Clinical Pathology (1-4) Flashcards
1
Q
name the 5 main disciplines involved with clinical pathology
A
- cytology
- hematology
- clinical biochemistry
- urine analysis
- serology
2
Q
this is the examination and assessment of cells in smears and fluids
A
cytology
3
Q
this sample collection technique is suitable for cutaneous masses, internal masses and organs, lymph nodes, etc
A
fine needs aspirates (FNAs)
4
Q
in this FNA technique, insert the needle, apply suctions, redirect the needle, release suction and take out needle
A
suction technique
5
Q
in this FNA technique, insert the needle, redirect, and take of the needle
A
non-suction technique
6
Q
this sample collection technique is suitable for tissues which are not readily reached; cotton swab with 0.9% NaCl used to collect sample
A
swabs
7
Q
name the smear prepartaion technique
sample is placed on one side of slide, spreading side on top to form cross, then gently spread towards the end of the sample slide
A
squash preparation
8
Q
name the slide prep technique
suitable for rapid diagnosis of some external lesions and excised tissues, which may subsequently be examined by histopathology
A
touch imprints
9
Q
name the smear preparation technique used for scrapings
A
squash technique
10
Q
fluids are submitted in thsi type of tube for cytology and/or total cell counts
A
EDTA tube
11
Q
name the smear preparation technique
works well with fluids of medium to high cellularity
A
blood smear technique
12
Q
name the smear preparation technique
works best for low cellular fluid samples
A
line smear
13
Q
name the 2 main stains used in practive for cytology
A
Diff-Quick or Rapi-Diff
14
Q
list the 5 step approach for assessing cytology slides
A
- examine with naked eye
- use low power (x4 and x10), look for large structures
- use x20 and x40, look at areas of interest
- use x100 oil immersion, for more detail
- look over entire smear!
15
Q
what 3 things should be deterimined when examining cytological preparations
A
- type of cell(s) present
- nature of process(es) present
- degree of abnormality
16
Q
name the 3 main categories of cell types when evaluating slides
A
- epithelial
- mesenchymal
- round cell
17
Q
name the category of cells seen on cytology slides
tend to exfoliate well and tend to be cohesive - often exfoliate in clusters, papillary structures, rows and occassionally form acinar structures
A
epithelial
18
Q
name the category of cells seen on cytology slides
mainly connective tissue cells, do not exfoliate well, are individualized and often have an indistinct cytoplasmic border
A
mesenchymal
19
Q
name the 5 types of round cells
A
Lymphocytes
TVT (transmissible veneral tumor)
Mast Cells
Plasma Cells
Histiocytes
20
Q
name the category of cells seen on cytology slides
cells exfoliate in high numbers as individualized cells
A
round cells
21
Q
name the process present based on the cytology
low protein fluid and a few cells, often reactive macrophages predominate
A
cyst
22
Q
name the abnormal cell morphology present
may look normal or have mild anisocytosis, slightly variable nucleus to cytoplasm ratio and/or increased cytoplasmic basophilia
A
hyperplasia
23
Q
name the abnormal cell morphology present
results from asynchronous maturation of different parts of the cell; mild to moderat anisocytosis, variation in nuclear size, increased N:C ratio, occassionally coarse chromatin
A
dysplasia
24
Q
name 6 criteria of malignant neoplasia
A
- anisocytosis
- anisokaryosis
- immature features/abnormal nucleoli
- multinucleation
- abnormal mitosis
- nuclear molding
25
# name the tube used for the blood test
routine hematology
EDTA
| (purple top vacutainer or pink plastic tube)
26
# name the tube used for the blood test
most biochemistry
clotted (serum)
| (red top vacutainer or white plastic tube)
27
# name the tube used for the blood test
coagulation tests
trisodium citrate
| (pale blue vacutainer, purple plastic tube)
28
