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DWT Exam 3 > Clinical Pathology > Flashcards

Clinical Pathology Flashcards

1
Q

Where is albumin produced and what is its major function?

A

Albumin is made in the liver and is slightly bigger than pores separating blood and urine. It serves to regulate oncotic pressure and is cleared by metabolically active tissue

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2
Q

What types of proteins make up globulins?

A

-Immunglobulins
-Complement proteins
-coagulation proteins
-haptoglobulin
-transferrin

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3
Q

Where are globulins made and what do they primarily do?

A

Globulins are made by B lymphocytes, plasma cells, and by the liver
They most function during inflammatory responses

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4
Q

What are positive acute phase proteins?

A

Most globulins

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5
Q

What are negative acute phase proteins?

A

Albumin

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6
Q

What are positive delayed response proteins?

A

immunoglobulins

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7
Q

T/F Negative delayed response proteins don’t really exist

A

True

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8
Q

What are the three methods we can measure total proteins?

A

Refractometer
Chemistry
Electrophoresis

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9
Q

What are common causes of panhypoproteinemia?

A

-hemorrhage
-protein losing enteropathy

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10
Q

What are common causes of selective hypoalbuminemia?

A

-Inflammation
-protein losing NEPHROPATHY
-liver failure

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11
Q

What are common causes of selective hypoglobulinemia?

A

Failure of passive transfer

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12
Q

What are common causes of panhyperproteinemia?

A

DEHYDRATION

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13
Q

What are common causes of selective hyperalbuminemia?

A

Dehydration

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14
Q

What are common causes of selective hyperglobulinemia?

A

-inflammation
-b cell lymphoma
-plasma cell neoplasia

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15
Q

What is indicated by polyclonal gammopathy?

A

antigenic stimulation

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16
Q

What is indicated by monoclonal gammopathy?

A

lymphoid neoplasia

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17
Q

When are EDTA tubes selected for fluid collection?

A

Fluid analysis and cytology

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18
Q

When are tubes with no additive selected for collection?

A

Culture
Biochemical testing

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19
Q

What are the two important to note based on gross appearance of fluid?

A

Color
Clarity

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20
Q

What are important measured concentrations of fluid analysis?

A

Total protein
Total nucleated cell count
RBC count

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21
Q

What are important things to ID upon microscopic examination of fluid?

A

Cell ID
Infectious agents
Acellular material

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22
Q

What percentage of a normal, healthy, adult animal’s weight is composed of water, how does this change in neonates?

A

In adults, 60% of weight is comprised of water
In neonates, this number reaches 80% (D+ more severe and can lead to death

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23
Q

What composes extracellular fluid?

A

1/3 of total body water
Blood
Intracellular fluid
Transcellular fluid
GI tract

24
Q

What composes intracellular fluid?

