Introduction- Corrigan Flashcards
Are clinical signs diseases? a diagnosis?
- NO
- NO
Physical effects created by pathophysiologic processes
Clinical Signs
(are NOT diseases)
Different ways to classify diseases? (5)
- Mechanistic
- Fxnal
- Temporal
- Acute vs. chronic
- Age
- Congenital vs. Acquired
- Focal vs. systemic
DAMNITV stands for?
- D - degenerative, developemental
- A - anomalous, allergic
- M - metabolic
- N - neoplastic, nutritional
- I - infectious, inflammatory, immune mediated, ischemic, idiopathic, iatrogenic
- T- trauma, toxic
- V- vascular
POMR?
Problem Oriented Medical Record
Who do you do a POMR?
- List all problems
- important ones first
- SOAP for each problem
- Subjective, Objective, Assessment, Plan
- Communicate to your client
What is on a CBC?
- RBC
- HCT
- Hb
- MCV
- MCHC
- Reticulocyte count
- WBC
- PLT counts
- TP
- BLOOD SMEAR!
Decreased PCV is due to what? (TQ)
Anemia
(regenerative or non-regenerative)
Causes of Regenerative Anemia?
(TQ)
-
Hemolysis
- IMHA
- Hemorrhage
(Regenerative Anemia = 2 H’s)
Causes of Non-Regenerative Anemia?
(3)
- Inflammation
- Renal dz.
- BM dz.
Non-regenerative = RIB
Increased PCV is due to?
(TQ)
Polycythemia
(relative or absolute)
4 reasons why _____ is Low?
- not making it
- using it
- breaking it down
- sequestrating it
Elevations in Total Solids?
(3)
- Dehydration
- check albumin
- Chronic infections
- Leukemia
Decreases in Total Solids?
(7)
- Poor nutrition
- Liver dz.
- Malabsorption
- Diarrhea
- PLN
- PLE
- Burns
How can you distinguish between PLN & PLE on a CBC?
- PLN- just lose albumin
- PLE- lose both albumin & globulin
Elevations in PCV & TS?
Dehydration & relative polycythemia
(if correct, both values return to WRI)
Elevated TS w/ Low PCV?
- Dehydration may be masking a more sever anemia
- When correct–> may decrease PCV to alarming levels
How can you estimate PCV?
Hb x 3
Which values should you use when interpretating Leukogram?
Absolute Values
Stress Leukogram
(TQ)
- Mature Neutrophilia
- Monocytosis
- Lymphopenia
- + eosinophilia
Physiologic Leukocytosis?
- Neutrophilia
- Lymphocytosis
(Catecholamines/Fear –> Cats!)
Inflammatory Leukogram?
> 1000 bands
OR
10% bands (if early or neutropenic)
Causes of Extreme Neutophilic Leukocytosis
- Pyometra
- Ehrlichia
- Heptazoanosis
- Fungus
3 things that should ALWAYS be on Rule Out List?
- Ehrlichia
- Neoplasia
- Fungus
Elevations in Mature Neutrophils #s?
(6)
- Stress - corticosteriods
- Fear - shifts marginating –> circulating pool
- Inflammation
- Infection
- Immune mediated dzs
- Neoplasia
Regenerative Left Shift?
- Leukocytosis
- Neutrophilia + Left Shift
- Segmented > Bands
Degenerative Left Shift?
- normal to decreased total neutrophils c
- Left Shift
- Bands > Segmented neutrophils.
- Body not meeting demand
Elevations in Lymphocytes?
(4)
- Chronic inflammation - Riskettsial infections
- Neoplasia
- Catecholamines - fear
- Hypoadrenocorticism - Addison’s
Decreases in Lymphocytes:
(4)
- Steriods
- Acute inflammation
- Effusions
- Lymphoid hypoplasia/aplasia
What cells are the markers of antigenic stimulation?
Lymphocytes
Which cells are markers of chronic inflammation?
Monocytes
Causes of Eosinophillia
- Allergic dz
- Parasitic dz
- Eosinophilic dz
- Mast Cell Neoplasia
- Hypoadrenocorticism - Addison’s
Which species are prone to eosinophilic dz’s?
