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Clinical Pathology (Elise) > Exam 2 Clin Path > Flashcards

Exam 2 Clin Path Flashcards

1
Q

What are causes of hypotonic dehydration?

A
  • Secretory diarrhea
  • Vomiting
  • 3rd space loss
  • Heat stress & sweating in horses: Often Cl-losses are greater than Na+losses
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1
Q

Mineralization of soft tissues occurs when calcium x phosphorus > ____

A

70

Also depends on PH

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2
Q

T/F: SDMA is clinically used to monitor and manage renal disease in cats

A

True!

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3
Q

T/F: Chronic renal failure is irreverible

A

True =(

(acute may or may not be irreversible)

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3
Q

Why is Cystatin C a good biomarker for renal function?

A
  • Constantly produced and released by nucleated cells
  • Freely filtered by glomerulus
  • Reabsorbed and catabolized in the renal tubules
  • Does not re-enter the bloodstream
  • Is not excreted in urine
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3
Q

What are two causes of a metabolic alkalosis?

A

Excessive Renal Loss of H+

  1. Diuretics
  2. Increased mineralocorticoid activity (aldosterone)
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3
Q

What are exudates and when do they occur?

A

High cell (>6000/uL) and high protein (>3 g/dl) that form due to increased capillary permeability due to inflmammation

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3
Q

What type of cells would you expect to find in an acute chylous effusion vs a lonstanding chylous effusion?

A

Acute- small lymphoblasts

Chronic- inflammatory = neutrophils and macrophages and lymphocytes

cells may be contracted and fragile due to the lipid in the effusion

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4
Q

T/F: Type AB cats are universal blood donors

A

FALSE- They are universal recipients and CANNOT donate blood

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4
Q

What makes a fluid suppurative??

A

More the 85-90% neutrophils

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4
Q

In large animals (LA), which reflects liver function better: ALT or AST?

A

AST

——————————————–

There is more ALT in muscle than in the liver so it is NOT used in LA.

AST is not liver specific, but it is more in the liver than ALT is in LA. Should run CK concurrently with ALT.

SDH* and GLDH can be used in LA.

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5
Q

What test Estimates the quantity of urinary protein excreted/ day?

A

Urinary Protein: Creatinine Ratio (UPCR)

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5
Q

What are the top 3 causes of NORMOglycemic glucosuria?

A
  1. Transient stress
  2. Reversible tubular damage: drugs, hypoxia, infection, toxins
  3. Cats with urethral obstruction (unknown mechanism)

Others:

Fanconi’s syndrome: inherited tubular transport protein defects
Primary renal glucosuria: inherited glucosuria w/o hyperglycemia

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6
Q

T/F: Cats can maintain some concentrating capacity with renal failure. Thus they may have renal azotemia, but still have concentrating ability

A

True… they are dessert animals

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6
Q

Why does hypercalcemia cause PU/PD?

A

Ca interferes with ADH receptor

Secondary to renal failure due to calcification

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7
Q

DEA and Dal are the 2 major blood groups of what species?

A

Canine

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8
Q

Is it normal to find some fluid in the abdomen of a horse?

A

Yup. There are reference intervals for it.

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9
Q

What is the significance of these crystals?

A

Ammonium biurate (urate)

Normal findings in Dalmatians, English bulldogs
Suggest liver disease (seen in association with ↓BUN, ↑NH3)

  • LIVER FAILURE
  • ‒CONGENITAL OR ACQUIRED SHUNTS
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9
Q

What are 4 common causes of respiratory acidosis?

A
  1. Anesthesia
  2. Diffuse pulmonary disease
  3. Intrathoracic lesions
  4. CNS disease
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9
Q

T/F: Plasma ionic Ca and inorganic phosphate are related reciprocally, and solubility is pH-dependant.

A

True

Increase in plasma P decreases plasma Ca

Alkaline pH or large increases in one or both of these ions promotes precipitation of Ca phosphate salts into soft tissues

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9
Q

What happens to calcium and glucose levels with ethelyne glycol toxicosis?

A

HYPOcalcemia (metabolite binds calcium)

HYPERglycemia (metabolite inhibits glucose uptake)

(may see Ca oxylate crystals in urine)

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10
Q

When do you lose the ability to concentrate urine?

A

after 66% loss

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11
Q

Why do we preform crossmatching?

A

Ensures optimal survival of transfused RBCs and RBC of the patient.

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12
Q

What are causes of Hypoalbuminemia?

A
  1. Decrease production
    • Inflammation (negative acute phase protein)
    • Liver Failure/Reduced Liver Mass (portosystemic shunt)
    • Sever malnutrition/digestion/absorption
    • intestinal parasites
  2. Abnormal Loss
    1. Blood loss (with globulin decrease)
    2. PLE (with globulin decrease)
    3. PLN
    4. 3rd spacing (vaculitis, effusions)
    5. Skin disease, burns
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12
Q

Do you like summary tables?

A
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13
Q

T/F: ~25% of addisions/hypoadrenocorticism patients develope hypercalcemia

A

True

Will also have low Na and high K

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14
Q

What are the three main causes of azotemia?

A
  1. Pre Renal- ↑ BUN, +/-↑ CREA, ↑ SpGr
  2. Renal - ↑ BUN, ↑ CREA, ↓ SpGr
  3. Post-Renal- ↑ BUN, ↑ CREA, variable SpGr
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15
Q

What else will you see if the hypoalbuminemia is caused by PLE?

A

Diarrhea

decreased cholesterol, Mg (+/-) and globumin

should do gastrointestinal endoscopy with biopsy or exploratory laparotomy

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15
Q

What type of tumor is this from? The patient had a monoclonal gammopathy.

A

Multiple Myeloma

Pink stuff= immunoglobulins

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15
Q

Which two causes of hypophosphatemia can also cause hypercalcemia?

A

primary hyperparathyroidism and hypercalcemia of malignancy

Hypercalcemia may result in mineralization of the kidneys, with resulting decreased GFR, and subsequent normal or increased serum P concentrations.

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16
Q

Why do you want to keep fine-needle aspirate slides away from formalin and formalin fumes?

A

Formalin interferes with the wright stain

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16
Q

Extremely high CK due to muscle injury can lead to increases in _________

A

ALT

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17
Q

Why does metabolic acidosis occur in severe renal disease?

A

–↑ urinary loss of HCO3
–↓ tubular secretion of H+ions
–Accumulation of unmeasured anions (high anion gap)

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18
Q

What directly influences the release ADH?

A
  • Na+ concentration (hyperosmolality)
  • Blood volume (SEVERE hypovolemia)

…release lead to water reabsorption via aquaporins in the CT

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19
Q

What are two causes of hypofibrinogenemia?

A

Liver failure (decreased production)

DIC (consumption)

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19
Q

What cells are common in joint fluid?

A

Large mononuclear cells = macrophages and synovial lining cells

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21
Q

T/F: Major Crosschecks combine the patients RBC with the donors RBC

A

FALSE!!!

Major Crosscheck = patient SERUM + donor RBC

————-

MINOR crosscheck = patients RBC + donor serum

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21
Q

When will hypercalcemia of malignancy cause hypophosphatemia?

A

Early stages, prior to kidney mineralization (which leads to a increase in Phos)

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22
Q

What are the advantages and disadvantage to catherization for urine collection?

A
  • Advantages - none listed…
  • Disadvantages
    • blood or epithelial cell contamination
    • trauma
    • Difficult, especially in females
    • Tracking material into bladder –> bladder infection
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23
Q

Hyperkalemia is associated with what? when is it life threatening?

A

Oliguria/anuria

Life-threatening in ARF and/or post-renal conditions

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24
Q

T/F: Type A cats are common in north america and they have strong isoantibodies against type B

A

False! they have WEAK isoantibodies

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24
Q

What are the advantages and disadvantages of voided urine collection?

A
  • Advantages - easy (?)
  • Disadvantages
    • Contamination - cannot use for culture
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24
Q

What is the most common liver disease in dogs?

A

Chronic Hepatitis

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25
Q

What should you do if your bile acids are increased?

A

Follow up

( Radiograph, U/S, FNA, wedge biopsy)

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26
Q

T/F: Single un-crossmatched whole blood transfusions tend to be well-tolerated in horses and other large animals

A

true

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26
Q

What are 4 systemic fungal diseases that you can find on cytology?

A

Histoplasmosis

Cryptococcosis
Blastomycosis

Coccidiodomycosis

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27
Q

What type of tumor are these cells from? Taken from a mass on a young dog.

A

Histiocytoma

Cytoplasms may be a little lighter than background protein material

Exfoliate very well - FNA will be very dense in cells

BENIGN- typically in young dogs, but can be in any age

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28
Q

What urine collection technique is recommended if you want to do a urine culture?

A

Cystocentesis

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29
Q

T/F: To detect hepatocellular damage in LA you should depend on AST with a concurrent CK.

A

True

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30
Q

TCO2 is ________; pCO2 is ________.

A

bicarb, acid

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31
Q

What is the most common cause of hyponatremia?

A

Hypovolemia

Losses via GIT, Renal (addisons, ketonuria, diuresis), Cutaneous, and 3rd space

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32
Q

What are 5 causes of Acidic urine?

A
  • High protein diets: Carnivores/omnivores
  • Respiratory/Metabolic Acidoses
  • Hypochloremic metabolic alkalosis + severe dehydration
  • Hypokalemia
    • K+ is exchanged for H+ to maintain electroneutrality
  • Furosemide –Blocks Na+K+2Cl-pump in Loop of Henle to Cause increases Na+& H+excretion
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32
Q

At what level of fasting bile acids will there usually be an identifiable liver lesion by histopathology?

