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Clinical diagnostics in Equine > Equine diagnostics: Sampling blood > Flashcards

Equine diagnostics: Sampling blood Flashcards

1
Q

Serum tubes contain…?

A

Either gel and/or coagulation activator

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2
Q

What is the GREY top tube used for?

A

Grey-top tube (potassium oxalate/sodium fluoride)

This tube contains potassium oxalate as an anticoagulant and sodium fluoride as a preservative – used to preserve glucose in whole blood and for some special chemistry tests.

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3
Q

Why is sodium citrate used for coagulation?

A

Citrate chelates free calcium ions preventing them from forming a complex with tissue factor and coagulation factor VIIa to promote the activation of coagulation factor X. This inhibits the extrinsic initiation of the coagulation cascade.

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4
Q

Where to obtain blood sample in horses? (5)

A
  • Jugular vein (v. jugularis)
  • Transverse facial vein sinus
  • Cephalic vein (v. cephalica) not in adults
  • Saphenous vein (v. saphena) not in adults
  • Lateral thoracic vein
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5
Q

Diff between plasma and serum.

A

Plasma includes coagulation factors.

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6
Q

Error sources: why can RBCs shrink after drawing?

A

Not enough blood drawn into the EDTA tube can cause RBC crenation due to EDTA being hypertonic.

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7
Q

Döhle bodies are

A

light blue-gray, oval, basophilic, leukocyte inclusions located in the peripheral cytoplasm of neutrophils.

The presence of Döhle bodies in mature and immature neutrophils on a blood smear can be normal if they are present only in small numbers. They are also normally more abundant in cats and horses.

If there are many neutrophils in the bloodstream containing Döhle bodies, these can be referred to as toxic neutrophils.

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8
Q

If you need to draw blood frequently to e.g. check GLU often. How would you do it?

A

You can draw via the IV catheter but discard a minimum of 3 ml of blood by aspiration and only then draw your sample so as not to dilute your sample with IV fluids etc.

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9
Q

MCH & MCHC difference

A

Hemoglobin amount per red blood cell (MCH).

The amount of hemoglobin relative to the size of the cell (hemoglobin concentration) per red blood cell (MCHC).

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10
Q

Relative Erythrocytosis/polycytemia indicates

A

Dehydration
* Hemoconcentration

or

Splenic contraction
* Stress
* Training

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11
Q

Absolute Erythrocytosis/polycytemia indicates

A

is rare

Primary
* Production increases in bone marrow
* Response to hypoxia
* Tumors

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12
Q

Regenerative anemia indicates

A

Hemorrhage
* External
* Internal

or

Hemolysis
* Infection
* Toxicosis
* Immune-mediated

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13
Q

Non-regenerative anemia indicates

A

Decreased production
* Bone marrow supression
* Inflammation
* Chronic diseases
* Iron-deficiencyx

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14
Q

Macrocytosis of RBCs may be seen in (2)

A

anemias

normal in neonatal foals

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15
Q

Microcytosis of RBCs may be seen in what situations (2)

A

Too much EDTA
* Common artefact

Microcytosis may be seen in Foals up to 1 year of age due to iron deficiency anemia.

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16
Q

RDW

A

red cell distribution width

Variation in red blood cell volume within the red cell population

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17
Q

A Decrease in RDW is

A

not clinically important.

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18
Q

Reticulocytes in horses

A

Horses do not have reticulocytes!

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19
Q

Since Horses do not have reticulocytes, how is anemia assessed?

A

In horses, the bone marrow response to anemia is often assessed by evaluating other parameters such as the presence of polychromasia (immature red blood cells) on a blood smear.

Additionally, measuring serum erythropoietin levels and assessing the overall clinical picture are important aspects of evaluating anemia in horses.

