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Clin path lab Services Final > Clin path Dr. Williams > Flashcards

Clin path Dr. Williams Flashcards

1
Q

What is the most common type of errors?

A

Pre-analytical

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2
Q

Always do what two tests?

A

Always do SPUN hct and PCV

The PCV results must be within 3 points of each other and if not there is a problem with the sample

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3
Q

What can cause in vitro hemolysis?

A

Traumatic venipuncture, small bore needle, delayed processing, exposure to extreme temps
(falsely decreased hct, PCV, MCV, RBC)

hemolysis outside of the body

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4
Q

What can cause in VIVO hemolysis?

A

IMHA, babesia, oxidant injury, toxin producing bacteria

Falsely increased MCHC and MCH falsely increase hgb levels but PCV and RBC are accurate

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5
Q

green top=

A

**lithium heparin- whole blood, plasma

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6
Q

What do we use red top with clot activator and serum separator gel?

A

serum collection only, no anticoagulant

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7
Q

What is blue top tube used for?

A

Na Citrate for blood transfusions and tests of the coagulation system (low toxicity)
**PT, PTT, TT
Mix WELL
check for clots

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8
Q

What could happen with underfilling EDTA (purple)

A

EDTA is hypertonic- underfilling- cells shrinking- decreased MCV and PCV
also check for clots

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9
Q

What two things does EDTA contamination cause?

A

Hypocalcemia and hyperkalemia

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10
Q

why do we remove serum/plasma right after centrifugation?

A

Pseudohypoglycemia

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11
Q

Diff quick does not reliably stain what type of cells?

A

Mast cells

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12
Q

In vitro hemolysis causes falsely decreased ____

What happens to sample left on the counter?

A

PCV;

Sample left on the counter for too long- cells swell

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13
Q

**what are some causes of increased PCV?

A

Greyhound, dehyd, splenic contraction, hypoxia/shock

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14
Q

***What are some causes of decreased PCV?

A

excess fluid tx, splenic relaxation, anemia (hemorrhage, hemolysis, decreased production)

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15
Q

What is an example of absolute erythrocytosis? What about relative erythrocytosis?

A

Absolute-> response to hypoxia, any cause for more oxygen to be going go tissues die to hypoxia
Relative–> Dehydration

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16
Q
  1. Increased PP and PCV likely means…

2. erythrocytosis is usually secondary to what?

A
  1. Dehydration
  2. hypoxia- altitude sickness- why animals in Colorado have higher PCV- secondary appropriate

but secondary INappropriate if secondary to neoplasia

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17
Q

***What does it usually mean if we have increased PP and normal PCV?

What about normal PP and decreased PCV?

A

Increased PP and normal PCV–> normal hydration but with inflammation or neoplasia or dehydration with anemia

Normal PP and decreased PCV–> intra or extravascular hemolysis, ineffective erythropoiesis

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18
Q

***What does it mean if there is decreased PP and PCV?

A

Blood loss

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19
Q

What is the only infectious agent you can see in platelets?

A

Anaplasma platys

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20
Q

***What is the main mech involved with thrombocytosis- NOT thrombocytopenia

A

Inflammation

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21
Q

left shift inflammation means more ____

A

bands

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22
Q

What does regenerative shift look like in terms of neutrophils?

A

Neutrophilia or normal amount of neutrophils with more segs than bands

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23
Q

Degenerative shift of neutrophils looks like….

A

more bands than segmented neutrophils OR neutropenia with segs more than bands

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24
Q

What is the Pelger-Huet Anomaly???

A

failure of mature granulocyte–> hypo-segmented granulocytes (Australian shepherds)

DO NOT confuse w/ degenerative left shift –look for eosinophils, if hypo-lobulated they have pelger-huet anomaly

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25
Q

**Erlichia canis–> KNOWW

A

Monocytotrophic ehrlichiosis
INFECTS MONOCYTES – morula w/in monocytes
THROMBOCYTOPENIA!!!!!!! Most significant clin-path change

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26
Q

***Ehrlichia Ewingii–>

A

Granulocytotropic ehrlichiosis
INFECTS NEUTROPHILS – morula w/in neutrophils
THROMBOCYTOPENIA!!!! Most consistent finding

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27
Q

**Anaplasma Phagocytophlum–>

A

Infects neutrophils!!!!- Morula within the neutrophil
thrombocytopenia!!!!
Granulocytotrophic anaplasmosis

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28
Q

Macroplatelets aka giant platelets….

