Haematology and Biochem

Question 1

albumins and globulins

Answer 1

albumin = most abundant, driver of oncotic pressure
- produced at constant rate by liver
- carries ion molecules

globulins = larger molecules, inflammatory cytokines and immunoglobulins
- produced by liver - acute phase proteins (inflammation) and coagulation proteins
- lymphocytes - immunoglobulins

Question 2

hyperproteinemia

Answer 2

high albumin - dehydration
high globulin - dehydration, inflammation, neoplasia

Question 3

hypoproteinemia

Answer 3

hypoalbuminemia -
reduce production - liver disease or inflammation
increased losses - renal disease (protein losing nephropathy, movement from blood into body cavity effusion

hypoglobulinemia -
rare
dehydration masking concurrent hypoalbuminemia
if actual hypoglobulinemia - immunodeficiency

panhypoproteinemia -
protein losing enteropathy - lymphoma, IBD, lymphangiectasia
protein losing dermatopathy - severe burns

Question 4

liver markers - enzymes

Answer 4

Hepatocellular -
SDH - liver only - large animal
ALT - liver and muscle but mostly liver - not in large animal
GLDH - liver - more stable than SDH

Hepatobilliary -
ALP - biliary, bone, intestine, steroid - steroid only present in dogs
GGT - biliary only - small increases significant

Question 5

liver markers - other

Answer 5

bile acids - specific to liver disease
bilirubin
cholesterol
albumin
glucose
coagulation factors

Question 6

bile acid stimulation

Answer 6

produced by hepatocytes then degraded in gut and reuptaken to liver for processing

tests ability of liver to reuptake - good test of liver function

increase –> reduced liver function, portosystemic shunt, cholestasis

Question 7

bilirubin

Answer 7

increased -
pre hepatic causes - excessive haem breakdown - haemolysis, fasting - unconjugate increased

hepatic causes - reduced ability to conjugate - toxic insult, lepto - conjugated and unconjugated both increased

post hepatic - gallstones, mucocoele, pancreatitis in cats - unconjugated increases first then both

Question 8

cholesterol

Answer 8

produced by liver but also uptake from food and release from fat

increased -
cholestasis - increased bilirubin, GGT, ALT
starvation/anorexia - also increased triglycerides
recent meal - also increased triglycerides
neprhotic syndrome

decreased -
reduced intestinal absorption - GI disease, hypoadrenocorticism

Question 9

hypoglycemia

Answer 9

diabetic ketoacidosis
starvation
insulinoma
artefact - wrong blood tube - should use fluoride oxalate

Question 10

coagulation factors

Answer 10

synthesised by liver - liver failure –> increased coagulation times

Question 11

muscular enzymes

Answer 11

creatinine kinase - muscle only - short half life
AST - muscle and liver - long half life
ALT - muscle and liver - more specific to liver

Question 12

pancreatic markers

Answer 12

pancreatic lipase -
increased in pancreatitis and when GFR is reduced

amylase -
pancreatitis or reduced GFR

tli -
decreased in exocrine pancreatic insufficiency or up with pancreatitis or incomplete starvation

Question 13

renal physiology

Answer 13

glomerulus - electrolytes out of blood, proteins stay in blood, RAAS

proximal tubule - resorption of electrolytes, vitamin D activation

loop of henle -
ascending - water absorption
descending - NaCl absorption
created medullary gradient to concentrate urine

distal tubule and collecting duct -
small amounts of electrolytes absorbed
reabsorbs water to concentrate urine

Question 14

glomerular filtration rate

Answer 14

speed at which fluid is filtered out of blood into bowmans capsule

controlled by -
hydrostatic pressure - rate at which blood moves in and out of the glomerular capillaries and rate filtered fluid moves through renal tubules
oncotic pressure - amount of albumin in peripheral blood

hydrostatic changes -
increased inflow - high CO, high blood pressure
decreased inflow - low CO, water loss
increased flow through tubules - excretion of osmoactive substances (glucose, mannotol), diurectics, loss of medullt tonicity (psyhod=genic polydipsia, diabetes insipidus, liver failure)
decreased flow through tubules - injury to glomerulus, injury to tubules, urolithiasis

oncotic changes -
hypoalbuminemia - loss or decreased production
hyperalbuminemia - dehydration

