Clin Path, Cytology

Question 1

What other clin path parameters can influence accuracy of Hct or PCV measurements and how?

Answer 1

Lipemia, icterus: no effect.
Hemolysis (sample collection or storage)
Insufficient centrifugation speed: falsely increase PCV (RBCs don’t pack properly)

Question 2

Cytology of normal joints - what cells?

Answer 2

Occasional MN small & large Lc/phagocytes

Question 3

What is the association between PCV and point of care blood glucose?

Answer 3

Inverse relation (lower HCT –> high BG & vice versa).
Correction formula available.

Question 4

What is the association between PCV & POC blood glucose measurements?

Answer 4

Inverse relation (lower HCT –> high BG & vice versa).
Correction formula available.

Question 5

2yo MN Lab, recent travel to Arizona. FNA of scapular mass. Diagnosis?

Answer 5

Coccidioiodomycosis immitis osteomyelitis

Question 6

3yo MN X breed dog. FNA of carpal mass. Diagnosis?

Answer 6

Blastomycosis dermatitidis

Question 7

FNA of lytic bone lesion. 4yo MN dog. Diagnosis?

Answer 7

Histoplasma capsulatum
(small, intra/extracellular, within Mp)

Question 8

2yo FS GSD. FNA of lytic vertebral lesion. Diagnosis?

Answer 8

Aspergillus sp. (terrus/fumigatus most common)

Question 9

3yo MN dog. FNA of spleen. Diagnosis & treatment options?

Answer 9

Leishmaniasis (infantum/donovani)
Allopurinol monotx OR
Combo allopurinol + meglumine antimionate if not azotemic (preferred)
Combo allopurinol + miltefosine = alternative
Tx proteinuria if significant

Question 10

What 2 parameters can falsely increase USG?

Answer 10

Marked glucosuria (e.g. hyperosmolar hyperglycemic syndrome)
Marked proteinuria
USG increases by 0.005 per 1g/dL of glucose/protein in urine

Question 11

Cytological diagnosis? List the types of disease, mode of inheritance & breeds that are associated with this condition?

Answer 11

Cystinuria. Inherited defect in proximal tubule COLA AA transporter. Mutations in SLC3A1 (encodes heavy chain) or SLC7A9 (encodes light chain).

Type Ia – autosomal recessive. SLC3A1. Newfies, Labs, Landseers.

Type IIa - autosomal dominant with incomplete penetrance. SLC3A1. ACD, Border Collies

Type IIb - SLC7A9. Mini Pins
Type III - sex linked, androgen dependent. Intact males. Mastiffs, English & French bulldogs

Question 12

In which 2 breeds may this be a normal finding?

Answer 12

Ammonium biurate (thorny apple shape)
Dalmatians & Eng Bulldogs.

Question 13

Cytological diagnosis? What condition is this classic for? What other ddx?

Answer 13

Calcium oxalate MONOhydrate (dihydrate = X shaped)

Ethyelen glycol toxicity (but not sensitive finding; less commonly see CaOx dihydrate)
DDx other dz causing hypercalciuria (eg paraneoplastic LSA)

Question 14

FNA of bladder trigone mass from 8yo MN dog. Cytological diagnosis? And what are the pink cytoplasmic vacuoles called?

Answer 14

Urothelial cell carcinoma
Melamed–Wolinska bodies (unique feature of TCC)

Question 15

FNA of renal mass from 1yo dog. 2 main ddx? What IHC stains can differentiate?

Answer 15

Renal LSA (cats usually B cell; granules may suggest T cell or granular LSA)
Nephroblastoma (YOUNG animals)
- Arises from embryonic metanephric blastema.
- IHC: cytokeratin+ (epithelial), vimentin+ (mesenchymal). Wilm’s tumor gene product + confirms dx.

Question 16

What are the lower detection limits of the urine dipstick & SSA test?

Answer 16

Urine dipstick = 30mg/dl (below that = microalbuminuria)
SSA test = 5mg/dl (can detect globulins + BJ proteins)

Question 17

What hematological changes may be associated with hyperthyroidism?

Answer 17

Increased Hct, macrocytosis (thyroid hormone induces RBC production with decreased maturation time & premature release of RBCs)