Clinical Pathology Flashcards

1
Q

What is the average life of a platelet?

A

10d

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2
Q

Which blood cell component has the shortest life span?

A

Neutrophils

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3
Q

How long do RBCs last in cats and dogs?

A

Cat 70d

Dog 110d

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4
Q

An increase of what signals an extravascular lysis?

A

Bilirubin?

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5
Q

An increase of what signals an intravascular lysis?

A

Free Hb

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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

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7
Q

When are nucleated RBCs seen in circulation?

A

accelerated erythropoesis OR BM damage

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8
Q

When are reticulocytes seen in circulation?

A

inc # in accelerated erythropoesis

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9
Q

Which stain canbe used to visualise reticulocytes clearly?

A

New Methylene Blue

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10
Q

Where is EPO produced?

A

Kidney - response to O2 insufficiency

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11
Q

Where is TPO produced?

A

liver - constantly

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12
Q

Which tube should be used for routine haematology?

A

EDTA

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13
Q

Which tube should be used for a blood smear?

A

syringe/sterile

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14
Q

What does MCV assess? How does it help to classify anaemia?

A

RBC size (Avg)

Macro/normo/microcytic

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15
Q

What does MCHC assess?

A

Average RBC Hb concentration

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16
Q

Which type of anaemia is indicated by macrocytosis?

A

Regenerative

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17
Q

Which type of anaemia is indicated with normoocytosis?

A

non-regenerative

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18
Q

Which type of anaemia is indicated by microcytosis?

A

Iron Deficiency

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19
Q

Which type of anaemia is indicated with hypochromic RBCs?

A

Regenerative or Iron Deficiency

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20
Q

What is the most sensitive way of assessing if an anaemia is regenerative?

A

BM examination

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21
Q

What is the most commonly used way of assessing if an anaemia is regenerative?

A

Reiculocyte Enmeration - BM assessment invasive and expensive

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22
Q

If assessing RBC regeneration via polychromasia, what value indicates non-regenerative anaemia?

A

<2 polychromatophils/HPF (x100)

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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

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24
Q

The presence of which cells indicate IMHA?

A

Shperocytes - small, without central pallor

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25
Q

What RBC clumping pattern is suggestive of IMHA?

A

Agglutination

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26
Q

What RBC clumping pattern is normal in horses?

A

Rouleaux

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27
Q

In the saline Agglutination test - do rouleaux or agglutinates persist?

A

Agglutinates!

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28
Q

An increase of which WBC may indicate adrenaline release in cats?

A

Lymphocytes

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29
Q

What does a monocytosis indicate?

A

Chronic inflammation

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30
Q

What does a moderate lymphocytosis indicate?

A

Chronic inflammation

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31
Q

What does a severe lymphocytosis indicate?

A

Leukaemia

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32
Q

What does a lymphopenia indicate? (3)

A

Acute inflammation
Stress leucogram
Viral Infection

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33
Q

What does a Neutrophilia indicate?

A

Inflammation

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34
Q

What does a Neutropenia indicate?

A

Overwhelming demand
Reduced BM production
Inc destruction

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35
Q

What does a left shift indicate?

A

Severe acute inflammation

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36
Q

What may an eosinophilia indicate?

A

Worm parasitism

Allergy (T1 hypersensitivity)

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37
Q

What are the 4 classes of thrombocytopenia?

A

Destructive
Consumptive
Reduced Production
Distributional

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38
Q

What are the possible causes of a destructive thrombocytopenia?

A

IMTP: AI, drug reaction, ID, neoplasia

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39
Q

What are the possible causes of a consumptive thrombocytopenia? (4)

A

DIC
Thrombosis
Vessel Inflm
Acute, severe blood loss

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40
Q

What is the cause of a reduced production thrombocytopenia?

A

BM damage

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41
Q

What are the possible causes of a distributive thrombocytopenia?

A

Splenomegaly
Severe Hypothermia
Endotoxaemia

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42
Q

What is the clinical significance of thrombocytosis?

A

None

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43
Q

What are the 3 main characteristics of ACUTE inflammation?

A

Oedema
Neutrophils
Inc Blood Flow

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44
Q

What are the 4 main characteristics of CHRONIC inflammation?

A

Lymphocytes/mø
BV proliferation
Fibrosis
Necrosis

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45
Q

Define Exudate

A

Escape of fluid, protein AND blood cells FROM vascular system.

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46
Q

What is the gross appearance of an exudate?

A

Turbid, opaque, variable colour

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47
Q

Define Pus.

