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RUSVM Clinical Pathology 2016 > *Differentials* > Flashcards

*Differentials* Flashcards

1
Q

Relative Polycythemia

A

Dehydration
Fluid Shifts
Redistribution: Excitement or Exercise

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2
Q

Absolute Polycythemia

A

Chronic Hypoxia
Renal Cysts
Tumors

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3
Q

Primary Polycythemia

A

Myeloproliferative disorder

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4
Q

Pure Transudate

A

Hypoalbuminemia

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5
Q

Modified Transudate

A

Impaired Blood or Lymph Flow

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6
Q

Exudates

A

Inflammation

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7
Q

Triglyceride in the fluid

A

Chylus Effusion

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8
Q

Round Discrete Cell tumors

A 
Lymphoma
Plasma cell tumors
Mast cell tumors
Histiocytomas
Transmissible Venereal tumors
Malignant histiocytosis
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9
Q

Mesenchymal tumors

A 
Lipomas
Hemangiopericytomas
Hemangiosarcomas
Osteosarcomas
Chondrosarcomas
Fibrosarcoma
Neurofibrosarcoma
Peripheral nerve sheaath tumor
Poorly differentiated sarcoma
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10
Q

Epithelial tumors

A

Basal cell tumors
Squamous Cell carcinomas
Thyroid carcinoma

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11
Q

Hypoalbuminemia

A 
Inflammation
Liver Failure 
Chronic Liver Disease
Reduction in liver mass : Portosystemic shunt 
Blood loss: Hemorrhage or GI Parasites
Protein Losing Enteropathy
Protein losing nephropathy 
Effusions or vasculitis
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12
Q 
Proteinuria 
Hypoalbuminemia
Hypercoagulable
Hypercholesterolemia
Ascites
A

Nephrotic Sydrome

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13
Q

Hypoglycemia
Hypocholesterolemia
Decreased Urea
Hyperglobulinemia

A

Hepatic Insufficiency

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14
Q

Hypercholesterolemia

A

Protein losing nephropathy

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15
Q

Hypoglobulinemia
Hypocholesterolemia
+/- Hypomagnesium

A

Protein losing enteropathy

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16
Q

Hyperalbuminemia

A

Dehydration

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17
Q

Hypoglobulinemia

A 
Severe combined immunodeficiency syndrome (SCIDS)
Hemorrhage 
Protein Losing Enteropathy
Failure of passive transfer in neonates
Chronic Liver Disease
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18
Q

Hyperglobulinemia

A

Dehydration
Inflammation
Neoplasia: Multiple Myeloma or B cell Lymphoma

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19
Q

Hypoalbuminemia

Hyperglobulinemia

A

Polyclonal gammopathy: Inflammation

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20
Q

Increased Gamma Globulins

A

Monoclonal gammopathy: Neoplasia

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21
Q

Panhypoproteinemia

A

Blood loss

Protein losing enteropathy

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22
Q

Panhyperproteinemia

A

Dehydration

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23
Q

Hypofibrinogenemia

A

Liver Failure

DIC

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24
Q

Hyperfibrinogenemia

A 
Inflammation
Renal Disease (Cats and Cattle)
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25
Q

Increased BUN

A

High Protein Diet
Upper GI Bleed
Increased Catabolism

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26
Q

Decreased BUN (Pre-Renal)

A

Low Protein Diet
Portosystemic Shunt
Liver insufficiency
Protein losing enteropathy

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27
Q

Decreased BUN (Renal)

A

Diuresis

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28
Q

Increased Creatinine

A

High Muscle Mass
Decreased GFR
Renal insufficiency

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29
Q

Decreased Creatinine

A

Not significant

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30
Q

Increased SDMA

A

Renal Tubular Disease

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31
Q

Isosthenuria

A

Renal Failure
Medullary Washout
Diabetes Mellitus
Diuresis

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32
Q

Polyuria

A 
Renal Failure
Pyelonephritis
Diuresis
Medullary Washout 
Diabetes
Hyperadrenocorticism
Pyometra
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33
Q 
Increased BUN
Increased CREA
Increased SpGr
Hyperphosphatemia
Hypermagnesemia
A

