Midterm 1 Flashcards
define isohydria
concentration of hydrogen ions
pH is equal to …
-log 10 (H+)
What is a buffer?
solution that can maintain a nearly constant pH
Particularity of a buffer solution
resists to pH changes
Typical buffer solution
weak acid/base + one of it’s salts
Most important physico-chemical buffer
carbonic acid - bicarbonate buffer system
What is the carbonic acid - bicarbonate buffer system
CO2 + H2O –> H2CO3 –> H+ + HCO3-
Which organs form the vital buffer system?
Kidneys and Lungs
When H+ increases what happens to CO2
equation moves to the left, so CO2 increases
Equation of excretion of H+ by lungs
(increase)H+ + HCO3- –> H2CO3 –> H2O + (increase)CO2
Define Kussmaul breathing, and when does it happen?
normal frequency of breathing but very deep inspiration and expiration, when CO2 is being excreted
What is the kidney’s buffering capacity?
Can retain or excrete H+
When CO2 increases what happens to H+
equation moves to the right , H+ AND HCO3- increases
What kind of blood sample is needed to asses respiratory functions?
Arterial blood
What kind of blood sample is needed to asses metabolic status?
Venous or arterial sample
Why is air contamination avoided while sampling blood?
pO2 would increase and pCO2 would decrease (shortly after) or increase after long period of time
What can be calculated based on the pH and CO2?
HCO3- and ABE
Which are the metabolic parameters?
HCO3- (TCO2)
ABE
Give a respiratory parameter
pCO2
Give the blood pH reference range
7.35 - 7.45
An increase of CO2 can be called
a shift in “acidic” direction
impaired gas exchange in the lungs, remaining CO2:
Respiratory acidosis
Hyperventilation :
respiratory alkalosis
What happens to HCO3- in acidosis
decreases
What happens to HCO3- in alkalosis
increases
What happens to ABE during alkalosis
parameter shifts from 0 to positive
What happens to ABE during acidosis
parameter shifts from 0 to negative
How are compensatory parameters easily detected
parameter is shifted in opposite direction compared to pH
How do the primary process parameters shift?
in the same direction as the pH
What does it mean if all parameters are shifted in the same direction as pH?
advanced acidosis called mixed acidosis
How can we determine if the compensation effort is visible?
If either metabolic or respiratory parameter is shifted in opposite direction as pH
Metabolic acidaemia
HCO3- decrease
ABE decrease
metabolic acidaemia causes:
HCO3- loss (diarrhea)
decreased acid excretion (renal failure)
metabolic acidosis effects:
Kussmaul type breathing
Vomiting
Hypercalcaemia
Hyperkalaemia
Define the anion gap
describes the difference between the commonly measured cations in plasma and commonly measured anions
equation of anion gap
(NA+ + K+ + Uc) = (CL- + HCO3- + Ua)
Exemple of unmeasured cations
Ca2+
Mg2+
globulins
Exemple of unmeasured anions
negatively charged proteins
phosphate
lactate
Reference range for anion gap
8-16 mmol/L
How is it called when an increase of CL- occurs to compensate the decrease of HCO3- in the case of diarrhea
hyperchloraemic metabolic acidosis
metabolic alkalosis parameters:
pH > 7.4
HCO3- increases
ABE increases
metabolic alkalosis causes:
increased acid loss (vomiting)
increase alkaline production/ intake
metabolic alkalosis effects:
breathing drepession
muscle weakness (hypokalaemia)
hypocalcaemia
Respiratory acidosis parameters:
pH < 7.4
pCO2 increases
pO2 decreases
Respiratory acidosis causes:
upper airway obstruction
pulmonary/pleural cavity disease
Respiratory acidosis treatment:
assist in the ventilation
Respiratory alkalosis parameters:
pH > 7.4
pCO2 decreases
pO2 increases
Respiratory alkalosis causes:
loss of CO2 by hyperventilating
Respiratory alkalosis treatment:
anxiolytic or mild sedative in case of hyper excitation
what is the goal of blood gas analysis?
asses effectiveness of gas exchange
Which sample is used for blood gas analysis ?
Arterial samples - assessment of respiratory functions
venous samples - how much oxygen is consumed
normal pCO2 values
40 mmHg
define haemostasis
group of processes initiated in the body in order to stop bleeding in case of tissue and/or blood vessel injuries
Give the 3 major groups of hemostasis disorders:
- Vasculopathy
- Thrombocytopathy
- Coagulopathy
define vasculopathy
decreased ability of vasoconstriction
(first step of haemostatis process)
define thrombocytopathy
decreased ability of platelets to aggregates
(second step)
define thrombocytopenia
decreased amount of thrombocytes in the blood
define coagulopathy
problem with intrinsic- extrinsic or common pathway of coagulation cascade
(third step)
explain the capillary resistance test
ligature on the arm, above the elbow
after 3-5 minutes 3 small petechie should appear
What do we test with BT, BMBT
thrombocytopenia, thrombocytopathies and vasopathies
explain the BT, BMBT test
make incision on inner part of ear or in buccal mucosal surface
measure time from appearance of the first drop of blood until ceasing of bleeding
give the normal BMBT time
3-5min
What test should be performed to test for coagulopathies?