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20
Q

Increase in Hgb could indicate

A
  • Dehydration
  • Spleen contraction (epinephrine)
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21
Q

Decrease in Hgb could indicate

A
  • Fluid overload (over-dilution with fluids)
  • Spleenic relaxation (anesthetics, sedation
  • Anemia
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22
Q

HCT/PCV increase could indicate (2)

A
  • Dehydration
  • Spleen contraction (epinephrine)
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23
Q

HCT/PCV decrease could indicate (3)

A
  • Fluid overload (over-dilution with fluids)
  • Spleen relaxation (anesthetics, sedation
  • Anemia
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24
Q
A

Monocyte

lymphocyte pic to show you the diff.

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25
Q

Neutrophil types (2)

A
  • Band neutrophils (immature)
  • Segmented neutrophils (mature)

circulate for 10-15h then move to tissues and body cavities

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26
Q

Left shift

A

Neutrophils: more Immature than mature

Indicates Inflammation

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27
Q

Toxic neutrophils

A

Neutrophils: toxic change includes Morpholoical abnormalities

Could indicate:
* Acute infection
* Stimulation of neutrophil production
* Time for maturation is shortened

28
Q

3 main causes of Neutrophilia

A

inflammation
corticosteroids, both exogenous and endogenous
endogenous epinephrine

29
Q

3 main reasons for Lymphocytosis

A
  • Non-specific inflammation response
  • Viral infection
  • Adrenaline
30
Q

4 main reasons for Lymphopenia

A
  • Common finding with viral infection
  • Acute infection or inflammation
  • Effect of corticosteroids
  • Immunosuppression
31
Q

Precursors to macrophages

A

Monocytes

32
Q

2 causes of Monocytosis

A
  • Inflammation
  • Tissue necrosis
33
Q

Monocytopenia in horses

A
  • Clinically not significant
  • Small amount also in healthy horses
34
Q

Eosinophilia in horses (4)

A
  • Rare, very slight changes
  • Internal parasites
  • Larvae migration in tissues
  • Hypersensitivity
35
Q

Eosinopenia in horses (3)

A
  • Small amount also in healthy horses
  • Common with stress leukogram
  • Endogenous corticosteroids
36
Q

Basophilia in horses (3)

A
  • Very rare
  • Mainly with eosinophilia
  • hypersensitivity
37
Q

Physiological leukocytosis

A

Due to Epinephrine (fight or flight reaction) but not the same as a stress leukogram.
* Spleenic contraction
* Neutrophilia (without left shift)
* Lymphocytosis

38
Q

stress leukogram

A

due to Endogenous corticosteroids

  • Neutrophilia (without left shift)
  • Eosinopenia
  • Lymphopenia
  • Monocytosis
39
Q

Thrombogram =

A

A thrombogram is a graphical representation or measurement of various parameters related to blood coagulation or clotting.

It provides information about the different stages of blood clot formation and can be used to assess the overall clotting profile of an individual.

40
Q

Name 4 Liver biochem values

A

ALP, Alkaline phosphatase
AST, Aspartate Aminotransferase

bilirubiin and GGT

41
Q

Name 2 biochem values that can tell you about muscle metabolism.

A

CK , Creatine Kinase
When muscle cells are damaged, CK is released into the bloodstream.

AST, aspartate aminotransferase
When muscle cells are damaged or injured, AST is released into the bloodstream, leading to elevated levels in blood tests.

Lactate
Increased levels of lactate in the blood may suggest that the muscles are relying on anaerobic metabolism for energy production.

42
Q

Total protein =

A

albumin+ globulins

Albumin: negative acute phase protein

43
Q

Hypoalbuminemia can be due to (2)

A

Losses (GIT, kidneys, body cavities)

Loss of production
* Inflammation, liver disease
* Starvation

44
Q

Hyperalbuminemia frequently indicates

A
  • Dehydration
45
Q

everything that isn’t albumin is

A

globulins

46
Q

Hyperglobulinemia can be due to

A
  • Chronic diseases
  • Neoplasia, Rare
47
Q

Hypoglobulinemia can be due to (6)

