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FCP - Pathology Week > Clinical Pathology > Flashcards

Clinical Pathology Flashcards

1
Q

Clinical Pathology

A

The practice of pathology as it pertains to the care of patients
The development, application and interpretation of laboratory procedures for:
○ Establishing a diagnosis and/or prognosis
○ Monitoring of treatment in sick animals
○ Monitoring animal health

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2
Q

What does clinical pathology involve?

A

Haematology
Clinical biochemistry
Cytology

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3
Q

Types of clinical pathology samples

A

Blood, serum, plasma
Urine
FNAs
Effusions
Cerebrospinal fluid
Lavages (BAL)
Synovial fluid

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4
Q

What is anatomic pathology?

A

Surgical pathology - histopathology
Necropsy

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5
Q

Which anti-coagulant should you use for haematology? (blood cytology)

A

EDTA
(Li-hep whole blood in exotics)

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6
Q

Which anti-coagulant should you use for clinical chemistry? (electrolyte levels)

A

○ Serum
○ Li-heparin plasma
○ EDTA plasma (rarely)

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7
Q

Which anti-coagulant should you use for measuring glucose?

A

Fluride-oxalate

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8
Q

Which anti-coagulant should you use for measuring haemostasis/coagulation?

A

Citrate

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9
Q

Which anti-coagulants work by holding onto calcium to stop the coagulation cascade?

A

EDTA - irreversible
Oxalate
Citrate - reversible so used to study coagulation

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10
Q

What is serum?

A

Whole blood that has been allowed to clot then centrifuged
Fibrinogen converted to fibrin and becomes part of clot so not present in serum

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11
Q

What is plasma?

A

Heparin prevents clot from happening
Centrifuged to separate liquid from cellular component
Fibrinogen not activated so present in plasma

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12
Q

What will happen is a biochemistry sample is contaminated with K-EDTA

A

False low calcium
False high potassium
Some enzymes (ALP) depend on cofactor which is taken out by EDTA

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13
Q

What is a normal draw/fill order?

A

Citrate tube first to prevent any clotting
Bacterial samples next to prevent contamination
EDTA later to reduce contamination with chemistry samples

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14
Q

Effects of haemolysis on results

A

Causes false increases in plasma/serum values of some compounds
[This is due to higher concentration from lysed RBCs]
○ Creatine kinase
○ Phosphate
○ Potassium in some species
Interferes with colorimetry - false values due to different absorbance levels

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15
Q

How can you avoid haemolysis

A

Choose appropriate gauge needle
Never dispense blood sample through needle - just syringe

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16
Q

Lipemia

A

High concentration of emulsified fat in the blood

17
Q

Effects of lipemia on results

A

Can increase or decrease values of some compounds in serum/plasma
Presence of extra lipid fractions causes false low values of electrolytes (less aqueous content)
Turbidity interferes with light detection methods - false results for colorimetry (increased refraction)

18
Q

Icterus

A

High levels of bilirubin in blood (jaundice)

19
Q

Which species has naturally higher bilirubin?

A

Horses

20
Q

Effects of icterus on results

A

Gives false results for colorimetry

21
Q

Pre-analytical sources of variation and errors in lab results

A

Patient preparation
E.g. Not fasted patient
Sample preparation
E.g. Choice of collection tube
Shipping

22
Q

Analytical sources of variation and errors in lab results

A

Appropriate equipment/reagents (Validated)
Still working (QC)

23
Q

Post-analytical sources of variation and errors in lab results

A

Results to the right place for the right patient
Appropriate interpretation
Diagnostic sensitivity and specificity

24
Q

Control of analytical variation

A

Validation of the techniques used
○ Assay parameters
○ Machine setup
○ Analytical range
○ Must be known before analysis starts
Quality control:
○ Must be performed regularly before and/or during routine analysis
○ Only know the equipment was working when the last QC passed

25
Q

Analytic range

A

Interval between the lowest and highest concentrations that the technique can measure

26
Q

Validation of an analytical technique - PASS

A

Precision
Accuracy
Specificity
Sensitivity

27
Q

Precision

A

Repeatability/reproducibility
Ability of a technique to give the same result for repeated measurements of the same specimen with the same technique

28
Q

Accuracy

A

Measuring the right thing correctly
Ability of a technique to give the true value (usually unknown) of the analyte measured

29
Q

Specificity

A

Different from « diagnostic specificity »
Ability of a technique to measure one single analyte in a complex solution

30
Q

Sensitivity

A

When do we need to dilute a sample

FCP - Pathology Week (20 decks)

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