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CLP 303 > Final (Lecture) Prep > Flashcards

Final (Lecture) Prep Flashcards

1
Q

True or false: Toxic changes always accompany changes in WBC numbers

A

False. Toxic changes can occur in the absence of changes in cell numbers

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2
Q

True or false: Morphology must be done in the optimal viewing area

A

True

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3
Q

Where on the slide could we double check for large/unusual cells?

A

Feathered edge

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4
Q

What 4 features of a WBC need to be assessed each time?

A

Maturation, Size, Cytoplasm and Nucleus

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5
Q

What are the differences between Cytoplasmic Basophilia/Vacuolation and vacuoles due to EDTA?

A

Vacuoles due to EDTA are crisp and round, perfect and distinct vacuoles. Cytoplasmic basophilia/vacuolation are indistinct, soft and blurry around the edge

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6
Q

What 3 toxic changes are often seen together?

A

Cytoplasmic basophilia, cytoplasmic vacuolation and doehle bodies

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7
Q

Why do toxic changes occur?

A

Accelerated granulopoiesis

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8
Q

What does Toxic Granulation mean?

A

Retention of primary granules, which is very rare

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9
Q

How many lobes must a neutrophil have in order to be hyper-segmented?

A

6 or more

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10
Q

What is a Pyknotic nucleus?

A

Small, dark and dense

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11
Q

What is a Karyorrhectic nucleus?

A

nucleus is pyknotic but fragments, resulting in multiple pyknotic nuclei

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12
Q

True or false: Donut neutrophils can be donut bands

A

True

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13
Q

What is the term for a WBC eating an RBC?

A

Erythrophagocytosis

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14
Q

What are 3 of the neutrophil changes we discussed? (There is 12)

A
  • Cytoplasmic basophilia
  • Cytoplasmic vacuolation
  • Giant neutrophil
  • Doehle bodies
  • Hypersegmentation
  • Pyknosis
  • Karryorhexis
  • Donut band/neutrophil
  • Smudge
  • Basket
  • Erythrophagocytosis
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15
Q

Most toxic changes occur where in the cell?

A

Cytoplasm

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16
Q

Giant neutrophils are more than _____um

A

16

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17
Q

How does a Giant neutrophil develop?

A

The nucleus matures without the cell dividing normally - cytoplasm is less mature

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18
Q

Giant neutrophils are common in ______ (species)

A

cats

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19
Q

What causes Cytoplasmic Basophilia?

A

Retained RNA due to either short maturation or something is interfering with maturation

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20
Q

True or false: Cytoplasmic vacuoles are most often found attached to the nucleus

A

False. They are most often found attached to the cell membrane

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21
Q

What is nuclear asynchrony?

A

Not everything in the cell is maturing at the same time

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22
Q

Doehle bodies are reminants of ______ and are common in cats

A

RNA

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23
Q

Toxic granulation is very uncommon and is seen mostly in ______ (species)

A

horse

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24
Q

What causes hypersegmentation?

A

An over-matured neutrophil that has been in circulation for longer than usual.

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25
Q

True or false: Technically, hypersegmentation is not a toxic change but is mostly caused by corticosteroids.

A

True

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26
Q

The presence of ______ is called a right shift

A

Hypersegmented neutrophils

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27
Q

Pelger-Huet Anomalies can be found in what types of WBCs?

A

Neutrophils, Eosinophils and Basophils

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28
Q

True or false: When Pelger-Huet Anomalies are present, only about half of the Granulocyte population will be affected

A

False. You will not find any normal granulocytes, all are affected

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29
Q

What is a Barr Body and how does it occur?

A

Small, drumstick-like nuclear appendage as a result of an extra X chromosome

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30
Q

Barr Bodies only occur in what gender?

A

Females or hermaphrodites

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31
Q

Describe the similarities and differences between Pyknotic cells and Karyorrhectic cells

A

While they both have shrunken and condensed (dead) nuclei, the number of fragments are the main difference. Pyknotic cells have 1 nucleus and Karyorrhectic cells are fragmented

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32
Q

What does a Bilobed neutrophil indicate?

A

There was once a left shift, as bilobed neutrophils began as myelocytes in circulation

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33
Q

True or false: Bilobed neutrophils can function normally and are not toxic unless other toxic changes are involved

A

True

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34
Q

Out of all of the neutrophil changes discussed, which ones are considered toxic?

A
  • Doehle bodies
  • Cytoplasmic basophilia/vacuolation
  • Donut nuclei
  • Giant neutrophils
  • Toxic granulation
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35
Q

What are the 8 lymphocyte changes we discussed?

A
  • Small
  • Medium
  • Large
  • Reactive
  • Granular
  • Lymphoblast
  • Atypical
  • Plasma
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36
Q

True or false: When assessing the size of a lymphocyte, you assess the entire cell’s size

A

False. The “size” is based on the size of the nuclei.

