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Clinical Medicine Master > Intro and Bloodwork (MR) > Flashcards

Intro and Bloodwork (MR) Flashcards

Clin Med Intro and Bloodwork/CBC lectures

1
Q

What is a Rule Out List?

A

List of Differentials

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2
Q

What is the 1º Rule Out?

A

What you think it is the most

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3
Q

How much kidney must be lost to show clinical signs?

A

66%

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4
Q

How much kidney must be lost to be azotemia?

A

75%

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5
Q

Azotemic and can concentrate urine, do they have kidney failure?

A

No, they are concentrating urine. Azotemia can be: Pre, Renal, Post

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6
Q

Are Clinical Signs diseases?

A

NO!

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7
Q

Most CX are what?

A

Protective mechanisms

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8
Q

When does loss of function give you the dz?

A

Beyond reserve capacity of the system

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9
Q

Does inflammation require loss of function?

A

NO

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10
Q

What is a problem list?

A

Every single problem an animal has

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11
Q

What are Rule Out lists designed for?

A

Every single problem has its own Rule Out List

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12
Q

DAMNITV: What does D stand for?

A

Degenerative Developmental

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13
Q

DAMNITV: What does A stand for?

A

Anomalous Allergic

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14
Q

DAMNITV: What does M stand for?

A

Metabolic

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15
Q

DAMNITV: What does N stand for?

A

Neoplastic Nutritional

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16
Q

DAMNITV: What does I stand for?

A 
Infectious 
Inflammatory
Immune Mediated
Idiopathic
Ischemic
Iatrogenic
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17
Q

DAMNITV: What does T stand for?

A

Trauma

Toxic

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18
Q

DAMNITV: What does V stand for?

A

Vascular

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19
Q

What does PARSIMONY mean?

A

Everything comes down to one thing

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20
Q

When should you collect baseline samples?

A

When pet is healthy

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21
Q

What is more important (regarding severity) for kidney function, azotemia or ability to concentrate?

A

Ability to concentrate, take a USG (UA)

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22
Q

TQ! What tests will you always want?

A

CBC, Chem, UA (at least USG)

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23
Q

What is polachyuria?

A

Small spots all over the place

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24
Q

CKD?

A

Chronic Kidney Disease

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25
Q

CDI?

A

Central Diabetes Insipidus

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26
Q

PSS?

A

Portal Systemic Shunt

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27
Q

1º NDI?

A

Nephrogenic Diabetes Inspipidus - exceedingly rare don’t have receptors for ADH, puppies

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28
Q

2º NDI?

A

Nephrogenic DI - inability of receptors to respond to ADH - most cases

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29
Q

When does epilepsy happen?

A

6 mo - 5 yrs

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30
Q

What do buff colored cocker spaniels get?

How many more times likely?

A

IMHA: This is your top differential.

8X more likely

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31
Q

When do we treat clinical signs?

A

When we know what is causing the clinical signs!

Diagnosis!

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32
Q

What does S.O.A.P. stand for?

A

Subjective
Objective
Assessment
Plan

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33
Q

Is CBC qualitative or quantitative?

A

BOTH

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34
Q

What is ALWAYS done with a CBC?

A

Blood Smear!!!

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35
Q

TQ! 2 Primary Rule Outs for Regenerative anemia?

A

Hemolysis

Hemorrhage

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36
Q

Why should you make sure tube is filled appropriately?

A

Anticoagulation Artifacts will change ratios of numbers

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37
Q

Immature cells are bigger or smaller?

A

Bigger

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38
Q

Decreased PCV is?

A

Anemia

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39
Q

Increased PCV is?

A

Polycythemia

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40
Q

What is PCV?

A

% of Whole blood that is RBC

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41
Q

Primary Rule Outs for Non-regenerative anemia?

A

Inflammatory
Renal Dz - Could be anywhere
Bone Marrow Dz

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42
Q

What comes with inflammation?

A

Cytokines

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43
Q

What do Cytokines do?

A

Turn on and turn off all kinds of cells including inflammatory cells and some of which live in the bone marrow

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44
Q

What is an increased PCV?

A

Polycythemia

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45
Q

Types of Polycythemia?

A

Relative

Absolute

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46
Q

What is Relative Polycythemia?

A

Dehydration

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47
Q

Total Solids is best measured how?

A

Refractometer

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48
Q

Acute phase proteins?

What are they turned on by?

A

Fibrinogen (LA!)
Haptoglobin
Liver

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49
Q

Total Solid Elevations occur due to?

