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
2
Q
True or false: Morphology must be done in the optimal viewing area
A
True
3
Q
Where on the slide could we double check for large/unusual cells?
A
Feathered edge
4
Q
What 4 features of a WBC need to be assessed each time?
A
Maturation, Size, Cytoplasm and Nucleus
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
6
Q
What 3 toxic changes are often seen together?
A
Cytoplasmic basophilia, cytoplasmic vacuolation and doehle bodies
7
Q
Why do toxic changes occur?
A
Accelerated granulopoiesis
8
Q
What does Toxic Granulation mean?
A
Retention of primary granules, which is very rare
9
Q
How many lobes must a neutrophil have in order to be hyper-segmented?
A
6 or more
10
Q
What is a Pyknotic nucleus?
A
Small, dark and dense
11
Q
What is a Karyorrhectic nucleus?
A
nucleus is pyknotic but fragments, resulting in multiple pyknotic nuclei
12
Q
True or false: Donut neutrophils can be donut bands
A
True
13
Q
What is the term for a WBC eating an RBC?
A
Erythrophagocytosis
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
15
Q
Most toxic changes occur where in the cell?
A
Cytoplasm
16
Q
Giant neutrophils are more than _____um
A
16
17
Q
How does a Giant neutrophil develop?
A
The nucleus matures without the cell dividing normally - cytoplasm is less mature
18
Q
Giant neutrophils are common in ______ (species)
A
cats
19
Q
What causes Cytoplasmic Basophilia?
A
Retained RNA due to either short maturation or something is interfering with maturation
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
21
Q
What is nuclear asynchrony?
A
Not everything in the cell is maturing at the same time
22
Q
Doehle bodies are reminants of ______ and are common in cats
A
RNA
23
Q
Toxic granulation is very uncommon and is seen mostly in ______ (species)
A
horse
24
Q
What causes hypersegmentation?
A
An over-matured neutrophil that has been in circulation for longer than usual.
25
True or false: Technically, hypersegmentation is not a toxic change but is mostly caused by corticosteroids.
True
26
The presence of ______ is called a right shift
Hypersegmented neutrophils
27
Pelger-Huet Anomalies can be found in what types of WBCs?
Neutrophils, Eosinophils and Basophils
28
True or false: When Pelger-Huet Anomalies are present, only about half of the Granulocyte population will be affected
False. You will not find any normal granulocytes, all are affected
29
What is a Barr Body and how does it occur?
Small, drumstick-like nuclear appendage as a result of an extra X chromosome
30
Barr Bodies only occur in what gender?
Females or hermaphrodites
31
Describe the similarities and differences between Pyknotic cells and Karyorrhectic cells
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
32
What does a Bilobed neutrophil indicate?
There was once a left shift, as bilobed neutrophils began as myelocytes in circulation
33
True or false: Bilobed neutrophils can function normally and are not toxic unless other toxic changes are involved
True
34
Out of all of the neutrophil changes discussed, which ones are considered toxic?
- Doehle bodies
- Cytoplasmic basophilia/vacuolation
- Donut nuclei
- Giant neutrophils
- Toxic granulation
35
What are the 8 lymphocyte changes we discussed?
- Small
- Medium
- Large
- Reactive
- Granular
- Lymphoblast
- Atypical
- Plasma
36
True or false: When assessing the size of a lymphocyte, you assess the entire cell's size
False. The "size" is based on the size of the nuclei.
37
Small lymphocytes have a nucleis the size of ____ rbc(s)
1
38
True or false: Reactive lymphocytes have to be small lymphocytes.
False. They have to be large lymphocytes
39
Reactive lymphocytes will often have a _______ and will NOT have _______
Perinuclear clear zone, Nucleoli
40
Granular lymphocytes have a collection of large ________ granules
Azurophilic (primary)
41
Granular lymphocytes often indicate ______ but can also be seen in neoplastic cells
Inflammation
42
Lymphoblasts always have one or more _______ and are usually large lymphocytes
Nucleoli
43
A lymphocyte with a nucleus that has deep clefts or multiple infoldings is called a ______
Atypical lymphocyte
44
If a lymphocyte looks odd but you can't classify it, call it ______
Atypical
45
Lymphoblasts have _____ chromatin
Stippled
46
What is Chediak-Higashi Syndrome?
An inherited syndrome in cattle and persian cats that results in decreased phagocytosis and therefore recurrent infections
47
What is the key characteristic of Chediak-Higashi Syndrome?
Huge, pink-purple granules
48
A lymphocyte described as round to oval with an oval nucleus and abundant, deep purple granules is called a ________
Mast cell
49
Mast Cells are often seen in the feathered edge and on a ________ smear
Buffy coat
50
Mast cells can be caused by inflammatory disease or _____
mastocytosis
51
What is leukoagglutination and what is it most often caused by?