Dehydration
Shock
Cardiac Insufficiency

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34
Q

Increased CREA

A

Increased Muscle Mass

Dams with dysfunctional placentas prevent normal clearance of fetal CREA

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35
Q

Increased BUN
Increased CREA
Decreased SpGr
Hyperphosphatemia

A 
Renal DAMAGE!!
Infectious 
Toxic 
Hypoxia
Neoplasia
Congenital
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36
Q

Increased BUN
Increased CREA
Decreased SpGr

A 
NOT ALWAYS RENAL DAMAGE!!
Diabetes Insipidus
Endocrine: Cortisol, glucose
Fanconi syndrome 
Diuresis
Medullary washout
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37
Q

Increased BUN
Increased CREA
Variable SpGr

A

Obstruction of urinary outflow:
Urolithiasis
Uroabdomen
Trauma

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38
Q

Pre-Renal Proteinuria

A

Paraproteinuria
Hemoglobinuria
Myoglobinuria
Post-colostral proteinuria

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39
Q

Glomerular Proteinuria

A

Hypoalbuminemia

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40
Q

Tubular Proteinuria

A

Normal Albumin

Loss of low molecular weight proteins

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41
Q

Post Renal Proteinuria

A

Hemorrhage/Inflammatory
Trauma
Neoplasia

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42
Q

Hypercalcemia with signs of Renal Disease

A

Mineralization of the renal tubules caused by hypercalcemia

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43
Q

Hypercalcemia
Polyuria
Low concentrating ability

A

Impairs urine concentrating ability by affecting ADH receptors

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44
Q

Hypocalcemia

A

Decreased in Vitamin D

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45
Q

Hyperphosphatemia and renal disease

A

Renal failure due to mineralization of soft tissues

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46
Q

Normalkalemia

A

Chronic Renal Failure

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47
Q

Hypokalemia

A

Decreased intake

Hypokalemia nephropathy in cats

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48
Q

Hyperkalemia

A

Acute Renal Failure

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49
Q

Hyperkalemia
Hyponatremia
Increased urea in the blood
Peritoneal creatinine 2x serum creatinine

A

Uroabdomen

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50
Q 
Good BCS
Anorexia
Vomiting
Diarrhea
Halitosis
Oliguric or anuric
Neuro: Depressed or seizures
Azotemia
Hyperkalemia
Acidemia
Proteinuria
Cellular Casts in the urine
Variable SpGr
A

Acute Renal Failure

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51
Q 
Geriatric - frequently in cats
Poor BCS
Anorexia
vomiting
Diarrhea
Halitosis
Polyuric
Neuro: Depressed
Hypertension 
Azotemia
Isosthenuria
A

Chronic Renal Failure

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52
Q 
GFR less than 20-25%
Nonregenerative anemia
Dehydration 
Azotemia
Hyperphosphatemia
Metabolic Acidosis
Normal to Hypokalemia
Polyuria
Isosthenuria
A

Chronic Renal Failure

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53
Q 
GFR less than 5% of normal
Nonregenerative anemia
Marked dehydration 
Marked Azotemia
Hyperphosphatemia
Metabolic Acidosis
Hyperkalemia
Isosthenuria
Oliguria to anuria
A

Chronic Renal Failure

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54
Q

Proteinuria
Hypoproteinemia: Hypoalbuminemia and Normalglobulinemia
Azotemia
Isosthenuria

A

Glomerulonephrits

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55
Q

Hyperglycemic glucosuria

A 
Diabetes Mellitus
Hyperadrenocorticism 
Drugs
Postprandial 
Acute pancreatitis
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56
Q

Normalglycemic glucosuria

A

Transient stress
Reversible tubular damage: Drugs, Hypoxia, infection, toxins
Urethral obstruction

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57
Q

Bilirubinuria

A

Liver disease
Bile duct obstruction
Hemolysis

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58
Q

Ketonuria

A

Negative energy balance
DKA
Insulinoma

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59
Q

Hemoglobinuria

A

Intravascular hemolysis

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60
Q

Hematuria

A 
Trauma
Infection 
Inflammation
Infarction 
calculi
neoplasia
coagulopathy
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61
Q

Myoglobinuria

Increased CK and AST

A

Myocyte damage

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62
Q

Alkaline urine

A

low protein diet
UTI
Respiratory or Metabolic Alkalosis
Alkalinizing drugs

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63
Q

Acidic urine

A 
High protein diets
Respiratory and Metabolic Acidoses
Hypochloremic metabolic alkalosis + severe dehydration
Hypokalemia
Furosemide
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64
Q