A

>25 umol/L

If b/w 10 and 25 (“grey zone”) you should preform a 2 hours post-prandaial bile acid test

Normal fasting bile acids is

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33
Q

What two blood types are highly immunogenic and can cause neonatal isoerythrolysis in horses?

A

Aa & Qa

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33
Q

What are 4 common causes of alkaline urine?

A
  • Urinary Tract Infections (UTI)
    • Urea splitting bacteria: Proteus, Pseudomonas, Staphylococcus
  • Low protein diets; Herbivores –OR- Diet treatment for pathologic crystalluria
  • Respiratory/Metabolic alkalosis
  • Alkalinizing drugs
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33
Q

What is the significance of Epithelial and Fatty casts in urine?

A

Activetubular degeneration or necrosis
Renal ischemia, or toxic nephrosis
NOT evidence of extent or reversibility of injury

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33
Q

Think of pCO2 as an ___

A

acid

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34
Q

Acidoisis ____ ionized calcium

Alkalosis ______ ionized calcium

(Decrease or increase)

A

Acidosis INCREASES ionized calcium

Alkalosis DECREASES ionized calcium

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35
Q

What are type B cats susceptible to?

A

severe/lethal transfusion reactions and neonatal isoerythrolysis

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35
Q

What is a normal anion gap? What normal ions are not considered?

A

15-25 is normal

Ca2+, Mg2+, gammaglobulins, Albumin, phosphate, sulfate, organic acids are not considered

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36
Q

Immune complex & Amyloid deposition on the renal glomerulus occur in what disease?

A

GLOMERULONEPHRITIS (GN)

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36
Q

Which types of enzymes Usually attached to membranes, rarely
increase due to cell injury

A

Induced enzymes

—————————–

Increases are usually due to increased production

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37
Q

What group of tumors has these characteristics:

  • cells in sheets or clusters
  • usually many cells present
  • distinct cytoplasmic borders + /-
  • cells often large with abundant cytoplasm
  • sometimes show signs of differentiation
A
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38
Q

How do the periperal blood cells and prognosis vary between acute and chronic leukemias?

A
  • Acute- immature blast cells and short survival time
  • Chronic- “mature” well-differentiated cells and long survival time
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39
Q

What are dalmatians at risk of when given a blood transfusion?

A

acute and delayed onset hemolytic transfusion reactions

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40
Q

What urine SpGr is considered hypersthenuria?

A

>1.040

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41
Q

The compensation for acid-base imbalances is of the ______ system and _______type

A

opposite, opposite

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42
Q

In Spectrophotometry: analyte + chemical –> ______

A

color

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43
Q

When is isosthenuria normal?

A

If the animal is perfectly hydrated

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44
Q

Which is more common in dogs and cats: T-cell CLL or B-cell CLL

A

T-cell CLL (often LGLs)

T cells tend to proliferate in the spleen

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45
Q

Are you more concerned if a patient has a 2+ bilirubin with a USG of 1.020 or USG 1.040?

A

USG 1.020

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45
Q

Bile acids are made by the liver from ________

A

cholesterol

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46
Q

Symmetric dimethylarginine (SDMA) is a great test to rule ___ chronic renal failure in cats

A

OUT

_____

100% sensitivity test

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47
Q

How does necrotizing pancreatitis cause liver disease?

A

Cytokins insut liver

Inflammation can cause obstruction of the bile duct

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48
Q

T/F: DEA 7 occurs in 50% of the canine population and is highly immunogenic

A

FALSE! it is midly immunogenic

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48
Q

Abdominal fluid from a foals abdomen. What is the arrow pointing to? What is your diagnosis?

A

arrow: Calcium carbonate crystal (normal finding in horse urine)
diagnosis: uroabdomen

———————————————————-

It is common for a foals bladder to rupture, especially males, during parturition

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48
Q

How much liver function lost do you need in order to see a decrease in albumin?

A

60-80% function lost = Chronic liver disease

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49
Q

What is the cause of prerenal proteinuria?

A

Increased small proteins in blood

  • Paraproteinuria (Bence-Jones= multiple myeloma)
  • Hemoglobinuria
  • Myoglobinuria
  • Post-colostral proteinuria
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50
Q

How does addisons disease cause hyperkalemia due to failure of renal excretion?

A

Decrease aldosterone –> K retention & Na loss

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50
Q

Cholestasis ____ serum cholesterol

(increases/decreases)

A

increase

Chol is a precursor of bile acids

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51
Q

Normal cells are about ____% small lymphocytes

A

~95%

will also find very few lymphoblasts (2-3%), plasma cells, macrophages and other cells

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52
Q

If you have decreased total calcium, what should you check first:

  1. albumin
  2. urine calcium
  3. Lung X-rays for calcification
  4. go on a cancer hunt
A

1. albumin

50% of Ca is bound to albumin, thus a decrease in total calcium can be due to a decrease in albumin (= apparent hypocalcemia)

Can calculate a corrected calcium (=Total Ca - Albumin + 3.5) or measure ionized/active calcium to determine if it is a true hypocalcemia

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54
Q

What are your DDx’s for polyuria?

A
  1. Renal
    • Renal failute (loss of ~ 66% of functional renal mass)
    • pyelonephritis
  2. Extra-Renal
    • Diuresis
    • medullary washout
    • endocrine issue (diabetes, cushings)
    • pyometra (endotoxins)
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54
Q

What will you see in the blood work and urinalysis of an animal with chronic renal disease with a GFR fo ~20% of normal

A
  • Blood work
    • Nonregenerative anemia
    • Dehydration
    • Azotemia
    • Hyperphosphatemia (85%)
    • Metabolic Acidosis
    • Normal to Hypokalemic (MOST IMPORTANT)
  • Urinalysis
    • polyuria
    • isothenuria
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56
Q

What do you look for on your Macroscopic crossmatch?

A

Hemolysis (red serum)

Agglutination (specks)

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57
Q

What do you see in the BW and Urinalysis of a animal in end-stage renal disease (GFR ~5%)

A
  • Bloodwork
    • Nonregenerative anemia
    • Marked dehydration & azotemia (patients are uremic)
    • Hyperphosphatemia
    • Metabolic acidosis
    • Hyperkalemia***
  • Urinalysis
    • Isosthenuria
    • Oliguria to anuria
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57
Q

What is your diagnosis for a 2 year old dog with:

  • Non-regenerative anemia with other cell lines normal
  • Azotemic
  • High Ca & High Phos – product is enough for mineralization
  • High K
  • Urine SpGr of 1.010
A

Primary Renal Disease - Congenital Polycystic Kidney Disease

He thinks he is a horse and developed a secondary hyperparathyroidism

Must correct calcium ASAP to reduce further mineralization

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57
Q

Why does a small focal hepatic necrosis not change your leakage enzyme levels?

A

Only a small number of hepatocytes are leaking. It is not enough to appear abnormal on refernce intervals

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58
Q

Blood typing identifies specific RBC ____ in an animal

A

antigens (Ag)

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58
Q

What process should you expect if you have a suppurative joint fluid?

A

Immune mediated or bacteial

immune mediated joint disease usually involves multiple joints and they are usually peripheral joint

If septic, it is difficult to find bacteria because they tend to stick to the surface of the joints

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59
Q

With protein measurements with a chemistry analyzer, which is calculated: albumin or globulin?

A

Globulin!

Chemistry analyzers use spectrophotometry and a dye binds to albumin to obtain an accurate measurement of albumin.

Globulin is calculated by substracting the measured albumin from the measured TP

Globulin = TP-Albumin

This calcualtion is drawn from the fact that almost all total protein in blood is from either albumin or globulin

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60
Q

Should we be worried if there is a decreased CREA?

A

***Nope, it is not clinicall significant ***

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61
Q

In a hemoabdomen/thorax, will you find platelets?

A

Nope, if you find someit means you may have hit a vessel

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61
Q

What is the purple stuff in the background of this cat abdominal effusion with a 5.5 TP (high) and Low NCC

A

protein - the pealed off area is another indicator of high protein fluids

the cat had FIP

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62
Q

What is your diagnosis if you have a 8 y.o. dog with:

  • Neutropenia
  • Lymphocytosis (13.8 on 1-4.8 reference interval)
  • Azotemic
  • High Ca (15.4 on 9-11.2 RI) & High Phos (7.1 on 2.8-6.1 RI)
  • Increased TP (7.9 on 5.4-7.4 RI) - normal ALB and High Glob
  • Increase Total bili and increased Alk Phos and ALT
  • Normal Na
  • High K (5.8 on 4.1-5.5 RI)
  • Low TCO2 and a increased anion gap
  • Urine SpGr 1.011 & 2+ urine protein

And the following on a liver FNA

A

Hypercalcemia of malignancy secondary to lymphoma

Lymphocytosis and hypercalcemia are the key indicators

Lymphoma infiltrated the liver and bone marrow - explains liver signs and neutropenia

Increase K due to metabolic acidosis or oliguric

Increase anion gap could be due to increase Phos

Kidney signs, electrolyte imbalance and azotemia are due to calcification of kidney –> decrease GFR

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62
Q

What will happen to your ammonia and BUN levels during liver disease?

A

Ammonia increases = BAD

BUN decreases

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63
Q

What is your diagnosis if you have a older male dog patient presenting with seizures, tremors and these findings:

  • Stress leukogram
  • mildly increased glucose
  • Low calcium
  • High Phosphorus
  • Normal albumin
  • No Azotemia
  • Low normal PTH
A

Primary Hypoparathyroidism

PTH should be very high in the presence of such low Ca, thus a low normal PTH is considered abnormal

Any variation in Ca and P should be concerning

The lack of Azotemia rules out renal disease

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64
Q

Perirectal/Anal sac apocrine tumors are typically _______ (benign or malignant)

A

Malignant!