Question 15

renal biomarkers

Answer 15

urea -
produced by liver in protein metabolism and excreted by kidneys
concentration dependant on production (liver failure, high protein diet, increased with GI bleeding) and rate of excretion (renal damage)

creatinine -
released by muscles at constant rate and excreted by kidneys
concentration dependant on production (mucle mass or wasting) and rate of excretion (Renal damage)

Question 16

azotemia

Answer 16

increase in creatinine, urea and SDMA

pre-renal - problem with renal blood supply or increased urea production in liver

renal - problem with kidney itself

post-renal - obstruction of urine outflow

evaluation -
USG - low likely renal, high assess bladder size, CRT and dehydration
enlarged bladder and history of anuria - post renal
dehydration and normal CRT - pre renal

Question 17

uremia

Answer 17

clinical signs associated with azotemia -
lethargy/depression
mucosal ulceration
vomiting/diarrhoea
respiratory signs - uremic pneumonitis, metastatic calcification
hypertension
hypokalemia myopathy - plantigrade stance (Cats)
hyperkalemia bradycardia - AKI and urinary obstruction
non-regenerative anemia

Question 18

differences between AKI and CKD - electrolytes

Answer 18

Sodium - drops in both

chloride - follows sodium - if increasing independently then Fanconi’s syndrome

potassium -
increased in AKI
increased in CKD in dogs and horses, decreased in cats

calcium -
increased in AKI
increased then drops in CKD
drops in urinary obstruction

prosphate - increases in both

magnesium - increases in both

Question 19

alabama rot

Answer 19

cutaneous and renal glomerular vasculopathy (CRGV)
skin lesions
acute renal failure

Question 20

differences between AKI and CKD - signs

Answer 20

collapse - more acute
alabama rot - acute
non regenerative anemia - chronic
weight loss - chronic
severity of azotemia - more severe in acute

PUPD
anuria

Question 21

sodium

Answer 21

most abundant electrolyte
maintains osmotic pressure

increase -
diabetes insipidus - free water loss
water deprivation
salt poisoning
ayperaldosteronism

decrease -
loss from GIT - diarrhoea vomiting
kidney failure - diabetes mellitus, medullary washout
addisons
cavity effusion
perspiration - horses

Question 22

chloride

Answer 22

second most abundant
usually moves with sodium

greater chloride loss than sodium -
vomiting
pyloric outflow obstruction - GDV, LDA, foreign body

greater sodium loss -
proximal small intestinal diarrhoea - pancreatitis
renal tubular injury - fanconi’s
cushings

can use corrected chloride to work out if moving in same direction

Question 23

potassium

Answer 23

regulates pH and cell electrochemical gradient - exchanged for H+ when blood pH altered

increases -
acidosis
reduced renal excretion - CKD, AKI, urinary obstruction, addisons
artefact - hemolysis, delayed serum separation

decreases -
alkalosis
decreased intake - anorexia in horses
perspiration - horses

Question 24

metabolic and respiratory acidosis

Answer 24

metabolic - acids or bases building up in tissues
respiratory - affected by ability to exhale CO2

Question 25

causes of metabolic acidosis

Answer 25

loss of sodium in excess of chloride - loss of sodium in bicarbm hydrochloric acid left behind - small intestinal diarrhoea, renal tubular injury (fanconis) retained acids - ketones (diabetes), lactate (injured or hypoxic tissues), uremic acids (renal injury)

Question 26

causes of metabolic alkalosis

Answer 26

loss of acid - loss of HCl through vomiting, GDV, LDA, gastric foreign body, gastrointestinal stasis

