Clinical Pathology

Question 1

What is the criteria of malignancy?

Answer 1

Cellular crowding, loss of organisation

Ansiocytosis

Macrocytosis

Altered N:C ratio

Bi and multinucleation

Nuclear molding

Aberrant chromatin pattern (finely stippled to corse)

Nucleoli increased number and size, abnormal shapes

Mitoses increased mitotic rate and atypical mitotic figures

Question 2

Type of cytology preparations

Answer 2

1. Fine needle biopsy

Fine needle aspirate

Ultrasound guided fine needle biopsy

Used for cutaneous/subcutaneous nodules

2. Impression smears

Superficial lesions and biopsies

Remove any crust and clean the surface

Blot any blood

Press the slide onto the lesion

3. Swabs or scrapings

Used for derm, nasal/oral, ocular and vaginal

4. Fluid smears or cavity washes

Collect in appropriate tube EDTA for cell preservation, inhibits clotting

Question 3

Plasma v Serum

Answer 3

serum = plasma - clotting factors (removal of fibrinogen)

thus lower protein due to fibrinogen consumption in clotting

leave blood to clot for at least 30 mins before spinning down and harvesting serum

serum is best for storage as no leakage or consumption of substances from cells

Question 4

Urine analysis

Answer 4

Specific gravity
refractometric reading to assess concentration ability of the renal tubular system increase with pathologic solutes (proteins, glucose)

hyperstenuria >1.012
isostenuria 1.008-1.012
hypostenuria <1.008

dipstick
if different to usual, possible renal tubular disease, bacteria falsely increasing pH, prolonged storage
protein typically low in healthy urine - increased in renal disease, urinary tract inflammation, neoplasm
glucose not found in healthy urine - if also high in blood diabetes mellitus if high just in urine renal tubular damge

Question 5

Hyperadrenocoriticism

Answer 5

Cushings

Most common is pituitary adenoma causing increased ACTH so increased cortisol (can be a adrenal tumour)

Abdominal distension, coat thinning, lethargy, PU, PD

ACTH stimulation test

1. basal blood
2. Add ACTH
3. 1hr later measure basal cortisol

Low dose dexamethasome test

1. basal blood
2. dexamethasome
3. cortisol 4 to 8 hr later

Question 6

Equine pars intermedia adenoma

Answer 6

Pituitary pars intermedia dysfunction
Equine cushings

• micro/macro adenoma within pars intermedia, loss of dopamine melantropes
• PU,PD, abnormal curly hair, abnormal fat distribution, excessive sweating

Plasma ACTH testing or overnight dexamethasome testing

TRH stimulation test

• basal
• 1.0mg TRH
• post TRH 10 mins later
• submit plasma ACTH response

Question 7

Hypoadrenocortisim

Answer 7

Addisons disease
absolute lack of adrenocortical steriods
primary hypoadrenocorticism
Iatrogenic

clinical signs haemtology lack of stress response, chemistry electrolyte abnormalities, azotaemia, hypercalcaemia, urinalysis normal to low USG

Question 8

Feline hyperthyroidism

Answer 8

Excessive thyroid hormones, hyperplastic nodules (common adenoma, carcinoma more rare)

• weigh loss despite good appetite, tachycardic, palpble goitre
• haematology erythrocytosis, stress leukogram
• chemistry increased ALP and ALP activity
• total t4 and free t4 basal concentrations

Question 9

Canine hypothyriodism

Answer 9

Ireversible acquired thyroid gland disease, rarely nutritional, congenital, central

Adult onset lymphocytic thyroiditis or idiopathic thyroid degeneration

Lymphocytic thyrioditis immune mediated destruction

Idiopathic thyroid atrophy, replacement by adipose or fibrous tissue

Mild non-regenerative anaemia, hypercholesterolaemia, hypertriglycerdaemia

Basal testing for total thyroxine concentration and free thyroxine concentration