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Fundamentals of Diagnostics > Clin Path > Flashcards

Clin Path Flashcards

1
Q

Your hemoglobin value multiplied by what number should equal your hematocrit +/- 1-3 values?

A

(Hgb x 3 = HCT +/- 1-3)

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2
Q

What is indicated if your Hgb x 3 does not equal HCT +/- 1-3?

A

(Hemolysis, can be in vivo or in vitro, look for icterus or increased bilirubin for in vivo causes of hemolysis)

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3
Q

What can cause neutrophilia?

A

(Inflammation and corticosteroid response (stress))

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4
Q

What can cause lymphocytosis?

A

(Epinephrine leukogram or chronic inflammation)

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5
Q

What are the more common causes of monocytosis?

A

(Stress leukogram and increased demand for macrophages; also (from eclinpath) recovery from acute marrow injury, paraneoplastic response, and monocytic/monoblastic leukemia)

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6
Q

What is the common cause of lymphopenia?

A

(Stress leukogram; also (from eclinpath) acute infection, loss of lymphocytes (chylothorax, lymphangiectasia), lymphocytolysis (viral infection, corticosteroid usage), and primary or secondary immunodeficiency)

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7
Q

What is the more common cause of neutropenia?

A

(Overwhelming inflammation)

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8
Q

Why should you confirm platelet counts with a blood smear?

A

(Bc platelet clumping can throw you numbers off)

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9
Q

How can you determine the functionality of platelets in your patient?

A

(Buccal mucosal bleeding time, aggregometry, and flow cytometry)

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10
Q

Is PTT or PT time associated with the intrinsic clotting pathway?

A

(PTT, PT is extrinsic)

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11
Q

What clotting factors are a part of the intrinsic clotting pathway?

A

(Factors 12, 11, 9, and 8)

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12
Q

What clotting factors are a part of the extrinsic clotting pathway?

A

(Factor 7 and 3 (tissue factor))

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13
Q

What clotting factors are a part of the common clotting pathway?

A

(Factors 10, 5, 2 (thrombin), and 1 (fibrinogen))

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14
Q

Fibrinogen is an acute phase protein and it will increase/decrease (choose) when an animal is dehydrated and increase/decrease (choose) in an animal with inflammation.

A

(decrease with dehydration and increase with inflammation)

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15
Q

How do you calculate the plasma protein to fibrinogen ratio?

A

(Plasma protein minus fibrinogen divided by fibrinogen)

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16
Q

Give the PP:F values that indicate inflammation versus dehydration in horses versus cattle.

A

(Horses: <15 is inflammation, >20 is dehydration, cattle: <10 is inflammation, >15 is dehydration)

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17
Q

When is running a serum protein electrophoresis typically reserved for?

A

(In cases of unexplained hypoglobulinemia)

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18
Q

What are the normal glucose ranges for dogs, cats, horses, and cattle?

A

(Dog – 180-200, cat → 270-290, horse → 160-180, and cattle → 100-140)

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19
Q

(T/F) SDMA may increase earlier than creatinine in cases of CKD.

A

(T)

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20
Q

What proportion of renal tissue needs to be lost before azotemia is apparent on blood work?

A

(¾ loss of renal mass)

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21
Q

What proportion of renal tissue needs to be lost before the urine becomes isosthenuric?

A

(⅔ loss of renal mass)

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22
Q

How do you correct the chloride value?

A

(Take the average of the sodium reference interval and divide that by the measured sodium then multiply the measured chloride by that value)

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23
Q

Hypochloremia indicates alkalosis/acidosis (choose).

A

(Alkalosis, hyperchloremia would indicate acidosis)

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24
Q

ALT is typically used as an indicator of liver injury, what can interfere with that in dogs versus cats?

A

(Dogs → severe musculoskeletal damage and cats → hemolysis)

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25
Q

What values can be used to determine liver function?

A

(Albumin, BUN, glucose, cholesterol, coag factors, conjugated bilirubin, fibrogen, ammonia, bile acids, and RBC)

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26
Q

What values can be used to determine liver injury?

A

(ALT, AST, GDH, SDH (specific for liver damage, used in large animal but too expensive in small animal), and LDH (this one has lots of interference so not used a lot))

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27
Q

What values can be used to indicate cholestasis?

A

(ALP, GGT, bilirubin, and a urinalysis)

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28
Q

What is the primary value used to determine if there is muscle injury?