Question 27

causes of respiratory acidosis

Answer 27

inadequate exhilation of CO2 - build up causes acidosis respiratory tract obstruction pulmonary fibrosis pulmonary thromboembolism pulmonary neoplasia pneumonia

Question 28

causes of respiratory alkalosis

Answer 28

when CO2 exhaled excessively tachypnoea

Question 29

mixed acid base disorders

Answer 29

more than one acid base disorder occurring at the same time renal failure with vomiting - renal failure --> metabolic acidosis vomiting --> metabolic alkalsosis diabetic ketoacidosis with pancreatitis septic abdomen (lactic acidosis) and hyperventilation vomiting causing aspiration pneumonia

Question 30

aberrations in calcium

Answer 30

balanced with phosphorus by PTH and vitamin D excreted by kidneys and absorbed by kidneys total calcium - bound to uremic acids and albumin so fluctuate with variations in these free calcium - unbound, tightly controlled by PTH, vitamin D and calcitonin hypercalcemia - hyperparathyroidism - decreased excretion and increased bone resorption addisons - decreased excretion renal disease - decreased excretion D-hypervitaminosis - psoriasis cream or rodenticide poisoning idiopathic - cats osteolytic - osteosarcoma neoplastic - PTH related peptide secreated by tumours (anal sac carcinoma) error, artefact hypocalcemia - nutrition - insufficient calcium or magnesium, or too much phosphorus renal - insufficient vitamin D production, reduced reabsorption, urinary tract obstruction pregnancy/lactation pancreatic exocrine insufficiency or acute pancreatitis tissue injury - necrosis, rhabdo rumen overload

Question 31

aberrations in phosphorus

Answer 31

increases - decreased excretion - renal injury release from injured cells - necrosis (tumours), rhabdo, excessive vitamin D decreases - increased excretion - hyperparathyroidism, fanconis, renal failure in horses reduced intake hypovitaminosis D

Question 32

aberrations in magnesium

Answer 32

rarely measured increases - renal disease - reduced excretion decreases - dietary - staggers

Question 33

precision and accuracy

Answer 33

accuracy = ability to get close to the right answers precision = ability to give a repeatable result

Question 34

grey zones

Answer 34

middle area where difficult to diagnose seasonal or diurnal variation - ACTH peaks naturally in autumn so use different ranges for PPID in Autumn breed and age variation generic intervals used for exotics so less accurate

Question 35

sensitivity and specificity

Answer 35

sensitivity = ability to accurately detect a sick patient specificity = ability to accurately detect healthy patents

Question 36

further tests

Answer 36

azotemia on biochem - urinalysis severe liver enzyme elevations - bile acid stim hyperkalemia and hyonatremia - basal cortisol

Question 37

considerations in discordant results

Answer 37

calibration grey zones decision threshold reliability hemolysed/lipemic/icteric samples sample taking and handling sensitivity or specificity of test artefacts individual variation concurrent disease history omissions

Question 38

venepuncture sites - exotic mammals

Answer 38

cranial vena cava - GA, blind technique jugular cephalic lateral saphenous - esp rabbits lateral and dorsal tail veins - rats and mice marginal ear vein - rabbits, small volumes

Question 39

venepuncture sites - birds

Answer 39

wing/ulnar vein - fragile, prone to haemorrhage medial tarsal vein - most species, harder in raptors, corvids, small passerines right jugular - not in pigeons, waterfowl, gulls

Question 40

venepuncture sites - chelonians

Answer 40

jugular - best subcarapacial sinus - blind, large samples dorsal tail - smaller samples brachial plexus - large tortoises

Question 41

venepuncture sites - squamates

Answer 41

ventral tail - care if autotomises, avoid hemipenes

Question 42

venepuncture sites - reptiles

Answer 42

cardiocentesis - direct from ventricle, find heart with doppler

Question 43

biochemistry - exotics total protein

Answer 43

total protein - increased - inflammation, vitellogenesis, lipemia decreased - malnutrition, parasites, liver, kidnets, enteropathy, skin losses, lymph dilution

