Clinical Pathology Flashcards
1
Q
What is the average life of a platelet?
A
10d
2
Q
Which blood cell component has the shortest life span?
A
Neutrophils
3
Q
How long do RBCs last in cats and dogs?
A
Cat 70d
Dog 110d
4
Q
An increase of what signals an extravascular lysis?
A
Bilirubin?
5
Q
An increase of what signals an intravascular lysis?
A
Free Hb
6
Q
What change to neutrophil populations may be seen with severe inflammation?
A
Juvenile (Band) neutrophils present – called Left Shift.
If v severe - neutropenia
7
Q
When are nucleated RBCs seen in circulation?
A
accelerated erythropoesis OR BM damage
8
Q
When are reticulocytes seen in circulation?
A
inc # in accelerated erythropoesis
9
Q
Which stain canbe used to visualise reticulocytes clearly?
A
New Methylene Blue
10
Q
Where is EPO produced?
A
Kidney - response to O2 insufficiency
11
Q
Where is TPO produced?
A
liver - constantly
12
Q
Which tube should be used for routine haematology?
A
EDTA
13
Q
Which tube should be used for a blood smear?
A
syringe/sterile
14
Q
What does MCV assess? How does it help to classify anaemia?
A
RBC size (Avg)
Macro/normo/microcytic
15
Q
What does MCHC assess?
A
Average RBC Hb concentration
16
Q
Which type of anaemia is indicated by macrocytosis?
A
Regenerative
17
Q
Which type of anaemia is indicated with normoocytosis?
A
non-regenerative
18
Q
Which type of anaemia is indicated by microcytosis?
A
Iron Deficiency
19
Q
Which type of anaemia is indicated with hypochromic RBCs?
A
Regenerative or Iron Deficiency
20
Q
What is the most sensitive way of assessing if an anaemia is regenerative?
A
BM examination
21
Q
What is the most commonly used way of assessing if an anaemia is regenerative?
A
Reiculocyte Enmeration - BM assessment invasive and expensive
22
Q
If assessing RBC regeneration via polychromasia, what value indicates non-regenerative anaemia?
A
<2 polychromatophils/HPF (x100)
23
Q
What changes can be seen on haematology of a patient who has suffered a haemorrhage in recent hours?
A
Dilution –> reduced Hct and TP
24
Q
The presence of which cells indicate IMHA?
A
Shperocytes - small, without central pallor
25
What RBC clumping pattern is suggestive of IMHA?
Agglutination
26
What RBC clumping pattern is normal in horses?
Rouleaux
27
In the saline Agglutination test - do rouleaux or agglutinates persist?
Agglutinates!
28
An increase of which WBC may indicate adrenaline release in cats?
Lymphocytes
29
What does a monocytosis indicate?
Chronic inflammation
30
What does a moderate lymphocytosis indicate?
Chronic inflammation
31
What does a severe lymphocytosis indicate?
Leukaemia
32
What does a lymphopenia indicate? (3)
Acute inflammation
Stress leucogram
Viral Infection
33
What does a Neutrophilia indicate?
Inflammation
34
What does a Neutropenia indicate?
Overwhelming demand
Reduced BM production
Inc destruction
35
What does a left shift indicate?
Severe acute inflammation
36
What may an eosinophilia indicate?
Worm parasitism
| Allergy (T1 hypersensitivity)
37
What are the 4 classes of thrombocytopenia?
Destructive
Consumptive
Reduced Production
Distributional
38
What are the possible causes of a destructive thrombocytopenia?
IMTP: AI, drug reaction, ID, neoplasia
39
What are the possible causes of a consumptive thrombocytopenia? (4)
DIC
Thrombosis
Vessel Inflm
Acute, severe blood loss
40
What is the cause of a reduced production thrombocytopenia?
BM damage
41
What are the possible causes of a distributive thrombocytopenia?
Splenomegaly
Severe Hypothermia
Endotoxaemia
42
What is the clinical significance of thrombocytosis?
None
43
What are the 3 main characteristics of ACUTE inflammation?
Oedema
Neutrophils
Inc Blood Flow
44
What are the 4 main characteristics of CHRONIC inflammation?