A

Inflammatory exudate rich in leukocytes and cell debris

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48
Q

What are the two changes to the vasculature which occur with acute inflammation?

A

Vasodilation

Increased vasc permeability

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49
Q

What are the 5 stages of leukocyte extravasation?

A
Rolling
Activation
Adherence
Transmigration
Migration
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50
Q

When do neutrophils predominate at the site of inflammation?

A

6-24h

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51
Q

When do macrophages predominate at the site of inflammation?

A

24-48h

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52
Q

What is the first stage of fibrosis?

A

Granulation tissue formation

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53
Q

What are the 4 stages of CT repair?

A

Angiogenesis
Mig/prolif of fibroblasts
ECM deposition
Remodelling of fibrous tissue

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54
Q

What is the predominant cell type in granulomatous inflammation?

A

Activated Mø

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55
Q

Describe the structure of a granuloma.

A

Centre: caseous necrosis w/calcification
Surrounded by epithelioid møs
Periphery: lymphocytes

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56
Q

Which agent is most known for inducting granulomatous inflammation?

A

Mycobacteria

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57
Q

What is healing under primary intention?

A

Wounds with opposed edges - surgical

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58
Q

What is healing via secondary intention?

A

more inflammation, larger granulation tissue and wound contraction present

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59
Q

How long does a blood clot take to form in 1e vs 2e intention healing?

A

1: 24h
2: 2-3d

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60
Q

How long does a granulation take to heal the gap in 1e vs 2e intention healing?

A

1: 2-7d
2: 1-2w

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61
Q

How long does a initial, weak scarring take to form in 1e vs 2e intention healing?

A

1: 2-4w
2: 3-6w

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62
Q

Which 2 systemic factors influence wound healing?

A

Nutrition

Hormones

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63
Q

Which 4 local factors affect wound healing?

A

Infection
Mechanics
Foreign Material
Size/Location of wound

64
Q

What are the 3 main features of a low-protein transudate?

A

Clear/Colourless
TP <25g/l
cells <1.5x10^9

65
Q

What would you see on cytology of low-protein transudate?

A

very few cells, mainly: Monocytes and Møs

some: lymphocytes, mesothelial cells & neutrophils

66
Q

On analysis of a red peritoneal fluid sample, what cytological sign would confirm that this was a true haemorrhage, and not contamination?

A

Erythrophagocytosis

also no PLTs

67
Q

what are the 4 main features of a modified transudate?

A

Clear
Colourless or coloured
Protein >25g/L
Cell count <10x10^9/L

68
Q

What is the main cause of high protein transudates?

A

Inc intravascular hydraulic pressure in liver or lungs.

i.e. CHF/vena cava neoplasia

69
Q

What is the main cause of high protein transudates?

A

Inc intravascular hydraulic pressure in liver or lungs.

i.e. CHF/vena cava neoplasia

70
Q

What are the 5 main charcteristics of an exudate?

A

Turbid
Yellow/Brown/bloody
Protein >25/30g/L
Cells: HIGH >5x10^9

Mostly neutrophils

71
Q

What can be seen in cytology of non-septic exudates?

A

non-degen neuts

low #s of hypersegmented neuts & pyknotic cells

72
Q

What can be seen in cytology of septic exudates?

A

Intracellular organisms
Degen Neuts
Karyolysis & karyorrhexis

73
Q

Describe FIP fluid.

A

Yellow
High Protein (frothy)
Moderate cellularity
Alb:Glob <0.8

74
Q

What are the 3 cytological features of FIP?

A

abundant proteinaceous background
Cells (mostly neutrophils)
Few macrophages

75
Q

What are the 3 cytological features of bile peritonitis?

A

Neutrophils
Møs w/green pigment
bilirubin [fluid] > bilirubin [plasma]

76
Q

What is the major feature of peritoneal fluid in bladder rupture?

A

Fluid creatinine > plasma creatinine (>2x)

77
Q

Describe the features of reactive mesothelial cells.

A

Eosinophilic brush border
Multinucleated
Variable shape/sizes

78
Q

How does inflammatory synovial fluid appear?

A

Yellow and turbid

79
Q

What re the 4 main features of NORMAL synovial fluid?

A

Clear/pale yellow
Viscous
Hypocelluar
Protein background

80
Q

What is the difference between synovial fluid in inflammatory arthropathies & OA?

A

OA: mononuclear cells

Inflm: Neutrophils & high cellularity

81
Q

Which blood tube should be used for glucose measurement?