Question 44

biochemistry - exotics

Answer 44

total protein - increased - inflammation, vitellogenesis, lipemia decreased - malnutrition, parasites, liver, kidnets, enteropathy, skin losses, lymph dilution ALT - not useful, not released in liver damage ALP - bone damage only AST - liver and muscle damage, assessed with ck CK - bird - tissue/muscle damage reptile - muscle damage mammal - any muscle disease process NB increases associated with traumatic venepucture GLDH - bird - hepatocellular damage reptile - hepatocellular damage GGT - cholestasis bile acids - mammal - hepatic coccidiosis bird - liver insufficiency (decreased in microhepatica) reptile - varying usefullness bile pigments - birds - somtimes bilirubin - liver disease reptiles - biliverdin - liver disease glucose - mammals - stress, pain, food, GI obstruction, GI stasis. decreased with insulinomas, septicemia, severe liver disease, starvation reptile - vary by species lactate - increased - shock, low CO, liver failure, sepsis, seizures birds - capture myopathy reptile - anaerobic metabolism uric acid - renal insufficieny bird - main renal indicator, postpranddial, egg production, gout. decreased in liver disease and starvation reptile - renal indicator urea - mammal - main renal marker creatinine - consistently low in birds and reptiles calcium - huge increase in egg laying females mammal - neoplasia, renal failure, impaired excretion, dietary

Question 45

exotics biochem species differences

Answer 45

birds - uric acid for renal low protein normal stable glucose calcium affected by egg laying reptile - lymph dilution common - reduces everything effects of sex and season AST - muscle, with CK GGT for renal GDH for heptocellular necrosis biliverdin uric acid for renal - fasted samples in carnivores calcium - egg laying species

Question 46

metabolic bone disease

Answer 46

hypocalcemia - calcium leached from bones collapse seizures tremors

Question 47

egg laying biochem

Answer 47

increased total protein, globulin, uric acid, ALP, total calcium - constituents of egg and shell check ionised calcium

Question 48

haematopoiesis

Answer 48

formation of all cellular components of blood in bone marrow some in liver and spleen - extramedullary

Question 49

erythropoiesis

Answer 49

kidney cells detect tissue hypoxia --> erythropoeitin --> signalling cascade --> progenitors differentiate to erythrocytes

Question 50

myelopoiesis

Answer 50

white blood cells stimulated by IL3, GM-CSF, G-CSF unregulated production in response to inflammation

Question 51

thrombopoiesis

Answer 51

plasma thrombopoietin produced by liver (stimulates production)

Question 52

neutrophils

Answer 52

first response phagocytosis degranulation extracellular traps

Question 53

eosinophils

Answer 53

parasites allergic responses

Question 54

basophils

Answer 54

parasites allergic response histamine release

Question 55

lymphocytes

Answer 55

t cells - immune medaited immunity b cells - humoral - antibody production NK cells - innate - phagocytosis

Question 56

monocytes

Answer 56

macrophages in tissue immune response regulation phagocytosis microbicidal

Question 57

spherocytes

Answer 57

dogs small, round erythrocytes dense staining

Question 58

agglutination

Answer 58

grapes

Question 59

rouleux

Answer 59

stack of coins

Question 60

hypochromia

Answer 60

iron deficiency erythrocytes increased central palor

Question 61

band neutrophils

Answer 61

released from bone marrow early increased demand

Question 62

toxic change neutrophils

Answer 62

released too early from bone marrow

Question 63

howell jolly body

Answer 63

remnants of RBC nuclei - usually removed by spleen splenic dysfunction

Question 64

heinz bodies and eccentrocytes

Answer 64

oxidative damage - hemoglobin oxidised and pushed to cell margin paracetamol in cats some other toxins diabetic ketoacidosis

Question 65

regenerative vs non-regenerative anemia

Answer 65

regenerative - bone marrow responding - reticulocytes (polychromatiphils, uneven sized RBCs (ansiocytosis), nucleated RBCs, howell jolly bodies ^ short ddx list non-regenerative - long ddx list

