Past Questions Flashcards
In respiratory alkalosis a pH >7,4
pCO2 <40mmHg
pO2 >40mmHg
is expected
True or False
TRUE
A puppy Arrives to the clinique and later is diagnosed with Parvo enteritis. The symptoms include severe diarrhoea and exsiccosis with hyperventilation.
A venous sample is taken and the following result are seen (reference intreval)
pH= 7,390 (7,35-7,45)
pCO2= 37,6 Hgmm (35-50)
pO2= 50Hgmm (40-50)
HCO3=18,7 Hgmm (20-28)
ABE=-7,4 mmol/L (-3,5-+3,5)
What is your conclusion?
A. Metabolic Acidosis, Compensated
B. Metabolic Alkalosis, Uncompensated
C. Respiratory Alkalosis, Uncompensated
D. Respiratory Acidosis, Compensated
E. Respiratory Acidosis, Uncompensated
F. Respiratory Alkalosis, Compensated
G. Metabolic acidosis, Uncomp
H. Metabolic Alkalosis, Compensated
A. Metabolic Acidosis, Compensated
Compensated = 7,35-7,45
In metabolic alkalosis a pH > 7,4,
HCO3 concentration >28 mmol/L,
BE >+3,5 mmol/L
TRUE or FALSE
TRUE
In Respiratory alkalosis pH >7,4
pCO2 < 40 mmHg
pO2 > 40 mmHg
is expected
True or false
TRUE
The anion gap gets signifficantly incresed in the following case
a, In case of poor perfusion (Lactic adidosis)
b. If gamma globulins are in excess ( ununmeasured cation)
c. HCO3 is lost due to diarrhoea
a. In case of poor perfusion (Lactic adidosis)
Increased anion gap = Lactacidosis = Shock, hypovolaemia, poor tissue perfusion, tissue necrosis
Creatinin is a degradation product of muscle creatine
TRUE or FALSE
TRUE
Creatinine is an important constituent of muscle energy stores. Creatinine is utilized to form
creatin.
The glucose absorption test can distinguish malabsorption from diabetes mellitus
TRUE or FALSE
FALSE
Glucose absorption test is performed when we suspect chronic bowel disease, exocrine pancreatic insufficiency, or it can be used instead of iv glucose tolerance test.
Multiple choice:
Total bilirubin is expected to increase in serum due to an increase in bilirubin I formation in the case of
a. Acute Hemolysis
b. Decreased conjugation in the liver
c. Extrahepatic bile duct obstruction
d. Haemotoma formation (resorbtion icterus)
e. Bile peritonitis
a. Acute Hemolysis
Fill inn blank spots
Prepare 3% acetic acid solution. One-two drops of native (not centrifuged) samples must be dripped into the solution. If coagulation (smoky appearance) occurs the result is ——– due to the ———-, coagulation of labile proteins ( globulins ), as weak acid can coagulate these proteins. If coagulation is not observed but the sample is dissolved in the solution the result is ——— due to the fact that stable proteins, such as ——– does not show coagulation in weak acids.
- *exudate**
- *fibrinogen**
- *transudate**
- *albumin**
Ruminal fluid PH is lower before feeding than after
TRUE or FALSE
FALSE
Match the analytes with the information they can give
MCV
OSMOTIC RESISTANCE
RETICULOCYTE COUNT
RDW
MCHC
- Anisocytosis = variable cell size - iron deficiency and regenerative process
- Regeneration
- Macrocytosis
- Intravascular haemolysis
- Hypochromasia
MCV - Anisocytosis
OSMOTIC RESISTANCE - Regeneration
RETICULOCYTE COUNT - Macrocytosis
RDW - Intravascular hemolysis
MCHC - Hypochromasia
Which is not a prerenal cause of increased urea concentration
a. Cardiac failure
b. Shock
c. Glomerular problem
d. Addisons Disease
e. Dehydration
d. Addisons Disease
Multiple choice: Select the correct answer
THROMBOCYTHOPATHY can be found in cases of
a. Uremia
b. Anti Freeze poisoning
c. NSAID treatment
d. Rodenticide poisoning
e. Liver failure
a. Uremia
Drag the words below and drop them into their places!