DO NOT CONFUSE with perianal adenomas

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64
Q

What are causes of Hyperphosphatemia?

A
  • Decrease GFR due to renal or pre-renal- MOST COMMON CAUSE
  • Ruptures bladder and ureter
  • urethral obstruction
  • Vit D intoxication
  • ACUTE acidosis - due to decrease use of P (chronic will cause decrease P)
  • Excessove P intake - only if unfunctional kidney
  • Primay Hypoparathyroidism
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65
Q

T/F: Fibrinogen (Beta globulin) is a positive acute phase protein

A

True!

It is used as a marker of inflammation in Horses, ruminants and camelids

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66
Q

In what species and age group are histiocytomas most common in?

A

YOUNG dogs (~6m-2yrs)

benign and spontaneously regress

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67
Q

Any analyte filtered by the glomerulus is an indicator of _____

A

GFR

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68
Q

If your urine is red-brown, what cause will not have a change in serum color?

A

Myoglobin

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69
Q

What is the source of renal cells? What is their significance?

A

Source- renal tubules

Significance- renal tubular injury: infectious, toxic, and ischemic injury

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69
Q

What type of crystals have a “picket fence” appearance in Ethylene glycol toxicosis?

A

Calcium oxalate monohydrate

Also seenin healthy animals, animals with Oxalate urolithiasis and Hypercalciuric or hyperoxaluric disorders

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69
Q

What type of tumor? From a uncastrated male/female.

A

TVT- Transmissible Veneareal tumor

Small Vacuoles and abundant large nucleoli

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71
Q

What measures the intensity of light passig though or emitting from a test chamber?

A

Photometry

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72
Q

T/F: increases in fibrinogen alone usually do not significantly affect the total protein concentration

A

True!

————

Fibrinogen is part of the beta-globulin fraction that is measured in mg/dL, while TP/ALB/GLOB is measured in g/dL

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72
Q

Which test in more stable: SDH or GLDH

A

GLDH

SDH is liver specific for hepatocellular damage in large animals, BUT it has a short half life in vitro and needs to be ran ASAP (

GLDH is liver specific, more stable, but difficult assay to preform and generally in NOT USED, but occasionally used in large animals.

To detect hepatocellular damage in LA you should depend on AST with a concurrent CK.

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73
Q

What are 4 causes in increase in nonvolatile acids/ High Anion Gap Acidosis?

A
  • *K**etones
  • *L**actate
  • *U**remic acids (phosphates, sulfates)
  • *E**thylene glycol metabolites (toxins)
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74
Q

What are two possibilities of having a fluid bacteria but no neutrophils?

A

(1) accidently tapped the GI tract (common in large animals) = enterocentesis
(2) Massive rupture and the cells are diluted

go back to clinical signs and blood work

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75
Q

T/F: Lymph node aspirate cells are very fragile and clot quickly. Thus it is very common to see Smudgocytes

A

True

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76
Q

What are causes of Hypokalemia?

A
  • Decreased intake or low K+ IV fluids
  • Loss
    • Alimentary: vomiting, diarrhea, abomasal disorders**
    • Renal: Diuresis, Hyperaldosteronism (Cushing’s), Renal failure in cats (mechanism is unclear)
    • Horse sweat
  • Redistribution: –Alkalemia –INSULIN injection (or glucose bolus)
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77
Q

What happens to Na when total body K decreases?

A

Na moves into cells to maintain electroneutrality

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78
Q

What is on this slide? When will you see this (3 things)?

A

Keratin

(1) SCC
(2) epidermal inclusion cysts

(3) From the skin of the slide handler*** or animal

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79
Q

Why do you get a paradoxical aciduria in patients that are hypovolemic, hypochloremic and alkalotic?

A
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80
Q

Although freely filtered by the kidney, why is BUN a poor indicator of GFR?

A
  1. Liver Production Varies
    • increases with high protein diet & upper GI bleed
    • decreases with liver failure
  2. About 60% is reabsorbed, and this reabsorption varies with rate of flow thru tubules
    • 50% is passively reabsorbed in PCT, 10% is actively reabsorbed in CT
    • slow flow –> more BUN resorbed
  3. It is excreted in other ways
    • horses and ruminants excrete BUN through the GI
    • Ruminants put urea into the salivary glands and then back into the rumen so that microflora can create a.a.
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81
Q

How would you interpret this protein electrophoresis? Monoclonal, polyclonal or normal?

A

Normal

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83
Q

What type of tumor are these cells from? FNA was taken from a lump at a previous vaccination site on a cat

A

Giant Cell Sarcoma

—————————————————-

Vaccine induced sarcoma in cats

Should vaccinate cats on lower limbs and tails, in case amputation is necessary

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84
Q

Which species becomes hypochloremic with renal failure?

A

Cattle

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85
Q

Which of the following are function of the kidney:

  1. Water balance
  2. Produce hormones: Erythropoietin & Renin
  3. Activate vitamin D–Calcium & Phosphorous homeostasis
  4. Regulate blood pressure –RAAS
  5. Excrete Waste (urea, creatinine, NH4+, K+, H +, PO4, drugs, hormones, enzymes)
  6. Conserve important substances
  7. Regulate acid-base balance
A

all of them!!

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86
Q

If changes in Na+ and Cl-are proportional,then consider differentials that pertain to abnormalities in _______

A

Na

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87
Q

How does hypercalcemia lead to hypomagnesium?

A

Hypercalcemia inhbits renal Mg reabsorption

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88
Q

T/F: Bilirubinuria of +1 is notmal in some dogs

A

true

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89
Q

How does hypercalcemia cause PU/PD (with no azotemia)?

A

Ca interferes with the ADH receptor

Will see PU/PD BEFORE calcification of renal tubules

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90
Q

Why does liver failure cause PU/PD?

A

lack of BUN –> inability to create proper concentration gradient

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91
Q

What problems are seen with hypotonic dehydration? Why is the dehydration poorly fixed?

A
  • Fluid shifts from vasculature into cells
    • Vascular volume decreases further, and cells swell
    • **Cerebral edema occurs when Na+, Especially with rapid change
      • depression, ataxia etc**
  • Osmoreceptors not stimulated, ADH not released
  • May or may not have renal medullary washout
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92
Q

50% of dogs with Acute lymphoblastic leukemia have _________

A

lymphadenopathy

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93
Q

“Leakage liver enzymes” may take ____ weeks to decrease after injury?

A

2 weeks

As a side note, remember, Leakage enzymes are neither specific for the cause of the liver disease nor predictive of outcome.

These include ALT, AST, SDH, and GLDH

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94
Q

Portal Vein Hypoplasia is commonly in which dog breeds?

A

small breeds – Maltese, Yorkshire terriers, Cairn terriers

Diagnosis requires wedge biopsy. Dz does not change animals life span

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95
Q

What would your urine specific gravity be if you have renal azotemia?

A

Isothenuria (1.007-1.013)

Renal azotemia occurs at 75% loss, while concentrating ability is lost at 66% loss of functional renal mass

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95
Q

What are DDx for the cause of renal damage that lead to a renal azotemia?

A
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95
Q

What are the disadvantages of using serum BUN and CREA levels as proxies for GFR?

A

‐Variance in biomarker production rate
‐Variance in extrarenal factors that ↓ GFR
‐Renal handling is not consistent (esp. BUN)
‐Provide general estimates of renal tubular function

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96
Q

What are the two major roles of Albumin?

A

Transport Protein

Colloidal osmotic pressure

(+ Buffer capcaity)

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98
Q

What are 6 examples of effective osmoles in serum?

A

Na+, Cl-, HCO3-, proteins, glucose, ethylene glycol

They are all osmotically active and cause water to move toward it

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99
Q

What species are these most common in? What is their significance?

A

Struvite Crystals

Most common crystal in dogs and cats

Formation is favored by alkaline pH - promoted by urease positive bacteria

Can be found in normal patients

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100
Q

What is the Base Excess (BE) calculation used for?

A

Calculate bicarbonate dosage in IVF

It Characterizes the overall metabolic acid-base status independent of the respiratory acid-base status

Metabolic alkalosis=(+) BE
Metabolic acidosis=(-) BE

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101
Q

What is the most common cause of Cl loss > Na loss (selective Cl loss)?

A

hypochloremic metabolic alkalosis

Gastric secretions are NOTresorbed by the small intestine

  • Monogastric: severe vomiting
  • Ruminants: abomasal disorders, high GI obstructions
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102
Q

Where does urea come from?

A

Synthesized in the liver

Dietary protein amino acids are deaminated in the liver and then the amine group of the a.a. is used to make urea which is then put into the blood

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103
Q

Is it better to diagnose round cell tumors via histology or cytology?

A

cytology - you will be able to see granules better and you will not have any fixation artifacts

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104
Q

All cats carry an antigen from the ____ blood group

A

AB

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105
Q

What are your DDx if you hvae prerenal azotemia (↑ BUN, +/-↑ CREA, ↑ SpGr )

A
  1. Decreased GFR (also affects P & Mg)
    • Dehydration
    • Shock
    • Cardiac insufficiency (↓ C.O.)
  2. Increased Urea Production
    • Upper GI Bleed*
    • High protein diet
    • Endogenous protein catabolism
    • Ruminants, ↓ ruminal motility
  3. Increased Creatinine Production
    • Increased Muscle Mass - grey hounds
    • Dysfunctinal placentas –> prevents normal clearance of fetal CREA (resolves within a few daws)
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106
Q

What is the term for increaded frequency of urination?