A

Are as large or larger than RBC, FeLV, thrombopoiesis, KC spaniels with it inherited

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29
Q

Platelet clumps are usually seen in what species?

A

Feline- can help differentiate between thrombocytopenia and pseudothrormbocytopenia

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30
Q

Increased number of bands means

A

left shift in neutrophils and are usually assoc. with (acute) inflammation

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31
Q

What is the difference between regenerative and degenerative left shift?

A

Regenerative- neutrophil count is normal or high and outnumber the bands
Degenerative- the bands outnumber neutrophils and neutropenia with neutrophils outnumber the bands

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32
Q

Banded neutrophils have more dense ____ than segmented neutrophils because they are more ____

A

chromatin; immature

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33
Q

Name this condition- failure of mature granulocyte (neutrophils, eosinophils and basophils) nuclei to lobulate (hyper segmented)

Usually an incidental finding
DO NOT confuse with what?

A

Pelger- Huet Anomaly; DO NOT confuse with degenerative left shift

Pelger-Huet Anomaly does not affect how the neutrophil operates

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34
Q

Why would a lymphocyte become reactive? What does it look like?

A

Proliferate in response to antigens; may have convoluted nuclei, bigger in size, increased cytoplasmic basophilia (look like foamy, larger lymphocytes to me)

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35
Q

___ are cells that are one stage less mature than a neutrophil and indicate more sickened animals. Normal to see low numbers of them but increased numbers means…

A

Bands; left shift and means there is inflamm condition

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36
Q

____ have similar nucleus to neut but less lobulated and have pale blue to neutral cytoplasm with RED granules?

A

Eosinophils

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37
Q

What are grey eosinophils and where are they found?

A

Greyhounds; they are poorly stained granules of eosinophils that are grey

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38
Q

____ cells have light blue or granular cytoplasm with blue granules and nucleus that is similar to neut but less lobulated?

A

Basophils

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39
Q

What is the HALLMARK of the acute stage of Ehrlichia canis?

A

Thrombocytopenia (decreased platelets)

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40
Q

Ehrlichia Ewingii-

A

Granulocytic ehrlichiosis

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41
Q

Diagnosis of Ehrlichia Ewingii–

A

Morular (CANNOT diff from A. phagocytopilum) found in the granulocytes

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42
Q

What is the most consistent finding with Ehrlichia, Ewingii, E. canis, and Anaplasma Phagocytophilum?

A

Thrombocytopenia (low platelet)

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43
Q

Hepatozoonosis-

Hepatozoon canis

A

In hemolymphatic tissues

anemia, +/- extreme neutrophilia

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44
Q

Hepatozoonosis- Hepatozoon Americanum

A

mainly infects muscular tissues causing myositis and lameness, anemia, and definitely has neutrophilia

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45
Q

What % has circulating gamonts in the leukocytes with Hepatozoon Americanum?

A

<0.1%

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46
Q

Is extremely neutrophilia always occuring with Hepatozoon canis infection?

A

Nope, infrequent observation

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47
Q

Hepatozoonosis

How can we ID hepatozoon canis vs Hepatozoon americanum?

A

H. canis is ID via gamonts

H. americanum is ID via gamonts in the neutrophils (detected in <0.1% of the leukocytes *know)

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48
Q

When should we use purple top for urine sample?

A

Only if the sample is hemorrhagic and you want to do a cytology (the EDTA will preserve the cell morphology)

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49
Q

What are some consequences to delayed processing of a urine sample (left out for more than 30 mins or so)???

A

Increased pH, formation of crystals, increased turbidity and bacterial growth, color change (bilirubin is sens to light)

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50
Q

How long can a urine sample be in the fridge for?

A

6-24 hours usually

Warm before examining if was placed in the fridge

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51
Q

What are the only normal colors of urine?

A

Pale to normal yellow or amber colored

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52
Q

USG is an indirect measurement of ____

A

osmolality

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53
Q

____ and elevated protein can affected ____

A

Glucose; USG

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54
Q

What is USG of 1.008-1.012 suggestive of?

A

Isothenuria; decreased USG; renal failure or increased water intake before sample was received
means kidneys are not concentrating NOR diluting and the urine and plasma osmolality is the same

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55
Q

Vet dipsticks of USG, urobilinogen, nitrate, and leukocyte counts are not accurate in vet med. T/F

A

True!!!

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56
Q

After a meal urine is usally ____, pH > 8 can cause….