Lymphocytes/mø
BV proliferation
Fibrosis
Necrosis
45
Define Exudate
Escape of fluid, protein AND blood cells FROM vascular system.
46
What is the gross appearance of an exudate?
Turbid, opaque, variable colour
47
Define Pus.
Inflammatory exudate rich in leukocytes and cell debris
48
What are the two changes to the vasculature which occur with acute inflammation?
Vasodilation
Increased vasc permeability
49
What are the 5 stages of leukocyte extravasation?
```
Rolling
Activation
Adherence
Transmigration
Migration
```
50
When do neutrophils predominate at the site of inflammation?
6-24h
51
When do macrophages predominate at the site of inflammation?
24-48h
52
What is the first stage of fibrosis?
Granulation tissue formation
53
What are the 4 stages of CT repair?
Angiogenesis
Mig/prolif of fibroblasts
ECM deposition
Remodelling of fibrous tissue
54
What is the predominant cell type in granulomatous inflammation?
Activated Mø
55
Describe the structure of a granuloma.
Centre: caseous necrosis w/calcification
Surrounded by epithelioid møs
Periphery: lymphocytes
56
Which agent is most known for inducting granulomatous inflammation?
Mycobacteria
57
What is healing under primary intention?
Wounds with opposed edges - surgical
58
What is healing via secondary intention?
more inflammation, larger granulation tissue and wound contraction present
59
How long does a blood clot take to form in 1e vs 2e intention healing?
1: 24h
2: 2-3d
60
How long does a granulation take to heal the gap in 1e vs 2e intention healing?
1: 2-7d
2: 1-2w
61
How long does a initial, weak scarring take to form in 1e vs 2e intention healing?
1: 2-4w
2: 3-6w
62
Which 2 systemic factors influence wound healing?
Nutrition
| Hormones
63
Which 4 local factors affect wound healing?
Infection
Mechanics
Foreign Material
Size/Location of wound
64
What are the 3 main features of a low-protein transudate?
Clear/Colourless
TP <25g/l
cells <1.5x10^9
65
What would you see on cytology of low-protein transudate?
very few cells, mainly: Monocytes and Møs
some: lymphocytes, mesothelial cells & neutrophils
66
On analysis of a red peritoneal fluid sample, what cytological sign would confirm that this was a true haemorrhage, and not contamination?
Erythrophagocytosis
| also no PLTs
67
what are the 4 main features of a modified transudate?
Clear
Colourless or coloured
Protein >25g/L
Cell count <10x10^9/L
68
What is the main cause of high protein transudates?
Inc intravascular hydraulic pressure in liver or lungs.
i.e. CHF/vena cava neoplasia
69
What is the main cause of high protein transudates?
Inc intravascular hydraulic pressure in liver or lungs.
i.e. CHF/vena cava neoplasia
70
What are the 5 main charcteristics of an exudate?
Turbid
Yellow/Brown/bloody
Protein >25/30g/L
Cells: HIGH >5x10^9
Mostly neutrophils
71
What can be seen in cytology of non-septic exudates?
non-degen neuts
low #s of hypersegmented neuts & pyknotic cells
72
What can be seen in cytology of septic exudates?
Intracellular organisms
Degen Neuts
Karyolysis & karyorrhexis
73
Describe FIP fluid.
Yellow
High Protein (frothy)
Moderate cellularity
Alb:Glob <0.8
74
What are the 3 cytological features of FIP?
abundant proteinaceous background
Cells (mostly neutrophils)
Few macrophages
75
What are the 3 cytological features of bile peritonitis?
Neutrophils
Møs w/green pigment
bilirubin [fluid] > bilirubin [plasma]
76
What is the major feature of peritoneal fluid in bladder rupture?
Fluid creatinine > plasma creatinine (>2x)
77
Describe the features of reactive mesothelial cells.
Eosinophilic brush border
Multinucleated
Variable shape/sizes
78
How does inflammatory synovial fluid appear?
Yellow and turbid
79
What re the 4 main features of NORMAL synovial fluid?
Clear/pale yellow
Viscous
Hypocelluar
Protein background
80
What is the difference between synovial fluid in inflammatory arthropathies & OA?