A

pollakiuria

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108
Q

What could be in the urine sample if the color is:

Yellow-orange

Yellow- green/brown

Red

Red-brown

Brown to black

A
  • Yellow-orange- bilirubin
    • intravascular hemolysis (IMHA)
    • delayed transfusion reactions
  • Yellow- green/brown - bilirubin & biliverdin
  • Red- rbc, Hfb & Mgb
  • Red-brown- RBCs, Hb, Mgb, MetHgb
  • Brown to black - MetHgb
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109
Q

What type of tumor are these cells from? they were taken from a very hard mass closely associated with a bone

A

Osteosarcoma

pink stuff= GAGs- glycosaminoglycans

May be spindle shaped or look like normal osteoclast

May be easier to diagnose via cytology > histology

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110
Q

What are two causes of osmotic shifts from ICF to ECF that causes hyponatremia?

A

Hyperglycemia

Mannitol administration

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111
Q

What is a common signalment/clinical history of a animal with post-renal azotemia?

A

Castrated male cat

straining to urinate

large bladde/Dsitended abdomen

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111
Q

Horses with renal failure tend to have ______ calcium levels

A

high = hypercalcemic

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112
Q

What should you do if you suspect Transitional cell carcinoma?

A

Send it to an expert

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114
Q

What are the causes of bilirubinuria?

A
  1. Liver disease
  2. Bile duct obstruction
  3. Hemolysis

​Others: –Starvation –Pyrexia –Horses off feed

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116
Q

What would be a renal cause of decreased BUN?

A

Decreased reabsorption in the PCT with water

decreased GFR (IVF diuresis) or increase tubular flow (osmotic diuresis)

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117
Q

T/F: It is common to find the cause of the reactive node within the cytologic specimen

A

FALSE!

In most cases you do NOT find the cause for the reactive node in the cytologic specimen.
The “antigen” stimulating the node is outside the node but in its field of drainage.

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118
Q

What is the only tumor the elicits an inflammatory response?

A

Squamous Cell Carcinoma

Keratin can induce inflammation

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119
Q

Aldosterone is secreted in response to what three things?

A

Angiotensin, Hyperkalemia & ACTH

It acts to conserve Na and secrete K

121
Q

What is the source of transitional cells in a urine sample? What is their significance?

A

Source= renal pelvis, ureter, bladder, proximal urethra

Significance= Seen with hyperplasia associated with inflammation -or- transitional cell tumors (benign and malignant)

122
Q

What is the one differential for panhyperproteinemia?

A

dehydration

123
Q

What is the typical signalment of a chronic renal failure patient?

A

geriatric cat, with a poor BCS

124
Q

What is the differency b/w Grass Tetany and Milk Tetany?

A
  • Grass Tetany- High K content of pasture blocks Mg absorption
  • Milk Tetany- Milk is low in Mg
125
Q

What happens to your globulin levels during chronic liver disease?

A
  1. May decrease, some are synthesized by the liver ( alpha and beta)
  2. Probably increase, due to the lack of kuffer cells filtering GIT antigens in the liver. These antigens then enter circulationand stimulate an increase in production of gamma globulins by lymphoid tissue
126
Q

PTH _________ Ca and is inhibited by calcitonin

A

increases Ca

127
Q

What do bacteria reduce bilirubin into?

A

urobilinogen

It is reabsorbed and excreted in the urine (makes urine yellow)

128
Q

Calcitonin is produced by the C cells of the thyroid gland and _________serum Ca concentration by inhibiting PTH

A

decreases

129
Q

What is the osmole gap? What does it mean if it is increased?

A

Osmole Gap = measured osmolality -calculated osmolality

  • An increased Osmole gap indicates An increase in an osmotically active molecule in blood; that is not measured on the serum biochemical profile
  • An osmole gap less than 30 is OK
  • Ex: TOXINS! and some therapeutics = Ethylene glycol, methanol, paraldehyde, Mannitol or radiographic contrast medium
130
Q

Pottasium levels are often _______in chronic renal failure

A

normal

Increased tubular secretion prevents hyperkalemia

131
Q

GFR is considered a sensitive index of functional ____ ___

A

renal mass

132
Q

What are the late signs of a portosystemic shunt?

A

Liver failure decreased albumin, BUN, glucose, cholesterol, coag factors
Marked increase in bile acids
Maybe cholestasis ( inc bilirubin, ALP)
Microcytic anemia

133
Q

What are causes of hypochloremic metabolic alkalosis in monogastrics and ruminants?

A

Monogastrics: severe vomiting, pyloric outflow obstruction
Ruminants: sequestration of fluid in abomasum and forestomachs. GI atony

Can result in paradoxical aciduria

134
Q

What are the causes of a pre-reanl decreased BUN?

A
  1. Decreased Urea Production
    • low a.a. delivery to liver - Portosystemic shunts, decreased protein diet
    • hepatic insufficiency (>80% loss)
  2. Intestinal Loss
    • PLE & Diarrhea in monogastrics
    • Metobolism in gut in horses and Cattle*
136
Q

What are key difference b/w ARF and CRF? (ie history, CS, PCV, potassium levels)

A
137
Q

If you see a cast in urine, what should you do?

A

Send it out to be evaluated

…alot could indicate renal disease

138
Q

When does mineralization of soft tissue occur?

A

Ca x PO4> 70

139
Q

What blood type is the universal donor in horses?

A

premise is false! there are NO UNIVERSAL DONORS- there are over 7 blood systems and over 400000 combination

140
Q

What method is most commonly used to measure fibrinogen?

A

Heat precipitation with use of refractometry (estimate)

141
Q

When would you use packed RbC? Whole Blood? FFP? Platelet-rich plasma?

A
142
Q

Protein on dipsticks only detect ______

A

albumin

144
Q

What other signs would you see if a hypoalbuminemia is due to liver insufficiency?

A

Decrease glucose, cholesterol and urea

Increased globulins (usually)- the liver is not lfiltering antigens

Check bile acids and NH3

145
Q

What can lead to neonatal isoerythrolysis in bovine?

A

vaccination of blood origin

146
Q

Blood typing identifies specific RBC _____, while crossmating identifies RBC ____

A

antigens** , antibodies**

“positives” for both tests = agglutination

147
Q

Why would you see an increase in bilirubin?

A
  1. Increased production due to RBC destruction
  2. Decrease uptake/conjugation by liver
    • Decrease blood flow (tumor, shunt, etc)
    • Decrease in functional hepatocytes
    • Long term Food depervation in horses*, cattle and cats
  3. Blockage of bile flow
148
Q

GGT is a better than ALP to detect markers of cholestasis in CATs, except in cases of _____ _____

A

Hepatic lipidosis

149
Q

What are the early signs of portosystemic shunts?

A

Enzyme activity may be normal or increased
Bile acids increased
Microcytic anemia maybe

150
Q

Type B cats have strong isoantibodies against type ____

A

A

Type B cats are at risk for neonatal isoerythrolysis if queen is mated with a type A or type AB tom = Fading Kitten Syndome

150
Q

Which will return to normal more quickly: AST or ALT

A

AST

151
Q

Define azotemia

A

Retention of nitrogenous waste products in blood
↑ [BUN] and/or ↑ [CREA]
Implies 75% loss of renal function

152
Q

What should you do if your SDMA is increased, but your CREA is normal?

A
  1. Go back to the patient: Does your history, C/S, and/or PE findings support renal disease
  2. Rule out all other causes of ↓ GFR besides CRF: Pre-renal, Renal, Post-renal
    • May need to run additional diagnostics:
      • UPCR
      • Urine culture and sensitivity
      • Blood pressure measurement
      • r/o other infectious diseases (lyme, leptospirosis, ehrlichiosis)
      • Imaging (uroliths, structural changes, etc.)
153
Q

Why do you find stain sediment on cytology slides?

A

If the stain is not rinsed properly

or if the stain is not changed regularly

154
Q

What blood albumin levels do you see with glomular proteinuria?

A

Hypoalbuminemia

155
Q

T/F: Sarcoma cells are commonly found in effusions?

A

False- they do not exfoliate well

156
Q

What are clinical signs of abnormal serum K concentrations?

A

Cardiac dysfunction* –can be life-threatening
Skeletal muscle dysfunction

157
Q

What are non-immue mediated transfusion reactions (aka complications)?

A

Sepsis

Volume overload

Tranmission of infectious agents

158
Q

What are 2 common causes of ketonuria?

A
  1. Negative Energy balance
  2. DKA
159
Q

What osmolites are used to estimate osmolality in plasma?

A

Na, Glucose and BUN

160
Q

What are these cells from?

A

Salivary Mucocele

Orange crystal= Hematoidin crystal (RBC breakdown product)

Mucin in the backbround

161
Q

Why would you find nothing on a FNA (3 reasons)?

A
  1. Missed lesion
  2. Lipoma (fat dissolved in alcohol dip)
  3. Lesion is connective tissue
162
Q

Portocaval shunt can cause what kind of anemia?

A

Microcytic

163
Q

What are the three causes of a lymphoproliferative disorder?

A
  1. Lymphocyte neoplasm
  2. Plasma cell neoplasm
  3. Dog with Ehrlichia
164
Q

Where does ADH act?

A

Collecting ducts - on aquaporins

Responds to increase osmolality and decrease plasma volume

165
Q

What should you susepct as the cause of an increased ALP without hyperbilirubinemia?

A

ALP increase is induced by steroids (exogenous or endogenous) or anticonvulsant medication

————————-

Effects may last 1-2 months, so get a good history

Dont forget about topical eye and otic steroids.

166
Q

What tumor cells have abundant vacuolated cytoplasm, many multinucleated cells, and look like macrophages with criteria of malignancy?

A

Malignant histiocytosis, histiocytic sarcoma

167
Q

Small cell lymphomas can be possibly identified by atipical cytoplasmic projections called ____________

A

“Cone heads”

If a dog, PCR can also identify lymphoma

168
Q

What are common causes of a loss of HCO3 –> metabolic acidosis?

