Exam Review Flashcards
What would we expect to happen to our cells if the urine was a very pale colour?
Cells will lyse rapidly
What plasma colour is normal for Equine?
Very yellow
What are some changes that occur overtime in a blood sample/with aged blood?
if serum or plasma is touching rbcs the glucose dereases, if exposed to light bilirubin will decrease 50% per hour, cells deteriorate or rupture, vacuolization of cells, platelets become macrocytic
Casts in urine only come from the ______
kidney tubules
If protein is present in urine, you should check the sediment for signs of ______ or _______. Why?
blood, inflammation. if no hemorrhage or inflammation present, it means there could be tubular lesions
a) how are struvite crystals and calcium oxalate monohydrate crystals similar?
b) what is the best way to tell them apart?
a) both can be elongated, rectangular shapes with pointed ends. Both are colourless.
b) the struvite crystal appears 3D with a bevel and the COM is flat
Grey top tubes are primarily used for _________ when sample is sent to an outside lab
Glucose testing
Why do we want to avoid excitement in patients before collecting blood?
Epinephrine causes immediate changes including neutrophilia, lymphocytosis, and thrombocytosis
Once you centrifuge a sample and get the serum or plasma, it is ok to not label it because it is easy to tell which one it is
False. Its impossible to tell, label serum or plasma!
Aged blood makes neutrophil chromatin appear:
expanded and hypochromic
The colour of urine is usually affected by the ________
concentration
What is a LTT tube?
Lavender Top Tube
What is the turnaround time for a sample?
Once a sample is collected the blood smear should be made in 15 mins
Compare the optimal viewing area (OVA) to the feathered edge (FE) in the following ways
a) Size of cells
b) Central pallor
c) Shape of cells
d) Colour of cells
e) Distribution of cells
a) OVA is the proper size while FE is larger than the cell should be (macrocytic)
b) OVA is visible (if present) and FE is absent
c) OVA is round or actual cell shape and FE is flat on edges in a cobblestone pattern, often ruptured
d) OVA is properly stained while FE is pale
e) OVA is evenly distributed and FE has holes and streaks (swiss cheese)
True or false, the Specific Gravity unit is L/L
False. Specific Gravity has no units. L/L is a PCV measurement in scientific units
What is a SST tube?
Serum Separator Tube (Gold or Tiger)
Green/brown urine should be processed immediately due to the possible presence of:
bilirubin which breaks down 50% each hour
What is a BTT tube:
Blue Top Tube
The general rule of thumb when collecting serum or plasma is collect _____ times as much as you need (volume)
3x
state the proper term for “small, frequent amounts of urine”
pollakiuria
After a tiger/gold top tube is spun, what do the layers look like?
Blood cells at the bottom, serum on top with the silicon plug in between which makes it easy to pipette off the serum and put it into a red top tube.
What plasma colour is normal for ruminants?
Noticeably yellow
state the proper term for “the presence of visible flakes in urine”
flocculence
What are 2 mistakes we can make that cause Hemolysis during processing of serum or plasma?
not rimming the clot before spinning a serum sample, spinning for too long or too fast
Our patient has a pH of 9. How long should we wait to read the urine sediment?
Do not wait. Alkaline urine results in dissolution of casts and lysis of cells
Tiger or Gold top tubes contain a _______ which is a ______ activator
Silicone plug, clot activator
state the proper term for “increased monocyte concentration in circulation”
monocytosis
True or false: to dilute specific gravity that is off the scale, it is generally just an eyeball ratio
False. Do NOT eyeball. Must be prescise so use graduated pipette or tuberculin syringe
We use tiger or gold top tubes to produce ______. Which must be separated into a fresh red top tube.
serum
The normal range of specific gravity is:
1.008-1.012
What causes icteric plasma/serum?
Can be normal, or due to hemolysis or liver disease
What does EDTA mean?
Ethylenediaminetetraacetic acid
state the proper term for “shriveling of RBC”
crenation
Can blood collected in Potassium Heparin be used to measure Potassium Levels?
Totally. No. It cant. You should know this.
What is an advtanage of using the screw top on a collection tube?
cannot stick needle through, preventing hemolysis
Gold top tube (SST) cannot be used for:
Phenobarbital, Potassium Bromide, Digoxin
state the term for “increased cell size”
macrocytic
What is the common site of blood collection in bovine?