OA: mononuclear cells
Inflm: Neutrophils & high cellularity
81
Which blood tube should be used for glucose measurement?
Fluoride/Oxalate
82
Which blood tube should be used for haematology?
EDTA
83
Which blood tube should be used for culture?
sterile
84
Which blood tube should be used for coagulation profiles?
Citrate
85
Which blood tubes can be used for biochemistry?
Lithium Heparin
Serum activator
Serum Gel
86
Which blood tube should be used for peritoneal fluid cytology?
EDTA
87
Where should thoracocentesis be performed?
Rib Space 7/8 in ventral 1/3rd.
Cranial to rib!!
88
How is a relative polychytaemia treated?
Tx cause
| Replace lost fluid
89
What causes a 1e absolute polycytaemia?
Myeloproliferative disorders
90
What causes a 2e absolute polycytaemia?
Inc EPO production
91
Below what PLT count are dogs at risk of spontaneous haemorrhage?
<50x10^9/L
92
Below what PLT count are cats at risk of spontaneous haemorrhage?
<30x10^9/L
93
What are the signs of vWD? (type 1)
MMs bleeding
Bruising
Haemorrhage during Surgery
94
What are the 3 common causes of increased FDPs?
DIC
Thrombotic Dz
Reduced hepatic clearance
95
What are D dimers specific for?
breakdown of cross-linked fibrin - likely DIC
96
Which test allows you to rule out a defect of the primary hemostasis?
BMBT
97
Predict the bone marrow findings in case of immune-mediated thrombocytopenia
Increased Thrombopoesis
98
What type of erythrocyte abnormality is often seen in animals with DIC?
Schistocytes
99
Which blood Ag should donor dogs NOT have?
1.1
100
Define Major cross match.
Check for Ab in recipient plasma against donation.
101
Which fluid, and how much, should a dog be given after donating blood?
2-3x donated volume in crystalloids
102
Transfusion of which feline blood type causes a MAJOR transfusion reaction?
Type A blood to type B cat
103
What % of a horses BW is blood volume?
8%
104
What 3 signs in a horse, minus anaemia, would signal chronic blood loss?
epistaxis
Haematuria
Malaena
105
What 3 signs in a horse, minus anaemia, would signal haemolysis?
Fever
Icterus
Pigmenturia
106
Normal PCV for thoroughbred
35-45%
107
Normal PCV for pony/draught horse
26-35%
108
What 2 changes will you see on smear exam of a horse with haemolytic anaemia?
Spherocytes
| Heinz Bodies
109
What are 2 pathogens which cause equine anaemia?
EIA (lentivirus)
| Ehrlichia
110
Which test allows diagnosis of EIA?
Coggins Test
111
How do erythrocytes appear on cytology of iron deficiency anaemia?
Microcytic
| Hypochromic
112
What is the most common cause of Iron Deficiency anaemia in smallies?
GIT bleed
113
What are the 2 most common signs on cytology of IMHA in smallies?
Spherocytosis
| Autoagluttination
114
What dose of preds should be used to control IMHA?
1-2mg/kg BID
reduce by 25% every 3w
115
Which drug may be given alongside prednisolone if it alone is not controlling IMHA? Dose? (Dogs ONLY)
Azathioprine
| 2mg/kg SID
116
What must the O be warned about when prescribing azathioprine tablets?
DO NOT CRUSH OR BREAK!
117
What si the 3rd line treatment for IMHA in dogs?
Ciclosporin (+Preds)
118
Which 2 supportive drugs can be given in IMHA to reduce (excessive) platelet activation?
Clopidogrel
| Low dose aspirin
119
Which supportive drug can be given in IMHA to reduce (excessive) activation of the coagulation cascade?
Heparin
120
How is mycoplasma haemofelis anaemia treated?
Doxycycline
| Prednisolone
121
what do schistocytes on a blood smear indicate? (SA)
Mechanical Damage
122
What is the prognosis of oestrogen toxicity?
VERY Poor
123
What are markers of hepatocellular damage?
AST
LDH
ALT (more spec)
124
What is a marker of cholestasis?