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37
Q

Small lymphocytes have a nucleis the size of ____ rbc(s)

A

1

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38
Q

True or false: Reactive lymphocytes have to be small lymphocytes.

A

False. They have to be large lymphocytes

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39
Q

Reactive lymphocytes will often have a _______ and will NOT have _______

A

Perinuclear clear zone, Nucleoli

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40
Q

Granular lymphocytes have a collection of large ________ granules

A

Azurophilic (primary)

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41
Q

Granular lymphocytes often indicate ______ but can also be seen in neoplastic cells

A

Inflammation

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42
Q

Lymphoblasts always have one or more _______ and are usually large lymphocytes

A

Nucleoli

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43
Q

A lymphocyte with a nucleus that has deep clefts or multiple infoldings is called a ______

A

Atypical lymphocyte

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44
Q

If a lymphocyte looks odd but you can’t classify it, call it ______

A

Atypical

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45
Q

Lymphoblasts have _____ chromatin

A

Stippled

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46
Q

What is Chediak-Higashi Syndrome?

A

An inherited syndrome in cattle and persian cats that results in decreased phagocytosis and therefore recurrent infections

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47
Q

What is the key characteristic of Chediak-Higashi Syndrome?

A

Huge, pink-purple granules

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48
Q

A lymphocyte described as round to oval with an oval nucleus and abundant, deep purple granules is called a ________

A

Mast cell

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49
Q

Mast Cells are often seen in the feathered edge and on a ________ smear

A

Buffy coat

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50
Q

Mast cells can be caused by inflammatory disease or _____

A

mastocytosis

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51
Q

What is leukoagglutination and what is it most often caused by?

A

Clumping of WBCs in peripheral blood and it is often an artficact due to prolonged storage or EDTA

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52
Q

What does a Canine Distemper Inclusion look like?

A

A round, pale basophilic or magenta intracytoplasmic inclusion in WBCs and RBCs

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53
Q

What 3 organism species can affect WBCs?

A

Ehrlichia, Hemogregarines, Leukocytozoon

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54
Q

What are 6 ways to detect blood-borne organisms?

A
  • blood smear
  • buffy coat smear
  • modified knott’s test
  • filter test
  • serology (snap test)
  • DNA testing (PCR)
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55
Q

What is the benefit to using a Modified Knott’s test over a Filter test to identify Dirofilaria immitis?

A

Using a knott’s test you can see the head and therefore identify the species. Using a filter test you can identify microfilaria but not the species due to the head sticking to the filter

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56
Q

Mycoplasma haemofelis is the cause of ________ in cats

A

Feline infectious anemia

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57
Q

Mycoplasma haemofelis lives ______ (relative to the cell) and has coccoid, rod or ring forms

A

Epicellular - on the outer surface

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58
Q

Mycoplasma haemofelis will ______ when exposed to EDTA, if sample gets cold, or if it has sat for longer than 15 mins

A

detach

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59
Q

The number one cause of anemia in young cats is:

A

Mycoplasma haemofelis

60
Q

How can you tell the difference between Mycoplasma haemofelis and an artifact?

A

If the patient is not anemic, it is probably an artifact

61
Q

It is important to differentiate Mycoplasma haemofelis from what 4 things?

A
  • stain debris
  • refractile artifacts
  • poorly stained howell-jolly bodies
  • basophilic stippling
62
Q

It is easiest to look for the ______ shaped form of Mycoplasma haemofelis

A

Ring

63
Q

What are 4 clinical signs/developments from Mycoplasma haemofelis?

A
  • Regenerative anemia
  • icterus
  • splenomegaly
  • intermittent fever
64
Q

Mycoplasma haemofelis can be treated with what 3 elements?

A
  • Tetracyclines
  • Prednisone (maybe)
  • Transfusion if PCV is critically low
65
Q

True or false: Ehrlichia is an intracellular parasite of monocytes, neutrophils and lymphocytes

A

True

66
Q

How is Ehrlichia transmitted

A

Ticks

67
Q

Ehrlichia results in pancytopenia. What does this mean?

A

Decrease in ALL blood cells

68
Q

Ehrlichia forms _____ in the cytoplasm

A

morulae

69
Q

Babesia is a protozoan infection which affects only _______ blood cells

A

RBC’s

70
Q

How does Babesia cause anemia?

A

It continuously reproduces until the RBC bursts

71
Q

What does Babesia look like? What is the best stain to use?

A

Pear or rod shaped, like a crystal. New methylene blue.

72
Q

How is Babesia transmitted?

A

Ticks

73
Q

Does Babesia cause intravascular hemolysis or extravascular hemolysis?

