Intro Flashcards
CBC
-runs on anti-coagulated blood
-includes erythrogram (RBCs), leukogram (WBCs), thrombogram (platelets), smear evaluation
-may also run a bone marrow sample (FNA +/- biopsy)
Minimum database
-includes a CBC, biochem panel, urinalysis
Biochemistry
-Run on serum (less common on plasma)
-panel of more than 20 tests
-evaluates organ functions/damage, homeostasis
Components of biochemistry panel
-Analyte (glucose, calcium, etc.)
-enzyme activity (ALT, amylase, etc)
-calculated value (anion gap, globulins)
Urinalysis
- physical
-gross evaluation (colour, odour, clarity)
-urine specific gravity - dipstick
-chemical constituents - Microscopic
-presence of crystals, cells, organisms
Hemostasis
The ability of blood to clot when needed
*blue top tube
-look at platelets (primary hemostasis
Coagulation testing
1.secondary hemostasis: PT and PTT
- Inhibitors of hemostasisL antithrombin
- Global hemostasis: thromboelastometry/TEG
Endocrinology
Evaluation of blood hormone levels to detect disease
-check resting values, stimulated values, suppressed values
What are the key areas focused on with endocrinology?
-pituitary and adrenal
-thyroid and parathyroid
-endocrine pancreas
Cytology
Microscopic evaluation of cells obtained via FNA, impression smears, or in fluids
*can help with shortening differential list
Main Limitation
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
Protein components
Total protein= albumin + globulin
Production of most proteins
Mostly produced by liver except immunoglobulins
Difference between plasma and serum
Plasma contains fibrinogen; serum does not
Measurement of Plasma Total Protein (in a CBC)
-measured by refractometry
-fibrinogen also reported in large animals
Serum protein (in biochem panel)
-Measured total protein and albumin
-Globulin is calculated
-A:G ratio is calculated value
=albumin divided by globulin
Globulin calculation
Globulin= total protein-albumin
What is A:G ratio used for?
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
Normal A:G ratio patterns
- Panhyperproteinemia
- Panhypoproteinemia
Panhyperproteinemia
-increases albumin and globulin
-normal A:G ratio
-from dehydration
Panhypoproteinemia
-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
Protein patterns with decreases A:G ratio
-selective hypoalbuminemia (+/- hypoproteinemia)
-acute inflammation
-selective (marked) hyperglobulinemia
selective hypoalbuminemia (+/- hypoproteinemia)
-decreased albumin, normal globulin
-decreased A:G ratio
-from protein losing nephropathy, starvation (wildlife), cachexia (neoplasia, chronic inflammation)
Acute inflammation
-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)
Selective (marked) hyperglobulinemia
-normal albumin, markedly elevated globulin
-decreased AG ratio
-usually results in increased total protein (hyperproteinemia)
What typically causes selective (marked) hyperglobulinemia?
-usually from chronic antigenic stimulation or neoplasia (B cell or plasma cell tumour producing clonal gammaglobulins)
Selective hypoglobulinemia (+/- hypoproteinemia)
-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)
Hepatic dysfunction/failure
-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
