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Lab Flashcards

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1
Q

identify what this blood tube is

A

serum tube

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2
Q

what is found within serum tubes?

A

CAT beads

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3
Q

what is the role of CAT beads in serum tubes?

A

encourage clotting to occur faster
makes sample more stable

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4
Q

what are serum tubes used for?

A

biochem
hormonal assays
serology

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5
Q

what are you assessing during serology?

A

antibodies

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6
Q

identify what this blood tube is

A

lithium heparin

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7
Q

what is the role of heparin tubes?

A

biochem in house

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8
Q

what is the benefit of heparin tubes?

A

tests can be run straight away

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9
Q

why can tests on blood in a heparin tube be run straight away?

A

anticoagulant present

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10
Q

identify this blood tube

A

EDTA

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11
Q

what are EDTA tubes used for?

A

haematology

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12
Q

identify this tube

A

citrate

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13
Q

what are citrate tubes used for?

A

coagulation profiles

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14
Q

identify these tubes

A

oxalate

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15
Q

what are oxalate tubes used for?

A

glucose - rare thanks to glucometers

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16
Q

what is the difference between serum and plasma?

A

serum has been allowed to clot on it’s own so contains no clotting factors as they have been used

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17
Q

why does plasma contain clotting factors?

A

collected in tubes that contain anticoagulant - no clotting factors used

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18
Q

does serum or plasma contain clotting factors?

A

plasma

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19
Q

what tubes contain anti-coagulant?

A

heparin
EDTA
citrate
oxalate

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20
Q

what order should tubes be filled?

A

serum
heparin
EDTA

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21
Q

what tube must be filled last?

A

EDTA

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22
Q

why must EDTA be filled last?

A

binds calcium

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23
Q

why is calcium binding of benefit in EDTA tubes?

A

prevents clotting

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24
Q

what results are seen on EDTA contamination of biochem samples?

A

low calcium
high potassium

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25
Q

why is high potassium seen with EDTA contamination of biochem?

A

2 molecules of K+ attached to each EDTA molecule

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26
Q

why are heparin tubes of benefit for emergency patients?

A

can be used to run tests immediately

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27
Q

what do reference ranges include?

A

95% of healthy animals

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28
Q

why doe reference ranges only include 95% of healthy animals?

A

top and bottom 2.5% disregarded as not representative of population as a whole

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29
Q

what is low total protein known as?

A

hypoproteinaemia

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30
Q

how is a deviation from the reference range defined as mild?

A

within the ‘window’ of the reference range

if ref range is 20, 20 above or below is ‘mild’

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31
Q

how is a deviation from the reference range defined as moderate?

A

outside or up to double the ‘window’ of the reference range

if ref range is 20, 20-40 above or below is ‘moderate’

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32
Q

how is a deviation from the reference range defined as marked?

A

3-4x the ‘window’ of the reference range

if ref range is 20, more than 40 above or below is ‘marked’

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33
Q

what is hypoalbuminaemia?

A

low albumin

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34
Q

make sure you practice some reference ranges

A

ok!!

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35
Q

what does ALT stand for?

A

alanine aminotransferase

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36
Q

what does ALP stand for?

A

alkaline phosphatase

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37
Q

what does GGT stand for?

A

Gamma-glutmyl transferase

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38
Q

what is hyperbilirubinaemia?

A

high bilirubin within the blood

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39
Q

what is hypocholesterolaemia?

A

low cholesterol within the blood

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40
Q

what is low calcium?

A

hypocalcaemia

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41
Q

what are the main causes of high ALT?

A

primary hepatopathy
secondary to cholestasis
artefact
due to muscle damage

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42
Q

what is cholestasis?

A

bile not moving as it should out of the GB

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43
Q

how can a patient with elevated ALT be checked to see if it is muscle related?

A

check CK as muscle specific

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44
Q

what are the markers of hepatocellular damage?

A

ALT
AST
GLDH
SDH

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45
Q

what is indicated by ALT, AST, GLDH, SDH?

A

hepatocellular damage

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46
Q

what is occuring during hepatocellular damage?

A

cells leaking hepatic enzymes

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47
Q

what are the markers of cholestasis?

A

ALP
GGT

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48
Q

what is indicated by ALP and GGT?