A

Intravascular

74
Q

A long, snake-like membrane that is more common in wildlife is a parasite called:

A

Trypanasome

75
Q

Anaplasmosis affects _____ only

A

Ruminants

76
Q

Anaplasmosis can cause the PCV to drop ____%

A

50-80

77
Q

Anaplasmosis causes severe ______

A

IMHA

78
Q

Anaplasma platys leaves inclusions in the ______ and causes cyclic thrombocytopenia

A

thrombocytes

79
Q

What are the 5 main functions of kidneys?

A
  1. Excrete metabolic wastes (urea, cratinine, electrolytes, etc)
  2. water & electrolyte balance
  3. pH balance
  4. secretion of erythropoietin and hormones
  5. regulation of BP
80
Q

All urine is formed with a specific gravity of 1.008-1.012 (Isosthenuric). As the urine goes through the tubules, it can be modified or contaminated. If the animal needs to rid of water, the urine will become ______, if the animal needs to retain water, the urine will become _______

A

dilute, concentrated

81
Q

Where does urine concentration occur?

A

Renal tubules

82
Q

In order to perform its main jobs, the kidneys must have what 2 structural characteristics?

A
  • Normal glomerular filtration

- Normal renal tubular integrity

83
Q

Define renal disease

A

Morphologic or functional lesions

84
Q

Define renal insufficiency

A

Diminished renal function with NO azotemia

85
Q

Define renal failure

A

Derangements in fluid and electrolyte balance and azotemia due to decreased renal function

86
Q

Define polyuria

A

Increased volume of urine

87
Q

Define pollakiuria

A

Small, frequent amounts of urine

88
Q

Define oliguria

A

Decreased volume of urine

89
Q

Define anuria

A

Not urinating

90
Q

Define stranguria

A

Difficulty urinating

91
Q

What are the 6 rule-outs for a patient presenting with PU/PD?

A
  1. Kidney disease
  2. Liver disease
  3. Diabetes
  4. Hyperthyroidism (cats only)
  5. Cushing’s disease
  6. Pyometra
92
Q

Define azotemia

A

Increased BUN and/or Creatinine levels in the blood

93
Q

Define Uremia

A

Azotemia with clinical signs of renal failure

94
Q

What are 4 things that can cause decreased glomerular filtration rate?

A

Dehydration, cardiac disease, shock and renal disease

95
Q

Describe the process of having a build up of Urea (BUN) in the blood

A

Protein from food is broken down, in the liver the protein is metabolized and the garbage left behind is Urea which the body can’t use. Urea leaves liver through blood, goes to kidney and filters through glomerulus and exits through urine. If urine flow is slow, it will reasborb into blood

96
Q

What are the main differences between Pre-renal, Renal and Post-renal Azotemia?

A

Pre-renal: Occurs before the glomerulus, something is effecting the amount of urea made or the delivery to the glomerulus (dehydration is #1 cause)
Renal: Problem with kidney = renal failure.
Post-renal: Obstructs from leaving the body in urine

97
Q

Why is Creatinine better than BUN for assessing renal function?

A

BUN is affected by diet while Creatinine is not

98
Q

SDMA is a new test, why is it beneficial?

A

SDMA levels increase as early as 25% loss of renal function

99
Q

If a patient has chronic renal failure, why would their RBC numbers be low?

A

The kidneys aren’t producing enough erythropoietin to stimulate the production of RBCs

100
Q

What are 4 things that will result in increased Urea (BUN)

A
  1. Dehydration
  2. High protein diets
  3. Cardiac issues
  4. Urinary blockage
101
Q

What is a UPC? What does it do?

A

Urinary Protein:Crearinine ratio. Used to determine whether protein loss in urine is excessive

102
Q

Protein:Creatinine should be no more than:

A

0.6-1.0

103
Q

Increased UPC suggests what?

A

Increased glomerular permeability, the protein is leaking into the urine

104
Q

Why are liver cells quickly damaged by anything in the blood?

A

Hepatocytes are constantly in contact with the blood

105
Q

When hepatocytes produce bile, it goes into the ________ and then is stored until it is needed

A

Bile canaliculi

106
Q

How can hepatocytes cause choleostasis?

A

If the hepatocytes swell, the bile canaliculi become squished and will slow/stop bile

107
Q

Why do animals with decreased liver function often lose weight even if they are eating?

A

Because the liver is not metabolizing carbs, lipids, ammonia and amino acids like it should

108
Q

How do liver screening and liver function tests differ?

A

Liver screening tells us if the liver is working or not. Liver function tests tell us how and how well it is working

109
Q

What elements are produced by the liver? (8)

A
  • Albumin
  • Globulins
  • Cholesterol
  • Coagulation factors
  • Glucose
  • Urea
  • Bilirubin
  • Bile acids
110
Q

What are the 4 main SPECIFIC clinical signs related to liver failure?