A

‒GI loss from diarrhea
‒Intestinal ileus
‒Salivation (ruminants) –choke
‒Urinary loss
‒Titration

169
Q

How do you tell the difference from nocardia or actinomyces in cytology?

A

acid fast

nocardia is partially acid fast while actinomyces is not

they are both difficult to culture

they are both gram positive filamentous bacterium

170
Q

Cats with Acute Lymhoblastic leukemia are usually young and ______ positive

A

FeLV

171
Q

What are the 3 function of alpha1, alpha2, and beat globulins?

A

Inflammation

Coagulation

Transport proteins

171
Q

What are causes of hyperalbuminemia?

A

Dehydration!…and thats it!

171
Q

When does hypokalemia occur in renal failure patients?

A
  1. When decreased appetite/ K intake in uremic animals
  2. Hypokalemic nephropathy in cats
171
Q

What are causes of Hyperosmolality with NO Fluid Shifts?

A

Increased plasma concentration of ineffective solutes: intracellular osmolality = extracellular osmolality

Example: uremia - Urea/BUN is freely diffusable

172
Q

What is happening when there is a Normal osmole gap with increased measured osmolality?

A

There is increased Na+, or markedly increased urea or glucose (ie if uremic or a diabetic patient)

173
Q

What are causes of Pseudohyperkalemia?

A
  • EDTA contamination
  • Marked thrombocytosis: leakage of intracellular K+
  • Hemolysis: K+ released from RBCs
  • Separate serum quickly! –Horses, Pigs–Most cattle, some sheep –Akitas, some Japanese dog breeds –Mice and rats, monkeys
174
Q

What are the effects of PTH, Calcitonin and Vit D in Phos levels?

A
  • PTH decreases Phos
    • by decreasing renal tubular reabsorption
  • Calcitonin decreases Phos
    • by inhibiting PTH stimulated bone resorption
    • by increasing movement into tissues
    • by decreasing renal tubular resorption of phosphorus.
  • Vitamin D increases Phos
    • by stimulating absorption from intestine and kidney
    • by inihibiting PTH synthesis.
175
Q

Do you typically have to treat animals with delayed hemolytic immune-mediated reaction to transfusions?

A

NOPE

They are usually mild reactions

176
Q

What are causes of lymphocytosis that are NOT leukemia?

A

Ehrlichia

Vaccinated PUPPIES

Addisions (rare)

Spirocurpi lupi (maybe)

Excitement (Cats)

Bartonella henselae

177
Q

T/F: Over worked horses can develop hypomagnesemia

A

True- Horses lose Mg through sweat

179
Q

What are causes of isotonic dehydration?

A

Renal Disease

Diarrhea

180
Q

What are the 5 top causes of Hyperglycemic glucosuria?

A
  1. •Diabetes mellitus –glucose
  2. •Hyperadrenocorticism –cortisol
  3. •Drugs –dextrose, glucocorticoids, progesterone
  4. •Postprandial
  5. •Acute pancreatitis

​

Less common: stress, pheochromocytoma, glucagonoma, head trauma

181
Q

‘”Any substance, structure or process that can be measured in the body or its products and influence or predict the incidence of outcome or disease.” is considered a what?

A

Biomarker

182
Q

Which will occur first, polyuria or azotemia?

A

Polyuria

183
Q

What are the advantages and disadvantages of cystocentesis?

A
  • Advantages
    • minimizes contamination and iatrogenic contamination
    • aid localization of hematuria, pyuris and bacteriuria
    • therapeutic cystocentesis in blocked cat
  • Diadvantages
    • Cannot use if pyometra, coagulopathy, neoplasm
    • If insufficient volume in bladder
    • Patient resist restraint and abdominal palapation
184
Q

Reflectand photometry is used in ___ chemistry systems, which is common w/ “in house” analyzers

A

dry

________

(1) fluid is placed on fiber pad –> (2) chemical reaction –> (3) product form is proportional to the concentration of analyte

185
Q

Why is creatinine a good indicator of GFR?

A
  1. Consistently and constantly produce by endogenous muscle catabolism
  2. Freely filtered
  3. NOT reabsorbed
  4. Excreted Unchanged
186
Q

What influences the release of aldosterone?

A

Plasma volume *, hyperkalemia, angiotensin II, ACTH

…Acts on the CT to reabsorb Na and exchange K for K

187
Q

What else will you see if a hypoalbuminemia is due to PLN?

A

Hypercholesterolemia (usually)

You should preform a urinalysis and urine protein:creatinine ratio

188
Q

Which type of enzymes escape from the cell as a result of injury to cell membranes or organelles

A

Leakage enzymes

Injury may be as severe as cell death, or may be as mild as increased cell membrane permeability.

Include: ALT, AST, SDH, GLDH, CK

190
Q

Why does albumin travel the farthest on a gel electrophoresis?

A

Small size (69 kDa)

High negative charge

192
Q

What are two causes of panhypoproteinemia?

A

Blood loss and PLE

193
Q

Hypercalcemia due to renal disease is common in _________ (species)

A

horses

Horses secrete large amounts of Ca through their urine

194
Q

Thyroid tumors are ______ in dogs and ______ in cats

(Benign or malignant)

A

DOG= malignant

CAT=benign/hyperplasia

195
Q

What tumors are considered Mesenchymal tumors?

A

Lipomas
hemangiopericytomas
hemangiosarcomas
osteosarcomas
chrondrosarcomas

197
Q

SulphosalicylicAcid Test(SSA) is used to confirm dipstick results and reacts with ____, _____ and _______

A

Albumin, globulins & bence-jones proteins

198
Q

What kind of tumor are these cells from? Take form a soft mass on a dog.

A

Lipoma

Typically benign, very common in dogs

Look like normal cutaneous fat, so ensure you actually hit the mass

May be hormonally active

199
Q

Why are greyhounds such good blood donors? what should you watch out for?

A

Grey hounds are large, have high PCV, and most are DEA 1.1 negative & >50% are DEA 4/6 positive (universal donors)

WATCH OUT FOR: Babesia, Anaplasma, Ehrlichia

201
Q

What else will you see in the blood work if a hypoalbuminemia is due to malnutrition?

A

decreased glucose, chlesterol and urea

——————

also a thing BCS and ravenous appetite

202
Q

What happens to serum ALB during tubular proteinuria?

A

Normal or increased serum ALB (e.g. no hypoalbuminemia)

203
Q

T/F: Cold fluids are more dense, Falsely increasing SpGr

A

True - glucose and urea can also falsly increase SpGr

204
Q

In what species is it normal to find some protein (mostly albumin) in the urine of a healthy animal?

A

Dog

205
Q

What is the significance of > 2/LPF hyaline casts?

A

Indicate proteinuria of renal or extra-renal disease
e.g. glomerular disease / Bence-Jones proteinuria

206
Q

What 4 things determine the pH of blood?

A
  1. pCO2- Changes in ventilation
  2. Addition or removal of acids (H+) - Lactate, Toxic metabolites of ethylene glycol, Loss of H+
  3. Strong ion movements – Na+, K+, Cl-
  4. Serum proteins, phosphates, and other weak acids
207
Q

What are the sources of squamous cells? When are they pathologic in urine samples?

A

Sital urethra, vaginal tract, skin – very common

Only pahtologic in sertoli cell tumor causing squamous cell metaplasia in male dogs

Squamous cells are large, thin, transparent and angular/folded

208
Q

Which liver specific leakage enzyme can also increase in very severe muscle injury?

A

ALT

209
Q

T/F: Specific agents are more likely to maybe be identified in inflammed lymph node (lymphadenitis) apsirates, compared to reactive lymph nodes

A

TRUE!

Ex. Equine strangles, plague

210
Q

What benign epithelial tumor is this?

A

Perianal gland adenomas

“Hepatoid tumor” - abundant cytoplasm, single round nucleolus

BENIGN- common in male dogs

Can be found on the tail head or prepuce

Responsive to Testosterone- should castrate males

DO NOT confuse with perirectal apocrine gland carcinoma

211
Q

What class of tumors typically have these characteristics:

  • Individual cells
  • exfoliate well
  • circular cells with distinct cytoplasmic borders
A

Round/Discrete Cell Tumors

213
Q

How would you be able to confirm this is a chylous effusion?

A

cholesterol:triglyceride ratio or compare triglyceride in fluid to that of serum (Chyle is high in triglycerides, if an animal eating).

look at history and cells within- can be due to trauma or tumor

214
Q

There is low numbers to 100% neutrophils in _________ lymphadenitis

A

suppurative

216
Q

What are causes of increased serum Na?

A
217
Q

When do you have a monunuclear inflammatory fluid in a cavity?

A

Foreign body or mycobacterium infection

conists of primarily macrophages

218
Q

T/F: Similar to ALP, Gamma glutamyl transferase (GGT) will be increased in young animals due to bone formation

A

FALSE- there is NO GGT produced by bones

It also may NOT be affected by anticonvulsant therapy (maybe)

219
Q

Peritoneal [CREA] 2x serum [CREA] = diagnostic for ___________

A

uroperitoneum

221
Q

What is the significance of Waxy casts?

A

ALWAYS of pathologic significance
Associated with chronic renal disease

222
Q

What are 4 causes of false negative bilibrubinuria?

A
  1. Old sample
  2. Light exposure
  3. Nitrites
  4. Ascorbic acid
224
Q

What does it mean if after calculating corrected chloride, it is still below the reference interval?

A

a selective loss of Cl-should be suspected

(dont need to memorize equation, just how to use it)

225
Q

Why is there constipation with renal failure?

