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Diagnostics 2 > Midterm > Flashcards

Midterm Flashcards

1
Q

What are the causes of a non-regenerative anemia?

A

-pre-regenerative
-chronic renal disease
-inflammation
-bone marrow disease
-hypothyroidism or cushings
-iron deficiency
-precursor targeted IMHA

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2
Q

What are the causes of neutrophilia?

A

-Inflammation
-stress
-physiologic
-chronic leukemia
-paraneoplastic

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3
Q

What are the causes of a monocytosis?

A

-inflammation
-stress
-acute or chronic leukemia

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4
Q

What are the causes of thrombocytosis?

A

-essential thrombocythemia
-splenic contraction/splenectomy
-inflammation
-iron deficiency

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5
Q

What is commonly seen with anemia of chronic disease?

A

Mild normocytic, normochromic, non-regenerative anemia

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6
Q

T/F: Reactive thrombocytosis secondary to inflammation is a common cause of thrombocytosis in animals

A

True

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7
Q

What are the different methods for sampling the respiratory system?

A

-nasal swab/nasal biopsy (often polyps are connected to a tumor)
-paranasal trephination
-transtracheal aspiration (culture/cytology)/endoscopic tracheobronchial aspiration (allows for visualization)
-bronchioalveolar lavage (for asthma or infectious bronchitis)
-lung biopsy
-thoracocentesis (pleural fluid evaluation, cytology, bacterial/fungal culture)
-necropsy

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8
Q

What are the most common diseases of the nasal cavity?

A

-viral (herpesvirus in cats)
-bacterial (atrophic rhinitis in pigs or actinomycosis in cows)
-fungal (aspirgillosis in dogs and horses, crypto in cats)
-cancer (adenocarcinoma, SCC, mesenchymal tumors (chrondro or osteosarcoma) or tooth related tumors

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9
Q

What causes atrophic rhinitis in pigs?

A

Coinfection with bordatella bronchiseptica (not normal flora) and pasteurella multocida (normal flora)

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10
Q

If there is a large granulomatous lesion compressing the cribriform plate and the brain in a cat, what is the likely diagnosis?

A

Cryptococcus
-can see similar lesions in horses

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11
Q

Why are ethmoid hematomas in horses so difficult to treat?

A

They will continuously regrow
- causes profuse bleeding from the nares

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12
Q

What is the most common bacterial isolate from the respiratory tract in horses?

A

Strep equi ssp zooepidemicus
- normal flora bacteria
- also most common bacteria with pneumonia

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13
Q

Describe subepiglottal ulcers?

A

Common in racing horses
- causes inflammation in larynx causing them to not breath normally

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14
Q

What causes fibronecrotic laryngitis in cows?

A

Fusobacterium necrophorum and histophilus somni
- focally extensive lesions

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15
Q

What are some other pathologies that histophilus somni can cause?

A

Thromboembolic meningoencephalitis in pigs
-BRD in cattle

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16
Q

What is the cause of diffuse fibronecrotic pharyngitis and tracheitis? What is the cause of this in horses?

A

Infectious bovine rhinotracheitis virus
- in horses caused by equine herpesvirus 1

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17
Q

What are all the agents associated with BRDC?

A

Viruses: BRSV, PI3, BVD, IBR, coronavirus
Bacteria: Pasteurella multocida, mannheimia haemolytica, mycoplasma bovis, histophilus somni, truparella pyogenes

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18
Q

What is the Lungworm agent?

A

Dictyocaulus viviparus

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19
Q

If you get a cuture from a cow with BRDC and you just have trueparella, what does this mean?

A

You have to keep digging
- this is an opportunistic infection, something else caused the damage initially

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20
Q

How does mycoplasma cause disease?

A

Attaches itself to the cilia as it wants to be one, which slows down the mucociliary apparatus
-can cause bronchiectasis

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21
Q

If you see fibrinous bronchopneumonia in a cow with suspected shipping fever, what agent is likely involved?

A

Mannheimia hemolytica
- part of normal flora

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22
Q

What are the main respiratory defenses?

A

Nasal colonization and shedding
-mucociliary clearance
-host defense factors in epithelial lining
-inflammatory response of epithelial cells
-alveolar macrophages
-recruited neutrophils

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23
Q

T/F: viral infections always come before bacterial in BRDC infections

A

False
-usually the case but can also be due to cold air, dehydration, vitamin D deficiency, stress, steroid use, and many other causes

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24
Q

What is fog fever?