Clumping of WBCs in peripheral blood and it is often an artficact due to prolonged storage or EDTA
52
What does a Canine Distemper Inclusion look like?
A round, pale basophilic or magenta intracytoplasmic inclusion in WBCs and RBCs
53
What 3 organism species can affect WBCs?
Ehrlichia, Hemogregarines, Leukocytozoon
54
What are 6 ways to detect blood-borne organisms?
- blood smear
- buffy coat smear
- modified knott's test
- filter test
- serology (snap test)
- DNA testing (PCR)
55
What is the benefit to using a Modified Knott's test over a Filter test to identify Dirofilaria immitis?
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
56
Mycoplasma haemofelis is the cause of ________ in cats
Feline infectious anemia
57
Mycoplasma haemofelis lives ______ (relative to the cell) and has coccoid, rod or ring forms
Epicellular - on the outer surface
58
Mycoplasma haemofelis will ______ when exposed to EDTA, if sample gets cold, or if it has sat for longer than 15 mins
detach
59
The number one cause of anemia in young cats is:
Mycoplasma haemofelis
60
How can you tell the difference between Mycoplasma haemofelis and an artifact?
If the patient is not anemic, it is probably an artifact
61
It is important to differentiate Mycoplasma haemofelis from what 4 things?
- stain debris
- refractile artifacts
- poorly stained howell-jolly bodies
- basophilic stippling
62
It is easiest to look for the ______ shaped form of Mycoplasma haemofelis
Ring
63
What are 4 clinical signs/developments from Mycoplasma haemofelis?
- Regenerative anemia
- icterus
- splenomegaly
- intermittent fever
64
Mycoplasma haemofelis can be treated with what 3 elements?
- Tetracyclines
- Prednisone (maybe)
- Transfusion if PCV is critically low
65
True or false: Ehrlichia is an intracellular parasite of monocytes, neutrophils and lymphocytes
True
66
How is Ehrlichia transmitted
Ticks
67
Ehrlichia results in pancytopenia. What does this mean?
Decrease in ALL blood cells
68
Ehrlichia forms _____ in the cytoplasm
morulae
69
Babesia is a protozoan infection which affects only _______ blood cells
RBC's
70
How does Babesia cause anemia?
It continuously reproduces until the RBC bursts
71
What does Babesia look like? What is the best stain to use?
Pear or rod shaped, like a crystal. New methylene blue.
72
How is Babesia transmitted?
Ticks
73
Does Babesia cause intravascular hemolysis or extravascular hemolysis?
Intravascular
74
A long, snake-like membrane that is more common in wildlife is a parasite called:
Trypanasome
75
Anaplasmosis affects _____ only
Ruminants
76
Anaplasmosis can cause the PCV to drop ____%
50-80
77
Anaplasmosis causes severe ______
IMHA
78
Anaplasma platys leaves inclusions in the ______ and causes cyclic thrombocytopenia
thrombocytes
79
What are the 5 main functions of kidneys?
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
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 _______
dilute, concentrated
81
Where does urine concentration occur?
Renal tubules
82
In order to perform its main jobs, the kidneys must have what 2 structural characteristics?
- Normal glomerular filtration
| - Normal renal tubular integrity
83
Define renal disease
Morphologic or functional lesions
84
Define renal insufficiency
Diminished renal function with NO azotemia
85
Define renal failure
Derangements in fluid and electrolyte balance and azotemia due to decreased renal function
86
Define polyuria
Increased volume of urine
87
Define pollakiuria
Small, frequent amounts of urine
88
Define oliguria
Decreased volume of urine
89
Define anuria
Not urinating
90
Define stranguria
Difficulty urinating
91
What are the 6 rule-outs for a patient presenting with PU/PD?
1. Kidney disease
2. Liver disease
3. Diabetes
4. Hyperthyroidism (cats only)
5. Cushing's disease
6. Pyometra
92
Define azotemia
Increased BUN and/or Creatinine levels in the blood
93
Define Uremia
Azotemia with clinical signs of renal failure
94
What are 4 things that can cause decreased glomerular filtration rate?
Dehydration, cardiac disease, shock and renal disease
95
Describe the process of having a build up of Urea (BUN) in the blood
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
What are the main differences between Pre-renal, Renal and Post-renal Azotemia?
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
Why is Creatinine better than BUN for assessing renal function?
BUN is affected by diet while Creatinine is not
98
SDMA is a new test, why is it beneficial?
SDMA levels increase as early as 25% loss of renal function
99
If a patient has chronic renal failure, why would their RBC numbers be low?
The kidneys aren't producing enough erythropoietin to stimulate the production of RBCs
100
What are 4 things that will result in increased Urea (BUN)
1. Dehydration
2. High protein diets
3. Cardiac issues
4. Urinary blockage
101
What is a UPC? What does it do?