Jugular, Tail
What are 3 advantaged of using the Vacutainer system? (Although we do not use it)
- Consistent drawback pressure rather than humans changing pressure and risking vein collapse
- Sample cannot be contaminated as it is going directly from vein to sterile container
- Clotting less common because it is not exposed to air between collection and process
Deep yellow plasma is defined as:
Icteric
When transferring a fresh blood sample from syringe to blood collection tube, what is the best process to do so? Why? Give details.
Remove the needle from the syringe, take tube top off, let the blood run down the side of the tube slowly until it is adequately filled. All of these steps prevent hemolysis
Before selecting a tube for a sample collection, you should reference the_____
laboratory manual
The ____ produces most proteins
Liver
Tiger/Gold top tubes cannot be used for ________ testing
Phenobarbital
Grey top tube contains ___________ plus or minus _________
Sodium fluoride, potassium oxalate
When shipping blood smears, always follow these 3 rules:
- send fixed, unstained smear with the sample 2. protect with small styrofoam container 3. keep one smear to compare findings
Why do we fast patients before some blood samples?
Lipemia alters results (fat in blood, usually after a meal)
From 1-6 list the recommended order of collection (if you would need to do all of these tests)
- Blood culture
- Coagulation (light blue)
- Serum tube (red, gold)
- Heparin (green)
- EDTA (lavender)
- Sodium fluoride (grey)
What is a RTT tube?
Red Top Tube
Dipsticks should be read with fresh, ______ temperature, well-mixed urine
room
A dog has a WBC count of 23.2 x 10(9)/L. On a cell count, you find neutrophils at 61%. What is the absolute number of Neutrophils?
14.2 x 10(9)/L
If the tube is not filled, spun and separated, anticoagulant causes:
severe hemolysis
What is the main cause of hypoproteinemia?
Liver disease not creating enough Albumin (main protein in plasma/serum)
The _______ top tube contains EDTA liquid or powder which is an _________
Lavender, anticoagulant
What is a Fibrin Clot? How does it happen? How can we avoid it?
Gelatinous mass, Centrifuging too soon or too fast, let clot at room temperature for 20 mins before spinning (10 mins in gold top)
What size needle is commonly used to collect blood from canines?
20-22
Gross urine exam includes what 3 elements
Colour, Clarity, Odour
Define hypochromic (be specific)
decreased colour, specifically decreased hemoglobin concentration in RBC
Which of the following produces antibodies?
a) Basophil
b) Monocyte
c) Lymphocyte
c) lymphocyte
state the proper term for “increased neutrophil concentration in circulation”
neutrophilia
What is the predominant protein we measure in the blood?
Albumin
pH of urine is primarily effected by what 2 factors?
diet & presence of bacteria
What does Lactescence mean in relation to plasma/serum?
Opaque, milk-like appearance that contains an even higher level of triglycerides
Heparin tubes (green) cannot be used for:
Bile acid measurement
Green top tube is most often used to produce ______ but can be used for ______ testing
plasma, blood gas testing
Heparin is a(n)_________ which means when filled it must be ________
Anticoagulant, inverted
State the proper term for “decreased lymphocytes in circulation”
lymphopenia or lymphocytopenia
What are 2 things that might alter specific gravity results?
glucose, protein
Which of the following acts as an Antihistamine?
a) Neutrophil
b) Basophil
c) Eosinophil
c) Eosinophil
To avoid damage to whole blood while shipping the sample, you should:
Wrap ice packs
If the plasma/serum is white in colour or looks milky, what could be causing this?
Lipemia, often from recent meal. If the animal was fasted then it is likelyneither liver disease or hypothyroidism
Which term of clarity means “can read text through the sample, but it is hazy”
Mild cloudiness
If urine has a “fruity” odour, you would expect the dipstick to be positive for ______
ketones
List one other cause (besides dehydration) of hyperproteinemia
Antibody production due to infection or tumor
What is a GTT tube?
Green Top Tube
The protein content of ______ is higher than _____ (components of the blood)
plasma, serum
state the proper term for “clear holes in the cytoplasm of a monocyte”
vacuoles
The instrument used to measure serum protein is called a:
refractometer
a) how are hyaline and waxy casts similar?
b) what is the best way to tell them apart?
a) both are colourless, tubular structures formed in renal tubules
b) the hyaline cast has a refractive index (and is hard to see unstained) while the waxy cast has a high refractive index
Describe the main differences between the appearance of monocytes and lymphocytes in the following ways:
a) Size
b) Chromatin
c) Cytoplasm appearance
d) Amount of cytoplasm
e) Nuclear shape
a) L vary in size M are usually very big
b) L very thick and smudged, M fine and reticular
c) L Variable from pale basophilic to deeply basophilic, smooth or granular, M consistently blue-grey with fine grainy look like ground glas
d) L varies from thin rim to as much as a monocyte M has about 50/50 nucleus to cytoplasm
e) L usually round or indented, M very pleomorphic
Which term of clarity means “can see the text through the sample, but cant read it”
Moderately cloudy
How are crystals typically reported during urinalysis?