A

Atypical interstitial pneumonia of cattle
- occurs during spring with lush pastures
- lush pastures contain a large amount of Tryptophan which is converted to 3-methyl indole in the rumen

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25
Q

What is the reportable disease that you should have on the top of your differential list if you see granulomatous lung abscesses in a cow?

A

Tuberculosis
- Mycobacterium bovis
- the US is currently free of this disease

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26
Q

What is vena cava syndrome in cattle?

A

Acidosis causes ruminal papilla sloughing allowing for bacterial translocation from rumen to the liver
- after the liver it can travel through the vena cava and heart and make its way to the lungs where it results in pulmonary thromboemboli
- emboli can also result in jugular thrombosis and deep vein thrombosis

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27
Q

Describe the agents responsible for ovine enzootic pneumonia

A

-environmental factors: crowding, humidity, temperature, air quality, stress
-viral infections: RSV, BPIV-3, adenovirus
-bacterial infections: mannheimia hemolytica, pasteurella multocida, mycoplasma ovipneumonia (big killer of bigborn sheep), histophilus somni

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28
Q

Describe OPP and CAE

A

Small ruminant lentiviruses
-results in progressive interstitial pneumonia, encephalitis, arthritis and mastitis

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29
Q

What is the one condition that does not follow the rules and causes caudodorsal distribution of fibrinous bronchopneumonia in pigs?

A

Actinobacillus pleuropneumonia

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30
Q

Why is interstitial pneumonia hard to diagnose on necropsy?

A

It is diffuse
- if you dont have normal lung to compare it to you may think it looks normal

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31
Q

What is the main clinical sign of retroviral pulmonary carcinomatosis (ovine pulmonary adenocarcinoma)?

A

When you tilt their head down, gravity causes a large amount of fluid to flow out of nares

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32
Q

What does diffuse interstitial pneumonia with multifocal lobar atelactasis look like in pigs? What are some conditions that can cause it?

A

Looks like a checkerboard
- caused by PRRSV and porcine influenza virus

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33
Q

What are the different causes of fibrinous polyserositis in pigs?

A

Mycoplasma hyorhinis, **glaeserella parasuis (glassers disease), streptococcus suis, Ecoli

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34
Q

What area of the lungs are most affected by suppurative bronchopnuemonia in horse?

A
  • only affects cranioventral aspect of the diaphragmatic lobe of lungs
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35
Q

What is the most common cause of pneumonia in horses?

A

Strep equi ssp zooepidemicus

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36
Q

What is the cause of equine nodular pulmonary fibrosis?

A

EHV-5
- usually located on dorsal aspect of diaphragmatic lung lobes

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37
Q

What is commonly seen on histopath of a foal with rhodococcus equi?

A

Giant cell macrophages
-also can cause ulcerative colitis, lymphadenitis, or osteomyelitis

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38
Q

What are the common agents responsible for bronchopneumonia in dogs and cats?

A

Usually secondary
- pasteurella
-streptococcus
-Ecoli
-klebsiella
-bordatella bronchiseptica

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39
Q

What are the main causes of interstitial pneumonia in dogs and cats?

A

Dogs: canine distemper (main one), canine parainfluenza, canine adenovirus, canine influenza, canine herpesvirus 1 (usually only in young animals)

Cats: feline rhinotracheitis (feline herpesvirus 1), feline calcivirus

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40
Q

What can cause diffuse granulomatous pneumonia in dogs and cats?

A

Histoplasmosis
-can also be seen with blastomyces or cryptococcus in some cases

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41
Q

What are the features of heart muscle on histopath?

A

Striations, intercalated discs, branching, central nucleus

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42
Q

What are some congenital malformations of the heart?

A

VSD(most are high in the ventricle),ASD, PDA, persistent right aortic arch (along with megaesophagus), tetrology of fallot

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43
Q

When does PDA become a problem?

A

If it doesnt close by 2 weeks
- wont see lesions for months however
-causes continuous washing machine murmur

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44
Q

Where does pulmonic stenosis or subaortic stenosis occur?

A

Pulmonic- right at level of the valve
Subaortic stenosis - right below the valve

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45
Q

What tumors affect the heart?

A

Hemangiosarcoma, chemodectoma (heart base tumors) and lymphoma

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46
Q

What are the classic locations of hemangiosarcoma?

