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Diagnostics > Clin Path > Flashcards

Clin Path Flashcards

give differentials unless other question is asked

1
Q

lymphopenia

A

usually stress, can be acute inflammation

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2
Q

mild normocytic, normochromic, non-regenerative anemia

A

anemia of chronic disease/inflammation, end stage renal disease

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3
Q

selective hypoalbuminemia

A

hepatic failure, PLN, inflammation, less likely PLE

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4
Q

hyperglobulinemia

A

dehydration, inflammation, neoplasia

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5
Q

how can you rule out renal azotemia

A

USG>1.035 = concentrating urine well

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6
Q

what electrolyte abnormalities are seen with urinary bladder rupture

A

low sodium, low chloride, high potassium

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7
Q

hyperphosphatemia

A

decreased GFR from dehydration is by far most likely
in horses, may be diffuse intestinal dz

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8
Q

decreased anion gap

A

not clinically significant, usually due to hypoalbuminemia

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9
Q

elevated TCO2

A

metabolic alkalosis
can be compensatory for a respiratory acidosis or secondary to hypoalbuminemia

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10
Q

hyperglobulinemia with hypoalbuminemia

A

inflammation

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11
Q

hyperglycemia

A

glucocorticoid stress, epinephrine excitement, sepsis (may be high or low), diabetes mellitus

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12
Q

elevated GGT

A

cholestasis (expect increased direct bilirubin), biliary hyperplasia, intestinal dz in horses

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13
Q

elevated indirect bilirubin in horses

A

fasting/anorexia

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14
Q

how do you calculate corrected chloride

A

(avg Na RI/measured Na) x measured CL

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15
Q

hyponatremia and hypochloremia

A

volume overload, excessive water intake, hypertonic fluid loss (secretory diarrhea), hypotonic fluid loss (GI, renal, 3rd space)

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16
Q

high anion gap

A

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

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17
Q

decreased TCO2

A

metabolic acidosis

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18
Q

what is the cause of lactate formation

A

poor perfusion, hypovolemia, dehydration

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19
Q

neutrophilia, monocytosis, lymphopenia, eosinopenia

A

stress leukogram

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20
Q

hypercalcemia

A

neoplasia (lymphoma), idiopathic, hyperparathyroidism, addison’s (expect low Na, high K), renal disease, vitamin D toxicosis (expect high P), granulomatous inflammation, osteolysis

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21
Q

what is PTHrP

A

parathyroid hormone related protein is the cause of a significant amount of hypercalcemia associated with malignancy

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22
Q

how can ketosis be ruled out

A

no ketones on urinalysis

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23
Q

describe a pure transudate

A

<2g/dL protein, <1500 cells/mL

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24
Q

pure transudate differentials

A

PLN, PLE, liver failure, causes of modified transudate

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25
Q

describe a modified transudate

A

> 2g/dL protein, <5000 cells/mL

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26
Q

modified transudate differentials

A

hypertension, heart failure, heartworm disease, lymphadenopathy, FIP, obstruction of Ca vena cava or hepatic vein, neoplasia, lung dz/torsion, diaphragmatic hernia, long standing transudates, many others

27
Q

describe a septic exudate

A

> 2g/dL protein, >5000 cells/mL, degenerate neutrophils, infectious agents

28
Q

septic exudate differentials

A

pleuropneumonia, esophageal perf, GI perf or necrosis, ruptured bladder, penetrating wound, foreign body, hematogenous

29
Q

describe a sterile exudate

A

> 2g/dL protein, >5000 cells/mL, non-degenerate neutrophils, no infectious agents

30
Q

sterile exudate differentials

A

anything that causes inflammation in body space; pancreatitis, enteritis, colitis, displaced organs/tissues, ruptured bladder, FIP, neoplasia

31
Q

describe a hemorrhagic effusion

A

> 1,000,000 RBCs, erythrophagia, hemosiderin (brown and mostly in macrophages) on microscopic exam