ALP
| GGT (more spec)
125
What are the 3 types of hyperbilirubinaemia?
Pre-hepatic (haemolysis)
Hepatic (dec uptake, conjugation, excretion)
Post-hepatic (2e to obstruction of extrahepatic bile duct)
126
What is seen on biochem of post-hepatic hyperbilrubinaemia?
Cholestatic enzymes (ALP/GGT) > leakage enzymes (ALT/AST)
127
What test can be done to examine heptaobiliary pathology?
Fasting Serum Bile Acids
>25-30mmol/L indicate Dz!
128
What test can be conducted to reveal hepatobiliary Dz if fasting BA is normal?
BAST - BA measured 2h after fatty meal
>25-30mmol/L indicate Dz!
129
What 3 things may be seen on haem exam in liver Dz?
Microcytosis
Ovalocytes (lipidosis)
Acanthocytes
130
What 3 things may be seen on urinalysis in liver Dz?
Isosthenuria
Bilirubinuria
Ammonium Biurate Crystals
131
What are 3 markers of hepatic function?
Serum bile acids (BA) and ammonia
132
What are 3 markers of cholestasis?
Bilirubin, GGT and ALP
133
What is a specific, sensitive test for exocrine pancreatic insufficiency?
trypsin-like immunoreactivity
<2.5mg/L in dogs
<8mg/L in cats
134
What is a specific, sensitive test for pancreatitis?
canine pancreatic lipase
+ US
135
How does an epithelial tumour appear on cytology?
"islands” of cohesive polygonal cells
136
How does a round cell tumour appear on cytology?
"sea" of round discrete cells
137
How does a mesenchymal tumour appear on cytology?
Spindle cells with indistinct edges embedded in extracellular ‘matrix'
138
What are the criteria of malignancy? (3 min for tumour)
```
Multinucleation
Karyomegaly
Mitoses
Nuclear moulding
Large/angular/mixed size nucleoli
Hypercellularity
Pleomorphism
High/variable N:C ratio
```
139
What are the 5 types of round cell tumour?
```
Histiocytoma
Plasma cell tumor
Mast cell tumor
Lymphoma
TVT
```
140
Describe the cytology of a histiocytoma.
Light blue faded cytoplasm
| Small lymphocytes
141
Describe the cytology of a histiocytic sarcoma.
Marked pleomorphism
Kayromegaly
Multinucleation
142
Describe the cytology of a lymphoma
Round cells
High N:C ratio
Large blasts (>neut)
Monomorphic
143
Describe the cytology of a mast cell tumour.
Magents granules in cytoplasm
144
Describe the cytology of a plasmacytoma
Deep blue cytoplasm, perinuclear halo, eosinophilic borders.
| Round, eccentric nucleus
145
Describe the cytology of a sebaceous adenoma
Clusters of cohesive heavily vacuolated cells
146
Describe the cytology of a squamous cell carcinoma
Polygonal cells
Marked pleomorphism
2e neutrophilic inflm
147
Describe the cytology of an anal sac adenocarcinoma
"naked nuclei" in rosettes and rows
148
Which ions are high in ECF?
Na, Cl, HCO3
149
Which ion is high in ICF?
K+
150
How is hyperkalaemia treateD?
IVFT with Low K fluids (saline +/-5% glucose)
| CaGluconate if CV effects
151
What are the causes of hyper calcaemia?
```
HARD IONS G
HyperPTH/HyperTH
Addisons
Renal Dz
D Vitamin D tox
Idiopathic (cat)
Osteolytic
Neoplasia
Spurious
Granulomatous Dz
```
152
What are the main causes of hypocalcaemia?
```
Malabsorption
Pancreatitis
Renal Dz
EDTA tube
Hypolabuminaemia
EG toxicity
```
153
What is the most sensitive test for GFR?
SDMA
154
How does a dec GFR affect Phosphate?
Cats/Dogs/Farm: INC
| Horses: Dec
155
What should the UPCR be in dogs and cats?
Dog: <0.5
Cat: <0.4
156
What would you suspect if glucosuria was present with a normal plasma glucose?
Tubular Dz = Fanconis
157
What is the gold std substance to use for a urine clearance test?
Iohexol