# name the tube used for the blood test
glucose
fluoride oxalate
| (grey top vacutainer or yellow plastic tube)
29
# name the tube used for the blood test
hormone tests
serum or heparinized plasma
| (green top vacutainer or orange plastic tube)
30
this value tells you the percentage of the sample occupied by RBCs
packed cell volume (PCV)
31
a decrease in packed cell volume (PCV) is called this
anemia
32
an increase in packed cell volume (PCV) is called this
erythrocytosis
33
this is the white layer on top of the PCV which is composed of WBCs and platelets
buffy coat
34
what 4 things can be evaluated with a microhematocrit tube
1. packed cell volume (PCV)
2. Buffy coat
3. Plasma color
4. total solids
35
name the 6 main estimations performed to assess numerical RBC data
1. total RBC count
2. Hematocrit (Hct)
3. Hemoglobin concentration (Hb)
4. mean cell volume (MCV)
5. mean cell hemoglobin concentration (MCHC)
6. Reticulocyte count
36
name the two main types of anemia
1. Regenerative
2. Non-regenerative
37
name two examples of regenerative anemia
hemorrhagic anemia
hemolytic anemia
38
# name the type of anemia
reticulocytosis, anisocytosis, may be macrocytic hypochromic
regenerative anemia
39
# name the type of anemia
usually normocytic normochromic except in deficiency
non-regenerative anemia
40
these are immature RBCs, one stage before the mature RBC - do not have nuclei but have clumps of cytoplasmic RNA
reticulocyte
41
these are nucleated RBCs which are one stage less mature than reticulocytes
metarubriocytes
42
this value tells you the average volume of erythrocytes present
mean corpuscular volume (MCV)
43
this is when MCV is within the reference interval for the species
normocytic
44
this is when MCV (RBC size) is increased
macrocytic
45
this is when MCV (RBC size) is decreased
microcytic
46
name 4 things that can cause macrocytic RBCs
1. regeneration
2. genetic characteristics
3. feline leukemia virus
4. artefacs (agglutination)
47
name 5 things that can cause microcytic RBCs
1. iron deficiency
2. portosystemic shunt or liver disease
3. age
4. genetic characteristics
5. marked fragmentation
48
this value is the average concentration of RBC Hb on a weight per volme basis - often calculated (Hb/Hct)x100
mean corpuscular hemoglobin concentration (MCHC)
49
this is when the cell Hb content (color) is decreased
hypochromic
50
name 2 things that can cause hypochromic RBCs
1. regenerative response
2. iron deficiency
51
# name the type of RBC distribution
coin stacking of erythrocytes
rouleaux
52
# name the type of RBC distribution
aggregation of erythrocytes due to presence of anti-erythrocyte antibodies causing immune-mediated anemia
agglutination
53
how to distinguish rouleaux and agglutination from each other
saline dispersion test (rouleaux will disperse)
54
define anisocytosis
variation in size
55
define poikilocytosis
variation in shape
56
# name the type of RBC poikilocyte
crenated RBCs with evenly arranged sharp spikes around the periphery, usually an artefact due to slow drying of the smear or ageing of the sample
echinocyte
57
# name the type of RBC poikilocyte
uneven, rounded spikes caused by damage to RBCs in the circulation
acanthocyte
58
# name the type of RBC poikilocyte
irregular fragments caused by damage to RBCs in the circulation
schistocyte
59
# name the type of RBC poikilocyte
small buttons attached to RBCs, often seen as "little noses" - presence indicates oxidative damage to the RBCs
Heinz bodies
60
# name the type of RBC poikilocyte
nuclear remnants in RBCs; high numbers can be due to increased RBC turnover, defective production, or defective splenic removal
Howell-Jolly bodies
61
# name the type of RBC poikilocyte
aka target cells; can be seen with regeneration, lipid imbalances or liver disease
codocytes
62
# name the type of RBC poikilocyte
small, round, densely-staining RBC with no central pallor
spherocyte
63
an increase in immature neutrophils is called this
