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Blood II > Final ATE2639 > Flashcards

Final ATE2639 Flashcards

1
Q

Chemistry
Interference Factors

A
  • Hemolysis
  • Icterus
  • Lipemia
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2
Q

Albumin
Function

A
  • Produced in liver
  • Maintains osmotic pressure (keeps fluid within vascular system)
  • Transports certain molecules (Calcium)
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3
Q

Albumin
Increased

A

Hyperalbuminemia
* fluid has decreased
* dehydration

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4
Q

Albumin
Decreased

A

Hypoalbuminemia
* decreased synthesis by liver
* loss from kidney disease (check for proteinuria)
* hemorrage or GI loss (if globulin also decreased)

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5
Q

Globulins

A

Alpha and Beta
* made in liver
* acute phase proteins

Gamma
* made by plasma proteins (B lymphocytes)
* immunoglobulins (think antibodies)
* most common

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6
Q

Globulin
Increased

A

Hyperglobulinemia
* inflammation / infections
* neoplasia
* tick-borne diseases
* HW disease
* dehydration (if albumin also increased)

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7
Q

Globulin
Decreased

A

Hypoglobulinemia
* immunodeficiencies
* inherited
* failure of passive transfer
* FeLV / FIV
* hemorrage or GI loss (if albumin also decreased)

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8
Q

Liver Enzyme
Functions

A

Leakage Enzymes
* inside the cell
* increase when damage to cell

Cholestatic Enzymes
* outside the cell
* found within biliary tract

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9
Q

ALP and ALT
in Cats

A

Both have a shorter half life in cats
* if it goes up, it will come down very quickly
* if elevated liver values, there is a major issue (it went up super high and is now at the level being seen)

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10
Q

ALT

A
  • Liver-specific
  • Leakage enzyme
  • Enzyme free within hepatocyte cytoplasm - leakage from damage
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11
Q

AST

A
  • Liver
  • Leakage enzyme - hepatocyte damage
  • Skeletal muscles - IM injections and exercise
  • Erythrocyte hemolysis
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12
Q

AST
Increases

A

Only elevates with severe liver disease
* if elevated, check for hemolysis and creatine

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13
Q

APL
Enzyme Type

A

Cholestatic
* with many isoenzymes

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14
Q

ALP
Locations

A
  • Hepatobiliary (liver)
  • Bone / Cartilage
  • Steriods
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15
Q

ALP
Elevations

A

Young Animals
* bone developement

Older Animals
* cholestasis
* osteosarcoma

Steriods (dogs only)
Drugs (phenobarbital)

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16
Q

GGT

A
  • Cholestatic enzyme
  • Liver (biliary)
  • If elevated, biliary in nature
  • Elevates with obstructive liver disease
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17
Q

Bilirubin

A
  • Produced from breakdown of hemoglobin
  • Elevated due to hepatic damage - bilirubin unable to be secreted into bile after being conjugated
  • In IMHA, see this increased because there is so much RBC breakdown, liver can’t keep up
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18
Q

Bile Acid

A
  • Synthesized in liver, stored in gallbladder
  • Stimulated by meal to help breakdown fat
  • Elevates with liver disease, PSS, and cholestasis
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19
Q

Bile Acid Testing

A
  • 12 hour fast
  • Collect sample
  • Feed high fat meal (wait 2 hours)
  • Collect sample
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20
Q

Bile Acid Testing
Normal Results

A
  • Before Meal: low levels
  • After meal: slightly elevated but WNL
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21
Q

Indicators of Normal Liver Function

A
  • Protein (albumin)
  • Cholesterol
  • Glucose
  • BUN

if all are low alongside liver elevations

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22
Q

BUN

A

Protein waste product removed by kidneys

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23
Q

BUN
Elevated

A

Pre-renal
* Dehydration
* High protein diet

Renal
* Actual kidney disease causing elevation

Post-renal
* Any type of obstruction

75% of kidney function gone

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24
Q

BUN
Decreased

A

Contamination of blood with bacteria
* refrigerate sample
* assess quickly

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25
Q

Creatinine

A

Produced from skeletal muscle metabolism
* function of total body muscle mass

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26
Q

Creatinine
Increased

A
  • Dehydration
  • Renal disease
  • Obstruction

75% of kidney function gone

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27
Q

Creatinine
Decreased

A

Total muscle mass loss
* levels may look normal or start to normalize because of loss, and kidneys not needing to work as hard