A

Right auricle, spleen, skin
-neoplasia of endothelial cells (causes poorly formed blood vessels)

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47
Q

What is cardiac tamponade?

A

Excessive pressure in the pericardium preventing the heart from contracting effectively or fill effectively

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48
Q

What is the common clinical presentation of chemodectomas?

A

Effusion in pericardial sac
- tumor itself is usually benign

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49
Q

What species most commonly gets lymphoma in the heart?

A

Cows
-also get it in heart, abomasum, uterus, spinal cord, lymph node (retrobulbar most commonly)
-associated with bovine leukosis virus (though very few cows develop lesions)

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50
Q

What are the main types of cardiomyopathy in vet med?

A

Hypertrophic, dilated, restrictive, boxer

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51
Q

What is the common signalment for DCM?

A

Large breed dogs
-results in decreased contractility, dilation is due to volume overload
-can also occur as a result of grain free diets
-can be seen in cats due to taurine deficiency

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52
Q

Who gets HCM?

A

Cats
- can be primary or secondary (associated with hyperthyroidism)
-concentric hypertrophy is due to pressure overload
-heart should weight 18 grams or less (if more, it is sus)
-on histopath will see fibrous infiltrates and disorganization of fibers and lipid deposits

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53
Q

In boxer cardiomyopathy, what is the heart wall replaced with?

A

Lipid
- over 75% of the wall replaced

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54
Q

Who gets myxomatous mitral valve disease?

A

Small breed dogs (Cavaliers mostly)
- valves look thin and shiny

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55
Q

What can cause myocardial necrosis in a puppy?

A

Parvo

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56
Q

What do horses get that causes myocardial necrosis?

A

Ionophore toxicity
-often occurs when horses get into cattle feed
-causes sudden death

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57
Q

What is white muscle disease a result of?

A

Selenium or vitamin E deficiency
-selenium is a cofactor for glutathione reductase which helps to break down free radicals
-shows up most commonly in heart, tongue, and diaphragm and masseter muscles
-always take sample of papillary muscle (most frequently affected)

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58
Q

What can occur with death of heart muscle

A

Fibrosis of heart muscle
- flow of blood to lung will be affected (hemosiderin in macrophages)
- necrosis around central vein of liver +/- fat accumulation

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59
Q

T/F: sepsis can lead to endocarditis, myocarditis and pericarditis

A

True

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60
Q

What are some physical exam findings that would point one towards an infectious/inflammatory differential?

A

-fever
-generalized lymphadenopathy
-multisystemic disease

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61
Q

What on a CBC points towards inflammation?

A

Let shift, leukocytosis, toxic changes, lymphopenia (could be due to acute inflammation or stress)

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62
Q

If the HCT is low, and RBCs are normal, can you still categorize the patient as anemic?

A

YES

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63
Q

What are the 3 things that can cause a selective
and severe hypoalbuminemia?

A

-Protein losing nephropathy
-Liver failure
-Inflammation

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64
Q

With PLE, what changes do you expect to see to the proteins?

A

Hypoalbuminemia + hypoalbuminemia

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65
Q

How can you rule out hepatic failure as a differential?

A

If all of the markers of liver function are normal
- Glucose
-BUN
- cholesterol

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66
Q

How can you rule out a protein losing nephropathy?

A

Look at urine protein
- if negative, this can be ruled out

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67
Q

What are the causes of hyperglobulinemia?

A

Inflammation
Neoplasia (lymphoma and plasma cell)
Dehydration

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68
Q

How can you rule out renal causes of azotemia?

A

Adequately concentrated urine

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69
Q

What electrolyte changes may be seen with urinary bladder rupture?

A

Hyponatremia, hypochloremia, and hyperkalemia

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70
Q

Why may you have a decreased anion gap?

A

Hypoalbuminemia
- albumin is an unmeasured anion (have to increase other anions- chloride and bicarb- in order to maintain electroneutrality)

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71
Q

What is the equation for anion gap?

A

(Sodium + potassium)- (chloride + bicarb)

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72
Q

What does an elevated TCO2 indicate?

A

A metabolic alkalosis

73
Q

If alkalosis is due to vomiting, what would you expect the electrolyte values to look like?

A

Chloride would be lower than sodium (corrected chloride)

74
Q

T/F: foals < 6 months have lower MCV than adult horses

A

True

75
Q

What does MCH tell you?