Pre-Renal Proteinuria

A

Fever
Hypertension
Seizures

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65
Q

Renal Proteinuria

A

Glomerulonephritis

Renal damage

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66
Q

Post-Renal Proteinuria

A

Hemorrhage

Infection

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67
Q

Transitional epithelial cells in urine

A

Hyperplasia with inflammation

Transitional cell tumors

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68
Q

Caudate cells in urine

A

Pyelonephritis

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69
Q

Renal Cells in urine

A

Renal tubular injury: Infectious, toxic, and ischemic injury

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70
Q

RBCs in the urine

A

Hemorrhage

Inflammation

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71
Q

WBCs in the urine

A

Inflammation: infection and noninfectious

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72
Q

Lipids in urine

A

Degeneration of sloughed cells

Renal tubular injury

73
Q

Struvites in urine

A

Normal

Urease positive bacteria promote formation

74
Q

Bilirubinuria

A

Normal in dogs

In other species: Hemolysis, heptaobiliary disease

75
Q

Calcium carbonate in urine

A

Normal in horses, rabbits, guinea pigs, and goats

76
Q

Calcium oxalate dihydrate in urine

A

Normal in domestic animals
Storage artifact
Increased calcium excretion due to hypercalcemia

77
Q

Calcium oxalate monohydrate in urine

A 
Seen in normal animals and horses
also associated with:
Urolithiasis
Hypercalciuric disorders
Hyperoxaluric disorders
Ehtylene glycol toxicosis
78
Q

Ammonium biurate in the urine

A

Normal in dalmations and english bulldogs
Liver failure
Congenital or acquired shunts

79
Q

Cystinuria

A

Inherited disease - renal function is normal

80
Q

Hyponatremia

A 
GI loss: Vomiting, diarrhea, saliva
Renal:  Hypoadrenocorticism, Ketonuria, Diuresis
Effusions: Peritonitis, Ascites, Chylothorax, Uroabdomen, GI sequestration
Sweating  
CHF
Cirrhosis
Nephrotic syndrome
Body fluid shifts: Hyperglycemia
Decreased intake
Psychogenic Polydipsia
Nephrotic Syndrome
Hepatic or Renal Failure
Edema
81
Q

Hypernatremia

A

Dehydration
Increased intake
Increased aldosterone

82
Q

Hypochloremia

A 
All the causes of Hyponatremia! 
Hypochloremic metabolic alkalosis --> Paradoxical aciduria
Severe vomiting
Abomasal disorders
High GI obstruction 
Sweating
83
Q

Hyperchloremia

A

All the causes of Hypernatremia!
GI loss of HCO3 - Diarrhea
Alkalemia

84
Q

Hyperkalemia

A 
Failure of Renal Excretion
Hypoadrenocorticism: Aldosterone
Inorganic acidosis
Insulin deficiency 
Muscle trauma: Rhabdomyolysis
Massive hemolysis
Increased intake or administration
Potassium Sparing Diuretics
85
Q

Hypokalemia

A 
Decreased intake
Vomiting
Diarrhea
abomasal disorders
Horse sweat
Alkalemia
Insulin injection
86
Q

No difference between calculated osmolality and measured osmolality but increase in measured osmolality?

A

Increased Sodium or Glucose or Urea

87
Q

No difference between calculated osmolarity and measured osmolarity but there is a decreased in measured osmolality?

A

Decreased sodium

88
Q

There is a difference between calculated and measured osmolality with an increase in measured osmolality?