A

2/3 of total body water
Fluid within cells

25
What are 3rd spaces?
Abdominal cavity, pleural space, pericardial space
26
What are distinguishing factors of pure (protein poor) transudate?
Appearance: clear, colorless, light yellow TP: <2.0 g/dL TNCC: < 1,500/microL Typically mononuclear Pathogenesis: Dec. oncotic pressure, inc. capillary hydrostatic pressure, dec lymphatic drainage Etiologies: protein losing nephropathy, protein losing enteropathy, liver failure
27
What are distinguishing factors of modified (protein rich) transudate?
Appearance: clear, hazy, or cloudy, usually yellow TP: > 2.0 g/dL TNCC < 5,000 /microL typically neutrophils present Pathogenesis: inc capillary hydrostatic pressure, dec lymphatic drainage Etiology: hypertensive disorders, lymphadenopathy, FIP etc
28
What are distinguishing factors of septic exudate?
Appearance: hazy, cloudy, flocculent, yellow, tan, cream, orange TP: >2.0 g/dL TNCC: >5,000 /microL Neutrophils and infectious agents Pathogenesis: inc interendothelial spaces and diapedesis of neutrophils Etiologies: Visceral tissue (IN -> OUT) -pleuropneumonia, esophageal perf, GI perf/necrosis, ruptured bladder Parietal tissue (OUT -> IN) -penetrating wounds/FB, hematogenous
29
What are distinguishing features of sterile exudate?
Appearance: hazy, cloudy, yellow, tan, cream, orange TP: > 2.0 g/dL TNCC: >5,000/microL Neutrophils, but NO infectious agents Pathogenesis: Inc. interendothelial spaces, diapedesis of neutrophils Etiologies: pancreatitis, enteritis/colitis, displaced organs/tissues, ruptured bladders, FIP, neoplasia
30
What are distinguishing features of hemorrhagic effusions?
Appearance: opaque, red TP: > 2.0 g/dL RBC: >1,000,000 / microL Looks like blood smear upon microscopic examination with erythrophagia and hemosiderin Pathogenesis: leakage of blood Etiology: Trauma, displaced organs/tissues, hemorrhaging neoplasms, coag disorders, idiopathic
31
What are distinguishing features of a chylous effusion?
Appearance: hazy, cloudy, opaque, pinkish white, white TP: > 2.0 g/dL TNCC: variable small lymphocytes Chemistry: triglycerides >100mg/dL Pathogenesis: leakage of lymphatics that drain the GI tract Etiology: idiopathic, trauma, heart disease, displaced organs/tissues, lymphadenopathy, neoplasms
32
What are distinguishing features of a uroperitoneum/uroabdomen?
Appearance: clear, hazy, cloudy, pale yellow, yellow TP: variable TNCC: variable Micro. exam: variable Fluid Chemistry: creatinine Pathogenesis: ruptured bladder Etiologies: uroliths, mucus plugs, trauma, neoplasms
33
What are distinguishing features of a bilious effusion?
Appearance: hazy, cloudy, flocculent, yellow, tan, orange, green, brown TP: > 2.0 g/dL TNCC: >5,000 /microL Bile on micro examination Fluid chemistry: Bile Pathogenesis: ruptured biliary tract Etiology: choleliths, mucocele, trauma, neoplasms
34
What are distinguishing features of a neoplastic effusion?
Appearance: clarity and color is variable TP: variable, but often > 2.0 g/dL TNCC: variable, but often > 5,000 /microL Neoplastic cells on microscopic examination
35
What are the 4 types of noninflammatory cells?
1. Round: individualized and rounf 2. Epithelial: cell to cell, individualized, round, polygonal 3. Mesenchymal: Matrix, individualized, spindle, stellate 4. Naked nuclei: fragile cells with invisible borders, round nuclei, uniform nuclei
36
What are the criteria of malignancy?
1. Anisokaryosis (variation in size of nuclei) 2. Pleomorphism (variability in size and shape) 3. High nucleus to cytoplasm ratio (N:C) 4. Mitotic figures present 5. Atypical nuclei 6. Coarse chromatin 7. Nuclear molding (adjacent cell nuclei conform to eachother) 8. Multinucleation
37
What are key features of enzymes?
-measure in serum or plasma -catalyze cellular reactions -originate from cells -measure ACTIVITY, not quantity -induced or "leakage" -tissue and species specificity -varied half life -only worry about increases not decreases
38
What can cause increased enzymatic activity?
-Injury (leakage): bleb, leak, necrosis -Induction -Decreased clearance -Hyperplasia -Ingestion -Xenobiotic or endogenous chemical induction
39
Creatine Kinase
Results from cell injury Muscle and hemolysis Short half life (2-3 hrs)
40
AST
Cell injury Liver and muscle and hemolysis Small and large animals
41
SDH
Cell injury Liver Replaces ALT for animal Sample handling is critical
42
ALT
Cell injury Mostly liver specific Small animal specific
43
GGT
Induced Hepatobiliary Cholestasis -> decreased bile flow
44
ALP
Induced Hepatobiliary Cholestasis -> Decreased bile flow SMALL ANIMALS ONLY 1. Tissue unspecific isoenzyme liver, bone, placenta, renal 2. Intestinal isoenzyme GI, K9 c-steroid induced
45
cALP
DOGS ONLY Intestinal ALP gene, but in liver Drug induced production -corticosteroids, phenobarbital, or cholestasis
46
Canine ALP Interpretation
< 4x increase -> nonspecific >4x increase -> cholestasis and/or glucocorticoids, anticonvulsants
47
LPS
Cell injury Exocrine pancreases (pancreatitis) 2 hr half life in canines Use in conjunction with amylase Pancreatitis -> increase 3-8X Corticosteroids -> increase up to 5X
48
PLI
Cell injury More specific for exocrine pancreases than LPS cPLI -> canine pancreatitis
49
AMS
Cell injury Exocrine pancreases (pancreatitis) and other tissue types
50
T/F Acids donate H+ while bases accept H+
True
51
What are normal blood pH parameters and what qualifies as alkalemia and acidemia?
Normal Blood pH: 7.35-7.45 Alkalemia: pH > 7.45 Acidemia: pH < 7.35
52
How is blood pH metabolically regulated?
Kidneys: Excrete H+, retain HCO3-, take hours to days Blood Buffers: Titrate H+ in seconds
53
What are the metabolic acid base testing options?
Blood gas: pH, Bicarbonate (HCO3-) Biochemistry: TCO2, anion gap, sodium vs. chloride Urinalysis: Urine pH
54
What are respiratory acid base testing options?
Blood gas: pH, pCO2
55
What are requirements for testing blood gas?
-Heparinized whole blood -Patient body temp -Anaerobic conditions and ready for rapid processing

DWT Exam 3 (6 decks)

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