A

Fluoride/Oxalate

82
Q

Which blood tube should be used for haematology?

A

EDTA

83
Q

Which blood tube should be used for culture?

A

sterile

84
Q

Which blood tube should be used for coagulation profiles?

A

Citrate

85
Q

Which blood tubes can be used for biochemistry?

A

Lithium Heparin
Serum activator
Serum Gel

86
Q

Which blood tube should be used for peritoneal fluid cytology?

A

EDTA

87
Q

Where should thoracocentesis be performed?

A

Rib Space 7/8 in ventral 1/3rd.

Cranial to rib!!

88
Q

How is a relative polychytaemia treated?

A

Tx cause

Replace lost fluid

89
Q

What causes a 1e absolute polycytaemia?

A

Myeloproliferative disorders

90
Q

What causes a 2e absolute polycytaemia?

A

Inc EPO production

91
Q

Below what PLT count are dogs at risk of spontaneous haemorrhage?

A

<50x10^9/L

92
Q

Below what PLT count are cats at risk of spontaneous haemorrhage?

A

<30x10^9/L

93
Q

What are the signs of vWD? (type 1)

A

MMs bleeding
Bruising
Haemorrhage during Surgery

94
Q

What are the 3 common causes of increased FDPs?

A

DIC
Thrombotic Dz
Reduced hepatic clearance

95
Q

What are D dimers specific for?

A

breakdown of cross-linked fibrin - likely DIC

96
Q

Which test allows you to rule out a defect of the primary hemostasis?

A

BMBT

97
Q

Predict the bone marrow findings in case of immune-mediated thrombocytopenia

A

Increased Thrombopoesis

98
Q

What type of erythrocyte abnormality is often seen in animals with DIC?

A

Schistocytes

99
Q

Which blood Ag should donor dogs NOT have?

A

1.1

100
Q

Define Major cross match.

A

Check for Ab in recipient plasma against donation.

101
Q

Which fluid, and how much, should a dog be given after donating blood?

A

2-3x donated volume in crystalloids

102
Q

Transfusion of which feline blood type causes a MAJOR transfusion reaction?

A

Type A blood to type B cat

103
Q

What % of a horses BW is blood volume?

A

8%

104
Q

What 3 signs in a horse, minus anaemia, would signal chronic blood loss?

A

epistaxis
Haematuria
Malaena

105
Q

What 3 signs in a horse, minus anaemia, would signal haemolysis?

A

Fever
Icterus
Pigmenturia

106
Q

Normal PCV for thoroughbred

A

35-45%

107
Q

Normal PCV for pony/draught horse

A

26-35%

108
Q

What 2 changes will you see on smear exam of a horse with haemolytic anaemia?

A

Spherocytes

Heinz Bodies

109
Q

What are 2 pathogens which cause equine anaemia?

A

EIA (lentivirus)

Ehrlichia

110
Q

Which test allows diagnosis of EIA?

A

Coggins Test

111
Q

How do erythrocytes appear on cytology of iron deficiency anaemia?

A

Microcytic

Hypochromic

112
Q

What is the most common cause of Iron Deficiency anaemia in smallies?

A

GIT bleed

113
Q

What are the 2 most common signs on cytology of IMHA in smallies?

A

Spherocytosis

Autoagluttination

114
Q

What dose of preds should be used to control IMHA?

A

1-2mg/kg BID

reduce by 25% every 3w

115
Q

Which drug may be given alongside prednisolone if it alone is not controlling IMHA? Dose? (Dogs ONLY)

A

Azathioprine

2mg/kg SID

116
Q

What must the O be warned about when prescribing azathioprine tablets?

A

DO NOT CRUSH OR BREAK!

117
Q

What si the 3rd line treatment for IMHA in dogs?

A

Ciclosporin (+Preds)

118
Q

Which 2 supportive drugs can be given in IMHA to reduce (excessive) platelet activation?

A

Clopidogrel

Low dose aspirin

119
Q

Which supportive drug can be given in IMHA to reduce (excessive) activation of the coagulation cascade?

A

Heparin

120
Q

How is mycoplasma haemofelis anaemia treated?

A

Doxycycline

Prednisolone

121
Q

what do schistocytes on a blood smear indicate? (SA)

A

Mechanical Damage

122
Q

What is the prognosis of oestrogen toxicity?

A

VERY Poor

123
Q

What are markers of hepatocellular damage?

A

AST
LDH
ALT (more spec)

124
Q

What is a marker of cholestasis?

A

ALP

GGT (more spec)

125
Q

What are the 3 types of hyperbilirubinaemia?