shift to the left
64
-philia or -cytosis indicate this
increase
65
-penia indicates this
a decrease
66
# name the WBC
increase seen in inflammation, excitment, stress, and hyperadrenocorticalism (Cushing's disease)
decrese in overwhelming infections and endotoxemia
neutrophils
67
# name the WBC
increase may occur in hypersensitivity, parasitism, some cases of hypoadrenocorticism (Addison's disease), neoplasia, mast cell disorders
eosinophils
68
# name the WBC
rarely seen in peripheral blood but increase may be seen in conjunction with eosinophilia and mast cell disease
basophils
69
# name the WBC
increase seen in excitement chronic infection
decrease seen in stress, lymphoma, early viral diseases and lymph loss
lymphocytes
70
# name the WBC
increase seen in inflammation, necrosis and stress
monocytes
71
# name the WBC patterns seen with the condition
adrenalin mediated stress (excitement)
neutrophilia and lymphocytosis
72
# name the WBC patterns seen with the condition
corticosteroid mediated stress
neutrophilia, monocytosis, lymphopenia, eosinopenia (SMILED)
73
# name the WBC patterns seen with the condition
inflammatory
neutrophilia +/- left shift, monocytosis, +/- lymphocytosis
74
# name the WBC patterns seen with the condition
hypersensitivity
eosinophilia +/- basophilia
75
these participate in coagulation, and abnormalities in their numbers or function can lead to coagulopathies; appear as small, anucleated, discoid to irregular cytoplasmic fragments containing purple granules
platelets
76
as a rule of thumb, there should be this many platelets per 100xHPF in healthy dogs and cats
15-20
77
# name the change in platelet numbers seen with these conditions
inflammation, regenerative anemia, paraneoplastic, many others
thrombocytosis
78
name the 5 main types of routine biochemical assays
1. proteins
2. enzymes
3. metabolites
4. electrolytes
5. hormones
79
what two types of serum and plasma proteins make up the total protein concentration
albumin and globulins
80
what is the only difference between serum and plasma
plasma contains fibrinogen, serum does not
81
where are most proteins synthesized?
liver
82
name the 4 main types of globulins
1. immunoglobulins
2. transport proteins
3. acute phase proteins
4. enzymes
83
# name the type of globulin
bind to specific antigens
ex: IgA, IgM, IgG
immunoglobulin
84
# name the type of globulin
ex: transferrin (binds iron) & lipoproteins (carry lipids)
transport proteins
85
# name the type of globulin
synthesized in the liver in response to inflammation; synthesis may be increased or decreased
acute phase proteins (APPs)
86
increased serum albumin is most commonly due to this
dehydration
| (also glucocorticoid therapy)
87
increased globulins is usually due to this
inflammation or an immune response
| (also neoplasia of B-cells and plasma cells)
88
this test shows more detail of the main protein groups present - sample is placed on thin gel and a current is passed along it; proteins migrate towards anode and pattern of bands allows main groups to be quantified
serum protein electrophoresis
89
most alpha and beta globulins are this type of globulin
APPs and transport proteins
90
gamma globulins are this type of globulin
immunoglobulins
91
name 6 causes of decreased serum protein
1. liver disease
2. inflammation
3. protein-losing nephropathy
4. protein-losing enteropathy
5. protein-losing dermatopathy
6. whole blood loss
92
# which serum protein(s) is decreased?
in liver disease
mainly albumin
93
# which serum protein(s) is decreased?
in inflammation
albumin
| (globulins often increased)
94
# which serum protein(s) is decreased?
in protein-losing nephropathy
albumin more than globulins
| (sieving effect)
95
# which serum protein(s) is decreased?
in protein-losing enteropathy
albumin and globulins
| (no sieving effect)
96
# which serum protein(s) is decreased?
in protein-losing dermatopathy
albumin and globulins
| (no sieving effect)