——-lity (body) fluids. Osmolarity is expressed in different units than osmolality______ osmolality——- expresses the osmotic pressure of the . The calculation of osmolality osmolarity——– is performed based on the formula below if all of the parameter concentrations are given in mimol/I: Osmolality (mOsm/kg) = 2(__+__)+(lucose____)
Osmola
kg
L
(Na+ +K)
(urea+g)
Multiple choise
Choose the amylase isoenzymes
a. Pancreatic
b. Musculoskeletal
c. Intestinal
d. Renal
e. Salivary
a. Pancreatic
c. Intestinal
d. Renal
e. Salivary
Match the lipid fraction with the apolipoproteins carrying them
Triacyl glycerol
Cholesteriol
Phospholipids
Free fatty acids
Triacyl glycerol - VLDL
Cholesteriol - LDL/HDL
Phospholipids - HDL
Free fatty acids - ALBUMIN
Multiple choice
ACTH stimulation test is used for
a. Monitor treatment for hyperadrenocorticoism
b. Diagnose ectopic ACTH production
c. Screen overall pituitary hyperfunction
d. Screen for hyperadrenocorticoism
e. Diagnose hypoadrenocorticoism
a. Monitor treatment for hyperadrenocorticoism
d. Screen for hyperadrenocorticoism
e. Diagnose hypoadrenocorticoism
Match the process with the expected laboratory parameter changes
- THROMBOCYTOPENIA
- DIC
- RODENTICIDE (dicumarol) Toxicosis, late
- HEMOPHILIA A
- RODENTICIDE (WAFARIN) Poisonin, early
- THROMBOCYTOPENIA - BMBT incr, APTT unchanged, PT unchanged
- DIC - BMBT incr, APTT incr, PT incr
- RODENTICIDE (dicumarol) Toxicosis, late - BMBT Unchanged, APTT incr, PT incr
- HEMOPHILIA A - BMBT unchanged, APTT incr, PT unchanged
- RODENTICIDE (WAFARIN) Poisoning, early - BMBT unchanged, APTT unchanged , PT incr
a. VIII
d. IX
Factors involved in APTT are: XI., IX., VIII., X., V., II., I., XIII.
Bloodsmares are used to check
a. Platelet Roleauxformation indicating immune mediated thrombocytopenia
b. Platelet number estimation
c. Wether the hematology analysers platelet count is valid or not
d. Platelet aggregate/clump formation
e. Macrothrombocytopenia
b. Platelet number estimation.
c. Whether the hematology analysers platelet count is valid or not
d. Platelet aggregate/clump formation
- BMBT and Thrombocyte count unchanged and aPTT and PTT Increased
= late stage of dicumarol- toxicosis
- BMBT increased, aPTT may be increased, others unchanged
= Von Willebrand
- BMBT, Thrombocyte count, aPTT, and PTT all INCREASED (Plateletcount decreased)
= DIC
- BMBT increased, Thrombocyte # and aPTT and PTT unchanged
= Thrombocytopathy
- BMBT as well as thrombocyte count and aPTT unchanged, PTT INCREASED
= Dicumarol Toxicosis 1st stage
- BMBT increased, Thrombocyte # DECREASED, aPTT and PTT unchanged
= Thrombocytopenia
TRUE
a. Anticoagulated sample (Citrate 1:9)
Haemophilias are leading to a defect of the
Dicumarol is a competetive antagonist to VIT K
True or False
TRUE
Breeds affected by von Willebrands disease
Doberman Pinscher
Match the Changes with the alterations
VASOPATHY
THROMBOCYTOPATHY
THROMBOCYTOPENIA
COAGULOPATHY
1.
Changes expected in von Willebrands disease are
a. Increased/Unchange aPTT
b. Increase BMBT
c. Decreased/Unchanged aPTT
d. Decreased PTT
e. Increased PTT
a. Increased/Unchange aPTT
b. Increase BMBT
Patients suffering from von Willenbrands disease may present with an increased PTT
True or False
True
ESSAY
Methode nr 1:
If you measure both TP for the plasma and the serum concentration – you will have the fibrinogen TP concentration by the difference between them.
Methode nr 2: Is based on the heat labile character of fibrinogen. Take one part of the plasma, and measure the TP (Biurette test). For the other part of the plasma, you will heat it and centrifuge it, then measure the TP. The TP concentration for fibrinogen will be the difference between the regular plasma and the heated+centrifuged plasma.