A

The amount of iron in each RBC
- if RBCs are smaller there will be less iron
- low MCHC is more definitive for diagnosing an iron deficiency anemia

76
Q

What are the causes of hyperglycemia?

A

Glucocorticoid stress, sepsis (can cause hyper or hypoglycemia), epinephrine excitement

77
Q

When is there a risk of tissue mineralization

A

When Ca X P >80

78
Q

What are some causes of hyperphosphatemia?

A

Decreased GFR, diffuse intestinal disease, rhabdomyolysis

79
Q

What are some potential causes of an elevated GGT in horses?

A

Cholestasis, biliary hyperplasia, intestinal disease

80
Q

What is the most common cause of a hyperbilirubinemia due to elevated indirect bilirubin?

A

Fasting/anorexia

81
Q

When should you calculate a corrected chloride?

A

When there is a hyponatremia along with a hypochloremia

82
Q

How do you calculate corrected chloride?

A

(middle of Na reference/measured Na) X cl

83
Q

What are some causes of a hyponatremia and hypochloremia?

A

-volume overload
-excessive water intake
-hypertonic fluid loss (secretory diarrhea)
-hypotonic fluid loss (GI, renal, 3rd space)

84
Q

What is an elevated anion gap by definition?

A

A titrational metabolic acidosis
- can be due to ketones, lactate, uremic acids, or ethylene glycol

85
Q

What do the cranial mediastinal, sternal, and hilar lymph nodes drain?

A

Mediastinal: 2nd stop for lymph nodes that drain head and forelimbs, also drains ribs and thoracic vertebrae, some of caudal lungs
Sternal: abdominal cavity and body wall, mammary glands
Hilar: drain the lungs

86
Q

What can significant enlargement of the hilar lymph nodes lead to?

A

Ventral deviation of the carina

87
Q

What are the two main differentials for a miliary interstitial or nodular structured interstitial pattern?

A

Fungal pneumonia: blasto, histo, coccidiomycosis (valley fever)

Less likely: neoplasia (lymphoma or metastatic disease)
-more likely to have variety in sizes

88
Q

Where is blastomycosis typically found

A

in wet soils enriched with organic matter
- endemic areas include mississippi, ohio, st lawrence river and the atlantic states of the US

89
Q

Describe the pathogenesis of blastomycoses

A

Nasal cavity–> alveolar spaces–> phagocytized by macrophages –> pathogenic yeasts distributed throughout lymphatic and hematogenous routes–> most commonly travel to skin and bone
- the cutaneous form occurs in 20-50% of all patients with blasto, with a predilection for the nasal plane, face and plantar cushions

90
Q

How is blasto diagnosed?

A

-historically based on direct detection in tissues and fungal culture
-histopath allow for observation but not identification
-fungal culture is the most robust and irrefutable technique, but fungal growth is slow which delays diagnosis and treatment
-molecular tests are the main method of quick diagnosis today

91
Q

T/F: blasto is zoonotic

A

TRUE
- should where PPE if you suspect this

92
Q

Describe the features and pathogenesis of rhodococcus equi

A

-gram positive, facultative intracellular pathogen ubiquitous in soil
-VapA gene allows the bacteria to survive within macrophages
-inhibits fusion of the phagosome-lysosome, bacteria replicate within and eventually rupture macrophages (similar to pathogenesis of mycobacterium)
-young foals are at risk due to waning of passive humoral activity. Failure of passive transfer of colostrum is also a predisposing factor

93
Q

How can you diagnose rhodococcus? What are some other differentials?

A

Gross and histological findings
-bacterial culture and/or PCR amplification combined with cytologic examination of the transtracheal aspiration
-radiographic evidence of lung abscesses/granulomas, ultrasonography

Differentials for granulomatous pneumonia: aspergillus, histoplasma, Blastomyces, cocciodioises, cryptococcus, mycobacterium

94
Q

T/F: rhodococcus equi infections can be seen in a variety of other species besides horses

A

True

95
Q

Describe the pathogenesis of fibrinous bronchopneumonia as a result of Ecoli infections in cats

A
  1. Ingestion and/or inhalation
  2. Adherence and colonization
  3. VF CNF-1 reduces arrival of inflammatory cells and evades neutrophils
  4. CNF-1 induces edema and necrosis of the blood vessels and pulmonary parynchema
96
Q

What are the hallmark features of a stress leukogram?