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28
Q

USG Change

A

Not observed until at least 66% of kidney function is gone

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29
Q

SDMA
Elevations

A

Seen when >25% of kidney function is gone
* early indicator of kidney dysfunction
* not affected by other outside factors

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30
Q

USG Concentration
Hypersthenuria

A
  • Term not used often
  • Dogs: >1.030
  • Cats: >1.035
  • Decreased water intake
  • Dehydration
  • Increased urination
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31
Q

USG Concentration
Moderately Concentrated

A
  • Dogs: 1.013 - 1.029
  • Cats: 1.013 - 1.034
  • Normal function as long as hydrated normally
  • Inapproriate kidney response if otherwise dehydrated
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32
Q

USG Concentration
Isosthenuria

A
  • 1.008-1.012
  • Same as GRF and Plasma
  • Going out same as it came in
  • If azotemia / dehydration: renal dysfunction (retest to get repeated values)
  • If normal hydration: inappropriate response, but should be retested
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33
Q

USG Concentration
Hyposthenuria

A
  • <1.008
  • Kidneys are working, but are just not able to concentrate for whatever reason
  • Can be appropriate with primary polydipsia
  • Diabetes
  • Pyometra
  • Pyelonephritis
  • Steroids or Diuretics
  • Hypercalcemia
  • Liver failure
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34
Q

UPC Use

A

Quantitative assessment of renal proteinuria
* can indicate glomerular disease
* normal <1

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35
Q

Amylase

A
  • From Pancreas primarily (salivary glands, small intestine)
  • Breakdowns starches and glycogen
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36
Q

Amylase
Increases

A

Degree of elevation does not equal severity of disease
* Pancreatic disease (especially if >3x upper reference range)
* Kidney disease (excreted by them)

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37
Q

Lipase

A
  • Primary sourse: pancreas
  • Breakdowns long-chain fatty acids of lipids
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38
Q

Lipase
Elevation

A

Degree of elevation not equal to severity of disease
* Pancreatic disease
* Kidney and Liver disfunction
* Steriods

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39
Q

Trypsin

A
  • Produced exclusively in pancreas
  • Enzyme important for protein breakdown
  • Normally detected in feces (should be there)
  • Run TLI to get serum levels
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40
Q

TLI
Increases

A

Check Cobalamin and Folate levels
* Pancreatitis (normal range does not rule this out)
* Renal dysfunction (excreted by kidneys)
* Small intestine disease in cats

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41
Q

TLI
Decreased

A

Pancreas not making enough trypsin
* EPI
* Weight loss
* Polyphagia
* Diarrhea
* Secondary to chronic pancreatitis
* See a lot with GSD

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42
Q

PLI

A

Specific tests that are organ specific (no interference from extrapancreatic sources)
* do when TLI increased to get better diagnosis
* normal PLI does not rule out pancreatitis

43
Q

PLI
Increased

A
  • Pancreatitis
  • Renal dysfunction (excreted by kidneys) - not sure if significant or not
  • Potentialy from steroids, but unclear
44
Q

PLI
Decreased

A

Does not rule out pancreatitis

45
Q

Sodium

A

Most important cation of extracellular space
* around the cells
* helps with water distribution and osmotic pressure
* relationship with chloride (follows)

46
Q

Sodium
Increased

A

Hypernatremia
* Water loss: dehydration, diabetes
* Sodium gain: NaCl ingestion (sea water), IV of hypertonic saline solutions
* If chronic changes - must decrease slowly

47
Q

Sodium
Decreased

A

Hyponatremia
* Water gain: too much IV administration of dextrose in water
* Sodium loss: GI disease, renal loss, hypoadrenocorticism (Addison’s)
* Treat with saline infusion

48
Q

Potassium

A

Most important cation of intracellular space
* inside the cell
* important for muscle / cardiac/ nerve function

49
Q

Potassium
Increased

A

Hyperkalemia
* Acute renal failure
* Urinary bladder rupture
* Metabolic acidosis
* Hypoadenocorticism (Addison’s)

50
Q

Potassium
Decreased

A

Hypokalemia
* Diuretics
* CKD in cats
* GI loss
* Metabolic acidosis
* IVF >24 hr without supplementation