A

Presence of unmeasured osmole (ethylene glycol)

89
Q

Lymphadenopathy

A

Hyperplasia/Reactive (Antigenic Stimulation)
Lymphadenitis
Metastatic neoplasia
Primary neoplasia

90
Q

Greater than 50% lymphoblast

91
Q

Increase in plasma cells

A

Reactive lymph node (hyperplasia)

92
Q

Hematoidin crystal

A

RBC break down pigment indicating prior hemorrhage

93
Q

Apparent Hypocalcemia

A

Hypoalbuminemia causes a decrease in calcium bound to albumin

94
Q

Common causes of Hypocalcemia

A 
Renal Disease
Ethylene Glycol toxicosis 
Pancreatitis
Eclampsia
Sepsis
95
Q

Uncommon causes of Hypocalcemia

A 
Hypoparathyroidism 
Nutritional secondary hyperparathyroidism
inadequate calcium intake 
inadequate vitamin D intake 
excess phosphorus
Intestinal malabsorption 
Phosphate containing enemas
Citrate toxicity 
Hypomagnesemia 
Massive tissue degeneration 
Hypercalcitonism (C-cell thyroid tumors)
96
Q

Causes of Hypercalcemia

A 
Hypercalcemia of Malignancy 
Granulomatous inflammatory disease
Renal disease
Idiopathic hypercalcemia of cats
Vitamin D toxicosis 
Grape and Raisin Toxicosis Hypoadrenocorticism
Primary Hyperparathyroidism
97
Q

Causes of Hypophosphatemia

A 
Metabolic acidosis 
Diabetic Ketoacidosis 
Primary hyperparathyroidism 
Hypercalcemia of malignancy 
Vitamin D Deficiency 
Respiratory Alkalosis 
Decreased intestinal absorption 
Renal tubular defects 
Chronic renal failure in horses
98
Q

Causes of Hyperphosphatemia

A 
Decreased GFR (Pre renal azotemia or renal disease) 
Ruptured Bladder or ureter or urethral obstruction 
Vitamin D intoxication 
Acute acidosis 
Excessive P intake 
Primary Hypoparathyroidism
99
Q

Causes of Hypomagnesemia

A 
Lost through GI track, kidney, and skin of horses 
Malabsorption from the GI tract 
Diarrhea
Fluid diuresis 
Diuretics 
Renal Disease
Grass tetany 
Milk Tetany 
Diabetes Mellitus 
Hypercalcemia
Hyperaldosteronism 
Third space syndrome
100
Q

Causes of Hypermagnesemia

A

Compromised Renal function

Magnesium containing laxatives or antacids with decreased GFR

101
Q

Increased ALP

A

Cholestasis
Corticosteroid Induced
High in young animals from bone

102
Q

Increased GGT

A

Cholestasis (Especially in cats!!)
Steroid Induction
Hepatic injury

103
Q

Increased AST

A

Hepatocellular Damage

Rhabdomyolysis (Muscle Damage )

104
Q

Increased ALT

A

Hepatocellular Damage in dogs and cats!!

Myocardial Cell injury

105
Q

Increased CK

A

Rhabdomyolysis (Muscle Damage )

Myocardial cell injury

106
Q

Cause of Myoglobinuria

A

Rhabdomyolysis (Muscle Damage)

107
Q

Cause of Hemoglobinuria

108
Q

Increased Serum Natriuretic Peptide

A

Cardiac dysfunction

109
Q

Causes of Increased Plasma NT-proBNP

A 
Ventricular Hypertrophy
Tachycardia 
Hypoxia
Expanded Fluid Volume 
Reduce renal clearance of the peptide
110
Q

Increased SDH in Large Animals

A

Hepatocellular Damage

111
Q

Increased GLDH in Large Animals

A

Hepatocellular Damage

112
Q

Increased ALP in cats

A

Cholestasis
NO STEROID INDUCTION!!
Hyperthyroidism

113
Q

Increased ALP WITHOUT hyperbilirubinemia

A

steroid or anticonvulsant medication

114
Q

Hyperbilirubinemia

A

Hemolysis
Decreased uptake or conjugation by the liver
Blockage of bile (Cholestasis)

115
Q

Increased Bile Acids

A

Portosystemic Shunt
Cirrhosis
Decreased hepatic uptake (Inflammation, necrosis, steroid hepatopathy, decreased functional hepatic mass)
Decreased bile excretion (Cholestasis, bile duct leakage)

116
Q

Hypercholesterolemia

A

Cholestasis

117
Q

Hypocholesterolemia

A

Liver Failure

118
Q

Increased Enzyme Activity
Increased Bile Acids
Microcytic Anemia (Maybe)

A

Early Portosystemic Shunt

119
Q 
Hypoalbuminemia 
Decreased BUN 
Hypoglycemia 
Hypocholesterolemia 
Decreased Coag factors
Increased Bile Acids 
Cholestasis 
Microcyctic Anemia
A

