Intro

Question 1

CBC

Answer 1

-runs on anti-coagulated blood

-includes erythrogram (RBCs), leukogram (WBCs), thrombogram (platelets), smear evaluation

-may also run a bone marrow sample (FNA +/- biopsy)

Question 2

Minimum database

Answer 2

-includes a CBC, biochem panel, urinalysis

Question 3

Biochemistry

Answer 3

-Run on serum (less common on plasma)

-panel of more than 20 tests

-evaluates organ functions/damage, homeostasis

Question 4

Components of biochemistry panel

Answer 4

-Analyte (glucose, calcium, etc.)
-enzyme activity (ALT, amylase, etc)
-calculated value (anion gap, globulins)

Question 5

Urinalysis

Answer 5

1. physical
   -gross evaluation (colour, odour, clarity)
   -urine specific gravity
2. dipstick
   -chemical constituents
3. Microscopic
   -presence of crystals, cells, organisms

Question 6

Hemostasis

Answer 6

The ability of blood to clot when needed
*blue top tube

-look at platelets (primary hemostasis

Question 7

Coagulation testing

Answer 7

1.secondary hemostasis: PT and PTT

2. Inhibitors of hemostasisL antithrombin
3. Global hemostasis: thromboelastometry/TEG

Question 8

Endocrinology

Answer 8

Evaluation of blood hormone levels to detect disease
-check resting values, stimulated values, suppressed values

Question 9

What are the key areas focused on with endocrinology?

Answer 9

-pituitary and adrenal
-thyroid and parathyroid
-endocrine pancreas

Question 10

Cytology

Answer 10

Microscopic evaluation of cells obtained via FNA, impression smears, or in fluids

*can help with shortening differential list

Question 11

Main Limitation

Answer 11

Reference intervals
1. 5% chance normal animal falls outside RI
2. sick or healthy animals may fall outside range and therefore you may miss diagnosis or misdiagnose

Question 12

Protein components

Answer 12

Total protein= albumin + globulin

Question 13

Production of most proteins

Answer 13

Mostly produced by liver except immunoglobulins

Question 14

Difference between plasma and serum

Answer 14

Plasma contains fibrinogen; serum does not

Question 15

Measurement of Plasma Total Protein (in a CBC)

Answer 15

-measured by refractometry
-fibrinogen also reported in large animals

Question 16

Serum protein (in biochem panel)

Answer 16

-Measured total protein and albumin
-Globulin is calculated
-A:G ratio is calculated value
=albumin divided by globulin

Question 17

Globulin calculation

Answer 17

Globulin= total protein-albumin

Question 18

What is A:G ratio used for?

Answer 18

Helps to ID causes of change in serum protein
*will appear normal if both fractions change together
*will become abnormal if one fraction increases or decreases relative to the other

Question 19

Normal A:G ratio patterns

Answer 19

1. Panhyperproteinemia
2. Panhypoproteinemia

Question 20

Panhyperproteinemia

Answer 20

-increases albumin and globulin
-normal A:G ratio

-from dehydration

Question 21

Panhypoproteinemia

Answer 21

-decreases albumin and globulin
-normal A:G ratio

-from acute blood loss, overzealous fluid therapy, non-selective protein loss (protein losing enteropathy, severe exudative skin diseases eg burn injuries), cavitary effusions

Question 22

Protein patterns with decreases A:G ratio

Answer 22

-selective hypoalbuminemia (+/- hypoproteinemia)

-acute inflammation

-selective (marked) hyperglobulinemia

Question 23

selective hypoalbuminemia (+/- hypoproteinemia)

Answer 23

-decreased albumin, normal globulin
-decreased A:G ratio

-from protein losing nephropathy, starvation (wildlife), cachexia (neoplasia, chronic inflammation)

Question 24

Acute inflammation

Answer 24

-decreased albumin, increased globulin
-decreased A:G ratio

*decreased albumin from decreased hepatic synthesis (negative acute phase protein)
*increased globulins from increased synthesis of positive acute phase proteins (SAA, CRP, haptoglobin)

Question 25

Selective (marked) hyperglobulinemia

Answer 25

-normal albumin, markedly elevated globulin
-decreased AG ratio
-usually results in increased total protein (hyperproteinemia)

Question 26

What typically causes selective (marked) hyperglobulinemia?

Answer 26

-usually from chronic antigenic stimulation or neoplasia (B cell or plasma cell tumour producing clonal gammaglobulins)

Question 27

Selective hypoglobulinemia (+/- hypoproteinemia)

Answer 27

-normal albumin, decrease globulin
-increased A:G ratio

Adults: not clinically significant
Young animals: if mild then lack of antigenic stimulation and if marked then acquired or inherited immunodeficiency (eg. failure of passive transfer)

Question 28

Hepatic dysfunction/failure

Answer 28

-decreased albumin, variable globulin AND A:G ratio

*low albumin from decreased hepatic synthesis
*concurrent inflammation may increase immunoglobulin synthesis and mask a decrease in globulins or even result in high globulins