A

Mild leukocytosis (mature neutrophilia and mild monocytosis), lymphopenia and eosinopenia

97
Q

What is seen on bloodwork with a titrational metabolic acidosis?

A

-Elevated anion gap
- low TCO2

98
Q

What bloodwork changes would you expect to see with primary hyperparathyroidism?

A

-high calcium, low phosphorus

*primary hyperparathyroidism is rare

99
Q

What changes would you expect to see with the chemistry with addisons disease?

A

Changes in sodium, chloride and potassium

100
Q

What bloodwork changes would you expect to see with vitamin D toxicosis?

A

Elevated calcium and phosphorus

101
Q

What bloodwork changes would you expect to see with osteolytic disease?

A

Elevated calcium (only when very widespread) and phosphorus

102
Q

What test should you run if you want to determine if a hypercalcemia is idiopathic or due to cancer?

A

iCa, PTH, PTHrp
- PTHrp would be elevated if cancerus

103
Q

What are some causes of a pleural modified transudate?

A
  1. Heart failure
  2. Obstruction of caudal vena cava or hepatic vein (GDV, heartworm)
  3. Neoplasia
  4. Lung disease of torsion
  5. Diaphragmatic hernia
  6. Long standing transudates
104
Q

What are the differentials for eosinophilia?

A

Worms, wheezes and weird diseases (eosinophilic bronchopneumonia, hypereosinophilic syndrome, neoplasia, specifically mast cell and lymphoma)

105
Q

Describe what the most important values to look at are on blood gas and what elevations/decreases indicate

A

pH: if decreases=primary acidemia, if increased=primary alkalemia
pCO2: if decreased= respiratory alkalosis, if increased =respiratory acidosis
TCO2 (HCO3): if decreased = metabolic acidosis, if increased=metabolic alkalosis

106
Q

T/F: If pH is normal, there is not a compensatory reaction

A

True
- compensatory responses never get you back to normal pH
-may indicate a mixed acid base reaction

107
Q

What should you look at when interpreting acid-base on CBC/chem? What do changes indicate?

A

Na:
Cl: Decreases in corrected chloride =hypochloremic metabolic alkalosis (occurs with vomiting), increases in corrected chloride =”hyperchloremic” secretional metabolic acidosis (occurs a lot with diarrhea and loss of bicarb)
K: Acidosis causes increases (leaves cells as H enters), alkalosis causes decreases (enters cells as H leaves)
TCO2: Increased=metabolic alkalosis, decreased= metabolic acidosis
Anion Gap: Increased= titrational metabolic acidosis, decreased doesn’t matter clinically

108
Q

T/F: Gallop rhythm is an arrythmia

A

False- it is an auscultated sound
- not necessarily associated with an arrythmia

109
Q

What radiographic changes are seen with pleural effusion?

A

Increase in soft tissue opacity in periphery of thorax with conforms to the thorax margins
- retraction and rounding of lung lobe margins
- less gas within lung parenchyma–> increased opacity
- pleural fissure lines are widened (more separation between lung lobes)
-border effacement of heart and diaphragm

110
Q

Describe how you take a vertebral heart score

A

Take measurements of top dimesion of the long and wide view, line up with the cranial aspect of T4 vertebral body
-count vertebral bodies that the measurements span and determine the sum of the 2

111
Q

What is seen on radiographs with left sided heart enlargement?

A

Lateral: increased length of the heart mainly due to left atrial enlargement (looks like the heart is wearing a backpack)
DV: widening of the cranial heart due to left atrial and left auricular enlargement, left ventricular hypertrophy maintains a normal apex

112
Q

What is the consequences of HCM?

A

Disease of diastolic dysfunction
-causes left ventricular hypertrophy, and backup of fluid into the left atrium and eventually the pulmonary veins leading to cardiogenic pulmonary edema

113
Q

Where does pulmonary edema tend to occur in dogs with left sided congestive heart failure?

A

Perihilar
- more random distribution in cats

114
Q

Where do the pulmonary veins lie in relation to the arteries?

A

Ventral and central

115
Q

What happens to the pulmonary vasculature with right sided vs left sided disease?

A

Left sided: pulmonary venous distension
Right sided: pulmonary arterial enlargement

116
Q

What thoracic changes are commonly seen with heartworm disease in cats?

