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Applications Of Pathology > Clinical pathology > Flashcards

Clinical pathology Flashcards

1
Q

What is the purpose of clinical chemistry?

A
  • To assess for disease
  • To assess for organ function
  • Assess metabolic function
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2
Q

What substances in the blood are assessed for in a blood pcv?

A
  • Enzymes
  • Proteins
  • Albumins
  • Globulins
  • Electrolytes
  • Na
  • K
  • Cl
  • Minerals
  • Lipids
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3
Q

What other tests can be done in apart from haem?

A

All comes under clinical pathology

  • Cytology
  • Endocrinology
  • Urinalysis
  • Drug assays
  • Molecular testing
  • Immunohistochemsitry and flow cytometry
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4
Q

What are the advantages and disadv. of serum or plasma?

A

Serum is only obtained after leaving to clot for a minimum of 30 minutes.

Most biochemistry tests can be performed on plasma or serum.

Type of anticoagulant used to obtain plasma may impact ability to do tests though.

https://s3.amazonaws.com/brainscape-prod/system/cm/173/612/371/a_image_thumb.png?1450988340

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5
Q

When are enzymes used?

A

Assays often assessing function

Enzymes often require co-factors to catalyse substances

End point often a colour change

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6
Q

How do you know whether the result is significant?

A

Reference intervals and doses taken at 95% etc. Using standard deviation and mean results will make up a reference curve for the results to be interpredid by.

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7
Q

When do you take a sample?

A

Starving for 8-12 hours or 24 hours is useful.

Or

Sampling when clinical effects is most apparent-post seizure

Or

Peak times of when using drug analysis.

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8
Q

What is albumin?

A

One of the smallest proteins commonly found in plasma/serum.

Synthesised in the liver

Increases seen with dehydration

decreases will reflect:

  • increased loss of albumin
  • decreased production/negative acute phase protein
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9
Q

What is globulins?

A

Increases antigenic stimulation

Decreases due to loss of:

  • Haemorrhage
  • PLE
  • PLN
  • Decreased production or over increased protein catabolism
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10
Q

Whats azotaemia?

A

Elevation of urea and creatine

-could be:

pre renal

renal

post renal

could be due to:

  • hydration status of the patient and
  • USG

-

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11
Q

What could pre renal azotaemia be due to?

A

Dehydration- most commonly second to vomiting

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12
Q

What could be post renal azataemia be due to?

A

Obstruction- full bladder, possible history of stranguria

Ruptured bladder- post obstruction or RTA

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13
Q

What could renal azataemia be due to?

A

Due to renal failure, acute/chronic

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14
Q

Whats ALT and the consequences?

A

Alanine aminotransferase

Hepatocellular, most present in cells

Transient increase seen in liver damage.

Elevations may not correspond with degree of liver damage.

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15
Q

What ALP and the consequences?

A

Alkaline phosphatase.

Sensitive but not specific for cholestasis. Released from the brush broders of bile duct.

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16
Q

What GGT and the consequences?

A

Specific test for cholestasis and biliary tree disease

Less sensitive than ALP

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17
Q

Whats bilirubin and the consequences?

A

Increases may be pre hepatic, hepatic and post hepatic.

Pre hepatic:

Haemolysis, check HCT

Hepatic, post hepatic,

cholestasis

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18
Q

Whats bile acids and the consequences?

A

Functional test for the liver

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19
Q

Whats ammonia and the consequences?

A

Functional test for hepatocytes.

Elevations may also be seen following exposure to air

Need to seperate from EDTA plasma immediately.

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20
Q

Whats cholesterol and the consequences?

A

Metabolised within the liver

Inversely proportional to T4. Increases seen with

  • hepatic disease
  • endocrine disease
  • nephrotic syndrome

decreases seen with:

malabsorption

hyperthyroidism

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21
Q
A
22
Q

Whats creatine kinase and the consequences?

A

Indicative of muscle cell leakage/damage

Rapid elevation and relatively short life. AST has a slower response, but elevations may persist for longer.

23
Q

What is urinalysis?

A

Assess with the current hydration, Free catch of cystocentesis

Gross appearence USG, Dipstick, Sediment, Culture, Cytology.

24
Q

Where would you see calcium oxalate cyrstals usually?

A

In ethylene glycol poisoning

25
Q

What are the different types of sampling?

A

Fine needle aspiration/Fine needle biopsies/crocidile clipping/ surface impression smear/swab collection

26
Q

When do neutrophils come about and what do they look like?

A

They predominate in acute inflammation and can be degenerate. Swelling of cells with fuzzy outlines, most commonly in gram negative sepsis. https://s3.amazonaws.com/brainscape-prod/system/cm/173/647/407/a_image_thumb.png?1451145523

27
Q

When do macrophages come about and what do they look like?

A

Common in chronic inflammation. They are phagocytic and has cellular debris usually with foreign material.

https://s3.amazonaws.com/brainscape-prod/system/cm/173/673/283/a_image_thumb.png?1451145640

28
Q

When is lymphocytic inflammation most common?