A
  • Hemorrhage, protein losing enteropathies,
    exudative skin disorder
  • Infections
  • Immunodeficiency
  • Congenital
  • Acquired: passive transfer disorder
  • Tumors
48
Q

Albumin and globulins ratio

A

should be 1

Alb:glob=1

49
Q

Negative acute phase protein used in horses

A

albumin

50
Q

Main 2 Positive acute phase proteins in horses

A
  • Fibrinogen
  • SAA- serum amyloid A
51
Q

Fibrinogen in horses is measured from what sample

A

whole blood hematology, etda tube

52
Q

SAA- serum amyloid A is measured from what sample

A

From serum or heparinizied plasma
* Red/green cap

53
Q

Creatinine in Premature and newborn foals

A

have norm higher results (until 3 days)

54
Q

When to measure kidney values?

A
  • Colic
  • Colitis: Especially when get NSAIDs without fluids!
  • Foal: Neonatal nephropathy or prerenal/renal
  • Weight loss, other chronic diseases
  • Myositis
55
Q

Creatine:urea ratio can tell you?

A
56
Q

To test liver functionality (3)

A

Ammonia, urea, serum bile acids

57
Q

Hepatocellular “leakage”, which values would you test to assess (3)
* Measures cell death to membrane leakage
* AST, SDH, GLDH

A

Measures cell death to membrane leakage

AST: aspartate aminotransferase

SDH: sorbitol dehydrogenase

GLDH: glutamate dehydrogenase

58
Q

To assess Cholestasis, which values (2)

A

GGT, bilirubin

59
Q

GGT: gamma glutamyl transferase is Specific to

A

hepatobiliary disease (epithelium of biliary ducts)

Small increase seen in the following cases:
* Foals
* Colic
* Corticosteroids

60
Q

Bilirubin can be either

A

Conjugated (water soluble) and unconjugated form

  • 80% in erythrolysis (unconjugated)
  • Liver conjugates bilirubin
  • Eliminates bilirubin with bile acids (conjugated)
61
Q

Hyperbilirubinemia (unconjugated) can indicate? (3)

vs

Hyperbilirubinemia (conjugated)?

A

unconjugated:
* Hemolysis
* Starving
* Liver disease

Hyperbilirubinemia (conjugated)
* Biliary ducts obstruction
* Even in that case horses still have ca 50% unconjugated bilirubin

physiological icterus possible in horses!

62
Q

Most common liver leakage value

A

AST: aspartate aminotransferase but is not actually liver specific!

Can be found:
* Skeletal muscles, liver, heart muscles, erythrocytes, kidney epithelium

  • Could be normal with chronic diseases
  • Compare with CK, look for hemolysis!

Increases also:
* Young horse in training: ca 2x rise

63
Q

SDH is specific for?

A

the liver

  • Increases with primary and aslo secondary liver disease
  • Hepatocellular
  • Starts to increase ca 24h after injury
  • Not stable enzyme. -5h in room temperture, +4⁰C 24h - analyze fast!

GLDH – glutamate dehydrogenase is Similar to SDH, but more stable
* In young foal a bit higher

64
Q

Constant hyperglycemia in a very sick horse is a

A

negative prognostic indicator
Measure with insulin.

Hypoglycemia on the other hand is rare in adult horses since they have good gluconeogenesis.

65
Q

Hyperglycemia in horses

A
  • Sign of insuline resistance
  • Physiologicak: pregnancy, stress
  • Sepsis (inflammation mediator)
  • Drugs: corticosteroids
  • Metabolic syndrome
  • Iatrogenic: Glucose infusion
66
Q

Hypoglycemia in horses

A
  • Starvation, malabsorption
  • Exhausted horse (endurance)
  • Tumors
  • Sepsis
  • Liver failure
  • Important in foals!
67
Q

Hyperchloremia can be due to (3)

A
  • Kidney failure, tubular acidosis
  • Chronic respiratory alkalosis
  • Diuretics

Clinical diagnostics in Equine (6 decks)

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