+, ++. +++ per high power field
Clotting of whole blood can happen in what 3 ways (errors)
- prolonged collection time 2. inadequate mixing with anticoagulant 3. traumatic venipuncture
_____ (food) causes acidic urine while _____ products cause alkaline urine
Meat, wheat
what is the main cause of Hemolysis during storage?
freezing of whole blood
If plasma/serum is pale or colourless, what could be causing this?
Bone marrow depression, acute hemorrhage
List three artifacts that commonly seen in urine
Air bubbles, pollen, hair, fibers, glove powder crystals
True or false, to collect serum for a red top tube, you spin it so the serum is on top and then it is ready to be shipped to the lab
False. The serum must be removed off the top of the clot and placed into a new red top
Serum is producd by blood that has been ________ and plasma is produced by blood with a(n)_______
Clotted, anticoagulant
What is the common site of blood collection for feline/canine?
Jugular, cephalic
If you can see print through a urine sample but you cannot read the text the proper term for clarity is:
moderately cloudy
If your diluted SG read 1.042. What is your actual SG?
1.084
A pH higher than 7 means the urine is ______
alkaline
True or false: Once the light blue top tube is filled, it must be spun and the serum must be collected quickly
False. The plasma bust me collected!
What is a target cell? What causes this? How does the age of the sample relate to this?
An RBC with the appearance of a dart board with a bullseye in the middle, caused by hypothyroidism or liver diease. An aged sample will be pale and the target cells will not be visible therefore missing diagnosis
How do you adjust the smearing technique if the first smear you prepare is too thick?
Lower the spreader slide or smear slower
Which term of clarity means “cannot see the text but light travels through the sample”
Marked cloudiness
What are 3 mistakes we can make that cause Hemolysis during sample collection
too much alcohol, small needle, animal is wet
You have to take blood from a small cat. You only have 15 ml tubes available. Is this okay?
No! No no no!! Match the size of the tube to the size of the patient
state the proper term for “pH lower than 7”
acidic
Report a PCV of 17% in SI units
0.17 L/L
What are 5 main causes of Hemolysis
- damage during collection
- damage during transfer to tube
- damage during processing of serum/plasma
- damage during storage
- lipemia
A specific gravity lower than 1.008 is termed _______
Hyposthenuria
Which of the following sometimes contains rod-shaped granules?
a) Lymphocyte
b) Monocyte
c) Eosinophil
c) Eosinophil
List 3 sample collection objectives
Adequate sample volume, lack of interfering substances, no tissue fluids, no damage done, no alteration in values
List 3 diseases that cause Lipemia:
hypothyroidism, diabetes, cushing’s, pancreatitis, primary lipid disorder (common in schnauzer)
What plasma colour is normal for cats and dogs?
Straw-yellow and clear
What are 3 mistakes we can make that cause Hemolysis during transfer to tube
ejecting blood too quickly, forceful ejection of blood, shaking vigourously during inversion
There is one special tube that is designed to have the needle stuck into the top and blood pushed in. Why does this prevent hemolysis?
It has a very weak vacuum that gently pulls blood through
What is the common needle size used for blood collection in equine/bovine?
16-19
You are presented with a blood smear but you are not told the species of the patient. By examining the smear, how can you tell if it is a dog, cat or horse?
The best way is to look at eosinophilc. Lymphs, neuts and monos look similar between spp and basos are often not present.
Equine: granules very large , round and bright red/pink like a raspberry
Feline: granules are moderate in size, pink and rod shaped. Often very tightly packed
Canine: granules are large, pink and vary in size
If an item is only seen once every few fields in urine, its quantity should be reported as:
occasional
We need to collect 1 ml of blood from a cat. We only have Microtainer tubes. How many do we need to fill to get 1ml?
Each Microtainer contains 500 microliters which is half a ml. We would need to fill 2 microtainers.