A

alkaline; can cause disintegration of WBCs, RBCs, and casts

alkaline urine can cause false positive protein counts

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57
Q

Most protein in urine is _____ and must be interpreted in ___ and ____

A

Albumin; pH and USG

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58
Q

SAA test should always be performed on the ____

A

supernatant

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59
Q

SAA (Sulfosalicyclic acid test)- proteins are denatured by acids that form a precipitate that is seen as….

A

increased solution turbidity

**always perform on the supernatant!!

60
Q

What detects earlier stages of renal injury?

A

Urine protein: creatinine ratio

61
Q

Are ketones ever in the urine of healthy animals?

A

Nope

62
Q

Fat droplets in urine sample are usually seen in what animal and why?

A

Cats; cats normally store triglycerides in the renal tubular cells

63
Q

What are the factors affecting crystal growth?

A

pH, USG, duration since collection, storage

low numbers of certain crystals can be a normal finding

64
Q

What is normal in Dalmatians but can suggest liver issues or acidic conditions in other breeds?

A

Amorphous urates

65
Q

What is found in health dog and cat urine- amorphous crystals or amorphous urates?

A

Amorphous crystals

Alkaline pH

66
Q 
Coffin lid look 
aka Magnesium ammonium phosphate 
form in basic urine 
MOST COMMON UROLITH FORMATION IN CATS AND DOGS 
normal in low numbers though
A

Struvite

67
Q

What conditions do struvites thrive in?

A

Basic urine, UTI, low urine volume

68
Q

What crystal type is colorless and square with “maltese cross”?

A

Calcium oxalate DIHYDRATE

69
Q

What crystal type may be present in low numbers in healthy animals but increased numbers usually means ethylene glycol toxicity or ingestion of oxalate and form in ACIDIC pH?

A

Calcium oxalate DIHYDRATE

70
Q

What crystal is translucent with picket fence shape and not usually found in healthy animals?

A

Calcium oxalate monohydrate

71
Q

What does presence of Calcium oxalate monohydrate suggest?

A

Hypercalciuria or hyperoxaluria
most common calcium oxalate crystal type
ACIDIC pH
Most COMMON type of calcium oxalate crystal seen during ethylene glycol intoxication

72
Q

What crystal type looks like brown to yellow thorny spherical shapes?

A

Ammonium biurate

73
Q

What crystal forms NORMALLY in English Bulldogs and Dalamatians? What does it mean if it is seen in other breeds?

A

Ammonium biurate; seen in other breeds means high blood ammonia or uric acid levels usually due to portal vascular anomaly

74
Q

What crystal type develops in BASIC pH and found mostly in herbivores??

A

Calcium carbonate

circular glassy looking

75
Q

What crystal type is yellow to brown and develops in ACIDIC pH and is common in Dalmatians but may suggest liver dz in other breeds?

A

uric acid

76
Q

What crystal type is a small golden to brown needle to fiber looking crystal with possible normal presence in dogs with concentrated urine

A

Bilirubin crystals

77
Q

What does increased bilirubin crystal formation usually mean?

A

Bilirubinemia with subsequent bilirubinuria and pre-hepatic, hepatic, or post-hepatic causes

78
Q

What crystal looks like yellow to brown hair/needle things?

A

Bilirubin crystals (unlike ammonia biurate which are spherical yellow to brown spikey structures)

79
Q

What crystal type looks like weird furry/spikey dumbells?

A

Sulfur crystals

80
Q

What are reasons to see sulfur crystals?

A

Associated with reduced water intake while getting sulf drugs

81
Q

What are two types of parasites mentioned that can be seen in urinalysis?

A

Diotopjyma renale and Pearsonema aka capillaria

82
Q

Hypercalciuria or hyperphosphaturia due to hyperparathyroidism, hyperadrenalcorticism, distal renal tubular acidosis, glucocorticoids, furosemide = what type of crystals in urine???

A

Calcium phosphate

83
Q

What animal has the most central pallor seen (biconcave disc)?

A

Dogs

84
Q

Agglutination vs Rouleaux

A

agglutination is antibody mediated and looks like grapes and rouleaux is coin stacking apperance and is n in the cat, horse, pig BUT abn in dog (usually means hyperproteineima)

85
Q

How do we diff agglutination vs rouleaux?

A

Saline dispersion test, look at it grossy and microscopically

86
Q

What does the appearance of red granules in well-mixed blood sample suggest?

A

Agglutination (prob IMHA/hyperproteinemia)

87
Q

What are some things causing ghost cells?

A

Complement mediated intravascular hemolysis or oxidative damage or smearing trauma artifact

88
Q

What tells you its EXTRA AND INTRAvascular hemolysis???