Coagulation time
Why should samples be taken with one precise venipuncture? (for CT)
to not cause damage, which may increase tissue factors
What tests can be performed to measure the CT?
- appearance of the first fibrin strand
- Clotting time on plastic syringe, glass tube and in ACT (activated clotting time)
Appearance of the first fibrin strand normal time
1-2min
CT in plastic syringe normal time
10-12min
CT in glass tube normal time
4-5min
Which factors are activated in an ACT tube?
XII which activates IX
2 methods to count platelets
- blood smear
- automatic cell counter
big platelets are often found in …
King Charles spaniel
Cats
general platelet count
200-800 X10 9/L
explain the clot retraction test
leave blood clot in tube for some hours
it will become smaller and serum will appear
volume of serum released after 1 hour is 25% of whole volume of initial clot
What is tested with the clot retraction test
thrombocytes functions
organize species according to the size of their thrombocytes
horse, sheep, cattles < dogs, swine < cats
When should we expect signs of really severe bleeding disorder?
with coagulopathies
Which factors are involved in the Prothrombin time?
I, II, V, VII, X, XIII
Which factors are involved with the APTT (activated partial thromboplastin time) test
I, II, V, VIII, IX, X, XI, XIII
Prothombin test gives information to which pathway?
Extrinsic
APTT test gives information about which pathway?
Intrinsic
In which case an increase in APT and PT test would be observed?
Common pathway problem
During dicumarol/warfarin toxicosis which test will increase?
only PT during early stages
APTT later
What is the fibrinolytic pathway responsible for?
keep the clot formation within normal limits
Most accurate way to detect increased fibrinolysis
examination of D-dimer level in blood
FDP and D-dimers tests are helpful in the diagnosis of …
DIC, disseminated intravascular coagulopathy
What is an indicator of DIC
CT: increase
BT: increase
Platelet count: decrease
PT: increase
APTT: increase
TT: increase
FDP, D-dimer: increase
Which breed is commonly seen for Von Willebrand disease
Dobermann pinchers
What is missing in von Willebrand disease
Factor VIII
what do we use as solution for anticoagulant?
EDTA
how does EDTA work?
irreversibly binds Ca ions in sample
what happens if blood is stored with EDTA for over 12 hours?
cells will swell
Where can we evaluate blood biochemistry parameters?
serum
What can we use as anticoagulant while evaluating biochemistry parameters?
heparin
Which anticoagulant is used when testing for blood clotting parameters?
Na2-citrate
What are the water compartments of the organism?
extracellular, intracellular, transcellular and interstitial space
How can we evaluate perfusion?
Capillary refill time
color of mucous membrane
blood pressure
how can we evaluate hydration?
skin turgor
mucous membranes
sunken eyes
volume of urine
define perfusion
intravascular deficit or circulation problems
define hydration
interstitial or intracellular water supply
define packed cell volume or haematocrit
ratio of whole blood volume to the volume of red blood cells
what are the methods used to evaluate the PCV or Ht
- microcapillary method
- automated cell counter
- handheld HCT meter
What can be a false cause of increased PCV?
long sample storage with EDTA
What can be a physiological cause of increased PCV?
Congenital: greyhound, whippet, borzoi and hot blooded horses
what does dehydration/vomiting do to the PCV?
makes it increase
What can be a physiological cause of decreased PCV?
increase plasma volume during 3rd trimester of pregnancy
What can be an absolute cause of decreased PCV?
hours after acute bleeding
decreased red blood cell production
decreased life span
sequestration of RBC in spleen
What can be an absolute cause of decreased PCV?
hours after acute bleeding
decreased red blood cell production
decreased life span
sequestration of RBC in spleen
What would a reddish color of plasma mean?
haemolysis
What would a whit, opaque color of plasma mean?
hyperbilirubinaemia
What would a chocolate brown color of plasma mean?
mathaemoglobinaemia
color of horse and ruminant plasma
yellowish
What is the Buffy coat
the white blood cells form a whitish opaque layer
What is the mathematical equation used to calculate osmolality
2(Na+ + K+) + urea + glucose
What is the Biuret test used for?
used to measure TP, photometrically
true or false,
TP concentration of blood plasma depends on the water balance
True
how do we generally calculate globulin?
