export_final exam dx pathclin path ii Flashcards by Shari vandePol

major solutes that contrib to USG

urea

electrolytes

-not crystals, cells, casts

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do glucose and protein increase USG

only if MASSIVE amounts

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check what if dehydrated animal with inapprop dilute USG (things that promote PU)

hyponatremia

glucosura

hypercalcemia

-all promote PU

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when dose glucose overflow DvC

dogs>10mmol/L

cats>12-15mmol/L

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what may give false + of glucosuria in dipstick

peroxigard cleaning (vs Vit C = false negative)

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pathologic proteinuria- causes (3)

Glomerular dz
Hematuria
UTI

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get what type of sample if doing UPCR

free flow

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UPCR is a great test b/c it correlates well with:

24hr collection

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when think glomerular dz vs. tubular?

UPCR>3.0 glomerular

UPCR <3.0 tubular

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what causes false neg in protein dipstick and where come from

Bense Jones- mutliple myeloma- light chain immunoglobulins

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dipstick most sens to which protein

Albumin, not globulins

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+ “blood” or heme can mean (3)

hematuria

hemoglobin

myoglobin

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dipstick doesn’t detect which ketone?

BHB

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when is bilirubin in urine problem

any female dog, cats, or dogs>1+

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which bilirubin see in urine

conjujated (unconj bound to albumin)

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how false negative with bilirubinuria?

leave in sunlight too long

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calcium oxylate __hydrate is picket fence= ethylene glycol

calcium oxylate MONOhydrate (vs. square= normal or high #’s ethylene glycol too)

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when see pentagonal crystal-

cysteine- amino acid being lost b/c receptor not working= think fanconi syndrom!

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when do you see casts normally?

-only hyaline cast= normal

low pH

low GFR

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hyaline casts can be normal or dt

glomerular proteinurias

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granular casts dt

cellular or tub degeneration, inflamm, or necrosis

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paradoxyical aciduria b/c

decreased Cl, K, ECF vol b/c vomiting= RAAS and increase Na leading to inncreased bicarb resorption

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high urea, low-normal creat

GI ulcer
post-prandial
early pre-renal azotemia

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if SID (Na+k-Cl) is high

Cl responsive alkalosis (eg. vomiting)

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if SID is low

secretional acidosis (bad bad diarrhea)= increase in Cl vs Na with LOW tCO2

if bladder is ruptured, best ot measure:

creatinine

why high P and Mg with CKF

decreased GFR

CRF- high or low K

low if very chronic (decr GFR and wasting) -if acute renal failure then high K b/c of acidosis (bicarb gone so K shifts to ECF)

biggest diff in biochem with acute vs chronic renal failure

acute- high K (acidosis- no bicarb so K shifts to ECF) chronic-low K (decreased GFR, wasting)

why would BMBT increased with a CRF

uremic acid interfers with platelet activity

what does uremia influence with CRF

GI- ulcers Platelet functioning*

when amylase is high, when suspect pancreatitis and not renal failure?

pancreatitis

unique with cats and pancreatitis

no increase in amylase and lipase

if suspect chylothorax do what

fridge and see if separates

"dog killing virus" -v/d, lethargy, neuro, death <24h: virus and pathology

circo- acute necrotizing vasculitis

circo virus is a:

small, non-envel DNA

most import. rabies forms and vaccine protects against

skunk bats*

which influenza can affect dogs

H3N8-equine influenza

which H are most dangerous in influenza

H5, H7

how PCR on RNA viruses?

reverse transcription

cons with RT-PCR

product small and cannot sequence it!

pros of RT-PCR

- faster | - demonstrates what stage virus is in b/c give quantity of virus

only antiviral for flu

Tamiflu- specific for neuominidaze to prevent replication

when best to give antivirals?

preventative or chronic infection -too late if severe infection

t/f 1/3 dogs with hypothyroid will not have increased TSH

true! why run fT4 too

other clin path changes you'd see with hypothyroid animal

- hypercholesterolemia - hypertriglceridemia (low thyroxin levels affects hepatic lipase adn lipoprotein lipase) - anemia of chronic dz (normocytic, normochromic- non-reg)

how RO hyperthyroid in cat

normal tT4, fT4= euthyroid

what if normal tT4, high fT4

- could be non-thyroid illness masking true hyperthyroid | - or other illness in euthyroid cat (false positive fT4)

other clin path signs of hyperthyroid in a cat:

- high ALT, ALP without icterus, hyperbilirubinemia | - high P without azotemia

ACTH stim test to dx:

Cushings iatrogenic cushings Addisons

why see increase MCHC and protein with hypothyroid?

lipemia

most sensitive cushings screening test

LDDS

hypernatremia causes (3)

- Na intake - pure water loss - hypotonic fluid loss

eg. of hypernatremia b/c water loss

- DI - insensible losses (panting, fever) - inadeq access to water

hypernatremia b/c hypotonic fluid loss (most common cause of hypernat)

extra-renal: GI (v/d), perotinitis, cutaneous losses renal: diuretics (furosemide), osmotic diuresis

Na measurement if relative to:

amount of water

causes of hyponatremia:

- increase loss:v/d - increase total body water- iatrogenic fluids - shift water from ICF to ECF renal osmotic diuresis)

t/f low K always indicated total body K depletion

true despite serum K not being reliable indicator of total body potassium b/c most in cells

Hypokalemia

- anorexic or poor diet - shift ECF-ICF - increased loss: GI, renal, sweating

hyperkalemia

- addison's, UTI- increased renal retention | - shift ICF-ECF (acidemia, mm/tissue damage, hemolysis)

3 causes of pseudohyperkalemia

thrombocytosis leukocytosis delayed serum separation

this electrolyte often parallels hyponatremia

Chloride

if see increaes in platelets:

- hemolysis - stress/excitement (splenic contraction) - very early hemorrhage

UTI antibiotic choices:

1. amox 2. ampicillin 3. clavamox 4. fluoroquins-2nd choice 5. convenia- broad spect- overkill unless crazy cat * 3-5d for uncomplicated UTI

complicated UTI=

- 3 or > infection per/year | - relevant co-morbid: paresis, metab dz, etc

approach to complicated UTI

1. culture 2. tx empirically with amox for 2-4wk 3. couple days post tx, culture

Respiratory antibiotic choices

1. doxy (first choice) 2. clavamox 3. fluoroquins

if aspiration pneumonia, best broad spect choices

1. clindamycin+ enroflox 2. ampicillin + enro 3. ampi + amikacin-2nd choice

when use prophy ampicillin in dentistry?

underlying heart condition- for 24hrs post b/c risk of bacterial translocation

antibiotic choices for abdominal explore: kill e-coli

-2nd gen ceph- inject clavamox