Do not use Green top tube for routine mammalian hematology because Heparin interferes with:
cell staining
Light Blue top tube contains ______ and is used for _____ tests or ______ counts
Sodium citrate, coagulation, platelet
When 10ml of urine has been processed, what number of RBC is considered “normal”?
0-3/hpf (some say 0-5 in females)
True or false. An EDTA tube can be filled halfway with no problem
False. Tubes with additives must be filled completely or it will be diluted and therefore inaccurate
______ top tubes contain Heparin of various types
Green
Red or red-brown urine means:
Hematuria
stems into Hemoglobinuria or Myoglobinuria
Is this adequate processing? You have to send out a fecal in an SAF container as well as a blood sample and smear. You only have one Idexx bag left, and since they are from the same patient you put them in the bag together and send them to Idexx.
FALSE. Formalin fumes render blood un-stainable. Must be in separate bags sealed tightly
If the SG is “off the scale” how do we calculate the specific gravity?
- dilute the sample 1:1 with distilled water
- read the diluted SG
- multiple the LAST TWO digits to get the actual SG
If an animal has severe hemolysis due to disease or improper technique, what colour would we expect the plasma/serum to be?
pink-red
How are casts typically reported during urinalysis?
per low power field (/lpf)
A specific gravity higher than 1.012 is termed ________
hypersthenuria
If you raise the spreader slide, when preparing a blood smear, the smear will become:
shorter and thicker
Microtainer tubes exist and are good for cats and kittens. They have a minimum fill line of 250____ and maximum fill line of 500 _______ (units)
microliters (ul)
Platelet clumps are most likely to be found in what area of a smear:
feathered edge
state the proper term for pus in urine
pyuria
What is the most common cause of hyperproteinemia?
dehydration
state the proper term for “the top layer of a centrifuged microhematocrit tube”
plasma
State the proper term for “red staining”
eosinophilic
What three types of Heparin are common in Green top tubes?
Ammonia, sodium and potassium
what are the 4 main methods of urine collection?
Voided, catheterization, cystocentesis, manual expression
Red or Peach top tube is used for _______ and has no additive
Serum
If a blood smear is stained well, the RBC should be _____ and ______should be dark purple
pink, neutrophil nuclei
state the proper term for “increased platelet concentration”
thrombocytosis
Although plasma can be used for alkaline phosphatase testing, _____ cannot be used as an anticoagulant
EDTA
Which of the following “Ingests bacteria”
a) RBC
b) WBC
c) Neutrophil
c) Neutrophil
define crenation
shriveling of erythrocytes
EDTA tubes cannot be used for ________ testing (2)
Calcium or Alkaline Phosphatase
Lavender top tube is often used for:
routine hematology, CBC
We ignore the _____ pad on the dipstick in cats because it is not accurate
leukocyte
What is the common site of blood collection in equine?
Jugular
What is a disadvantage to using the light blue top tube?
Clean venipuncture is essential on first try
The white center in the middle of an RBC is called the:
zone of central pallor
What size needle is commonly used to collect blood from feline?
22-25
Fasting a patient before blood collection makes it easy for us to differentiate between Lipema from _____ or Lipemia from ______
food or disease
What is a GTT tube?
Grey Top Tube
define basophilic
blue staining
Which of the following can damage dipsticks?
a) touching them
b) leaving the lid off
c) exposing to moisture
d) exposing to temperature extremes
e) all of the above
f) none of the above
e) all of the above
The Grey top tube is finicky and hard to use 100% properly, therefore you should use a _______ top tube instead
red
Label blood collection tubes with what 4 things?
Patient name, plasma or serum, date and time
True or false. When waiting for the dipstick to be readable, it is okay to hold it vertically
False. It must be kept horizontal.
When plasma/serum is icteric, what are we actually looking at?
Bilirubin present in plasma
List one advantage and one disadvantage of staining urine samples
Advantages: easier to see
Disadvantages: false bacteria, increased bacteria, uneven staining
What colour of urine is “normal”?
light yellow to amber
Why do we have a recommended order of blood sample collection?
To prevent contamination of sample by substances that may interfere with results
When fasting a healthy patient before blood collection, how long is the fast?
12 hours
DO NOT ship samples in:
syringes with needles
Before use, a refractometer must be calibrated or zeroed with _________. Once calibrated, the value will read ______ on the specific gravity scale
Distilled water, 1.000
To tell the contents of a blood collection tube, what element of the tube must you look at?
the tube top colour
