammation (most common)
-splenic contraction
-rebound after thrombocytopenia

37
Q

what are your differentials for azotemia

A
  • dehydration thus decreased GFR (pre-renal)
  • renal dz
  • post-renal
38
Q

what are your differentials for urea increased more than creatinine

A
  • GI bleeding
  • muscle wasting
39
Q

if your patient is azotemic and has a low USG, what can you diagnose

A

renal azotemia

40
Q

what are your differentials for hyperphosphatemia

A
  • decreased GFR (most common) from hypovolemia or glomerular damage
  • tubular dz (decreased vit D synthesis -> decreased iCa -> increased PTH -> renal secondary hyperparathyroidism)
41
Q

what will your calcium level be with renal dz

A

increased, decreased, or normal

42
Q

what are your differentials for a true hypocalcemia

A
  • low vit D/decreased intestinal absorption
  • less likely primary low PTH
43
Q

what relationship of Ca to P indicates what risk?

A

Ca x P > 80-90 = risk of tissue mineralization

44
Q

how can you tell if a bilirubinemia is conjugated or unconjugated

A

conjugated bilirubin is passed in urine and more sensitive in urine than blood test
so, bilirubin in blood and not urine = unconjugated

45
Q

what are your differentials for increased unconjugated bilirubin

A
  • cholestasis
  • decreased Bu uptake by hepatocytes with fasting/anorexia
46
Q

what are your differentials for hyperkalemia

A
  • decreased GFR
  • acidosis (decreased excretion)
  • transcellular shift (necrosis)
47
Q

what is indicated by a decreased bicarb

A

titrational metabolic acidosis

48
Q

what is indicated by an increased anion gap? differentials?

A

titrational metabolic acidosis
ketones, lactate, uremic acids, ethylene glycol (KLUE)

49
Q

what is the most common cause of hypochloremia

A

vomiting

Fundamentals of Diagnostics Exam 2 (5 decks)

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