A

Spherocytes, ghost cells, and agglutination

89
Q

What are polychromatophilic cells?

A

Bluish-red RBC in stained blood films is called polychromasia aka polychromatophilic cells

Reticulocytes that stain bluish-red as they are stained red and blue
Stained with New Methylene Blue

90
Q

RBC with increased central pallor and faintly stained HGB mean….

A

Hypochromic RBC

91
Q

What can cause hypochromic erythrocyte?

A

Decreased intracellular HGB, Fe deficiency, Hypochromic anemia (decreased MCHC)

92
Q

What animal normally has anisocytosis (which is the variation of volumes/sizes of erythrocytes)???

A

Cattle

93
Q

MCV is the average ____ of RBCs

A

volume

94
Q

Macrocytes are large RBC and are assoc. with what?

A

Regeneration anemia, bc the volume of immature reticulocytes are larger than mature RBCs

95
Q

Low MCV usually means….

A

Iron def

96
Q

What does it mean if PCV is n but MCV is low???

A

Low Fe or portosystemic shunt unless its an Akita, Shiba Inu, Chow, Shar-pei

97
Q

What are some causes of microcytes (which are RBC that are decreased in volume/size)???

A

Fe def, hepatic failure/portosystemic shunts

*normal in Akitas, Chow, Shar-pei, Shiba Inu

98
Q

Basophilic stippling- what does it look like

A

Aggregated ribosomes and polyribosomes forming blue stained punctate inclusions
looks like speckled easter egg, diffuse across the membranes

99
Q

What are some causes of basophilic stippling?

A

Seen with regenerative anemias, esp with cattle. Lead poisoning is a huge cause
not usually seen in sm. animals

100
Q

Blood parasite vs basophilic stippling-

A

basophilic stippling is smaller dots diffusely over the whole RBC

101
Q

Heinz bodies, what are they?

What do they look like? Why do they occur?

A

They are aggregation of denatured hemoglobin caused by oxidative damage

Looks like little circles on the RBC almost like the RBC is growing a little head

Some causes are hemolysis from toxins
Low numbers are normally seen in cats

102
Q

What are some causes of hemolysis (toxins) causing Heinz Bodies?

A

Dogs- acetaminophen, hydrogen peroxide, onions, vit K, moth balls, garlic, skunks

Cats- Acetaminophen, propofol, propylene glycol, onions, methylene blue, benzocaine, methionine

Horses- onions, red maple

Ruminants- kale, copper, hydrogen peroxide, onions, rye grass

all are toxic in high doses and will cause heinz bodies but will not in lower doses

103
Q

Reticulocytes look just like basophilic stippling but how do we tell them apart?

A

Bc reticulocytes are seen with a specific stain- New Methylene Blue!!!

104
Q

Howell Jolly bodies are nuclear remnants of RBC that remained free in the cytoplasm after ___ of an ___ ____

A

mitosis of an erythrocyte precursor

Round, dense (dark blue to purple) and usually centrally located in the RBC

Seen in healthy animals, increased if there is accelerated erythropoiesis or decreased splenic function (like the animal had a splenectomy)

105
Q

What stain is used when looking for iron or iron related changes?

A

Prussian Blue staining

106
Q

___ means variation in RBC shapes, can be normal in deer and goats

A

Pokilocytosis

107
Q

Acanthocyte (spur or burr cells) are most common in what animal? What do they usually indicate?

A

Dogs; usually mean excess cholesterol, portosystemic shunts/liver dz, lymphoma, or hemolysis (DIC, hemangiosarcoma, glomerulonephritis)

108
Q

What cells are normally seen in low numbers and have central focus of HGB that is surrounded by a ring of pallor that separates it from peripheral HGB?

A

Codocytes (target cell or Mexican hat cell)

109
Q

What are some causes for codocytes?

A

Low numbers seen in n dog blood, regenerative anemia, iron def, cholestatic dz, post splenectomy

110
Q

What RBC type has eccentric staining HGB and adjacent clear space or crescent?

A

Eccentrocyte (bite cell or blister cell) caused by fusion of membranes damaged by oxidants

111
Q

Echinocyte occur in 3 types, what are these types?

What is the difference between Acanthocytes and Echinocytes

A

Type 1- irregularly shaped cells
Type 2- regularly blunt projections
Type 3- regularly spaced pointed projections

Difference is: Acanthocytes are irregularly spiculated cells (spicules are irregular in size, shape and distribution around the RBC membrane), whereas echinocytes are regularly spiculated cells

112
Q

echinocyte aka burr cells are seen from what complications in the body or conditions?