Late Portosystemic shunt

120
Q

Causes of Chronic Hepatitis

A 
Copper storage disease
Infectious (Lepto, ICH, etc)  
Drugs  (Primidone, phenobarbitol, some NSAIDs) 
Genetic 
Idiopathic (Immune mediated)
121
Q

Decreased TLI

A

Exocrine Pancreatic Insufficiency

122
Q

Decreased Folate

Decreased B12

A

Generalized Malabsorption

123
Q

Decreased Folate

Normal B12

A

Proximal Small Intestine defect

124
Q

Normal Folate

Decreased B12

A

Distal Small Intestine Defect

125
Q

Increased Folate

Decreased B12

A

Bacterial Overgrowth

126
Q 
Mild to Moderate nonregenerative anemia
Fasting Hypercholesterolemia
Fasting Hypertriglyceridemia
Decreased Total T4
Decreased Free T4
Increased TSH
A

Canine Hypothyroidism

127
Q

Decreassed Total T4

A

Canine Hypothyroidism

Euthyroid Sick Syndrome

128
Q

Decreased Total T4
Decreased Free T4
Decreased TSH

A

Secondary Hypothyroidism

129
Q

Decreased Total T4
Normal to decreased Free T4
Normal to increased TSH

A

Euthyroid Sick Syndrome

130
Q

Decreased TSH

A

Glucocorticoid induced

131
Q

Increased TSH

A

Early Hypothyroidism

132
Q

Normal Total T4
Normal Free T4
Normal TSH

A

Canine Thyroid Carcinoma (Nonproductive)

133
Q 
Tachycardia 
Hyperactivity 
Weight loss
Polyphagia 
Diarrhea 
Polycythemia 
Heinz Body Formation 
Stress Leukogram 
Mild to Moderate ALT 
Azotemia --> Dehydration 
Increased Total T4
A

Hyperthyroidism

134
Q

Hypercalcemia
Hypophosphatemia
Normal to Increased PTH

A

Primary Hyperparathyroidism

135
Q

Causes of Hypercalcemia

A 
D - Vitamine D Toxicosis 
R - Renal Failure 
A - Addison's Disease
G - Granulomatous Disease
O - Osterolytic Disease
N- Neoplasia 
S - Spurious 
H - Hyperparathyroidism 
I - Idiopathic (Cats), Iatrogenic 
T - Temperature, Toxins

DRAGONSHIT!!

136
Q

Hypocalcemia
Hyperphosphatemia
Normal to decreased PTH

A

Hypoparathyroidism

137
Q

PU/PD
Low USG

DDx??

A 
Diabetes Insipidus (Central and Nephrogenic) 
Psychogenic polydipsia (PPD)
138
Q

PU/PD

Concentrated Urine after Water Dep test

A

Psychogenic Polydipsia

139
Q

PU/PD
Low USG after Water Dep test
Concentrates with Desmospression administration

A

Central Diabetes Insipidus

140
Q

PU/PD
Low USG after Water Dep test
NO Concentrating with Desmospression administration

A

Nephrogenic Diabetes Insipidus

141
Q 
"Pot Bellied" appearance 
Panting 
Muscle Weakness
Ligament Weakness
Alopecia 
Calcinosis Cutis 
Cutaneous Hyperpigmentation
Stress Leukogram
Increased ALP 
Increased ALT 
Hypercholesterolemia Low USG 
UTI
A

Canine Hyperadrenocorticism

142
Q

Increased Urine Cortisol: Creatinine Ratio

A

Hyperadrenocorticism

143
Q

Injection of Steroids –>

No Suppression of ACTH

A

Pituitary Tumor

Adrenal Tumor

144
Q

If decreased ACTH at 8 hours after LDDST

A

Normal Dog

145
Q

If increased ACTH at 8 hours after LDDST

A

Hyperadrenocorticism

146
Q

If increased ACTH at 8 hours and 4 hours after LDDST

A

Hyperadrenocorticism (Primary-dependent Hyperadrenocorticism or Adrenal Tumor)

147
Q

If increased ACTH at 8 hours and decreased at 4 hours

A

Primary-dependent Hyperadrenocorticism (PPDH)