A

-increased lung opacity due to acute and chronic parenchymal inflammation and thromboembolism secondary to inflammatory reactions to arriving and dead adult heartworms
-enlarged caudal pulmonary arteries (right often moreso than left)
-cats tend to not get pulmonary hypertension or right heart changes
-Cats with feline asthma can look very similar in terms of the lung changes- bronchial pattern

*in dogs you can see right heart enlargement - increased sternal contact, reverse D appearance

117
Q

What is the MAIN difference between heartworm disease in dogs and cats?

A

Cardiac disease in dogs, respiratory disease in cats
-most cats with heartworm clear the infection on their own (aberrant host), they are more resistant
-cats have infections with fewer worms, but a few worms is still considered a heavy infection
-one third of cases are worms of the same sex
-microfilaria are very rare, and if present exist very transiently

118
Q

T/F: in cats, no single test will detect all of the heartworm cases

A

True

119
Q

Describe the use of serology in diagnosing heartworm

A

Antigen test: gold standard in dogs, not in cats. High specificity, but in cats will not detect male only infections
Antibody test: can detect antibodies 2 months post infection, but not all cats produce antibodies (just indicates exposure)
-if a cat is suspected of having heartworm, both tests are recommended (false negatives can still occur)

120
Q

How do you diagnose heartworm in cats?

A

Combo of diagnostics: antibody test, antigen test, thoracic radiographs, echocardiography
-repeat tests if you suspect infection and you keep getting negatives

121
Q

What occurs with DCM?

A

Functional deficit in contractility
- causes enlarged lumen of the left ventricle

122
Q

Why are hyperthyroid cats at a higher risk of developing HCM?

A

Due to increased catecholamine releases
- leads to hypertension and increased force required to contract the heart
- can also be primary and not associated with hyperthyroidism

123
Q

What does DCM predispose to? HCM?

A

DCM: Ascites
HCM: thrombus formation

124
Q

T/F: heart muscle can regenerate

A

False
- damage to heart is therefore a big deal

125
Q

What species are the most affected by white muscle disease?

A

Cow, sheep, pig > horse and goat > dog, cat, bird
- usually affects neonates

126
Q

How can you diagnose white muscle disease?

A

GPX in blood in living animals
-Se/vitamin E in liver of dead animals

127
Q

What is the last tissue type to lose fat?

A

The bone marrow

128
Q

What direction do thrombi build?

A

Retrograde
- opposite to the direction of blood flow
- towards heart in artery, away from heart in vein

129
Q

For all species except for the pig, how does flow through the lymph node occur?

A

Afferent lymphatic vessels come in through the capsule, lymph then percolates through the subcapsular sinuses, then down through cortex and medulla and out through the efferent lymphatics
- lymphoid follicles exist in the cortex, can tell how antigenically stimulated a lymph node is based on the density of the follicles and whether they are primary or secondary

130
Q

What can cause lymph nodes to be too small?

A
  • developmental disorders such as SCID
    -lack of antigenic stimulation (pathogen free animals)
    -cachexia/malnutrition (mainly decreases production of T lymphocytes)
    -aging/senile atrophy (generalized depression of the immune system–> loss of lymphocytes –> lymph node atrophy)
    -viral infections (destruction of lymphoid tissue, BVDV, Canine distemper)
131
Q

What is the term for enlarged lymph nodes? What are the 3 main differentials for this?

A

Lymphadenopathy
-can be due to lymphoid hyperplasia, lymphadenitis or neoplasia

132
Q

What can cause lymphoid hyperplasia?

A

-due to secondary lymphoid follicles reacting to anitgenic stimulation

Can be due to generalized lymph node hyperplasia (systemic inflammatory disease/infection) or localized lymph node hyperplasia (draining regional area of inflammation or antigenic stimulation)

133
Q

How can you differentiate hyperplasia vs neoplasia on necropsy?

A

Hyperplasia: will have a mottled appearance on the cut surface, retention of the cortical and medullary architecture, painful on palpation

Neoplasia: homogenous white/tan cut surface, loss of normal architecture, non-painful on palpation

134
Q

How is lymphadenitis different than lymphoid hyperplasia?