A

muscle weakness

226
Q

65% of dogs presenting withmulticentric lymphoma are _______

A

leukemic

227
Q

What benign epithelial tumor is this msot likely?

A

Basal Cell Tumor

228
Q

Hypermagnesemia is seen only when what organ function is compromised?

A

Renal

229
Q

What is most likely happening when there is a Normal osmole gap with a decreased measured osmolality?

A

decreased in [Na]

230
Q

Which dog breeds commonly have copper storage disease?

A

Bedlington terriers, West Highland White terriers, Skye terriers, Doberman, Dalmations, Labs

If you see an ALT increase in these breed when youn, you can use copper chelation theraoy and a low copper diet to slow progresion

231
Q

Since Urine SpGr is an estimate of urinary concentrating capacity it must always be accesed in conjunction with what?

A

Serum BUN & CREA and hydration status

232
Q

What is the significance of WBC and RBC casts?

A

WBC cast- tubular inflammation (pyelonephritis)

RBC cast- tubular hemorrhage (pyelonephritis)

233
Q

How does the half life of ALT differ between cats and dogs?

A

Cats- 6 hours

Dogs- 72 hours

Cat increases are generally considered more severe due to the short half life and a smaller degree of accumulation, when compared to dogs

234
Q

How do you interpret a positive/negative cross match?

A
235
Q

T/F: Cattle Salivary Phos excretion > renal Phos excretion

A

True!!

236
Q

If removing fluid from thoracic cavity, what should you use to avoid pneumothorax

A

use catheter, rather than needle

237
Q

Which two canine DEA blood types are highly immunogenic?

A

DEA 1.1 and DEA 1.2

238
Q

What causes hyperosmolality WITH fluid shifts? What does it lead to?

A

Cause: Increased plasma concentration of effective solutes: intracellular osmolality > extracellular osmolality

  • Examples: Hypernatremia & Severe hyperglycemia

Leads to cellular dehydration

239
Q

What are two indications for transfusion therapy

A

Anemia & Clinical Signs of Hypoxia

241
Q

Hyposthenuria and hypersthenuria are both _____ processes

A

active

243
Q

Kidneys have large functional reserve capacity if _________________

A

basement membrane is intact

244
Q

What is the pattern in whcih a substance absorbs light at various wavelenghts called?

A

Absorption Spectrum

Different analytes absorb and reflect different wavelengths of UV or IR light in a pattern that is typical of the substance

245
Q

T/F: Generally you should not bother blood typing large animals, except horses

A

true

Single un-crossmatched whole blood transfusions tend to be well-tolerated.

crossmatching/blood typing should only occur is repeated transfusions and plasma transfusions

246
Q

If liver enzymes are abnormal in a ‘healthy’ appearing, what should you do?

A

Many options: just cont ignore them

  • Repeat immediatly
  • Take a good history- determine in corticosteroid or anticonvalsant
  • If an old dogs, U/S liver and take FNA to determine if due to benign nodular hyperplasia
  • If a middle age dog, suspect chronic hepatitis and evaluate further (ie bile salts)
  • Consider other non-hepatic disease. Hypothyroid?
    Pancreatitis? Hypoxia? Peridontal disease?
  • Repeat in 4-6 weeks, no longer than 8 weeks
    • IF still increased, do bile acids
  • If young dog, consider portocaval shunt.
    • Do bile acids. IF increased, evaluate further for shunt.
    • If no shunt, consider portal vein hypoplasia. (small breeds – Maltese, Yorkshire terriers, Cairn terriers). Diagnose with wedge biopsy, life span usually normal.
    • IF bile acids normal in young dog, repeat enzymes and bile acids in one year
247
Q

What are these cells from? They contained macrophages that have phagocytosed RBC and contain hemosiderin

A

Hematoma

248
Q

What DEA blood types are universal blood DONERs? Why?

A

DEA 4 and DEA 6 - they are very common (98%) and are non-immunogenic

249
Q

What kind of cells?

A

Mesenchymal cells - fibrosarcoma

Tell by the spindle shaped, distinct nucleoli, chromatin pattern

Aspirate will be creamy and white

250
Q

What two things are required for a selective Cl loss / Paradoxical aciduria?

A
  • *1)Volume depletion
    2) Chloride depletion**

Kidney:

  • –Resorbs Na+ to correct dehydration
  • –Resorbs HCO3-instead of Cl-(electoneutrality)

Result: exacerbated alkalosis (more HCO3-)

251
Q

What are common causes of increase liver enzymes in young dogs?

A
  • Portocaval shunts- do bile acids test (will be VERY high)
  • Bone growth –> increased ALP
  • Portal vein hypoplasia - common in small breeds (Maltese,
    Yorkshire terriers, Cairn terriers).
    • Diagnose with wedge biopsy, life span usually normal.
253
Q

Why would you only find blood on a FNA?

A

Needle too large
Lesion is vascular
Lesion is mesenchymal tissue (connective tissue)

254
Q

overhydration may lead to what 3 things?

A

‒Cardiovascular overload
‒Pulmonary edema
‒Generalized edema

256
Q

What tumors are considered round/discrete cell tumors?

A

Lymphoma (lymphosarcoma)
Plasma cell tumors
Histiocytomas
Transmissable venereal tumors
Malignant histiocytosis

257
Q

Due to the ability to filter more large and negatively charged proteins, animals with GN typically have what blood and urine abnormalities?

A
  • Proteinuria -proteins enter the filtrate faster than they are resorbed
  • Hypoproteinemia-protein loss exceeds production
    • albumin loss >> globulins loss
259
Q

Diagnosis?

A

Crytococcus neoformans

No inflammatory reaction due to thick capsule not being antigenic

Staining/ink will give contrast to the capsules, they do not stain

261
Q

These are all characteristics of what group of tumors:

  • Elongated nuclei and cytoplasmic tails (spindle cells)
  • May be few cells present - do not exfoliate well
  • Cells usually individual but sometimes in clusters with intercellular matrix
  • Active fibroblasts resemble malignant mesenchymal cells
  • May see ground substance being secreted (pink in color)
A

Mesenchymal tumors- CT origin

Examples:

Fibrosarcoma

Hemangiosarcoma
Hemangiopericytoma- on limbs of dogs

Giant Cell Sarcoma - vaccine inducedin cats
Neurofibrosarcoma
Peripheral nerve sheath tumor

262
Q

More than ___% lymphoblasts within an lymph node cytology indicates lymphoma

A

>50%

In small cell lymphomas, the decrease in plasma cells can distinguish it from a reactive lymph node

In dogs, PCR can be used to confirm lymphoma

264
Q

What kind of crystal? significance?

A

Bilirubin

Dogs: ↓ number in highly concentrated urine is NORMAL
Abnormal in all other species: ICTERUS

265
Q

T/F: Most of the time hypercalcemia CAUSES kidney disease

A

TRUE

Hypercalcemia can cause kidney disease.

  • –Impairs urine concentrating ability causing primary PU
    • affects ADH receptors
  • –Commonly leads to mineralization of renal tubules –> nephronal(kidney) dysfunction
267
Q

Why are minor crossmatches rarely done?

A

Transfused serum is low volume compared to the patient’s serum; therefore, not enough antibodies present to cause significant issues.

Youmay want to preform one if you are transfusing a large volume of plasma

268
Q

What kind of crystal? What species are these found in?

A

Calcium Carbonate

NORMAL in horses, rabbits, guinea pigs and goats

269
Q

When will you typically have degenerative neutrophils in a fluid?

A

(1) old sample- aging (2) bacterial infection

271
Q

At what osmole gap value are you concerned about unaccounted osmoles?

A

Greater than 30!

272
Q

What renal biomarker increases with 40% loss of renal tubular function? ****

A

Symmetric dimethylarginine (SDMA)

273
Q

In what cases it it ok to imprint a ulcerative lesion?

A

TVT

274
Q

Chronic lymphocytic leukemia is more common in __

A

dogs

Must be differentiated from other causes of lymphocytosis.
But, If >35,000 lymphs, it is leukemia.

lymphocytes are small and appear well differentiated

usually asymptomatic until later stages/”blast crisis”

276
Q

At what level of renal insufficiency do you become azotemic?

A

75%

278
Q

What is the difference b/w plasma and serum? What tubes should you use to obtain each?

A
  • Plasma- liquid portion of blood that has not clotted.
    • Contains all proteins (ie fibrinogen and clotting factors), thus has a higher total protein than serum.
    • Collected in a tube containing a anti-coagulant= EDTA, Heparin, Citrate
  • Serum- liquid portion of blood that remains AFTER clotting.
    • Contains NO fibrinogen or coagulation factors.
    • Collect in a red top or tiger top tube.
280
Q

If you have a hemabdomen due to hemangiosarcoma, would you expect to find exfoliated neoplastic cells within the effusion?

A

NOPE, sarcomas usually do not exfoliate

Only lymphomas and carcinomas tend to exfoliate.

282
Q

What are 4 criteria of malignancy?

A

Variable nuclear size (anisokaryosis)
Large multiple nucleoli
Abnormal mitoses
Nuclear molding

283
Q

What can increase serum CK?

A

Sketetal uscle injury - necrosis, IM injections, trauma, exercise

Cardiac muscle injury

Severely anorexic cat- muscle catabolism

285
Q

What are the BEST blood donors for dogs? cats? horses?

A
286
Q

What type of tumor are these cells from?

A

Mast Cell tumor

Have wide surgical margins

~5% do not stain well with wright stain =( but in these cases you can use the abundance of eosinophils as a clue.

Mast cell secrete chemotactic substance for eosinophils

287
Q

What do diabetes mellitus, hypercalcemia , hyperaldosteronism and third space syndromes due to Mg levels?