148
Q 
Ferret: 
Alopecia 
Vulvar enlargement 
Aggression 
Muscle Atrophy 
Lethargy
Anemia 
Pancytopenia
A

Ferret Hyperadrenocorticism

149
Q 
Lack of Stress Leukogram 
Hyponatremia 
Pre Renal Azotemia 
Dehydration 
Increased BUN 
Hypoglycemia 
Hyperkalemia
A

Hypoadrenocorticism

150
Q

Amylase levels greater than 3-4x upper end of normal

A

Pancreatic injury

151
Q

Lipase greater than 2x upper end of normal

A

Pancreatic injury

Corticosteroids

152
Q

Higher levels of peritoneal amylase/lipase

A

Pancreatitis

153
Q

Increased TLI

A

Pancreatitis

Corticosteroids

154
Q

Increased Pancreatic lipase immunoreactivity (PLI)

A

Pancreatic injury

Anticonvulsant drugs

155
Q

C-reactive protein

A

Acute Pancreatitis

156
Q

Causes of Apparent Hypoglycemia

A

Glycolysis by erythrocytes due to failure to remove serum from clot within 30 min

157
Q

Causes of Hypoglycemia

A 
Insulinoma
Insulin overdose
Sepsis 
Hepatic Failure
Neonatal/juvenile hypoglycemia 
Ketosis/ Pregnancy toxemia 
Neoplasia
Starvation/malabsorption
Extreme exertion 
Hypoadrenocorticism
Xylitol in dogs 
Ingestion of Ackee Fruit
158
Q

Causes of Hyperglycemia

A 
Glucocorticoids
Catecholamines
Diabetes Mellitus 
Post-prandial 
Pancreatitis 
Hormone Imbalance
Ethylene Glycol
Drugs (Glucocorticoids and Megestrol acetate in cats) 
Milk fever in cattle
Moribund animals
Proximal duodenal obstruction in cattle
159
Q

Glucosuria

A

Diabetes Mellitus

Renal Tubular Disorder (Normal Blood glucose)

160
Q

Increased Fructosamine

A

Diabetes Mellitus

161
Q

Ketonemia and Ketonuria

A

Altered Lipid metabolism
Starvation
Pregnancy toxemia
Bovine Ketosis

162
Q

Excitement Leukogram

A

Lymphocytosis

163
Q

Stress Leukogram

A

Lymphopenia
Neutrophilia
Eosinopenia

164
Q

Inflammatory Leukogram

A

Neutrophilia (2x the upper limit)
Band Neutrophils present
Sometimes see Metamyelocytes

165
Q

Lymphocytosis

A

Excitement
Neoplastic lymphoproliferative disease
Antigenic Stimulation
Ehrlichia

166
Q

Neutropenia

A

Inflammation
Immune mediated destruction
Lack of production by bone marrow

167
Q

Lymphopenia

A

Steroid Response
Acute viral infections
Immunodeficiency

168
Q

Monocytosis

A

Inflammation

Stress Response

169
Q

Eosinophilia

A

Parasitism
Hypersensitivity
Lesions producing eosinophil chemoattractants

170
Q

Basophilia

A

Accompanies eosinophilia

171
Q

Microcytic Anemia

A

Iron Deficiency

Portosystemic Shunt

172
Q

Keratocytes
Schistocytes
Microcytic Anemia

A

Iron Deficiency

173
Q

Heinz Body Anemia in small animals

A

Acetominophen
Propylene glycol
Cats: Lymphoma, Hyperthyroidism, Diabetes
Ingestion of Onions and garlic powder
Dogs: Cephalosporins and Zinc toxicosis (penny ingestion)

174
Q

Heinz bodies in large animals

A

Horses: Phenothiazine and wilted red maple leaves
Cattle: Kale and Onions
Sheep: Copper toxicosis

175
Q

Basophilic Stippling

A

Normal in ruminants
Regenerative anemia in cats and dogs
Lead Poisoning

176
Q

Howell Jolly Bodies

A

Regenerative Anemia
Non-functioning spleen or splenectomy
Increased Corticosteroids
Lead Poisoning

177
Q

Agglutination

178
Q 
Regenerative anemia
Spherocytosis 
Agglutination 
neutrophilia with left shift 
thrombocytopenia

RUSVM Clinical Pathology 2016 (22 decks)

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