export_final exam dx pathclin path ii Flashcards
major solutes that contrib to USG
urea
electrolytes
-not crystals, cells, casts
do glucose and protein increase USG
only if MASSIVE amounts
check what if dehydrated animal with inapprop dilute USG (things that promote PU)
hyponatremia
glucosura
hypercalcemia
-all promote PU
when dose glucose overflow DvC
dogs>10mmol/L
cats>12-15mmol/L
what may give false + of glucosuria in dipstick
peroxigard cleaning (vs Vit C = false negative)
pathologic proteinuria- causes (3)
- Glomerular dz
- Hematuria
- UTI
get what type of sample if doing UPCR
free flow
UPCR is a great test b/c it correlates well with:
24hr collection
when think glomerular dz vs. tubular?
UPCR>3.0 glomerular
UPCR <3.0 tubular
what causes false neg in protein dipstick and where come from
Bense Jones- mutliple myeloma- light chain immunoglobulins
dipstick most sens to which protein
Albumin, not globulins
+ “blood” or heme can mean (3)
hematuria
hemoglobin
myoglobin
dipstick doesn’t detect which ketone?
BHB
when is bilirubin in urine problem
any female dog, cats, or dogs>1+
which bilirubin see in urine
conjujated (unconj bound to albumin)
how false negative with bilirubinuria?
leave in sunlight too long
calcium oxylate __hydrate is picket fence= ethylene glycol
calcium oxylate MONOhydrate (vs. square= normal or high #’s ethylene glycol too)
when see pentagonal crystal-
cysteine- amino acid being lost b/c receptor not working= think fanconi syndrom!
when do you see casts normally?
-only hyaline cast= normal
low pH
low GFR
hyaline casts can be normal or dt
glomerular proteinurias
granular casts dt
cellular or tub degeneration, inflamm, or necrosis
paradoxyical aciduria b/c
decreased Cl, K, ECF vol b/c vomiting= RAAS and increase Na leading to inncreased bicarb resorption
high urea, low-normal creat
- GI ulcer
- post-prandial
- early pre-renal azotemia
if SID (Na+k-Cl) is high
Cl responsive alkalosis (eg. vomiting)
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:
- amox
- ampicillin
- clavamox
- fluoroquins-2nd choice
- 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
- culture
- tx empirically with amox for 2-4wk
- couple days post tx, culture
Respiratory antibiotic choices
- doxy (first choice)
- clavamox
- fluoroquins
if aspiration pneumonia, best broad spect choices
- clindamycin+ enroflox
- ampicillin + enro
- 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
