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Veterinary Clinical Pathology > Intro and Laboratory Principles > Flashcards

Intro and Laboratory Principles Flashcards

1
Q

What is Clinical Pathology?

A

Hematology, clinical chemistry, exfoliative cytology, urinalysis, endocrinology, clinical immunology, toxicology

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2
Q

Reasons for testing

A

health screen, screen for disease, identify specific organ involvement, confirm presumptive diagnosis, confirm abnormal test, determine disease severity, formulate prognosis, monitor therapy or disease progression

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3
Q

Understanding reference intervals

A

2.5% of the healthy population will have values beyond either side of the median 95% and be deemed “abnormal” even though they are fine; is a compromise that increases the sensitivity of the test for recognizing sick animals because only a few healthy animals will be viewed as “abnormal”

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4
Q

What is the chance of an abnormal test result when testing a healthy animal?

A

5% chance when 1 analyze measured; 64% chance when 20 analytes measured

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5
Q

Factors affecting reference intervals

A

species, age, sex, time postprandial, time of day, emotional state, activity level, pregnancy/egg-laying, diet, region, time of year, generally collect overnight fasting samples from adult animals to increase chances of “normal”

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6
Q

Most common laboratory error

A

pre-analytical - ie. improper handling of samples (labeling), wrong anticoagulant/improper ratio of anticoagulant, traumatic blood draw or transfer of blood into tubes causing hemolysis

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7
Q

Blood samples getting old cause what cellular changes? and these changes affect what blood cell measurements.?

A

cell lysis
erythrocyte swelling -> affects MCV, MCHC, PCV
platelet activation -> affects MPV and platelet count

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8
Q

Platelet, leukocyte, and erythrocyte clumps could affect which blood cell measurements?

A

number/microliter blood decreased
platelets counted as leukocytes
MCV, MCHC, electronic HCT
MPV increased

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9
Q

What additive helps with platelet and leukocyte clumping?

A

citrate

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10
Q

Clot formation affects what blood cell measurements

A

all cell types decrease

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11
Q

Purple top tubes have what additive?

A

EDTA

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12
Q

Green top tubes have what additive?

A

Lithium heparin

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13
Q

Blue Top tubes have what additive?

A

citrate

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14
Q

What interfering substances cause analytical errors?

A

hemolysis, lipemia, hyperbilirubinemia

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15
Q

Falsely elevated potassium concentrations in horses and cattle can be due to what laboratory error/cellular process?

A

hemolysis - they have high K in RBCs

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16
Q

What three visual factors do you need to evaluate before examining blood samples?

A

color - tomato soup vs. syrump (methemoglobinemia)
Agglutination vs. rouleaux -if rouleaux you can use saline 10:1 to separate
is it mixed well?

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17
Q

Define rouleaux

A

“stack of coins” - due to non-specific binding of RBCs due to high protein content in the blood, will disperse with saline

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18
Q

Define agglutination

A

clumping of RBCs due to specific binding of RBCs by antibodies when IMHA is happening, will not disperse with saline test

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19
Q

What conditions cause lipemia in blood samples?

A

When animals not fasted before blood collection or with hyperlipidemic syndromes

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20
Q

How does lipemia affect blood samples?

A

causes turbidity
can interfere with anything that is measured by spectrophotometric assays
can dilute out normal substances like electrolytes in the aqueous component of the serum resulting in falsely decreased concentration (ion exclusion effect)

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21
Q

Give an example of a post-analytical laboratory error.

A

Error in data transcription

22
Q

What are the four components of a microhematocrit tube after spinning?

A

plasma, buffy coat, packed red blood cells, wax plug

23
Q

Three conditions that affect the appearance of the plasma in a microhematocrit tube?

A

hemolysis, lipemia, icterus

24
Q

What types of cells are in the buffy coat?