A

(CK, secondarily can used K and P since they are in high concentration in muscle cells, look for myoglobinuria, and compared AST and/or LDH to ALT (if they are high and ALT is not, more indicative of msk damage instead of liver))

29
Q

What is indicated by a mild versus a moderate to severe increase in lipase and amylase?

A

(Mild indicates decreased GFR, moderate to severe indicates exocrine pancreatic injury)

30
Q

What is indicated by an increase versus a decrease in TLI and PLI?

A

(If increased → exocrine pancreatic injury and/or decreased GFR , if decreased → chronic pancreatitis and exocrine pancreatic atrophy)

31
Q

Cobalamin will be increased/decreased (choose) and folate will be increased/decreased (choose) in cases of exocrine pancreatic insufficiency.

A

(Cobalamin will be decreased and folate will be increased in cases of EPI)

32
Q

What values can be used to determine the appropriateness of a patient’s energy metabolism?

A

(Glucose, fructosamine, cholesterol, triglycerides, ketones, and NEFAs)

33
Q

Typically, reference intervals are based on lab data from what population of animals for a given breed?

A

(Healthy adults (usually in a group of at least 120 individuals))

34
Q

What all can reference intervals vary based on?

A

(Equipment used, methodology, location, and the patient (species, breed, age, sex, diet, physiological state))

35
Q

How is a reference interval determined?

A

(Take the lab work of at least 120 healthy (typically adult) animals, find the mean and include both plus and minus two standard deviations from the mean, that’s your reference interval)

36
Q

What are the three sources of laboratory error?

A

(Preanalytical (largest variation occurs here), analytical (not a lot of variation occurs here), and post-analytical (second largest variation occurs here))

37
Q

Listed below are some of the things that can lead to preanalytical error, what can be done to prevent these things from occurring?

  • Inappropriate test request
  • Order entry error, errors on request form
  • Misidentification, labelling errors
  • Inappropriate container or sample
  • Insufficient volume
  • Inadequate transport or storage
  • Sample processing before analysis
A

(Standard operating procedures, training of personnel, and communication with clients)

38
Q

What can lead to analytical errors?

A

(Instrument malfunction, issues with the reagents, issues with the methodology, and operator error → these things are avoided through SOPs, training, automation, monitoring of results, and certification)

39
Q

What can lead to post-analytical errors?

A

(Failure in reporting, improper data entry, use of inappropriate reference intervals, and incorrect interpretation of results (this is a big one))

40
Q

Use of what type of tube can lead to a 0.0 mg/dL calcium and an erroneous increase in potassium?

A

(K3 EDTA tubes = purple)

41
Q

Leaving a sample exposed to air for too long with decrease/increase (choose) bicarb and lead to an decreased/increased (choose) anion gap.

A

(Too much air exposure leads to decreased bicarb because the sample will lose CO2, decreased bicarb will make the anion gap high)

42
Q

How do you determine how much blood you can safely collect from a patient?

A

(Find the amount of blood they have (~6-8% of their body weight), you can take 5% of that volume, 10% is the max you can remove and the animal will need 2 weeks to recover, 7.5% needs 1 week)

43
Q

What are the additives in the tube colors listed below, what tests are they typically used for, and if you were drawing every single one of these tubes in a single patient, what order would you draw them in?

Purple

A

(EDTA, , hematology, draw sixth)

44
Q

What are the additives in the tube colors listed below, what tests are they typically used for, and if you were drawing every single one of these tubes in a single patient, what order would you draw them in?

Blood culture bottle

A

(Culture media, blood culture, draw first)

45
Q

What are the additives in the tube colors listed below, what tests are they typically used for, and if you were drawing every single one of these tubes in a single patient, what order would you draw them in?

Yellow

A

(Gel/clot activator, chemistry, draw fourth)

46
Q

What are the additives in the tube colors listed below, what tests are they typically used for, and if you were drawing every single one of these tubes in a single patient, what order would you draw them in?

Grey

A

(Sodium fluoride, glucose/lactate, draw last)

47
Q

What are the additives in the tube colors listed below, what tests are they typically used for, and if you were drawing every single one of these tubes in a single patient, what order would you draw them in?

Light blue

A

(Sodium citrate, coagulation tests, draw second)

48
Q

What are the additives in the tube colors listed below, what tests are they typically used for, and if you were drawing every single one of these tubes in a single patient, what order would you draw them in?

Red

A

(Clot activator or nothing, chemistry, draw third)

49
Q

What are the additives in the tube colors listed below, what tests are they typically used for, and if you were drawing every single one of these tubes in a single patient, what order would you draw them in?