A
  1. Icterus (build up of unconjugated bilirubin)
  2. ascites (build up of low protein fluid in abdomen)
  3. palpable change in liver size
  4. CNS signs such as seizures after eating (when Ammonia is high)
111
Q

Liver function tests fall under what 4 categories?

A
  1. Hepatocellular damage
  2. Choleostasis
  3. Cell synthesis
  4. Bilirubin metabolism
112
Q

What is the main cause of increased liver enzymes?

A

Leakage

113
Q

Which 2 enzymes will be elevated with Hepatocellular leakage?

A

ALT and AST

114
Q

What is the difference between measuring ALT and measuring AST for liver screening?

A

AST is found in liver, RBCs, muscles and more. ALT is only found in the liver.

115
Q

Where is ALT found?

A

In hepatocytes

116
Q

What are 4 common causes of changes in AST values?

A

Liver disease, IM injections, strenuous exercise (muscle damage) hemolysis

117
Q

If the ALT is normal and the AST is up, is the problem in the liver?

A

No

118
Q

What are the 3 tests for Choleostasis?

A

ALP (Alkaline Phosphatase), GGT and Bilirubin

119
Q

What are extra-hepatic causes of choleostasis?

A

Enlarged gallbladder or pancreatitis which squishes the bile duct

120
Q

What are 4 causes of increased ALP in dogs?

A
  1. Choleostasis
  2. Corticosteroids
  3. Anticonvulsants
  4. Osteoblast activity
121
Q

What are 4 causes of increased ALP in cats?

A
  1. Fatty liver
  2. Diabetes
  3. Cholangiohepatitis
  4. Hyperthyroid
122
Q

True or false: Any increase in ALP in cats is significant

A

True

123
Q

ALP analyses cannot be done in a ______ top tube

A

lavender

124
Q

What are some examples of hepatic function tests? We discussed 7

A
  • Protein/albumin
  • Cholesterol
  • Bilirubin
  • Serum bile acids
  • Coagulation tests
  • Ammonia
  • Urea
125
Q

______ is the major protein produced by the liver

A

Albumin

126
Q

If albumin is decreased due to lack of production, this means _____% of liver function has been lost

A

70

127
Q

How is a Serum Bile Acids test performed?

A

Patient fasted 12 hours, not even allowed to smell food. Collect fasted sample. Feed 2 tsp (under 10lb) or 2 tbsp (over 10lb_ of high protein/fat food. Collect second sample 2 hrs post-feeding.

128
Q

What is the best way to test bile acids?

A

Urinary (no fasting required)

129
Q

Urine with excess bilirubin will be what colours?

A

Green-yellow/dark yellow/ brown-yellow

130
Q

An _______ is more sensitive to bilirubin than a urinalysis dipstick

A

Ictotest

131
Q

What functions is the Exocrine pancreas responsible for?

A

Production/secretion of digestive enzymes such as Amylase, lipase, trypsin and chymotrypsin

132
Q

What functions is the Endocrine pancreas responsible for?

A

Production and excretion of hormones responsible for controlling blood glucose levels (Insulin)

133
Q

True or false: Best exocrine pancreas screening tests are Amylase and Lipase

A

True

134
Q

Amylase digests _____ and lipase digests ______

A

starches, fats

135
Q

True or false: Amylase and Lipase are not specific or sensitive tests

A

True

136
Q

How do digestive enzymes elevate with pancreatic dysfunction?

A

If the pancreas is damaged the enzymes will leak into the blood stream

137
Q

True or false: Pancreatitis is not actually inflammation but it is acute pancreatic necrosis

A

True

138
Q

Why would a patient with pancreatic problems become diabetic?

A

Because the pancreas can also leak insulin

139
Q

What is the term for elevated Amylase?

A

Hyperamylasemia

140
Q

What 4 causes exist for Hyperamylasemia?

A

Pancreatic injury (dogs), Renal disease, Gastro obstruction or disease, Hepatic disease

141
Q

True or false: The presence of hyperamylasemia and hyperlipasemia does not mean the patient pancreatitis, but it is high on the list of rule-outs

A

True

142
Q

What are the expected clinical chemistry changes with pancreatic damage? (6)

A
  1. Amylase/Lipase
  2. Lipids
  3. Hepatic values
  4. Cholestatic tests
  5. Glucose
  6. Calcium
143
Q

What is the benefit of a PLI test?

A

Detects Lipase only from the pancreas, better to diagnose origin

144
Q

What does TLI mean? What does it do?

A

Trypsin-like immunoreactivity. Detects Trypsin and Trypsinogen

145
Q

What is the advantage of using a TLI?

A

More valuable than Amylase/Lipase in cats as they usually don’t change w/ pancreatitis

146
Q

True or false: TLI will decrease with exocrine pancreatic insufficiency

A

true

CLP 303 (6 decks)

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