Clinical pathology workshop

Question 1

Answer 1

Key findings:
- Moderate non-regenerative anemia (early-stage hemorrhage)
- Mild neutrophilia (stress/inflammation)
- Severely prolonged PT & aPTT (secondary hemostasis defect)
- Hypoproteinemia & mild hypocalcemia (suggests hemorrhage)
- Mild hyperglycemia (stress response)

Diagnosis:
- Rodenticide (coumarin) toxicity

Treatment:
- Vitamin K1, blood transfusion if severe bleeding

Question 2

Answer 2

Key findings:
- Severe hyperglycemia & glucosuria → Diabetes mellitus
- Azotemia (↑ urea & creatinine) → Likely dehydration + possible renal involvement
- Marked hypochloremia & mild hyponatremia → Osmotic diuresis
- Elevated liver enzymes (ALP, ALT, GGT, GLDH) → Hepatic involvement (cholangiohepatopathy)
- Hyperlipasemia & hyperamylasemia → Concurrent pancreatitis

Diagnosis:
- Diabetic Hyperosmolar Non-ketotic Syndrome (DHNS)

Management:
- Fluid therapy before insulin to prevent cerebral oedema
- Correct electrolyte imbalances & monitor glucose

Question 3

Answer 3

Key findings:
- Mild regenerative anemia (chronic disease)
- Marked leukocytosis, left shift, toxic neutrophils → Severe inflammation/infection
- Mild azotemia (consider hydration status)
- Elevated ALP & GGT → Cholestasis ± systemic illness
- Hypoalbuminemia → Negative acute-phase response or protein loss

Diagnosis:
- Pyometra

Treatment:
- Ovariohysterectomy (OHE)
- Supportive care (fluids, antibiotics, monitor renal function)

Question 4

Answer 4

Key findings:
- Hypercalcemia
- Azotemia (↑ urea & creatinine) → Pre-renal dehydration ± nephrocalcinosis
- Low USG → Nephrogenic diabetes insipidus (Ca inhibits ADH)
- Hyperphosphatemia → Suggests vitamin D toxicity
- PTH suppressed, PTHrP normal, 25OH Vit D elevated

Diagnosis:
- Hypervitaminosis D (Psoriasis Cream Toxicity)

Treatment:
- IV fluids (diuresis), bisphosphonates, corticosteroids
- Monitor renal function & calcium levels