Green

A

(Heparin, chemistry or hematology, draw fifth)

50
Q

What impact can the presence of heinz bodies have on the erythron?

A

(Can increase MCH, MCHC, retics, and platelets)

51
Q

Use of an EDTA tube will have what impact on the erythron?

A

(Decreased MCV and HCT)

52
Q

If a sample is old, what impact will that have on the leukon?

A

(There may be dohle bodies, decreased WBC, decreased neutrophils, increased band neutrophils, and increased or decreased lymphocytes)

53
Q

Give the impact the following findings may have on platelet numbers:

  • Clumps
  • Ghost cells
  • Organisms
A
  • Clumps (Decreased platelet numbers)
  • Ghost cells (Increased platelet numbers)
  • Organisms (Increased platelet numbers)
54
Q

How will hemolysis (whether in vivo or in vitro) impact the following values:

  • MCH/MCHC
  • PCV/HCT/RBC #
  • Platelets
  • CK
  • Phosphorus
  • AST, LDH, Magnesium
A
  • MCH/MCHC (Increase)
  • PCV/HCT/RBC # (Decrease)
  • Platelets (Increase, if there are ghost cells)
  • CK (Increase, intraRBC enzymes interfere in CK activity)
  • Phosphorus (Increase in horses, camelids, and asian dog breeds)
  • AST, LDH, Magnesium (Increase)
  • Will also impact your refractometry TP value
55
Q

What values on your CBC will be impacted by icterus?

A

(None, can decreased creatinine and total protein)

56
Q

How will lipemia impact the following values:

  • Platelets
  • HGB
  • Electrolytes
A
  • Platelets (Increased, bc of lipid droplets)
  • HGB (Increase)
  • Electrolytes (Decrease, bc of volume displacement)
  • Will also impact your refractometry TP value
57
Q

What types of crystals can develop in urine that is delayed prior to its analysis?

A

(Calcium oxalate and magnesium ammonium phosphate crystals)

58
Q

Will pH increase or decrease when a urine sample is delayed prior to analysis?

A

(Increase)

59
Q

What is indicated by the x and y axis on the RBC scatter plot obtained when using an Idexx ProCyte?

A

(X axis is fluorescence and Y axis is size)

60
Q

What does the fluorescence of a cell in the Idexx ProCyte RBC scatter plot depend on?

A

(The amount of RNA contained in a cell, RBCs have close to none so that is why they will be tucked up next to the y-axis whereas retics have RNA so they scatter out along the x-axis)

61
Q

Give the color dot that represents the cells listed below on a RBC scatter plot:

  • Mature RBCs
  • Reticulocytes
  • Platelets
  • Escaped WBCs
A
  • Mature RBCs (Red)
  • Reticulocytes (Purple)
  • Platelets (Blue)
  • Escaped WBCs (Orange)
62
Q

Typically the RBC and platelet clouds are separated on the RBC scatter plot with minimal dots between them, what is indicated if there are lots of red dots between the RBC and platelet cloud so much so that they could be touching?

A

(RBC fragmentation)

63
Q

Give the color dot that represents the cells listed below on a WBC scatter plot:

  • Unlysed RBCs
  • Neutrophils
  • Basophils
  • Eosinophils
  • Lymphocytes
  • Monocytes
A
  • Unlysed RBCs (Orange)
  • Neutrophils (Purple)
  • Basophils (Teal)
  • Eosinophils (Green)
  • Lymphocytes (Blue)
  • Monocytes (Red)
64
Q

What is indicated by the x and y axis on the WBC scatter plot obtained when using an Idexx ProCyte?

A

(X axis is granularity and Y axis is fluorescence)

65
Q

What occurs on a WBC scatter plot when there are band neutrophils?

A

(A left shift! The machine will starts to read the bands as lymphocytes bc the nucleus is less segmented so the neutrophil could will shift up and to the left and merge with the lymphocyte and monocyte cloud, you’ll see sharp demarcations and that will indicate to you that you need to check out wtf is going on)

66
Q

Marked platelet clumping typically takes what appearance on a WBC scatter plot?

A

(A curved line → clumped platelets are variable in size and granularity and appear with the WBC population)

67
Q

What additional test can you use to determine if what is noted as basophilic stippling is actually basophilic stippling versus siderocytes?

A

(Prussian blue stain, siderocytes will stain blue because they contain iron)

68
Q

When you multiple phosphorus by calcium and the value is greater than 70-90, what does that indicate?

A

(There is a risk of tissue mineralization)

Fundamentals of Diagnostics (12 decks)

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