A

Dehydration
Chronic Infections
Leukemia

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50
Q

Total Solids Decreases are due to?

A 
Poor nutrition 
Liver Disease
Malabsorption
Diahhrea
PLN/PLE
Burns
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51
Q

If something is low, what are the most possible reasons?

A

Using
Losing
Not making
Sequestering it

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52
Q

What are 2 smallest proteins?

A

Albumin

Antithrombin III

53
Q

Why would you go into DIC with a nephropathy?

A

Antithrombin III leaks out and then you cant clot.

54
Q

PLE you tend to lose which proteins?

Why?

A

Albumin & Globulins

Leakier than nephrons

55
Q

Which proteins are lost in PLN?

A

Albumin

Antithrombin III

56
Q

Elevations in both PCV and TS suggest?

A

Dehydration

Polycythemia

57
Q

Elevated TS with low/low-normal PCV suggest?

A

Dehydration masking more severe anemia.

PVC will tank once rehydrated!

58
Q

What is the difference between a Hct and PCV?

A

Hct is calculated

PCV is measured

59
Q

Hemoglobin does what?

A

Carries O2 in g/dL

60
Q

How do you get PCV from Hgb?

A

Hgb X 3

61
Q

Leukogram relative values are?

A

%

62
Q

I promise I will never do what with a leukogram?

A

Read relative (%) values.

63
Q

What is the very best leukogram machine?

A

Flow cytometry

64
Q

Which machine is most inaccurate?

A

QBC

65
Q

How is Leukogram taken manually?

A

Hemocytometer

66
Q

TQ!!! What is a Stress leukogram?

A

Mature Neutrophilia
Monocytosis,
Lymphopenia
(sometimes Eosinopenia)

67
Q

What is Physiological Leukocytosis?
Why?
Who?

A

Neutrophilia & Lymphocytosis
Catecholamines/fear
CATS!

68
Q

Corticosteroid Leukogram think what animal?

A

DOG

69
Q

What causes Extreme neutrophilic leukocytosis?

A 
Pyometra
Ehrlichia
Hepatozoanosis (can be really high 154,000 neuts)
Fungus
Leukemia >50,000
70
Q

What are the levels of leukocytosis in a leukemia?

A

> 50,000

71
Q

TQ! What will be on every DDX list ever!

A

Ehrlichia
Fungus
Neoplasia

72
Q

Why mature neutrophilia in stress leukogram?

A

Body releases neutrophils (mature bc not infection)

73
Q

If all neutrophils are young and numbers are decreased what is this?

A

Degenerative Left Shift

74
Q

Why Lymphopenia in stress leukogram?

A

They’re marginated

75
Q

What causes Monocytosis?

A

Chronic Inflammation
Necrosis
Steroids (stress leukogram),
Neoplasia

76
Q

Why would there be an elevation in Mature Neutrophils?

A 
Inflammation 
Infection
Immune Mediated Dz
Stress - corticosteroids
Fear
Neoplasia
77
Q

Why would there be a decrease in Mature Neutrophils?

A 
Overwhelming infection 
Overwhelming inflammation
Destruction
Neoplasia
Bone Marrow Dz, (Dysfunction or Suppression)
Cyclic Hematopoisis
78
Q

What is a Regenerative Left Shift?
Is it a normal reaction?
What cells will you see?

A

Neutrophil response to inflammation and are adequately responding to demand.
Yes
There are mature and immature cells.

79
Q

What is degenerative left shift?
Is it a normal reaction?
What cells are present?

A

Neutrophil production where release is not meeting the demand.
Abnormal response.
You will see bands but not mature/segmented neuts.

80
Q

What are lymphocytes?
What are they markers for?
Which cells are lymphocytes?

A

Circulating immune system cells
Antigenic stimulation
B & T cells

81
Q

What do B cells produce?

A

Ab

Cytokines

82
Q

What do T cells produce/do?

A

Cytokines
Assist B cells
Can be cytotoxic/killer
Specialized duties

83
Q

What causes elevations in Lymphocytes?

A 
Chronic inflammation
ESPECIALLY Rickettsial infections!!!!!,
Neoplasia
Catecholamines
HYPOadrenocorticism - it's a balance thing - absence of steroids
84
Q

What causes decreases in lymphocytes?

A

Steroids - suppress immune system cause margination
Acute inflammation
Effusions
Lymphoid Hyperplasia/aplasia

85
Q

What are Monocytes in the blood?

What are they markers of?