A

Lymphadenitis is a nidus of inflammation/infection within the lymph node itself vs just antigenic stimulation from an infection elsewhere

135
Q

Define lymphadenitis and describe the different morphological patterns associated with it

A

-regional lymph nodes drain a site of nearby infection and become infected themselves

Patterns:
- suppurative (strep)
-caseous (corynebacterium pseudotuberculosis)
-granulomatous (intracellular pathogens: histoplasma capsulatum, leishmania, mycobacterium)

136
Q

What are some less frequent manifestations of CL?

A

Ulcerative lymphangitis in cattle/horses
-pectoral abscesses in horses

137
Q

What is the pathogenesis of CL in sheep?

A

Skin wounds allow for bacteria to enter through the skin, bacteria then drain to the regional lymph nodes and form abscesses which is enclosed by a fibrous capsule
-repeated cycles of abscess formation and encapsulation can occur leading the cut surface to look like an onion (termed lamination)

138
Q

What is the classic presentation of granulomatous inflammation on histology?

A

Giant cell macrophages containing bacteria surrounded by lymphocytes and plasma cells

139
Q

What is primary neoplasia of the lymph node?

A

Lymphoma
- arise from lymphoid tissue outside the bone marrow
Classification guides treatment:
- anatomic location: multicentric, alimentary, mediastinal, cutaneous, etc
- immunophenotype: T cell, B cell, non B/non T
- cell morphology: size, nuclear features, mitotic rate
- histological pattern: diffuse vs follicular
- biologic behavior: low, intermediate, high grade

140
Q

What percentage of dogs with lymphoma will develop hypercalcemia?

A

15%
- due to PTHrp (comes from neoplasia itself)- AGASACA is the other neoplasm that does this

141
Q

In what species can viral infections contribute to the development of lymphoma?

A

Cats
- feline leukemia virus
- can cause mediastinal and multicentric forms, affects younger cats
Cattle
- bovine leukemia virus
- causes a lymphocytosis which can progress to lymphoma
- long latency period (more likely to find this in old cattle), young cattle more likely to be sporadic lymphoma

142
Q

Why do lymphomas so often metastasize? What tumor types are most likely to metastasize to the lymph node?

A

The two most common routes of metastasis are through the bloodstream and the LYMPHATICS
- usually found near the subcapsular sinus
- often poorly differentiated

Tumor types: SCC (late in course of disease), mammary carcinoma, gastric carcinoma, pulmonary carcinoma, osteosarcoma, melanoma

143
Q

What are the two main components of the spleen?

A

Red pulp: removes RBCs and microbes, stores RBCs
White pulp: secondary lymphoid tissue

144
Q

What is one of the main functions of the spleen?

A

To remove senescent erythrocytes

145
Q

What can trauma to the spleen result in?

A

Trauma can cause rupture and fibrosis
-can also cause selenosis or accessory spleens that seed into the omentum (must differentiate from hemangiosarcoma by taking biopsy)

146
Q

What are siderotic plaques?

A
  • common in older dogs
    -arise from healing of previous subcapsular hemorrhage
  • look like mineralization around the border (grey tan plaques)
147
Q

Why are splenic torsions more common in dogs and pigs?

A

The gastrosplenic ligament is much longer in these species
- usually occur in combination with gastric torsion in deep chested dogs
-medical crisis
- venous outflow more impaired than arterial supply–> congestion and infarction

148
Q

What are the two primary causes of splenic infarcts?

A

Acute vascular occlusion (usually due to thromboembolism)

Vasculitis (due to bacterial/viral infection)

*acute lesions will look red and enlarged, chronic will look grey and fibrosed

149
Q

What are some causes of small spleens?

A

-developmental disorders (SCID)
-cachexia/malnutrition (mainly decreases production of T lymphocytes)
-aging/senile atrophy (generalized depression of immune system– > loss of lymphocytes –> splenic lymphoid atrophy)
-splenic contraction (sympathetic activation, heart failure, shock)

150
Q

What do congestion and cellular infiltration of the spleen look like on necropsy?

A

Congestion: bloody
Cellular infiltrate: meaty

151
Q

What are the main causes of splenic congestion?

A

Barbiturates (most common cause)
Acute septicemia (anthrax, salmonellosis)

152
Q

What are the main causes of cellular infiltration of the spleen?

A

-macrophage hyperplasia (hemolytic anemia or chronic infectious disease)
-neoplasia (lymphoma** or leukemia)
-rarely amyloidosis or lysosomal storage disease

*- can also cause nodules

153
Q

What is the most common cause of splenic nodules in the cat?