by the difference of the TP and albumin concentration
Causes of a decrease of albumin concentration
decrease synthesis, intake
increase loss, utilisation
causes of an increase of albumin concentration
dehydration
2 reasons explaining a higher level of globulin
inflammatory process
process related to neoplasia
define polyclonal gammopathy
beta and gamma globulins derived from different clones
define monoclonal gammopathy
one protein fraction derived from one clone
when does a polyclonal gammopathy occur
inflammatory processes or some immune mediated diseases
when does a monoclonal gammopathy occur
immune mediated or neoplastic conditions
Onan electrophoresis how can we identify a monoclonal gammopathy
narrow peak comparable to the albumin
how to calculate fibrinogen concentration
plasma TP - serum TP
causes of fibrinogen concentration changes
increase: acute inflammation, dehydration
decrease: liver function impairment
most frequent method to measure glucose
glucometer
if patient has anaemia what happens to measured glucose?
measured lower
if patient has polycythaemia what happens to measured glucose?
measured higher
increase in glucose
stress
food intake
increase in glucose
stress
food intake
constant hyperglycemia
diabetes
progesterone effect
glucocorticosteroid therapy
decrease in glucose
ketosis in ruminant
starvation
insulin overdose
hunting dogs, puppies small breed, racehorses
Why is the intravenous glucose tolerance test used?
when suspected the onset of latent diabetes or insulinoma
When is the oral glucose tolerance test used?
when suspected chronic bowel disease
what can be used as a marker for average blood glucose levels over the previous 2-3 months ?
glycated haemoglobin
What is the appearance of keto bodies due to?
energy deficiency in liver cells
what is used to measured the amount of ketone bodies?
Ross-reagent
how can energy status of cattle be estimated?
by urea concentration analysis from milk and plasma
causes of hyperlipidemia
- ponies
- hypothyroidism
- pancreatitis
- increased fat diet
causes of decrease of lipid content
starvation
liver failure
malabsorption
causes of hypocholesterolaemia
mal nutrition
liver failure
causes of hypercholesterolaemia
diabetes
increased dietary fat
what is called the difference between calculated and measured osmolality
osmolar gap
above which value the osmolar gap is regarded to be pathologic
15
how can you calculate MCH?
Hgb/ RBC count x 10^12 = MCH
2 examples of decreased MCHC
newborn animals
regenerative anaemias
When do spherocytes appear?
in sensitive RBC membrane
how can you calculate MCV
PCV / RBC count x 1000
2 examples of increased MCHC
Vit B12, folic acid deficiency
lead poisoning
when do stomatocytes appear ?
When there is an increase in RBC production
what is the normal oxygen saturation of arterial blood
95-99%
what is the normal oxygen saturation of venous blood
80-90%
What are called Hgb molecules in 3+ form
methaemoglobin
(unable to carry oxygen)
Which species has the Hgb concentration affected by age
Swine
normal RBC count
4.5-8 x 10^12
What does MCH mean
mean corpuscular haemoglobin
what does MCV mean
mean corpuscular volume
what does MCHC mean
mean corpuscular haemoglobin concentration
in which species do reticulocytes only appear in bone marrow but not peripheral blood
horse, ruminants
define regenerative anaemia
enough RBC are being produced to replace and reach normal RBC count quickly
what are the different type of RBC sizes
macrocytosis
microcytosis
anisocytosis
poikylocytosis
what is a reticulocyte
young but mature RBC without nucleus
Spherocyte appears
sensitive RBC membrane
Acanthocyte (Spur cell) appears
RBC membrane failure
Schysocyte (RBC fragment) appears
traumatic or toxic damage
Anulocyte appears
iron deficiency anaemia
Codocyte (target cell) appears
regenerative process
Echynocyte appears
lab error
Sickle appears
RBC damage
Example of infection
parasitic
Example of inflammation
infection, imune mediated
What kind of sample is used for white blood cell counting?
anticoagulated blood
in WBC counting, scatters are detected by two light detectors what are they called?
forward and side scatter detector
what does the forward scatter detect?
size of the cells
what does the side scatter detect?
inner structure complexity
define “gaiting”
when a cloud of points (obtained with the side and forward scatter values) is framed and counted, we then have the cell count of a similar cell type
different pools of WBC in the body
- bone marrow
- blood vessels
- circulating blood
- tissue
how can physiological leukocytosis develop?
acute or chronic stress
when can we observe neutropenia
first period of inflammatory process, neutrophils are migrating to site of inflammation, decrease of WBC in blood.