32
Q

hemorrhagic effusion differentials

A

trauma, displaced organs/tissues, hemorrhaging neoplasms, coagulation disorders, idiopathic

33
Q

describe a chylous effusion

A

> 2g/dL protein, triglycerides > 100mg/dL almost pathopneumonic, small lymphocytes

34
Q

chylous effusion differentials

A

idiopathic, trauma, heart dz (leading cause in cats), displaced organs/tissues, lymphadenopathy, neoplasms

35
Q

describe a urinary effusion

A

creatinine higher in effusive fluid than plasma

36
Q

urinary effusion differentials

A

uroliths, mucus plugs, trauma, neoplasm

37
Q

describe a biliary effusion

A

> 2g/dL protein, >5000 cells/mL, bile (amorphous green/brown, extracellular and in macrophages) on microscopic exam, bilirubin higher in effusive fluid than plasma

38
Q

biliary effusion differentials

A

choleliths, mucocele, trauma, neoplasm

39
Q

describe a neoplastic effusion

A

neoplastic cells on microscopic exam

40
Q

eosinophilia

A

worms - heartworm, lung worms, ascarids, any worm with tissue migration of larval stages
wheezes - asthma, allergy, hypersensitivity reaction
weird diseases (moderate to severe elevation) - GI eosinophilic dz, hypereosinophilic syndrome, primary eosinophilic leukemia, paraneoplastic eosinophilia with mast cell or lymphoma

41
Q

what do changes in pH on blood gas indicate

A

primary acidemia (low) or alkalemia (high)
compensatory processes cannot bring the pH back into normal range

42
Q

high PCO2

A

respiratory acidosis
(CO2 is a resp acid)

43
Q

low PCO2

A

respiratory alkalosis
(CO2 is a resp acid)

44
Q

what does TCO2 represent on bloodwork

A

bicarb

45
Q

low TCO2

A

metabolic acidosis

46
Q

low pH, low PCO2, low TCO2

A

primary metabolic acidosis with compensatory respiratory alkalosis

47
Q

high bicarb

A

metabolic alkalosis

48
Q

low bicarb

A

metabolic acidosis

49
Q

hypochloremia (relative to Na)

A

vomiting

50
Q

what acid/base abnormality occurs with true hypochloremia

A

to compensate for loss of Cl, bicarb increases, causing a metabolic alkalosis

51
Q

increased Cl with normal Na

A

Cl is increased in response to loss of bicarb in diarrhea = secretional metabolic acidosis

52
Q

what do you expect K to do with an acidosis

A

increase b/c it exits cells as H+ enters cells

53
Q

what do you expect K to do with an alkalosis

A

decrease b/c it enters cells as H+ exits cells

54
Q

mild thrombocytopenia

A

platelet clumping, splenic sequestration, infectious cause, drug reaction, DIC (would also see RBC fragments)

55
Q

mild hyperalbuminemia

A

dehydration

56
Q

severe anemia with mild reticulocytosis (inappropriate regeneration)

A

chronic low grade anemia with acute anemia OR something wrong with bone marrow so unable to produce adequate reticulocytes OR early anemia

57
Q

macrocytic, hypochromic anemia

A

regeneration

58
Q

microcytic, hypochromic anemia

A

iron deficiency

59
Q

acanthocytes

A

liver disease or erythrocyte fragmentation

60
Q

keratocytes

A

iron deficiency, liver disease, myelodysplastic syndrome, erythrocyte fragmentation

61
Q

schistocytes

A

erythrocyte fragmentation due to: severe iron deficiency, microangiopathic hemolytic anemia, myelofibrosis, heart failure, glomerulonephritis, lots of other things

62
Q

fragmented RBCs and thrombocytopenia

A

DIC or microvascular disease

63
Q

elevated ALT

A

hepatocellular injury (not uncommon with hypoxic injury to liver secondary to anemia)

64
Q

at what platelet count do we worry about spontaneous hemorrhage

A

<50

Diagnostics (1 decks)

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