A

Mast cell neoplasia
- in the dog, can be due to nodular hyperplasia (benign- can lead to hematoma formation), hematoma, hemangiosarcoma, lymphoma, or metastatic neoplasia
- in all species can be caused by lymphoma, granulomas or abscesses

154
Q

What are the 5 causes of loss of serosal detail?

A

Lack of fat, peritoneal fluid, immaturity, visceral crowding, cellular infiltration

155
Q

What are the most common tissues of origin of a central abdominal mass?

A

Spleen, pancreas, intestines, ventral liver mass

156
Q

What are the most common tissues of origin of a dorsal abdominal mass?

A

Left kidney, left adrenal gland, mesenteric LN, ovary, intestine

157
Q

What are the most common tissues of origin of a cranioventral abdominal mass?

A

Right or left liver lobes, pyloric or antral region of the stomach, pancreas, gall bladder, hepatic lymph nodes

158
Q

What are the most common tissues of origin of a dorsocaudal abdominal mass?

A

medial iliac LN, colon/rectum, uterus, periprostatic cysts

159
Q

What are the most common tissues of origin of a ventrocaudal abdominal mass?

A

Urinary bladder, prostate, uterus, retained testicle, small intestine

160
Q

T/F: the center of the mass is usually the origin point

A

True

161
Q

What is the most likely differential for a focal splenic mass?

A

Hemangiosarcoma
- 2/3 of abdominal masses are mid ventral, 2/3 of those are associated with spleen, and 2/3 of those are hemangiosarcoma
-hematoma is the next ruleout

162
Q

When you see pulmonary nodules of varying sizes, what is the most likely diagnosis?

A

Pulmonary metastasis

163
Q

T/F: with generalized hepatomegaly, you will see a shift in the gastric axis

A

True
- pylorus is pushed caudally and dorsally

164
Q

What is the most common cause of generalized splenomegaly?

A

Splenic torsion or round cell infiltrate (will cause spleen to be in abnormal position- C shaped)

165
Q

What are the round cell tumors?

A

Lymphoma, mast cell, histiocyte

166
Q

Describe the pathology of splenic torsions

A

-spleen rotates on its vascular pedicle
-thin-walled splenic veins become occluded
-thicker walled splenic artery is partially occluded
-blood enters the spleen and cannot leave causing splenic congestion, splenomegaly and free fluid

167
Q

What will ultrasound of the spleen look like in the case of torsion?

A

Will look like a course screen compared to normal (lacy or mottled appearance)
-may also see absence of blood flow
-may see splenic vein thrombosis

Treatment is splenectomy

168
Q

T/F: generalized splenomegaly in a cat is typically benign

A

False
- this is true in dogs
- in cats, there is usually pathology as they don’t use the spleen as a blood reservoir as dogs do

169
Q

What is the next step if you suspect lymphoma in a cat?

A

US with fine needle aspirates
- main differential is mast cell tumor

170
Q

When can you see anemia as a result of kidney disease?

A

End stage
- at the point that kidney is so damaged that it is not producing erythropoietin anymore

171
Q

If you see a mild thrombocytopenia on bloodwork from a cat, what is the first thing you should look at?

A

The blood smear
- often a result of platelet clumping

*other differential may be splenic sequestration- but rare in cats

172
Q

What is the only reason for an elevated albumin?

A

Dehydration

173
Q

What are the main differentials for an enlarged spleen in a cat?

A

Neoplasia or infectious disease or torsion

174
Q

If you see a severe anemia with a moderate reticulocytosis (inadequately regenerative), what may this indicate?

A

Either there is a chronic anemia with an acute event occurring on top of it or there is a condition targeting the RBC precursors

175
Q

What are acanthocytes, keratocytes and schistocytes seen in response to?

A

Acanthocytes: liver disease, erythrocyte fragmentation
Keratocytes: iron deficiency, liver disease, myelodysplastic syndrome, erythrocyte fragmentation
Schistocytes: severe iron deficiency, microangiopathic hemolytic anemia, myelofibrosis, heart failure, glomerulonephritis

176
Q

T/F: ALT has longer half life than AST

A

True
- if there is prior injury to the liver, ALT may be elevated for longer than AST

177
Q

What is the significance of hemosideran presence in peritoneal fluid analysis?

A

Occurs with chronic breakdown of blood
- indicates that chronic hemorrhage is present

178
Q
A

Diagnostics 2 (1 decks)

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