51
Q

Potassium
Toxic Effects

A

Potential myocardial toxic effects
* life-threatening disorder when increased

52
Q

Chloride

A

Close relationship with Sodium

53
Q

Calcium

A
  • All cells require this to function
  • Maintains neuromuscular function and many enzymes
  • Facilitates blood coagulation
  • Inverse relationship with Phosphorus
54
Q

Calcium
Increased

A

Hypercalcemia
* hyperparathyroidism
* neoplastic osteolytic metastasis
* Hypervitaminosis D
* Paraneoplastic Syndrome (LSA, ASA)

55
Q

Calcium
Decreased

A

Hypocalcemia
* associated with hypoalbuminemia
* CKD
* hypoparathyroidism
* vitamin D deficiency
* malabsorption
* small breeds nursing large litters

56
Q

Phosphate
Increased

A

Hyperphosphatemia
* see in young, growing animals
* renal disease
* dehydration
* hypoparathyroidism
* look for hemolysis (organic phosphorus found in RBCs)

57
Q

In-House Microbiology

A
  • Separate room with limited traffic
  • Ventilation hood
  • Adequate light
  • Easy and washable floor and surfaces
  • At least 2 work areas
  • Incubator
  • Separate fridge
  • OSHA is VERY strict
58
Q

Sample Collections

A

Collect early in disease process, before antimicrobial initiation
* if already on antimicrobials, collect sample just before next dose (lowest antimicrobial concentration will be present)

59
Q

Gram Stain +

A

Cell walls composed of peptidoglycan
* retains crystal violet stain (primary)
* bacteria will appear purple

60
Q

Gram Stain +
Bacteria

A
  • Streptococcus
  • Staphlyococcus
  • Listeria
  • Corynebacterium
61
Q

Gram Stain -

A

Cell wall composed of double-lipid layer
* decolorized in order to accept the safranin/counter stain (secondary)
* bacteria stains pink

62
Q

Gram Stain -
Bacteria

A
  • Salmonella
  • Proteus
  • E. Coli
  • Klebsiella
  • Pasteurella (cat abscess)
  • Pseudomonas
  • Borrelia burgdorferi (weakly)
  • Bartonella (cat scratch fever)
  • Brucellosis
63
Q

Acid - Fast Stain

A
  • Ziehl-Neelson Stain
  • Detects mycobacterium and nocardia species
  • If stains remains, it’s positive (bright pink/red)
  • If stains remove, it’s negative (blue/ green)
64
Q

Microbiology
Culture Timing

A

Plates should incubate for 18-24 hours
* examine for growths
* negative after 3 days

65
Q

Culture Media Types

A
  • Transport
  • Enriched
  • Selective
  • Differential
  • Enrichment
66
Q

Culture Media Types
Transport

A

Preserves organism

67
Q

Culture Media Types
Enriched

A

Basic nutrient media with extra nutrients added
* formulated

68
Q

Culture Media Types
Selective

A

Inhibit / kill all but a few bacteria

69
Q

Culture Media Types
Differential

A

Indicators present
* allow to differentiate between the various organisms
* based on their biochemical reactions

70
Q

Culture Media Types
Enrichment

A

Favor growth of a particular group of organisms

71
Q

Blood Agar
Media

A

Enriched
* nearly anything will grow on it

Differential
* induces hemolysis

72
Q

Blood Agar
Hemolysis

A
  • Alpha: partial (only where organism is growing)
  • Beta: complete (where organism is growing and surrounding area)
  • Gamma: no change
73
Q

MacConkey Agar
Use

A

Selective and Differential media
* gram (-) grows
* gram (+) doesn’t grow
* determines if organism is able to ferment lactose (turns media red)

74
Q

Thioglycollate Broth
Use

A

Enrichment and Differential liquid media
* encourages fastidious / specific bacteria to grow
* can differentiate between anerobic and aerobic by reaction to broth in test tube and where it grows

75
Q

Antimicrobial Sensitivity Testing

A
  • Do after bacterial isolation
  • Determines susceptibility / resistance to antimicrobial drugs
  • Culture and Sensitivity / Identification
76
Q

Bacteria Oxygen Requirements
Main

A

Obligate Aerobes
* require oxygen to survive

Obligate Anaerobes
* killed / inhibited by presence of oxygen

Facultative Anaerobes
* can survive with or without oxygen
* generally do better without oxygen