Question 66

schistocytes

Answer 66

red cell fragments - cells squeezed through abnormal vessels (haemoangiosarcoma) or fragile (iron deficiency)

Question 67

PCR with anemia

Answer 67

hemotropic mycoplasmas in cats babesia in dogs ehrlichia and anaplasma in dogs FIV/FeLV

Question 68

serology with anemia

Answer 68

lepto panleukopenia parvo Equine infectious anemia FeCOV

Question 69

slide agglutination

Answer 69

IMHA

Question 70

coombs test

Answer 70

IMHA

Question 71

fecal occult blood with anemia

Answer 71

can test even if not grossly visible blood loss in GIT

Question 72

Anemia - biochem

Answer 72

reduced red cell mas reduced hemoglobin reduced PCV reduced red blood cell count

Question 73

anemia - pathophysiology and compensatory mechanisms

Answer 73

reduced oxygenation of tissues compensation - increased oxygen delivery increased CO increased RBC production vasoconstriction to shunt blood away from tissue with lower O2 demand

Question 74

anemia - signs

Answer 74

pale mm lethargy exercise intolerance tachypnoea tachycardia collapse icterus melaena - black, tarry stool pica

Question 75

anemia - classification

Answer 75

severity based on MCV values - low in iron deficiency, high if presence of immature RBCs non-regenerative vs regenerative

Question 76

regenerative anemia

Answer 76

haemorrhage, hemolysis 3-5 days for marrow to respond - pre-regenerative prolonged regenerative --> iron deficiency --> non-regenerative no iron defiency seen in severe paracitism hemolysis - extravascular - more common intravascular - acute and severe - hemoglobulinuria, haemoglobulinemia primary - IMHA - immune mediated - common - breed disposition, more in males secondary - secondary to infections (babesia, mycoplasma), neoplasia, drugs tocins - oxidation of hemoglobin - heinz bodies

Question 77

IMHA signs

Answer 77

lethargy anorexia pale mm bounding pulses murmur tachypnoea jaundice hepatosplenomegaly pyrexia diagnoses - hematology, agglutination, coombs test

Question 78

non-regenerative anemia

Answer 78

chronic inflammation most common endocrine - hypothyroidism, addisons renal - chronic failure - decreased erythropoietin, and decreased RBC lifespan due to uremic toxins primary bone marrow disorders - aplastic anemia pure red cell aplasia myelophthisis myelobirosis

Question 79

erythrocytosis

Answer 79

increased red cell mass - increased hemoglobin, PCV, hemocrit, red blood cell count dehydration - increased serum proteins, increased USG Primary erythrocytosis - bone marrow neoplasia failure in RBC feedback mechanisms low erythropoietin signs - neurological, cardiopulmonary, retinal changes secondary erythrocytosis - hypoxia solid tumours renal carcinoma

Question 80

neutrophilia

Answer 80

to meet demand - infection, immune mediated disease, inflammation, neoplasia independent of demand - leukemia persistence in circulation - chronic stress, steroids redistribution - shift from marginating to circulating pool - excitement, stress, increased blood pressure

Question 81

signs of toxicity in cells

Answer 81

dohle bodies - blue cytoplasmic inclusions foamy cytoplasm blueish cytoplasm toxic granules

Question 82

lyphocytosis

Answer 82

increased to meet demand - persistent antigenic stimulation without demand - lymphoid leukemia, lymphoma redistribution - excitement/acute stress, addisons

Question 83

monocytosis

Answer 83

to meet demand - infections, immune mediated disease, inflammation, necrosis, sepsis, neoplasia without demand - leukemia redistribution - chronic stress, steroids

Question 84

eosinophilia

Answer 84

to meet demand - allergic reaction, parasites, inflammation of mast cell rich tissue without demand - neoplasia (lymphoma, mast cell tumour, squamous cell carcinoma), hypereosinophilic syndrome, eosinophilic leukemia