A

cholestasis

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49
Q

what are the 2 types of liver function marker?

A

substances produced in the liver
substances conjugated and excreted by the liver

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50
Q

what substances are produced in the liver that can be used to measure function?

A

cholesterol
urea
glucose
albumin
some globulins
coagulation factors

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51
Q

what substances are conjugated and excreted by the liver that can be used to measure function?

A

bile acids
bilirubin

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52
Q

what can cause primary hepatocellular disease?

A

trauma
toxins
drugs
inflammation/infection
neoplasia
intrahepatic cholestasis
bile toxicity

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53
Q

what are the secondary causes of hepatocellular disease?

A

non-specific
many!!
liver is sensitive soul

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54
Q

what indicates primary causes of decreased hepatic function?

A

functional changes: increased levels of substances excreted and decreased levels of substances produced

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55
Q

what may increase if decreased hepatic function is seen?

A

bilirubin
bile acids
- should be excreted but liver can’t

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56
Q

what may decrease if decreased hepatic function seen?

A

albumin
cholesterol
urea
glucose
clotting factors

  • should be being made but liver can’t
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57
Q

how can xylitol toxicity be treated?

A

plasma transfusions to increase protein levels
vitamin K to support clotting factor formation
IVFT to clear toxins and support BP
antibiotics as immunocompromised due to reduced globulin

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58
Q

what complications can be seen with xylitol poisoning?

A

DIC

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59
Q

what are the signs seen with a classic stress leukogram?

A

neutrophilia
monocytosis
lymphopenia
eosinopenia

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60
Q

what does SMILED mean?!

A

Segmented neutrophils and Monocytes Increase
Lympocytes and Eosinophils Decrease

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61
Q

are all 4 components of the stress leukogram always seen?

A

no - 2-3 common
monocytosis v rare

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62
Q

what is an acanthocyte?

A

changes to RBC cell membrane causing fingerlike projections

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63
Q

where are acanthocytes seen?

A

old blood
artefact
toxin ingestion

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64
Q

why can mild electrolyte changes be so concerning?

A

even small changes can affect physiology (e.g. K+) and have catastrophic effects (e.g. bradycardia or arrest)

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65
Q

what tests may be sued if azotemia is seen?

A

urinalysis
US

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66
Q

what is hypersthenuria?

A

concentrated urine

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67
Q

what is hyposthenuria?

A

dilute urine

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68
Q

what is isosthenuria?

A

same SG as blood - kidneys not working

69
Q

what urine concentration is seen in kidney disease?

A

isosthenuria

70
Q

what may be seen on urinalysis that indicates AKI?

A

inappropriate urine conc
glucose
tubular casts

71
Q

how is ethylene glycol toxicity treated?

A

IVFT
supportive care
ethanol

72
Q

what is caused by ethylene glycol ingestion?

A

AKI

73
Q

what can be indicated by absence of stress leukogram?

A

chronic disease
immunosuppression
BM disease

74
Q

what is liver prone to on biochem?

A

secondary enzyme elevations

75
Q

how can you tell if secondary liver enzyme elevation has occurred?

A

GGT and ALP normal

76
Q

what must lab findings be used in conjunction with?

A

clinical signs

77
Q

what must be considered when assessing what blood results are clinically significant?

A

reference interval
species
significance of parameter itself
magnitude of change
clinical history

78
Q

what is the purpose of cytology?

A

screening test to look for cells in fluid and tissue samples

79
Q

where may fluid be acquired from for cytology?

A

BAL
CSF
synovial fluid
body cavities

80
Q

where may tissue samples be acquired from for cytology?

A

lumps
bumps
lymph nodes

81
Q

what clinical information is critical when assessing a lesion that cytology will be performed on?

A

clinical history
lesion evolution over days/weeks/months
previous treatment
characteristics of the lesion itself

82
Q

how can lesions be characterised?

A

location
are they firm / soft
dimensions
painful or non/painful
ulceration present
depth (cutaneous or subcutaneous)
adherent or non-adherent
how aspirate appears

83
Q

what are the 2 techniques for FNA?

A

suction
non-suction

84
Q

what is suction FNA used for?

A

hard cutaneous or subcutaneous masses
bone lesions
non-suction technique unsuccessful

85
Q

what is non-suction FNA used for?

