Clinical Pathology 1

Question 1

So you send out your bloodwork and get your results. How do you break it down into groups for interpretation?

Answer 1

CBC:
-Erythron - RBCs
-Leukon - WBCs
-Thrombon - Platelets

Chem + UA + Blood Gases
-Protein Metabolism (Total plasma protein + fibrinogen)
-Energy Metabolism
-Renal
-Minerals (Ca, P, Mg)
- Electrolytes and acid base
-Liver
-Muscle
-Pancreases and GIT

Question 2

What is included in the Eythron?

Answer 2

RBC masses - RBC count HGB, HCT/PCV
RBC Indices - MCHC and MCV
RBC Morphology
Regeneration - retic count, retic %, CHr, Morphologic changes
Iron Panel

Question 3

Hematocrit is calculated by:
PCV is determine by:

Answer 3

Machine
Hand/You
*Should match

Question 4

What are the causes of a regenerative anemia?

Answer 4

Hemorrhage and hemolysis

Question 5

If you are not given the HCT, how do you calculate it?

Answer 5

HgB x 3 = HCT +/- 1-3 (except in camelids)

Question 6

What does a heinz body indicate?

Answer 6

Oxidative Injury

Question 7

How can you tell an anemia may be regenerative without the reticulocyte percent?

Answer 7

If there you have increased MCV and normal MCHC (large cells regernating)

Question 8

What is included in the Leukon?

Answer 8

Leukocytosis -
-Neutrophilia - left vs right shift, inflammation, epinephrine/corticosteroids
-Lymphocytosis - epinephrine, chronic inflammation
-Monocytosis - stress leukogram, increase demand macrophages, eosinophilia/basophilia (worm, wheezes and weird diseases)

Leukopenia -
-Neutropenia - overwhelming inflammation
-Lymphopenia - eospinpenia - corticosteroid or stress
-Monocytopenia and Basopenia

Question 9

What is included in the Thrombon?

Answer 9

-Platelet count- thrombocytosis, thrombocytopenia (spontaneous hemorrhage)
-Platelet estimation - adequate, decreased, increased, platelet clumps
-Platelet morphology - enlarged (MPV), giant (RBC), infectious agents
-Platelet function (Buccal mucosal bleeding time, aggregometry, flow cytmetry
-vWF
-Coagulation factors (PT/APTT)
-Fibrinogen
-FDP/D-dimers
-Global hemostsis

Question 10

How can you prevent platelet clumps in your sample?

Answer 10

Use a vacutainer

Question 11

What parts of the chemistry are indicators of protein metabolism?

Answer 11

-Total plasma protein
-Fibrinogen
-Total Serum Protein
-Albumin
-Globulin
-Serum protein electrophoresis
-Acute phase proteins (serum amyloid A and C-reactive protien
-Ammonia
-Urea

Question 12

What is the equation needed to ID the ration that tells if inflammation or dehydration occurring?

Answer 12

PP:F ratio = (PP)- (Fibrinogen)/(Fibrinogen)

Horse:
<15 Inflammation
>20 Dehydration

Cattle:
<10 inflmmation
>15 dehydration

Question 13

What is the equation to find the globulins?

Answer 13

Tp - Albumin = Globulin

Question 14

What can serum protein electrophoresis tell us?

Answer 14

If there is polyclonal or monoclonal inflammation

Question 15

What does a polyclonal versus and monoclonal SPE look like?

Answer 15

Polyclonal - Tall narrow albumin and wide taller gamma

Monoclonal- short albumin and tall narrow gamma

Question 16

What parts of the chem should you consider for energy metabolism?

Answer 16

Carbohydrates - Glucose and Fructosamine

Lipids
-Cholesterol
-Triglycerides
-Ketones (BHB and urine)
-Unesterified fatty acids (NEFAS)

Question 17

If you see a high glucose on chem, what should you do next?

Answer 17

Check urine to see if transient or permanent

Question 18

What are the normal glucose thresholds?

Answer 18

Dog: 180-200mg/dL
Cat:270-290mg/dl
Horse: 160-180mg/dl
Cattle: 100-140mg/dl

Question 19

What chem parameters are you looking at to think about renal funciton?

Answer 19

Primary: Creatine, BUN, Urinalysis (UPC), SDMA

Secondary: Albumin, Minerals, electrolytes, Acid-Base

Question 20

What are the mineral on the chem test?

Answer 20

Primary: Calcium, Phosphorus, Magnesium
Secondary: Albumin, ALP and Renal Profile

Question 21

What does it mean if you have an increase in P?

Answer 21

Decreased glomerular filtration

Question 22

If calcium is low, where should you look next?

Answer 22

Look at the Albumin

Question 23

What values do you look at to determine electrolyte and acid-base status?

Answer 23

Na, K, Cl, Hco3 (Tco2), Anion Gap, Blood Gases

Question 24

Whats the formula for corrected chloride?

Answer 24

Average Na/Measured Na x measured Cl

High = metabolic acidosis
Low = Metabolic Alkalosis

Question 25

What values do you look at on chem to evaluate the liver?

Answer 25

Injury: ALT, AST, GLDH/GDH, SDH, LDH

Function: Albumin, BUN, Glucose, Cholesterol, Coagulation Factors, Conjugated Bilirubin, Fibrinogen, Ammonia, Bile Acid, RBC

Cholestasis: ALP, GGT, Bilirubin, Urinalysis, Unconjugated Bilirubin, Conjugated Bilirubin, Delta Bilirubin

Question 26

What parameters are used to identify muscle injury?

Answer 26

Primary: Ck

Secondary: AST vs ALT, LDH vs ALT, K and P, Urinalysis -> Myoglobin

Question 27

What parts do you asses to look for exocrine pancreas information?

Answer 27

Lipase and Amylase, Trypsin like immunoreactivity, Pancreatic lipase immunoreactivity, cobalamin and folate