A

leukocytes and platelets

25
What is fibrinogen and why is it important?
acute phase protein, precursor to fibrin in coagulation - important because it increases with inflammation so it can indicate infection in large animals that don't have dramatic neutrophilic responses; present in plasma but not serum because it is used up in clotting process - causes optimal platelet aggregation
26
What are the functions of plasma proteins?
``` transport of nutrients, hormones, waste and drugs colloid osmotic effects acid-base immunity hemostasis ```
27
Where are most plasma proteins synthesized?
in the liver - big problem if liver failures
28
Why do adults tend to have higher concentrations of plasma proteins than neonates?
exposure to antigens
29
What is the composition of plasma?
92% water | 8% solids - nutrients, proteins, hormones/enzymes, and electrolytes
30
Functions of plasma
transport of nutrients transport of by-products and waste transportation of cells maintain homeostasis (pH, temp, etc.)
31
What important things do you evaluate on peripheral blood film?
red blood cell density - anemia? | RBC size, shape, color, and inclusions
32
What is a normal PCV?
``` Roughly 30-50% Canine - 37-54 Feline 30-47 Equine 32-47 Bovine 24-46 ```
33
What is a normal plasma protein (TP)?
Roughly 6.0-8.0 g/dL
34
What is a normal plasma color?
dogs and cats: colorless | horses and bovines: colorless or pale yellow
35
What blood cell characteristics are analyzed by an automated hematology analyzer?
Quantity - RBC #/microliter, hemoglobin concentration/deciliter, hematocrit percentage Quality - mean cell volume (size of RBCs), red cell distribution width (size variation of RBCs), mean cell hemoglobin concentration (hemoglobin within RBCs)
36
MCV
Describes average size of RBC
37
RDW
red cell distribution width - describes how much variation there is in RBC size, corresponds to the standard deviation of RBC mean cell volume; =SD/MCV, when RBC cell size is more variable than normal - RDW is increased
38
When calculated hematocrit and spun PCV are not within 3% of each other which do you trust?
spun PCV - certain diseases cause HCT to be false because it is a calculation not a direct measurement
39
MCHC
ratio of hemoglobin to the number of RBCs decreased = regenerative anemia, iron deficiency anemia increased = artifact! not real ( could be due to hemolysis, lipemia, heinz bodies, WBC elevation)
40
Heinz bodies cause what types of errors in blood cell measurement?
Hb and MCHC increased | sometimes total leukocyte counts increased
41
nucleated erythrocytes cause what error in blood cell measurement?
often counted as luekocytes
42
You should never trust an automated ______ count in cats
platelet - cats are very prone to platelet clumping
43
Name the four types of blood film stains and what you use them for.
Romanowsky type stains (Wright, Wright-Giemsa, Diff-Quik) - evaluation of RBCs New Methylene Blue - reticulocytes, NMB wet prep Prussian Blue - look for Iron Cytochemical - ??
44
Describe ideal procedures for blood sample collection and handling
kept cool during storage and shipping - wrapped in paper towels to avoid direct contact with ice blood smears made from freshly collected blood, not stored and transported blood use DI water instead of tap
45
What does a water artifact look like?
moth eaten appearance of cells refractile artifact - looks bright in one plane, dark in another can be mistaken for RBC inclusion
46
Age related changes in RBCs
crenation - echinocyte formation lysis - decrease RBC and HCT, falsely high MCHC Hgb crystallization cellular swelling - falsely high MCV ( and thus HCT), decreased MCHC
47
Age related changes in WBCs
swelling and smoothing of nuclear chromatin (looks like band neutrophil formation) pyknosis and karyhorrhexis of nuclei cell smudging prominence of Dohle bodies pyknotic leukocytes look like nucleated RBCs - can be misinterpreted
48
Age related changes in platelets
clumping- decreases platelet count and increases MPV (small clump seen as single large platelet), large platelet clumps are excluded from count altogether degranulation (makes them difficult to see and enumerate)
49
The three parts of a blood smear
base, feathered edge, "counting area"
50
What do you analyze in the monolayer of a blood smear slide?
right behind feathered edge - cells spread, not overlapping and not disrupted so analyze size and shape of RBCs, WBCs uniform distributed in this section
51
What should you analyze in the feathered edge of a blood smear slide?
detect platelet clumps and microfilaria

Veterinary Clinical Pathology (5 decks)

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