Question 85

basophilia

Answer 85

to meet demand - hypersensitivities, parasitism, inflammation without demand - paraneoplastic syndromes (mast cell), basophilic leukemia

Question 86

neutropenia

Answer 86

increased demand - migration into tissue - bacterial sepsis, abscess, endotoxemia, tumour, necrosis redistribution - acute endotoxemia decreased production - bone marrow disease, drugs increased destruction - immune mediated

Question 87

leukopenia

Answer 87

loss of lymphocytes - loss of chylous fluid (lymph), protein losing enteropathy, chylothorax decreased production - viral infections, lympholytic drugs redistribution - chronic stress, steroids

Question 88

stress leukogram

Answer 88

leukocyte pattern due to increased cortisol neutrophilia, lymphopenia, eosinophilia reverse in addisons

Question 89

red cell morphology by species

Answer 89

dog - most obvious central pallor alpaca - oval, no nucleus birds and reptiles - nucleated red blood cells

Question 90

variation in regenerative response by species

Answer 90

horses - no polychromatophils, can't use this to assess regeneration

Question 91

variation in leukocyte response by species

Answer 91

cats - more extreme response to epinephrine dog - complete stress glucocorticoid response most common cattle - neutropenia common

Question 92

feline haemotrophic mycoplasma

Answer 92

haemoparasite feline infectious anemia - acute hemolytic anemia transmission in blood male cats with outdoor access species - m. hemofelis - most pathogenic - mild to severe disease in healthy cats candidatus m. haemomimutum - milder unless immunosuppressed candidatus m. turicensis - unlikely to cause clinical anemia unless concurrent disease one or combination PCR carrier signs - related to anemia weakness lethargy pale mm intermittent fever tachycardia tacypnea haemic murmur depression collapse regenerative or pre-regenerative non-regenerative in immune compromised patients diagnosis - coombs and agglutination rods, cocci or rings on surfaces of RBCs cant be cultures

Question 93

babesia canis

Answer 93

hemoparasite tick bourne sporozoites invade RBCs --> differentiate and divide --> rupture RBCs --> invade neighbouring RBCs hemolytic anemia regnerative can be associated with development of autoantibodies mild to moderate disease carrier signs - fever lethargy anorexia jaundice vomiting mild to severe diagnosis - hemolysed serum, spherocytes, positive coombs test, thrombocytopenia, neutropenia blood smear - large paired piriform organisms inside RBCs PCR - protozal DNA serology

Question 94

heaptozoonosis

Answer 94

hemoparasite tick borne - eaten and sporozoites penetrate intestinal epithelium --> spread to lymphatics --> monozoites infect neutrophils signs - related to severity of parasite burden low burdens may be asymptomatic risk of secondary infection - infected neutrophils non-specific signs hypoglobulinemia, hypoalbuminemia non-regenerative anemia neutrophilia diagnosis - blood smear PCR

Question 95

heartworm

Answer 95

hemoparasites mosquito vector dog definitive host nematode - dirofilaria immitis 3 stages - microfilaria - in blood larvae - in mosquito and tissue adult - pulmonary artery or right atrium in heavy burdens signs - mild - asymptomatic or cough moderate - cough, exercise intolerance, abnormal lungs sounds severe - above + dyspnoea, abnormal heart sounds, syncope, ascities, death caval syndrome - sudden onset, severe lethargy and weakness, hemoglobinuria and haemoglobinemia diagnosis - antigen detection, modified knotts NB cats - can get it but not definitive host - less signs and testing not reliable, use radiography and echo

Question 96

bovine babesiosis

Answer 96

hemoparasite babesia divergens red water fever merozoites invade RBCs --> burst --> intravascular hemolytic anemia mild to severe disease signs - related to severity of hemolysis fever depression icterus anorexia tachycardia/tachypnoea pale mm haemoglobinuria abortion milk drop diagnosis - PCR, blood smear evaulation - pear shaped structures in cytoplasm