A

soft cutaneous or subcutaneous masses
lymph nodes
vascular lesions/organs

86
Q

describe how to perform suction FNA

A

negative pressure applied to syringe and needle while needle is redirected within the mass
pressure relaxed before needle removed

87
Q

when applying negative pressure for suction FNA what should happen before the needle is removed?

A

pressure/suction relaxed before needle removed

88
Q

describe how to perform non-suction FNA

A

needle dug around in tissue without syringe attached
needle is removed
air placed in syringe and then needle attached
air used to put sample onto slide

89
Q

what are the main smear techniques for slide preparation?

A

line
squash
twist
spatter (not ideal!)

90
Q

how is the squash technique of slide preparation performed?

A

using two slides placed against each other spread from the frosted edge upwards
be gentle so that cells are not crushed

91
Q

aside from FNA what are other collection methods for cytology samples?

A

impression smear
scrape
imprint biopsy
imprint through rolling cotton bud for ear samples

92
Q

what can be assessed when using a skin scape sample?

A

mites

93
Q

what organism is commonly seen on ear cytology?

A

malassezia

94
Q

what organism is malassezia?

A

fungus - yeast

95
Q

what organism is seen here?

A

malassezia (yeast)

96
Q

is malassezia seen on normal skin?

A

yes in low numbers

97
Q

what indicates malassezia infection?

A

multiple organisms per HPF

98
Q

how should cytology slides be dried?

A

quickly - hairdryer on cool or air fixation

99
Q

what must be done with cytology slides before staining and packing?

A

ensure they are completely dry

100
Q

what should all slides be labelled with?

A

patient ID
site
date

101
Q

what is the most common staining technique used in practice?

A

Diff-Quick

102
Q

what are some stains used in commercial labs?

A

Giemsa/Modified Wright
Methylene blue
Toluidine blue
ziehl/Nielson

103
Q

what is Toluidine blue used to stain?

A

MCT samples

104
Q

what is useful about Toludine blue for MCT staining?

A

histamine granules show up well

105
Q

what is Diff-Quick solution A (blue) made up from?

A

Methanol

106
Q

what is Diff-Quick solution A (blue) used for?

A

fixation

107
Q

what is Diff-Quick solution B (red) made up from?

A

Eosin

108
Q

what is Diff-Quick solution C (purple) made up from?

A

Methylene blue

109
Q

what is Diff-Quick solution B (red) used for?

A

Eosionophilic (base) staining

110
Q

what is Diff-Quick solution C (purple) used for?

A

basophilic (acid) staining

111
Q

why should diff quick stains be replaced regularly?

A

methylene blue deteriorates quickly

112
Q

should the same Diff-Quick stains be used for all samples?

A

should have clean and then dirty set for dermatology

113
Q

what cells are seen in this picture?

A

neutrophils

114
Q

what power of lens is found in the eyepiece of a microscope?

A

10

115
Q

what is the combined power of the eyepiece and lens on a microscope?

A

lens power x10 for eyepiece

116
Q

what should be assessed on low magnification (10x)?

A

cellularity
preservation
staining
haemodilution
cell distribution
background

117
Q

assess cellularity in this image

A

low

118
Q

assess cellularity in this image

A

high

119
Q

what is haemodilution?

A

RBC present in sample

120
Q

what is the total magnification of the 40x lens?

A

400x human eye

121
Q

what is assessed on the high magnification (40x) lens of a microscope?

A

cellular vs non-cellular elements
inflammatory vs neoplastic
malignant vs benign

122
Q

what is assessed on the high magnification (100x) lens of a microscope?

A

presence of cytoplasmic granules
nuclear detail
presence of pathogens (bacteria, fungi, protozoa)

123
Q

what indicates inflammation on cytology?

A

neutrophils

124
Q

how do neutrophils appear on cytology?

A

clear nuclear outlines with dark purple chromatin
cytoplasm is pale and clear/slightly pink

125
Q

what are degenerate neutrophils?

A

neutrophils affected by toxic change (e.g. infection)

126
Q

how do degenerate neutrophils appear under the microscope?

A

loss of segmentation
lighter colored ‘fluffy’ nuclear chromatin and swollen appearance

127
Q

does the absence of bacteria on a slide mean there is no infection?