A

Decrease Mg

Due to diuresis - DM and hyperaldosteronism

Due to Inhibiting Mg reabsorption - hypercalcemia

Due to reduced cation reabsorption due to Cl deficiency- third space syndromes

288
Q

What are the clinical signs of hypermagnesemia?

A

paresis, paralysis, heart dysfunction , GI upset

290
Q

What type of crystals? significance?

A

Calcium oxalate dihydrate

NORMAL in domestic animals

Storage artifact

Pathologic:

  • Miniature Schnauzers are predisposed to calcium oxalate urolithiasis
  • Increased calcium excretion due to hypercalcemia (e.g. hyperparathyroidism)
  • Acute renal fialure
291
Q

What are non-bicarbonate components of maintaining blood pH?

A

Hemoglobin, Plasma proteins and others…

293
Q

T/F: TP measurement via a refractometer is simple and inexpensive and tells you the exact amount of protein

A

FALSE- it is only an estimate

———————-

Uses refractive index and assumes all solutes are proteins.

Lipids, cholesterol, glucose and urea can interfere with reading.

295
Q

What are causes of low serum Na?

A
296
Q

What is the most common cause of extreme Hypophosphatemia?

A

Most striking decreases are seen in patients with metabolic acidosis due to increased urinary loss (phosphates eliminated with excess acid)

Patients with diabetic ketoacidosis may have life-threatening hypophosphatemia due to increased urinary loss, both from acidosis, and osmotic diuresis.

Other causes:

  • Primary hyperparathyroidism (renal loss)
  • Hypercalcemia of malignancy (PTH-rp inhibits renal P reabsorption in EARLY stages of disease, P goes up once kidney mineralization occurs)
  • Vitamin D deficiency
  • Respiratory alkalosis
  • Decreased intestinal absorption of P
  • Renal tubular defects (ie, Fanconi syndrome)
  • Chronic renal failure in horses (opposite in SA)
297
Q

What is your disgnosis if you have a 6 yr old terier with:

  • Diarrhea for 2 months
  • Seizure today
  • On steroids
  • Regnerative anemia
  • VERY low protein (2.5 on 6.0 -8 RI)
  • VERY low Ca
  • Low Creat
  • Low Phos
  • LOW Mg
  • Low Alb and Glob
  • Low Chol
  • High liver enzymes with NO increase in Total bili
  • High CK
  • Low electrolytes= Na, K, Cl
  • Long Protime and APTT with Low Antithrombin III
A

Low Mg –> lack of PTH production and release

DUE TO MALABSORPTION (has had D for a long period)

Low Vit D, Vit K, protein and electrolytes due to malabsorption

Low Ca due to malabsorption and PTH deficiency –> Seizure

Steroid Hepatopathy due to steroid administration

Muscle damage due to IM injections and seizure

298
Q

What is you diagnosis for a 6 mo old female cat with:

  • Tachypnea, vomiting, weakness
  • stress leukogram with increased glucose
  • Azotemic
  • VERY high Ca (18 on 8.5-11 RI )
  • High K and Phos
  • Acidemic with high PCO3, low HCO3 and low PO2
A

Cholecalciferol (Vit D) Toxicosis –> causes hypercalcemia and hyperphosphatemia

Ca and Phos product is 171 –> mineralization of the kidneys and lungs

Metabolic acidosis and respiratory acidosis due to mineralization of lungs –> hypoxia

299
Q

Diagnosis?

A

Mononuclear inflammation with mycobacterium within M0

Mycobacterium is acid fast

300
Q

How do you tell the difference between polycythemia due to: Hemoconcentration, Appropriate increase in EPO, Inappropriate EPO or Polycythemia vera?

A
  • Relative Hemoconcentration - look at TP , it will also be increased
  • Approriate EPO- low arterial oxygen w/ EPO increase
    • check for collapsed trachea, lung issues and heart issues
  • Inappropriate EPO - normal arterial oxygen w/ EPO increase
    • check for kidney mass, cyst etc
  • Polycythemia vera- normal TP, arterial oxygen, and EPO
    • it is a non-neoplastic myeloproliferative disorder
302
Q

What is this dogs blood type?

A

DEA 1.2 - due to the weak line (compared to the control)

304
Q

what are causes of redistribution hyperkalemia?

A
305
Q

What are the 3 main causes of Bile acid increase?

A
  1. Deviation of Portal Circulation
    • Portosystemic shunt or cirrhosis
  2. Decrease in hepatocyte uptake
    • Inflammation, necrosis, Steroid hepatopathy, Decreased functional hepatic mass
  3. Decreased bile excretion with subsequent regurgitation into blood (~90% of bile acids are recycles from GIT)
    • Cholestasis, bile duct leakage
306
Q

accidental liver stick. diagnosis?

A

cholestasis

The bile within the canaliculi is indicative of cholestasis

308
Q

What should you do if you are unable to evaluate a urine sample within 30 minutes of collection?

A

refrigerate for up to 12 hours

Must warm to room temperature for 20 minutes before you perform the analysis

Have to Gently swish to remix and resuspend sediment

309
Q

What is the source of caudate cells? What is their significance?

A

Source- renal pelvis (cone shaped)

Significance: pyelonephritis

310
Q

What are 4 common causes of respiratory alkalosis?

A
  1. Hypoxemia
  2. Pain, anxiety, etc.
  3. Hyperthermia
  4. Drugs that stimulate the medullary respiratory center
311
Q

What type of tumor cells have an eccentric nuclei, golgi clearing and abundant cytoplasm?

A

Plasma cell tumors

312
Q

If you have a mononuclear inflammatory joint fluid, what two processes should you suspect?

A

Degenerative disease or trauma

313
Q

What are causes of hypoglobulinemia?

A
  1. Decrease production (SCIDS in dogs and horses)
  2. Abnormal loss (hemorrhage, PLE)
  3. Failure of passive transfer (FPT)
314
Q

What are the characteristics of fluid from a FIP cat?

A

High Protein (4-9)

Low Cells (

Yellow and thick

More Triglycerides than cholesterol

Higher globulin than albumin

315
Q

In renal failure, dogs and cats most commonly have ____ calcium

A

normal

Occasionally have hypocalcemia, But Rarely have hypercalcemia

316
Q

A lack of bile acids will lead to the decrease in absorption of what important fat soluable vitamines?

A

Vit K and D

317
Q

What are key differences b/w infectious, immmune-mediated and trauma joint fluid?

A
  • Infectious- high cell count, non-degenerative neutrophils, single joint, rare to finf agent
  • Immune-mediate- low to high cellularity, increase non degenerate neutrophils and usually MULTIPLE joints
  • Trauma- mononuclear inflammation and single joint
318
Q

If you suspect liver disease, what should you preform before you do your liver biopsy?

A

Coagulation profile

319
Q

What are the two ways to determine the plasma osmolality?

A
  1. Measurement- freezing point depression
  2. Estimated by Calculation using major osmotically active solutes
321
Q

What is the most common cause of hyperkalemia?

A

Failure of Renal Excretion (addisons disease*, oliguria, anuria, urethral obstruction, ruptured urinary bladder, loop diuretics)

Other causes:

Redistribution- acidosis, insulin deficiency, rhabdomyolysis, massive hemolysis

Increase Intake - Parenteral administration of K

In-vitro artifact

322
Q

What causes the release of atrial natriuretic factor?

A

↑central venous pressure (CVP)

…causes Na loss, diuresis and vasodilation

…inhibits aldosterone release

323
Q

What is present?

A

Talc crystals (from gloves) and Coccidioides immitis

324
Q

What are two manifestations of hypomagnesemia?

A
  1. Secondary hypokalemia due to renal wasting of K
  2. Impaired PTH production and release leading to secondary hypocalcemia

Clinical Signs: Associated with electrolyte abnormalities and NM and cardiac abnormalities

325
Q

In dogs, Hypercalcemia is most commonly due to ____________

A

Malignancy

Lymphoma > Perirectal apocrine gland carcinoma

Due to production of PTH-RP

326
Q

What are the clinical signs and treatment of acute hemolyitc immune-mediated reactions to transfusions?

A
327
Q

From cytology of cavity. What is it?

A

“bearded” mesothelial cells

328
Q

Acute myeloid leukemia must have
____% or greater blast cells in the bone marrow.

A

>20%

% of blasts in blood is variable

329
Q

What are causes of hypertonic dehydration?

A

‒Diabetes insipidus
‒Diabetes mellitus
‒Osmotic diuretics
‒Osmotic diarrhea
‒Water deprivation

330
Q

Mg plays an important role in the synthesis and release of what hormone?

A

PTH

Low Mg can lead to hypocalcemia

332
Q

If on the dip stick your protein is 2+, but on the SSA your protein in 3+, what does this mean?

A

there is albumin AND globulins/bence-jones proteins present

333
Q

What is your diagnosis of a 2 year old icteric & vomiting dog with:

  • Mild anemia
  • Inflammatory leukogram
  • No azotemia and normal glucose
  • Mild hypocalcemia (8.1)
  • Normal albumin
  • High cholesterol
  • ALK Phos increase
  • ALT increase
A

Pancreatitis

Mild hypocalcemia is due to Ca binding necrotic fat

High cholesterol, ALK Phos, and ALT indicate cholistasis and liver damage

Bile duct is obstructed due to swelling of the area due to pancreatitis

335
Q

What is your top DDx for a thoracic effusion of cat with high proteins and low cells and a polyclonal gammopathy?

A

FIP

——————————–

should do albumin”globulin ration, if high globulin it is more likely to be FIP

chylous effusion can cause a false high total protein and low cellularity, but the fluid would appear turbid and there would not typically be a polyclonal gamopathy

336
Q

What is this indicative of?