A

Most common in chronic inflammation. With a mixed population of lymphocytes and plasma cells. https://s3.amazonaws.com/brainscape-prod/system/cm/173/673/391/a_image_thumb.png?1451145739

29
Q

When is eosinophilic inflammation most common? and what does it look like?

A

Hypersensitivity/allergic reaction and hypereosinophilic reaction

https://s3.amazonaws.com/brainscape-prod/system/cm/173/673/420/a_image_thumb.png?1451145857

30
Q

How do you determine in cytology?

A

https://s3.amazonaws.com/brainscape-prod/system/cm/173/673/449/a_image_thumb.png?1451145938

31
Q

What determines whether its a sarcoma or a carcinoma? and what does this mean?

A

-Round cell tumours

from haematopoietic cells (mesoderm)

-Epithelial tumours

oma, carcinoma (benign)

prefix adeno (glandular)

-Mesenchymal tumours

oma or sarcoma (benign)

32
Q

When is a round cell come about and what is the significance?

A

Round to oval in shape. High nucleus to cytoplasm ratio. Arranged in sheet like patterns.

https://s3.amazonaws.com/brainscape-prod/system/cm/173/673/790/a_image_thumb.png?1451146688

33
Q

When are epithelial cells most common and why do they come about?

A

They are arranged in sheets, clusters etc.

https://s3.amazonaws.com/brainscape-prod/system/cm/173/673/845/a_image_thumb.png?1451146997

34
Q

What are the criterias of malignancies?

A
  • Anisocytosis (pleomorphism)
  • Anisokaryosis (variation in nuclues size_
  • Increased nucleus to cytoplasm ratio
  • Bi, multinucleation
  • coarse chromatin pattern
  • Nucleoli, increased number and size. abnormal shapes
  • Increased mitotic rate
  • Aberrant mitotic figures
35
Q

When do mesenchymal cells come about and why?

A

Arrangement in aggregates often haphazard or individual aggregates. https://s3.amazonaws.com/brainscape-prod/system/cm/173/674/278/a_image_thumb.png?1451147484

36
Q

What are the pitfalls of cytology?

A

https://s3.amazonaws.com/brainscape-prod/system/cm/173/674/387/a_image_thumb.png?1451147567

37
Q

Whats a common endocrine disorder in dogs and whats it do?

A

Cushings syndrome

Also known as hyperadrenocorticism, increased levels of cortisol.

May be rapidily increased with stimulus. Can be affected by many things.

Must have a good clinical suspicion of testing.

Can be caused either by a tumour of the pituitary gland in the pars distalis.

https://s3.amazonaws.com/brainscape-prod/system/cm/173/674/852/a_image_thumb.png?1451148575

38
Q

What is the test for cushings?

A

Low dose dexamethasone suppresion test.

Take basal sample, adminster a low amount of dexamethasone.

Measure cortisol and their levels 4 to 8 hours after adminstration.

In HAC: the dexameth. will escape after 8 hours. There is no suppression.

39
Q

What is the other test for cushings?

A

ACTH stimulation test.

Take basal sample.

Adminster ACTH sample

HAC will have ACTH levels above normal.

40
Q

When horsings get HAC why is it different to a dog get HAC?

A

A horse will get the pituitary tumour in the pars intermedia rahter than pars distalis.

41
Q

What tests can you use for HAC in a horse?

A

Equine testing dextamethasone suppression test. Unusual results in a ppid horse have increased post dextramethasone serum.

42
Q

Whats the difference between cushings and addisons?

A

Cushings is hyperadrenocorticism- too much adrenaline.

Addisons is hypoadrenocorticism- too little adrenaline.

43
Q

How do you test for addisons?

A

Exact same ACTH stimulation but expect low basal numbers than the average.

44
Q

What disease affecting the thyroids is most common in dogs but differnet in cats?

A

Dogs- Hypothyroidism: To low total output

Cats- Hyperthyroidism: to high total output

45
Q

What thyroid hormones do you know?

A

T4, T3, TSH (thyroid stimulating hormones

https://s3.amazonaws.com/brainscape-prod/system/cm/173/678/272/a_image_thumb.png?1451154374

46
Q

How do you test for feline hyperthyroidism?

A

Measure the total T4 protein- increase in amount of T4

47
Q

How do you test for canine hypothyroidism?

A

Low total T4

Increased TSH but low T4 due to bad thyroid refer to the other diagram.

Some drugs can also alter the T4

48
Q

What is dynamic testing and what can it split into?

A

Suppression of the hormone production

Maximal stimulation of production

49
Q

What are the major reasons for analyzing patient samples via laboratory procedures?

A

To detect an unidentified pathologic state

To define, classify, or confirm a pathopsychological disorder or disease state.

To assess changes in a pathologic state either due to a natural progression of the disease or medical therapy.

50
Q

What is the distribution in this graph?

https://s3.amazonaws.com/brainscape-prod/system/cm/173/678/772/q_image_thumb.png?1451155383

A

On the left it is a gaussian distribution. On the right it is a positive skewness distribition.

51
Q

How do you determine the specificity and sensitivity of results?

A

https://s3.amazonaws.com/brainscape-prod/system/cm/173/678/801/a_image_thumb.png?1451155954

Applications Of Pathology (6 decks)

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