When can we observe neutrophilia
later phase of inflammation, stimulating WBC growth In bone marrow by G-GSF factors
define regenerative left shift of WBC
increase of WBC count, neutrophilia and younger neutrophils.
sign of favourable prognosis
define degenerative left shift of WBC
greater utilization of neutrophils in the tissue than regenerative capacity of bone marrow
what does G-GSF and GM-CSF do?
growth factor that makes bone marrow produce more WBC (neutrophils)
what is a leukemia reaction
increase in WBC
What are Döhle-bodies, and in which species are they most common?
inclusion bodies in neutrophil granulocytes, in cats
what does right shift mean in WBC count?
many segmented and hyperhsegmented are seen in the smear, and an increase of WBC. typical of chronic inflamation
to what and how is the coagulation time correlated
coagulation time is inversely correlated to the concentration of fibrinogen and globulin in the blood
what’s can cause an increase in erythrocytes sedimentation rate
lower albumin levels, higher globulin levels
what are the body cavities?
abdominal
thoracic
pericardial
causes of accumulation of fluid in different cavities
increased permeability of vessels
increased hydrostatic pressure
impeded lymphatic flow
hormonal effects
what are the types of fluids
transudate
exudate
modified transudate
blood`lymph
describe the transudate fluid
colour: bloody or yellow
odour: none
consistency: watery
slightly alkaline
describe the modified transudate fluid
colour: bloody, opaque, grey-white, yellow
odour: sometimes
consistency: watery, slightly viscous
describe the exudate fluid
colour: bloody, generally opaque, grey-white, yellow-white
odour: often
consistency: viscous
acidic
Which fluid would have the most positive response to the Rivalta test
exudate > modified transudate > transudate
what can be an indicator of badder rupture
if creatinine level is higher in peritoneal fluid than in plasma
what is an indication of duodenal perforation or gall bladder rupture
if alpha amylase concentration is higher in peritoneal cavity than in plasma
high alpha amylase concentration in pleural cavity
ruptured oesophagus
more triglycerol than cholesterol in fluid means
fluid is of lymphatic origin
transudates causes of development
increased vessel permeability due to underlining causes
- increase of hydrostatic pressure of the blood
- decrease of plasma colloid oncotic pressure
- impeded lymphatic flow
- hormonal effects
exudates causes of development
Increased permeability of vessels due to inflammatory causes bacterial
viral
parasitic
inflammatory mediators
Increased migration of phagocites
Increased proliferation of mesothelial cells
Increased production of inflammatory proteins
which spaces are used to sample CSF
occipital and lumbal zona
examination of CSF colour
colour (red - fresh bleeding, yellow - bleeding in the past, opaque - in highly inflammatory or neoplastic conditions)
define ileus
persistent inhibition of arboreal transmission of gastric or intestinal content
increased parasympathomimetic effect on intestinal functions
increased smooth muscle contraction
increased intestinal metabolism causes increased gas formation and accumulation cranially to the effect
what effects does atropin and scopolamin have?
- inhibits effects of parasympathetic stimulant drugs
- decrease intestinal spasm in order to be able to perform rectal examination in horses an cattle when colic
what effects has an increased sympathomimetic
relaxing intestinal tissues
what is a consequence of a distal ileus
metabolic acidosis
what is a consequence of a proximal ileus
metabolic alkalosis at first then metabolic acidosis
what happens during a distal ileus
- empty stomach,
- vomit contains small intestinal fluid (high pH)
- dehydration
- anaerobic glycolysis
- lactic acid formation
a lack of bile flow can lead to…
severe endotoxaemia (bile is an endotoxin inactivator)
What happens to pancreatic enzymes
made in pancreas as proenzymes, activated in duodenum
an hematological analysis of a pancreatitis will show?
polycythaemia
degradation of red blood cells
anaemia
leukocytosis
neutrophilia
pancreatic enzymes in the plasma
alpha-amylase
lipase activity
example of alpha amylase enzyme
S-amylase
P-amylase
which organ excretes alpha amylase enzymes and lipase enzymes
kidney
methode to measure alpha amylase
starch digestion test
(more stain will get free as alpha amylase is present in plasma sample)
example of lipase isoenzyme
gastric lipase
intestinal lipase
to diagnose a pancreatitis what should the measurements be
increased:
- urine/plasma amylase
- urine creatinin
=/+ plasma creatinin
to diagnose a kidney failure what should be measured
increased:
- plasma amylase, plasma creatinin
decreased :
- urine amylase, urine creatinin
What is the defense mechanism against active tyrosine enzymes
antiprotease molecules:
- alpha 1- antitrypsine
- alpha 2-macroglobulin
Pancreatic acing atrophy mostly happens in which breed
German shepherd dogs
what test is used to diagnose EPI
TLI- concentration < 2,5
BT-PABA (cannot be absorbed, needs to be broken up)
A sudan III stain of faces allow us to see
undigested lipid particles
giema stained smear allows us to see
undigested striated muscle
lugol stained smear allows us to see
undigested starch (blue)