A

Pre-hepatic (haemolysis)
Hepatic (dec uptake, conjugation, excretion)
Post-hepatic (2e to obstruction of extrahepatic bile duct)

126
Q

What is seen on biochem of post-hepatic hyperbilrubinaemia?

A

Cholestatic enzymes (ALP/GGT) > leakage enzymes (ALT/AST)

127
Q

What test can be done to examine heptaobiliary pathology?

A

Fasting Serum Bile Acids

> 25-30mmol/L indicate Dz!

128
Q

What test can be conducted to reveal hepatobiliary Dz if fasting BA is normal?

A

BAST - BA measured 2h after fatty meal

> 25-30mmol/L indicate Dz!

129
Q

What 3 things may be seen on haem exam in liver Dz?

A

Microcytosis
Ovalocytes (lipidosis)
Acanthocytes

130
Q

What 3 things may be seen on urinalysis in liver Dz?

A

Isosthenuria
Bilirubinuria
Ammonium Biurate Crystals

131
Q

What are 3 markers of hepatic function?

A

Serum bile acids (BA) and ammonia

132
Q

What are 3 markers of cholestasis?

A

Bilirubin, GGT and ALP

133
Q

What is a specific, sensitive test for exocrine pancreatic insufficiency?

A

trypsin-like immunoreactivity

<2.5mg/L in dogs
<8mg/L in cats

134
Q

What is a specific, sensitive test for pancreatitis?

A

canine pancreatic lipase

+ US

135
Q

How does an epithelial tumour appear on cytology?

A

“islands” of cohesive polygonal cells

136
Q

How does a round cell tumour appear on cytology?

A

“sea” of round discrete cells

137
Q

How does a mesenchymal tumour appear on cytology?

A

Spindle cells with indistinct edges embedded in extracellular ‘matrix’

138
Q

What are the criteria of malignancy? (3 min for tumour)

A
Multinucleation
Karyomegaly 
Mitoses
Nuclear moulding 
Large/angular/mixed size nucleoli
Hypercellularity 
Pleomorphism 
High/variable N:C ratio
139
Q

What are the 5 types of round cell tumour?

A
Histiocytoma
Plasma cell tumor
Mast cell tumor
Lymphoma
TVT
140
Q

Describe the cytology of a histiocytoma.

A

Light blue faded cytoplasm

Small lymphocytes

141
Q

Describe the cytology of a histiocytic sarcoma.

A

Marked pleomorphism
Kayromegaly
Multinucleation

142
Q

Describe the cytology of a lymphoma

A

Round cells
High N:C ratio
Large blasts (>neut)
Monomorphic

143
Q

Describe the cytology of a mast cell tumour.

A

Magents granules in cytoplasm

144
Q

Describe the cytology of a plasmacytoma

A

Deep blue cytoplasm, perinuclear halo, eosinophilic borders.

Round, eccentric nucleus

145
Q

Describe the cytology of a sebaceous adenoma

A

Clusters of cohesive heavily vacuolated cells

146
Q

Describe the cytology of a squamous cell carcinoma

A

Polygonal cells
Marked pleomorphism
2e neutrophilic inflm

147
Q

Describe the cytology of an anal sac adenocarcinoma

A

“naked nuclei” in rosettes and rows

148
Q

Which ions are high in ECF?

A

Na, Cl, HCO3

149
Q

Which ion is high in ICF?

A

K+

150
Q

How is hyperkalaemia treateD?

A

IVFT with Low K fluids (saline +/-5% glucose)

CaGluconate if CV effects

151
Q

What are the causes of hyper calcaemia?

A
HARD IONS G
HyperPTH/HyperTH
Addisons
Renal Dz
D Vitamin D tox
Idiopathic (cat)
Osteolytic
Neoplasia
Spurious
Granulomatous Dz
152
Q

What are the main causes of hypocalcaemia?

A
Malabsorption
Pancreatitis
Renal Dz
EDTA tube
Hypolabuminaemia
EG toxicity
153
Q

What is the most sensitive test for GFR?

A

SDMA

154
Q

How does a dec GFR affect Phosphate?

A

Cats/Dogs/Farm: INC

Horses: Dec

155
Q

What should the UPCR be in dogs and cats?

A

Dog: <0.5
Cat: <0.4

156
Q

What would you suspect if glucosuria was present with a normal plasma glucose?

A

Tubular Dz = Fanconis

157
Q

What is the gold std substance to use for a urine clearance test?

A

Iohexol