Urinary Protein:Crearinine ratio. Used to determine whether protein loss in urine is excessive
102
Protein:Creatinine should be no more than:
0.6-1.0
103
Increased UPC suggests what?
Increased glomerular permeability, the protein is leaking into the urine
104
Why are liver cells quickly damaged by anything in the blood?
Hepatocytes are constantly in contact with the blood
105
When hepatocytes produce bile, it goes into the ________ and then is stored until it is needed
Bile canaliculi
106
How can hepatocytes cause choleostasis?
If the hepatocytes swell, the bile canaliculi become squished and will slow/stop bile
107
Why do animals with decreased liver function often lose weight even if they are eating?
Because the liver is not metabolizing carbs, lipids, ammonia and amino acids like it should
108
How do liver screening and liver function tests differ?
Liver screening tells us if the liver is working or not. Liver function tests tell us how and how well it is working
109
What elements are produced by the liver? (8)
- Albumin
- Globulins
- Cholesterol
- Coagulation factors
- Glucose
- Urea
- Bilirubin
- Bile acids
110
What are the 4 main SPECIFIC clinical signs related to liver failure?
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
Liver function tests fall under what 4 categories?
1. Hepatocellular damage
2. Choleostasis
3. Cell synthesis
4. Bilirubin metabolism
112
What is the main cause of increased liver enzymes?
Leakage
113
Which 2 enzymes will be elevated with Hepatocellular leakage?
ALT and AST
114
What is the difference between measuring ALT and measuring AST for liver screening?
AST is found in liver, RBCs, muscles and more. ALT is only found in the liver.
115
Where is ALT found?
In hepatocytes
116
What are 4 common causes of changes in AST values?
Liver disease, IM injections, strenuous exercise (muscle damage) hemolysis
117
If the ALT is normal and the AST is up, is the problem in the liver?
No
118
What are the 3 tests for Choleostasis?
ALP (Alkaline Phosphatase), GGT and Bilirubin
119
What are extra-hepatic causes of choleostasis?
Enlarged gallbladder or pancreatitis which squishes the bile duct
120
What are 4 causes of increased ALP in dogs?
1. Choleostasis
2. Corticosteroids
3. Anticonvulsants
4. Osteoblast activity
121
What are 4 causes of increased ALP in cats?
1. Fatty liver
2. Diabetes
3. Cholangiohepatitis
4. Hyperthyroid
122
True or false: Any increase in ALP in cats is significant
True
123
ALP analyses cannot be done in a ______ top tube
lavender
124
What are some examples of hepatic function tests? We discussed 7
- Protein/albumin
- Cholesterol
- Bilirubin
- Serum bile acids
- Coagulation tests
- Ammonia
- Urea
125
______ is the major protein produced by the liver
Albumin
126
If albumin is decreased due to lack of production, this means _____% of liver function has been lost
70
127
How is a Serum Bile Acids test performed?
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
What is the best way to test bile acids?
Urinary (no fasting required)
129
Urine with excess bilirubin will be what colours?
Green-yellow/dark yellow/ brown-yellow
130
An _______ is more sensitive to bilirubin than a urinalysis dipstick
Ictotest
131
What functions is the Exocrine pancreas responsible for?
Production/secretion of digestive enzymes such as Amylase, lipase, trypsin and chymotrypsin
132
What functions is the Endocrine pancreas responsible for?
Production and excretion of hormones responsible for controlling blood glucose levels (Insulin)
133
True or false: Best exocrine pancreas screening tests are Amylase and Lipase
True
134
Amylase digests _____ and lipase digests ______
starches, fats
135
True or false: Amylase and Lipase are not specific or sensitive tests
True
136
How do digestive enzymes elevate with pancreatic dysfunction?
If the pancreas is damaged the enzymes will leak into the blood stream
137
True or false: Pancreatitis is not actually inflammation but it is acute pancreatic necrosis
True
138
Why would a patient with pancreatic problems become diabetic?
Because the pancreas can also leak insulin
139
What is the term for elevated Amylase?
Hyperamylasemia
140
What 4 causes exist for Hyperamylasemia?
Pancreatic injury (dogs), Renal disease, Gastro obstruction or disease, Hepatic disease
141
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
True
142
What are the expected clinical chemistry changes with pancreatic damage? (6)
1. Amylase/Lipase
2. Lipids
3. Hepatic values
4. Cholestatic tests
5. Glucose
6. Calcium
143
What is the benefit of a PLI test?
Detects Lipase only from the pancreas, better to diagnose origin
144
What does TLI mean? What does it do?
Trypsin-like immunoreactivity. Detects Trypsin and Trypsinogen
145
What is the advantage of using a TLI?
More valuable than Amylase/Lipase in cats as they usually don't change w/ pancreatitis
146
True or false: TLI will decrease with exocrine pancreatic insufficiency
true