Cats!
Corrected Reticulocyte % (CPR)
(TQ)
- Dogs: > 1.5% = regeneration
- Cats: > 1% = regeneration
Which dog breeds have microcytic RBCs?
- Akita
- Shiba Inu
What should you be thinking of if the machine reads Hyperchromic RBCs?
Heinz bodies
look at Blood Smear
Which acute phase protein is an indicator of inflammation?
Fibrinogen
Causes of Thrombocytopenia?
(4)
TQ!
- Decreased production
- Increased use
- Increased destruction
- Sequestration
Which species have platelets that are easily activated?
Cats!
What can cause a false decrease in platelet numbers?
Platelet Party!
Heinz Bodies on a Blood Smear?
(4)
- Oxydative damage
- Denatured Hb
- Onion toxicity
- Tylenol toxicity
Technique for Saline Dilution to distinguish Agglutination?
- ½ drop of blood
- 4-5 drops of saline
Elevations in Total Protein (TP)?
- Dehydration
- Chronic infections
- Leukemia
Decreases in Total Protein?
(6)
- Poor nutrition
- Malabsorption
- Diarrhea
- Liver Dz
- Renal Dz
- Burns
Which protein is a liver fxn assessment?
(TQ)
Albumin!
Only clinical entity that causes hyperalbuminemia?
Dehydration
4 things that tell you about Liver Fxn?
(TQ)
- Cholesterol
- BUN
- Albumin
- Glucose
C-BAG!!!
AST comes from where? Is a marker of?
(AST=aspartate aminotranferase)
- Mitochondria
- Cellular damage
Does AST test liver fxn?
NO
AST is suggestive of what 4 things?
- Liver damage
- Kidney infection
- Myocardial infarction
- Mm. damage
In what species is an AST increase of 2-3x in magnitude not a proper indicator?
- Cats
- really short ½ life –> will often pee it out
Where does ALT come from? Accurate indicator of?
(ALT = alanine aminotransferase)
- Cytoplasm
- hepatocyte injury
At what time period will ALT be at its maximum in circulation?
48 hrs post acute injury
Does ALT measure Liver fxn?
NO
Where is ALP located? Indicator of what?
(ALP = alkaline phosphatase)
- Bile canaliculi membranes
- Cholestasis
ALP is a ___enzyme. Where else can it be found?
- isoenzyme
- Liver
- Bone - skeletal growth
- Pregnancy
- Steroids- Dogs
- Phenobarb
Why may GGT be useful in cats?
(GGT= gamma glutamyl transferase)
Elevations in ALP & GGT suggestive of Hepatic Lipidosis
BUN is made where? Indicates what?
(TQ)
- Liver
- 75% damage
Elevations in BUN?
(5)
- High protein intake
- GI bleeding - ulcers
- Renal Dz
- Dehydration
- Excercise
Decreases in BUN?
(4)
TQ
- Liver Dz.
- Poor diet
- Malabsorption
- Diuresis
Which breed of dogs have slightly higher than normal Creatinine levels?
NAVLE
Greyhounds
When will you see elevations of Creatinine?
Not till 75% of liver has been damaged
Azotemia MUST be evaluated with what?
(TQ)
Urine Specific Gravity (USG)
Which hormone has a greater effect on the body, PTH or Calcitonin?
(TQ)
PTH
(Parathyroid Hormone)
Which form of Ca should you evaluate if concerned about abnormal total Ca levels?
Ionized!
(free Ca in the body)
Causes of Hypercalcemia?
(10)
GOSH DARN IT
- G-granulomatous dz.
- O-osteopathy/osteolytic dz.
- S- spurious
- H- Hyperparathyroidism
- D- Hypervitaminosis D
- A- Addison’s
- R- Renal dz.
- N- Neoplasia = LSA, ASA, MM
- I- Idiopathic
- T- Temperature (Cats)
Facial itchyness can be a sign of what?
Hypocalcemia
Causes of Hypocalcemia?
(6)
HERPES
- H- hypoparathyroidism
- E- eclampsia
- R- renal dz.
- P- pacreatitis/phosphorus
- E- ethylene glycol toxicity
- S- spurious (fake)