A

Traveling to their designated site in tissue to become macrophages. Chronic inflammation

86
Q

Who shows up first neuts or monos?

A

Neuts ya twit!

87
Q

What type of cells are eosinophils and basophils?

A

Granulocytes

88
Q

What are eosinophils and basophils markers for?

A 
Allergic and Parasitic Dzs
Eosinophil dzs,
Mast cell neoplasia
HYPOadrenocorticism
Neoplasia
89
Q

Eosinopenia is caused by?

A

Steroids, Acute Inflammation

Bone Marrow Dz

90
Q

Eosinophils and Mast cells share what?

A

Same Cytokines (IL5) turns them on!

91
Q

Who gets eosinophilic dzs?

A

Cats & Horses

92
Q

What is the stain for reticulocytes?

What are you staining?

A

New Methylene Blue

RNA Precipitates

93
Q

% retic based on what cell count?

A

1000

94
Q

Two types of Feline Retics?

A

Aggregate & Punctate

95
Q

Which Feline Retics are newly released from marrow?

A

Aggregate (Lots of dots)

96
Q

What are aggregate retics specific from?

A

Bone Marrow Response

97
Q

What are Punctate Retics?

How long do they circulate?

A

Mature aggregates

7 days

98
Q

Corrected Reticulocyte % tells you what?

A

If it is regenerative enough

If bone marrow is responding appropriately to the severity of the PCV.

99
Q

What is the absolute retic count for dogs?

A

> 80,000

100
Q

What is the absolute retic count for cats?

A

> 40,000 aggregates

101
Q

What % of corrected reticulocyte % (CRP) indicates regeneration in a dog?

A

> 1.5%

102
Q

What % of corrected reticulocyte % (CRP) indicates regeneration in a cat?

A

> 1%

103
Q

What is Retic Production Index?

A

CRP/lifespan of retics

104
Q

What is MCHC for all species with discoid RBCs?

A

33 g/dL

105
Q

What is RDW?

A

Population spread

106
Q

Bimodal RDW signifies?

A

Regeneration

107
Q

MCV: Macrocytic RBCs signify?

A

Regeneration or you’re a poodle!

108
Q

MCV: Microcytic RBCs signify?

A

Fe deficiency
PSS (Portal Systemic Shunt)
Cu Deficiency
You’re an Akita or Shibu Inu

109
Q

MCHC measures what?

A

[Average Hgb]

110
Q

MCHC: What does HYPOchromia signify?

A

Hemorrhage
Hemolysis
Fe Deficiency

111
Q

MCHC: What does HYPERchromia signify?

A

DOESN’T HAPPEN, if machine reads this think HEINZ BODIES look at your blood smear

112
Q

What do congenital PSS animals tend to have for RBC indicies?

A

Microcytic hypochromic

113
Q

What is fibrinogen?

How long does it take to show up in blood after inflammation?

A

Acute Phase Protein

24 - 72 hours

114
Q

TQ!!! Which species activate platelets easily?

A

CATS!

Like Rough Stick!

115
Q

Which breed has larger platelets than others?

A

Cavalier King Charles

Sometimes they even have less of them

116
Q

When can platelets be artificially decreased?

A

Clumping

117
Q

Thrombocytopenia occurs due to?

A

Use it
Lose it,
Don’t make it
Sequestration

118
Q

What size are young platelets?

A

Bigger

119
Q

Thrombocytosis happens when?

A

Rare

Canine HYPERadrenocorticism

120
Q

Blood Smear: What changes morphology?

A 
Regeneration 
Hgb content
Membrane compostition
Structural Proteins
Oxidative Damage = Heinz bodies
Fragmentation
Platelet Clumping
121
Q

Why do a smear?

A

Helps decide if regenerative

122
Q

On Blood Smear what would RBC with low Hb look like?

A

clear

123
Q

Blood Smear: Heinz bodies happen due to?

A

Oxidative Damage
Denatured Hgb
Onion Toxicity
Tylenol Toxicity

124
Q

Blood Smear: Agglutination occurs due to?

A

IMHA

Rouleaux formation is NOT agglutination!

125
Q

How should you do Saline Dilution to decipher Rouleaux from Agglutination?

A

1/2 drop of blood with 4-5 drops of saline

126
Q

If bands are under 10,000 what scenario could their number be significant?

A

if > 10% total neuts

127
Q

QBC: Dark black line is?

A

DNA

128
Q

QBC: Thinner line is?

A

RNA/LP

Clinical Medicine Master (17 decks)

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