A

no if neutrophils present - culture should be performed

128
Q

what cells are seen in this image?

A

non-degenerate neutrophils

129
Q

what cells are seen in this image?

A

degenerate neutrophils

130
Q

what is seen on this slide?

A

MCT - many histamine granules

131
Q

what is seen on this slide?

A

evidence of lymphoma

132
Q

what is seen on this slide?

A

adipose tissue indicative of lymphoma

133
Q

what are the benefits of cytology?

A

easy
quick
cheap
relatively non-invasive

134
Q

what are the limitations of cytology?

A

screening test not confirmatory

135
Q

what is needed to to confirm suspicions seen on cytology?

A

histology

136
Q

why is QA/QC important for lab machines?

A

life/death/diagnostic decisions will be made based on results given so they must be correct

137
Q

how can QA/QC be maintained?

A

set-up correctly
maintain analysers and systems
interpret results
carry out controls
ensure accurate record keeping

138
Q

what are the advantages of in house labs?

A

fast turn around time
potential for improved patient monitoring
smaller sample volume needed
available OOH
available in remote areas
may save costs

139
Q

what are the 2 major variations which affect results?

A

biological
analytical

140
Q

what factors affect results prior to sampling?

A

biological

141
Q

what are the biological variables that may affect results?

A

inter-individual
intra-individual

142
Q

what are inter-individual factors?

A

inherent differences between groups of animals due to effects of species, breed, age and/or sex

143
Q

what are intra-individual factors?

A

transient differences in the same animal

144
Q

what are intra-individual factors due to?

A

environmental or external factors

145
Q

what are some examples of intra-individual factors?

A

diet (recent meal)
stress/excitement
reproductive status/lactation
drugs

146
Q

can intra-individual factors be eradicated?

A

no but should be minimised as much as possible

147
Q

what are the analytical factors that can affect results?

A

pre-analytical
analytical
post-analytical

148
Q

when do pre-analytical factors occur?

A

before the sample is run

149
Q

what are some pre-analytical factors that may affect results?

A

poor sampling technique
haemolysed, lipaemic or icteric plasma
wrong anticoag to blood ratio
sterile or non-sterile container if needed
transportation
storage

150
Q

what is a haemolysed sample?

A

one where RBCs have broken - plasma pink/red

151
Q

where should samples be stored?

A

fridge if there is delay in testing

152
Q

why should samples be stored in the fridge?

A

slows cell metabolism

153
Q

what is the fluid limit for sending samples by post?

A

50ml

154
Q

how must samples be packed for posting?

A

sealed container
leakproof bag
absorbative padding - enough to absorb all fluid if container breaks
packaged in rigid container

155
Q

when do analytical factors occur?

A

while the test is running

156
Q

should patient side and lab methods of blood testing be compared?

A

no - results vary significantly so should not be compared directly

157
Q

what are analytical factors?

A

factors which cause variaton/error during the analysis of the sample and influence the final result

158
Q

what are the 4 main analytical factors?

A

equipment
technician
analytical procedure
laboratory

159
Q

is quality control a legal requirement?

A

no regulation just recommendations
voluntary

160
Q

when should quality control be performed?

A

regularly according to manufacturer recommendations

161
Q

what is involved in quality control?

A

control material of known composition is measured to check the accuracy of the analytical process as results are known

162
Q

when is quality control performed?

A

during analysis to ensure validity of result

163
Q

what should be done if a control fails?

A

check for obvious problems
use another tube of control materials
repeat control in full

164
Q

what are some obvious reasons for control fails?

A

reagent depletion / expiry
mechanical faults
clots - machine clean

165
Q

once a repeat control has been tried and it fails what should be done?

A

use new lot of reagent, re-calibrate and repeat control
then run routine maintenance and repeat control
consult manufacturer

166
Q

when do post analytical factors occur?

A

after sample is run

167
Q

what are some examples of post analytical factors?

A

incorrect transfer of results to the patient record
results not archived correctly
storing the specimen incorrectly / not storing for additional tests

168
Q

what are the main ways to ensure QA/QC?

A

best sample possible
stick to maintainance routines
don’t use old reagents
check if results don’t make sense

Advanced Clinical Nursing Theory (36 decks)

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