77
Q

Bacteria Temp Requirements

A

Mesophiles
* grow best at 20-40 C / 68-104 F
* all bacteria pathogenic to animals

Psychrophile
* grows best below 20 C

Thermophile
* grows best above 40 C

78
Q

Bacterial Spores

A

Resistant parts created by bacteria
* don’t stain well
* where spore is located on bacteria determines the species

79
Q

Coliforms vs Non-Coliform Bacteria

A

Coliforms
* natural inhabitants of GI tract
* E. Coli, Salmonella
* cause secondary opportunistic infections

Non-Coliforms
* “3 P’s and 2 B’s”

80
Q

Pasteurella spp.

A
  • Non-coliform bacteria
  • Gram -, rods
  • Cat-bite abscess
81
Q

Pseudomonas spp.

A
  • Non-coliform bacteria
  • Gram -, rods
  • Environmental contaminant
  • Gets into ears - causes resistant ear infections
  • Creates grean culture on blood agar
  • Very smelly
82
Q

Proteus spp.

A
  • Non-coliform bacteria
  • Gram -, rods
  • Common with UTI
  • Also gets into wounds
  • Swarms cultures
83
Q

Fungus

A

Mold Form
* plant-like shapes
* very small
* dermatophytes most common

Yeast Form
* single-cellular organisms
* bud to reproduce

84
Q

Dermatophytes

A

Saprophytic (grow on dead things / cells)

85
Q

Dermatophyte

Microsporum canis

A
  • Zoophilic (find on other animals)
  • Very zoonotic and contagious to other animals
  • “Cigar-shapes”; thicker membranes with 6+ compartments inside
86
Q
A

Microsporum canis

87
Q

Dermatophyte

Microsporum gypseum

A
  • Geophilic (find in environment; in soil)
  • Not as zoonotic
  • Thin-walled cells; <6 compartments inside
88
Q
A

Microsporum gypseum

89
Q

Dermatophyte

Trichophyton mentagrophytes

A
  • Zoophilic (find on other animals)
  • Anthropophilic (find with humans)
  • Form “cigar-shapes” but globoid shapes are main colonies
90
Q
A

Trichophyton mentagrophyte

91
Q

Dermatophyte Testing

A
  • Collect hair around lesion or use new toothbrush to brush hair
  • Put sample on DTM culture
  • Look for color change and growth happening at same time
  • Once this is seen, do tape prep of colony and look under microscope
  • Determine if indeed ringworm and what type
92
Q

Aspergillus

A
  • Environmental contaminant
  • Affects respiratory / sinuses of dogs
  • Invasive: destroys sinus bone
  • Non-invasive: forms blockage
93
Q
A

Aspergillus

94
Q

Malassezia

A
  • Yeasts
  • Skin and ear issues
  • Do not need a culture to diagnose, just cytology
95
Q

Dimorphic Fungi

A

2 Forms: Yeast vs Mold
* “mold in cold”: cold environments; infectious and allows to get into body and forms into yeast form
* “yeast in beast”: find in warm areas on animal; forms actual disease process

96
Q

Dimorphic Fungi
Sending Samples to Lab

A

Lab needs to be alerted of potential sample
* biohazard sample
* need to be cautious and grow sample in correct way to avoid contamination to staff and environment

97
Q

Blastomyces

A
  • Dimorphic fungi
  • Found in river valleys
  • “Broad Based Buddings”
  • Cutaneous and Pulmonary Form
98
Q
A

Blastomyces

99
Q

Histoplasma capsulatum

A
  • Dimorphic fungi
  • Found worldwide in soil
  • Pulmonary disease in dogs and cats
  • GI disease in dogs
  • Small organisms in large macrophages
100
Q
A

Histoplasma capsulatum

101
Q

Cryptococcus neoformans

A
  • Dimorphic fungi
  • Associated with pigeon droppings
  • Upper respiratory and CN disease
  • Narrow-base budding
  • Pendulous attachment
  • Thick capsule
102
Q
A

Cryptococcus neoformans

103
Q

Coccidioides immitis

A
  • Dimorphic fungi
  • Found in desert
  • Cause respiratory disease
  • May disseminate and cause other diseases
  • Large, thick-walled with a lot of different yeast inside
104
Q
A

Coccidioides immitis

Blood II (13 decks)

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