A

Inflammation!

337
Q

What is this dogs blood type?

A

DEA 1.1

338
Q

The origin of the azotemia is detemined by the ________

A

Specific Gravity

339
Q

What is TCO2?

A

Estimate of plasma bicarbonate concentration by adding acid to a sample and mesauring the total CO2

95% of the measuredtotal CO2 (TCO2) in plasma is from HCO3-

TCO2 is NOTa measurement of pCO2

340
Q

If you have > ____% of the liver affected by hepatic necrosis/damage, your liver functions test will be abnormal

A

>60-80%

341
Q

Name the systemic fungal organism

A

Histoplasma capsulatum

342
Q

T/F: Evaluation for agglutination is sufficient while crossmatching all species

A

FALSE - You should look for hemolysis in HORSES.

Horses have both agglutinating and hemolytic antibodies

343
Q

Calcitriol/Vit D _____ Ca concentration by increasing absorption of Ca from the intestine, and by enhancing PTH action on bone and kidney.

A

increases

344
Q

Abdominal fluid from dog. What is your diagnosis?

Carcinoma? Lymphoma? Mesothelial Cells? Sarcoma?

A

Carcinoma

345
Q

What 4 parts of the dipstick should you ignore in a urinalysis?

A
  1. Leukocytes
  2. USG
  3. Nitrite
  4. Urobilinogen
346
Q

Approx 20% of dogs with liver disease have _____fasted bile acids

(decreased, normal, increased)

A

normal

347
Q

What happens to Glucose, Bun, Albumin and Chol during liver failure?

A

All decrease

348
Q

What is the brown matterial in this effusion?

A

Bile - both free and within macrophages

Bile pigment may turn black during macrophage digestion (below)

Can be in effusion due to ruptured bile duct or from GI origin (may see bacteria as well)

350
Q

What are neuro clinical manifestations secondary to cellular dehydration?

A

Depression -> stupor -> coma

Abnormal PLR, CN deficits, seizures

Must rehydrate patient SLOWLY

352
Q

What are 5 common causes of HYPOcalcemia? Can you name and less common ones?

A
  1. Renal Disease - due to high P & decrease activated vit D
  2. Ethylene glycol toxicosis (60%) - due to Ca becoming bound to acidic metabolites
  3. Pancreatitis - mild, necrotic fat binds Ca
  4. Eclampsia - Ca is going into milk production
  5. Sepsis - decrease in BOTH ionized and total

Less common causes:

  • Hypoparathyroidism
  • Nutritional secandary hyperparathyroidism- decrease Ca, inadequate Vit D, excess P
  • Malabsorption - Vit D is fat soluable
  • Phosphate-containing enemas (Fleet)
  • Hypomagnesemia- Mg is important for PTH production and release
  • Massive tissue degeneration - necrotic tissye binds Ca
  • Hypercalcitonism (C-cell thyroid tumor)
353
Q

What are the 3 main sources of increased ALP (ie the different isoenzymes)?

A
  1. Bone (osteoBLAST) - high in young growing animals with increased bone formation (or healing bone injury)
  2. Liver- cholestasis induced
  3. Corticosteroid induced- exogenous or cortisol producing tumor
    • Due to increase glycogen storage within hepatocytes –> swelling –> leakage of ALP

The subtypes have the same function but are structurally different.

Difficult and expensive (and inaccurate) to determine subtypes/isoenymes

354
Q

In electrophoresis, the movement of charged particles through a solution under the influence of an electrical field depens on what? (5 things)

A
  1. Net charge
  2. Size and Shape of protein
  3. Strength og electricl field
  4. Type of medium
  5. Temperature
355
Q

What are the most common breeds for chronic hepatitis?

A

Doberman (also hereditary)
Bedlington terrier
WHWT
Cocker (Inherited, not assoc w/ Cu)
Standard Poodle (Inherited, not assoc w/ Cu)
Labrador
Dalmation

356
Q

What are two causes of hyperfibrinogenemia?

A
  1. Inflammation
    • positive acute phase proteins
    • cytokines –>increase synthesis by the liver
  2. Renal Dz in CATS abd CATTLE (mechanism unknown)
357
Q

What special biochem test can you use if you suspect uroabdomen, chylous effusion or bile leakage?

A
  • Creatinine if suspect uroabdomen
  • Triglyceride if suspect chylous effusion
  • Bilirubin if suspect bile leakage

Should compare values to the serum values

358
Q

What is the clinical presentation of Multiple Myeloma?

A
  • Pathological fractures and bone pain- neoplastic plasma cell in the marrow release osteoclast activating factor, causing lysis of the bone to make room for expansion
    • Lytic lesions in bones
    • hypercalcemia –> mineralization of kidney - due to bone break down
  • Hyperviscosity of the blood - due to high Ig
    • Engorged retinal blood vessels (due to hyperviscosity)
    • CNS signs - due to hyperviscosity
  • >20 % plasma cells in bone marrow- usually in aggregates
    • r/o chronic antigen stimulation
  • monoclonal/biclonal gammopathy - usually IgG or IgA.
  • Bence-Jones proteins in urine**
  • Abnormal platelet functions - due to coating of PLT with Igs –> epistasis
    • ​thrombocytopenia
  • PU/PD
  • Anemia- crowding out of bone marrow. seen in cats.
359
Q

What is the significance of finding free lipid droplets in urine?

A

Likely from degeneration of sloughed cells
‒Usually an isolated finding, normal
‒Pathologic: Renal tubular injury

360
Q

Liver Failure ___ serum cholesterol

(increases/decreases)

A

decreases

the liver is a major site of CHOL synthesis

361
Q

What family of drugs commonly causes drug-associated crystals?

A

Sulfa family drugs!

Also Ampicillin, Ciprofloxacin, etc Anticonvulsants (especially polytherapy and in alkaline urine), Allupurinol administration and Radiographic contrast media

362
Q

In multiple myeloma, organ involvement is very common in ____

A

cats

363
Q

When does hyperphosphatemia occur in dogs, cats and horses?

A

When GFR is , phosphorus excretion impaired

(horses can lost P through the gut as well)

364
Q

Cats with chronic lymphocytic leukemia are usually FeLV _________

A

negative

365
Q

ALT, AST, SDH, and GLDH are all considered ______ enzymes that MAY indicate hepatocelluar injury

A

leakage

366
Q

What are causes of hyperglobulinemia?

A
  1. Dehydration
  2. Inflammation
    1. K9 ehrlichiosis
    2. FIP (super high)
  3. Neoplasia
    1. Multiple Myeloma
    2. B-cell Lymphoma
367
Q

An ALT that is more than ___ times than normal or an ALT that is persistently increased should be evaluated (even if the dog appears healthy)

A

2x

In middle aged to old dogs, may indicate chronic hepatitis, for which prompt diagnosis and therapy can improve survival time.
In young dogs, may indicate portocaval shunt, and you should measure bile acids.

368
Q

T/F:

  • Acute hemolytic immune-mediated reactions are severe reactions and are a result of extravascular hemolysis
  • Chronic hemolytic immune-mediated reactions to transfusions are mild and a result of intravascular hemolysis
A
  • *FALSE**
  • *Acute= intravascular** –> hemoglobinemia/uria

Chronic = extracascular –>hyperbilirubinemia/uria

369
Q

A urine specific gravity some where b/w 1.007 - 1.012 is considered what?

A

isothenuria

370
Q

What is this indicative of?

A

Neoplasia (ie multiple myeloma)

371
Q

What tubes and protocols do you use when collecting blood gas?

*** Learning objective***

A

Heparin (green) tube

Collects whole blood from a free flowing vessels as anaerobically as possible and then anayze it ASAP

If unable to analyze in >5 minutes - put it on ice

372
Q

If the change in Cl-concentrations are greater than Na+, then consider _______abnormalities

A

acid-base

373
Q

What would indicate a positive crossmatch?

A

Agglutination

374
Q

What are the major things you look at in a fluid analysis?

A
  1. Note color, clarity, odor
  2. Total protein (via refractometry)
  3. Cell count
375
Q

What is the 2 most important thing to consider when tooking at TP?

A

Hydration status

TP is interpreted with ALB and GLOB

377
Q

What three things are required for the kidney to conserve water?

A
  1. 33% functional nephrons
  2. Production & responsiveness to ADH
  3. Concentration Dradient
    1. medullary hypertonicity
    2. production of urea and aldosterone
378
Q

If lymphocyte concentration >______μl

you can be sure it is leukemia

A

> 35,000/μl

Also if If > 15,000/μl and Ehrlichia negative, it is leukemia

379
Q

Effusion from a dog. High cell count (+90,000) adn predominantly degenerate neutrophils with a mixture of different microorganisms. What is your diagnosis?

A

GI perforation/Bacterial peritonitis

380
Q

Effusion from a cat. What is your diagnosis?

A

Lymphoma

Due to abundant individual round cells with a high nucleus to cytoplsm ratio, nucleoli and lymphoglandular bodies due to ruptured cells

381
Q

In uroabdomen, why is there ↑ K & PO4 and ↓ Na & Cl in cats/dogs/foals?

A

Urea and K+ move into plasma quickly, plasma [] increases
Na+ and Cl-move into urine quickly, plasma [] decreases

CREA moves slowly

(Hyperkalemia doe not occur in cattle because they exrete excess K into saliva)

382
Q

Lymphomas are always benign or malignant

A

malignant

383
Q

What are your DDx for proteinuria?

A
  1. Hemorrhage (RBC should sediment out)
  2. UTI/Cystitis - see bacteria and WBC on sediment
  3. Intravascular hemolysis- see animal also
  4. Renal Disease - look at casts, UPCR

Clinical Pathology (Elise) (3 decks)

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