A

Lymphoma, IMHA, hemangiosarc, rattlesnack envenomation, doxorubicin toxicosis

Acanthocytes are irregularly spiculated cells (spicules are irregular in size, shape and distribution around the RBC membrane), whereas echinocytes are regularly spiculated cells

113
Q

What is the term for a spiculated RBC that frequently have only 1-2 spicules and indicate RBC fragmentation?

A

Keratocyte (helmet cell)

114
Q

What RBC change is associated with microvascular injury, Iron def, myelodysplastic syndrome, and trauma or oxidative injury?

A

Keratocyte (Helmet cell)

115
Q

What type of RBC is normal in the camelid?

A

Ovalocyte (Elliptocyte)

116
Q

What is this term based on the definition:

A RBC fragment usually resulting from direct physical damage. Irreg. shaped and usually comma or triangular shaped

A

Schistocyte (RBC fragment)

117
Q

What is evidence of microangiopathic dz (microvascular issues) in dogs or chronic doxorubicin administration?

A

Schistocyte which is RBC fragment

118
Q

What are some causes for spherocytes which are RBC that lost their biconcave shape?

A

IMHA, rattlesnake and bee stings, zinc toxicity

119
Q

**What is Kohler illumination?

A

Process of adjusting the condenser to produce the focus of the illumination source

If you see a black line, means you are out of line and need to shut down the diaphragm, focus center should be in the center always and then open the diaphragm

120
Q

Optimizing field of view aka ____ ____

A

Kohler illumination

121
Q

What causes a more intense color change with spectrophotometry?

A

amount of creatinine

122
Q

If you have what changes to the blood sample causes color change and you should interpret the sample(s) with caution—>

A

Lipemia, icterus or hemolysis

123
Q

***MCHC increased=

A

ARTIFACT

124
Q

why is plasma protein a component of CBC?

A

Helps decide if there is blood loss indicating anemia rather than lack of production/destruction

125
Q

***What are causes for decrease PP and PCV?

A

IMHA, GI issues, Babesia, blood loss, liver failure

126
Q

***What are some causes for n PP and decreased PCV?

A

Normal hydration status with intra or extravascular hemolysis, ineffective EPO

127
Q

**What are some causes of increased PP and n PCV

A

if hydration is n= inflamm, neoplasia

If dehydrated= anemic

128
Q

***What are causes for increased PP and PCV?

A

Dehydration

129
Q

E. canis is in the ____

A

monocyte

130
Q

H. americanum is found in the ______ and affects muscles

A

neutrophils

131
Q

what urine crystals form in ACIDIC urine???

A

Calcium oxalate dihydrate, calcium oxalate monohydrate, uric aid

132
Q

What urine crystals form in alkaline urine???

A

Struvite, calcium phosphate, calcium oxalate, ammonium biurate

133
Q

Mastocytemia does not always mean mast cell tumor T/F

A

True inflammation is the most common cause

134
Q

What 3 parasites are in the neutrophils?

A

H. canis and H. americanum and E. Ewingii

135
Q

What blood parasite affects monocytes?

A

E. canis

136
Q

Heinz body anemia is normally seen in SMALL numbers in ___ but indicate what in other animals???

A

cats; hemolysis (likely oxidative damage/toxins)

137
Q

Acanthocyte aka burr cell likely means what two conditions are possible?

A

Liver dz or lymphoma

138
Q

Low number of ____ are normally seen in blood of dogs. Abn means cholestatic dz, regenerative anemia, iron deficiency, splenectomy

A

codocytes (Mexican hat cells)

139
Q

**Increased PP and normal PCV–>

A

normal hydration but with inflammation or neoplasia or dehydration with anemia

140
Q

Mycoplasma is ___ of RBC unlike ____ which is inside

A

Outside; Babesiosis

141
Q

what does Babesia gibsoni look like?

A

Cytayxazoon in the cat

142
Q

what are the two forms of cytauxzoonosis?

A

Nonerythrocytic (schizont) and erythrocytic (piroplasm/merozoite)

143
Q

What are the diag. for Cytauxzoonosis?

A

Schizonts in the macrophages and/or merozoites in the erythrocytes
PCR too

144
Q

Appropriate rubricytosis means….

A

response to anemia with reticulocytosis

145
Q

INappropriate rubricytosis means….

A

rubricytosis without reticulocytosis

Clin path lab Services Final (6 decks)

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