Question 97

bovine anaplasmosis

Answer 97

hemoparasite tick borne a. phagocytophilium obligate intracellular bacteria - neutrophils disease via immunosuppresion persistent carrier status - up to 2 years diagnosis - blood smear - mulberry looking colonies of coccobacilliary bacteria PCR serology - not widely used

Question 98

equine piriplasmosis

Answer 98

hemoparasite tick borne babesia equi (theileria equi) or babesia caballi replicates in RBCs --> burst --> merozoites released into bloodstream --> infect more RBCs signs - acute - hemolytic anemia, icterus, hemoglobinuria, thrombocytopenia, fever, inappetence usually mild and non specific - indistinguishable from chronic inflammatory disorder

Question 99

candidatus mycoplasma hemolamae

Answer 99

camelid hemoparasite regenerative anemia associated with chronic disease combined with hemonchus cause more anemia blue dots on RBCs PCR

Question 100

hemonchus contortus

Answer 100

camelid GIT parasite most common camelid source of anemia higher in gut --> more severe combined with haemolamae cause more anemia

Question 101

benefits of cytology

Answer 101

no anaesthetic low risk complications quick non-invasive rapid results tumour grading surgical planning tumour staging fluid classification identifying infections used for anciliary tests - PARR, flow cytometry, PCR

Question 102

greasy slide ddx

Answer 102

lipoma steatititis/panniculitis pernodal fat mast cell tumour liposarcoma other soft tissue sarcoma

Question 103

cytology stains

Answer 103

in house - diff-quik, MGG lab - modified wrights

Question 104

hemodilution

Answer 104

too many erythrocytes or platelets on a slide, obscured rest of sample

Question 105

identifying inflammation on cytological specimen

Answer 105

white blood cells - neutrophils - well preserved or degenerate (pale blue swollen nucleus) - microorganisms and necrosis macrophages - activated (vacuolated and foamy) - phagocytosis and cell debris acute/suppurative - neutrophils chronic active/pyogrnulomatous - neutrophils and macrophages chronic/granulomatous - macrophages specific - eg eosinophils concurrent tissue reaction - hyperplasia/dysplasia

Question 106

hyperplasia

Answer 106

increased in number of cells in a tissue non-neoplasic often hormonal influence cytology (FNA) - high cellularity may have mild criteria of malignancy mildly increased N:C more prominent nucleoli finer chromatin

Question 107

dysplasia

Answer 107

disordered growth common in epithelial tissue secondary to inflammation loss of uniformity disordered architecture FNA - Nuclear to cytoplasmic asynchrony cytoplasmic basophilia anisokaryosis and ansiocytosis (uneven cell size and nuclear size) difficult to distinguish from neoplasia

Question 108

neoplasia

Answer 108

abnormal and excessive tissue growth growth uncoordinated with normal tissue irreversible - autonomous

Question 109

epithelial neoplasias

Answer 109

squamous cell carcinoma adenoma adenocarcinoma

Question 110

mesenchymal neoplasia

Answer 110

osteosarcoma haemoangiosarcoma lipoma lipsarcoma

Question 111

round cell neoplasias

Answer 111

mast cell tumour lymphoma leukemia histiocytoma/histocytic sarcoma plasma cell tumour transmissible veneral tumour

Question 112

neuroendocrine neoplasia

Answer 112

thyroid tumours pheochromacytomas

Question 113

criteria of malignancy

Answer 113

anisocytosis - uneven cell size anisokaryosis - variation in nuclear size increased N:C mitotic figures multinucleation nuclear moulding angular nuceli coarse clumped chromatin prominent nucleoli necrosis phagocytosis emperipoeisis - intact cells inside cytoplasm of other cells crowded cells

Question 114

lymphoma subtyping

Answer 114

small, intermediate or large lymphocytes presence or absence of nucleoli position of nucleus in cell shape of nucleus relative volume of cytoplasm presence/absence of golgi zone relative numbers of mitotic figures dimorphic lymphocyte distribution presence on ancilliary cells PARR Flow cytometry IHC