97
# which serum protein(s) is decreased?
in whole blood loss (hemorrhage)
albumin and globulins
| (no sieving effect)
98
give 2 examples of positive acute phase proteins
1. C-reactive protein (dogs)
2. serum amyloid A (cats, horses)
99
what is the main negative acute phase protein
albumin
100
this is a protein that is increased because of increased production by the liver during inflammation
positive acute phase proteins
101
this is a protein that is decreased because of decreased production by the liver during inflammation
negative acute phase protein
102
these increase in the serum due to escape from damaged cells or increased synthesis and only relatively large changes are considered significant
enzymes
103
# which enzyme to choose?
for hepatocellular damage?
ALT (dog, cat);
GLDH, AST (horse, ruminant)
104
# which enzyme to choose?
for cholestasis?
ALP, GGT
| (dog, cat, ruminant, horse)
105
# which enzyme to choose?
for increased synthesis?
SIALP (dog);
GGT (horse, ruminant)
106
# which enzyme to choose?
for muscle damage?
CK, AST
| (dog, cat, horse, ruminant)
107
# what enzyme does the abbreviation stand for?
ALT
alanine aminotransferase
108
# what enzyme does the abbreviation stand for?
ALP
alkaline phosphatase
109
# what enzyme does the abbreviation stand for?
AST
aspartate aminotransferase
110
# what enzyme does the abbreviation stand for?
CK
creatine kinase
111
# what enzyme does the abbreviation stand for?
GGT
gamma glutamyl transferase
112
# what enzyme does the abbreviation stand for?
GLDH
glutamate dehydrogenase
113
# what enzyme does the abbreviation stand for?
SIALP
steroid-induced isoenzyme of ALP
114
# which metabolite?
increased by: dehydration, decr. cardiac output, renal disease, post-renal obstruction
decreased by: liver disease
urea
115
# which metabolite?
increased by: renal disease, post-renal obsruction, Greyhounds
decreased by: low muscle mass
creatinine
116
# which metabolite?
increased by: post-prandial, impaired liver function
bile acids
117
# which metabolite?
increased by: hemolysis, liver disease, bile duct obstruction
bilirubin
118
# which metabolite?
increased by: Diabetes mellitus, hyperadrenocorticism, stress
decreased by: insulinoma, hypoadrenocorticism, liver disease
glucose
119
# which metabolite?
increased by: Diabetic ketoacidosis, pregnancy toxemia
beta hydroxybutyrate
120
# which metabolite?
increased by: post-prandial, hypothyroidism, hyperadrenocorticism, diabetes mellitus
triglycerides
121
# which metabolite?
increased by: post-prandial, hypothyroidism, hyperadrenocorticism, diabetes mellitus, protein-losing enteropathy/nephropathy
decreased by: liver disease
cholesterol
122
name 4 important electrolytes
sodium, potassium, chloride, bicarbonate
123
what is the percent of calcium that is:
ionized
protein bound
complexed with anions
50% ionized
40% protein bound
10% complexed with anions
124
which form of Calcium is the biologically active fraction
ionized form
125
what is a common cause of increased Ca
malignancy (ex: lymphoma)
| (tumors produce PTH-related protein)
126
what is a common cause of decreased Ca?
hypoalbuminemia and renal disease
| (hypoalbuminemia does not affect ionized Ca)
127
this type of test can confirm the presence of endocrine disease
hormone assays
128
# what hormone assay(s) should be used for the disease?
hyperadrenocorticism (Cushings' disease)
1. cortisol in dexamethasone suppression test
2. ACTH stim test
3. plasma ACTH
129
# what hormone assay(s) should be used for the disease?
hypoadrenocorticism (Addison's disease)
ACTH stimulation test
130
# what hormone assay(s) should be used for the disease?
hyperthyroidism
Total T4
131
# what hormone assay(s) should be used for the disease?
hypothyroidism
T4 and TSH