Method 3
The test used for thrombin time (TT) can be used for establishing fibrinogen concentration, as in this test the values are primarily dependent on the fibrinogen concentration.
The reagent contains bovine thrombin and Ca2+.
The clot formation can be determined by using standards of different fibrinogen concentrations.
Causes of fibrinogen conc change:
Increase in case of
- Acute inflammation
- Dehydration
Decrease in case of
- Liver function impairment
- Advanced protein deficiency
- DIG
- Chronic bleeding
- Blood loss
ESSAY
- Characterize the change of cholesterol concentration in plasma
Cholesterol measurements for the detection of increased fat mobilization
- Total cholesterol value INCREASES
In case of:
hypothyroidism,
hyperadrenocorticism,
nephrotic syndrome,
diabetes mellitus
- cholesterol catabolism decreases.
- Decreased esterification of cholesterol is a result of impaired liver function together with decreased apolipoprotein production. This causes decreased total cholesterol concentration.
Causes of hypocholesterolaemia:
· malnutrition
· liver failure (decreased synthesis)
· neoplastic disease
· hyperthyreosis (increased usage)
· decreased apolipoprotein synthesis Causes of hypercholesterolaemia:
· increased dietary fat content
· hypothyroidism
· hyperadrenocorticism
· diabetes mellitus
· nephrotic syndrome (concurrent low TP)
· cholestatic diseases (increased leakage from liver due to bile duct obstruction)
· idiopathic - primary dyslipidosis
Choose the Hemopoietic tumor(s) presenting with leukemia
a. Acute Myelogenous Leukemia
b. Polycythemia absoluta vera
c. Leukemoid Reaction
d. Lymphoma, Stage IV
e. Acute Lymphocytic Leukemioa
a. Acute Myelogenous Leukemia
b. Polycythemia absoluta vera
ESR in horses is considerably faster than in other species
True or False
TRUE
Immature NEUTROPHILS can appear in the circulation due to the following cases
a. Perlger-Huet anomaly
b. Addison’s Disease
c. Acute Lymphoblastic Leukemia
d. Right Shift
e. Hyperadrenocorticism
f. Left Shift
a. Perlger-Huet anomaly
b. Addison’s Disease
f. Left Shift
A left shift is characterized by
a. Neutrophilia (high neutrophil count)
b. Decreased number of lymphocytes in circulation
c. The appearance of immature neutrophils in large proportion in the circulation
d. The appearance of mature, hypersegmented neutrophils in the circulation
c. The appearance of immature neutrophils in large proportion in the circulation
Pair the changes with the category
A. Stresslaukogram
B. Very high # of Neutrophil cells in the circulation
C. Leukopenia (low WBC), Neutropenia (low neutrophil #), Appearance of bands/metamyelocytes
D. Leukocytosis (high WBC), neutrophilia (high neutrophil #), appearance of bands/metamyelocytes
E. Appearance of highly segmented neutrophil cells (3-4 segments)
- Regenerative left shift
- Degenerative left shift
- Right Shift
- Leukemoid reaction
- Right shift, Leukocytosis, Neutrophilia, lymphopenia, and eosinopenia
A. STRESS LEUKOGRAM
= 5. Right shift, Leukocytosis, Neutrophilia, lymphopenia, and eosinopenia
B. Very high # of NEOTROPHIL cells in the circulation
= 4. Leukemoid reaction
C. Leukopenia (low WBC), Neutropenia (low neutrophil #), Appearance of bands/metamyelocytes
= 1. DEgenerative left shift
D. Leukocytosis (high WBC), neutrophilia (high neutrophil #), appearance of bands/metamyelocytes
= REgenarative left shift
E. Appearance of highly segmented neutrophil cells (3-4 segments)
= 3. Right Shift
- How to determine BT, BMBT - What causes prolongation of bleeding time
Use a sharp, sterile blade and make an 0,1-0,2 mm deep and 0,5 cm long incision on the skin on inner part of external ear or on buccal mucosal surface.
Vipe the blood drop flowing under the wound with a cotton wool tissue in 20-30 sec intervals
(avoid touching the wound itself)
Measure the time from the appearance of first blood drop till the ceasing of bleeding
Normal BMBT = 3-5min.!
Prolongation of bleeding time is caused by thrombocytopenia, thrombocytopathies and vasopathies
So dependent on thrombolytic function, platelet count and capillary function.!
Lab signs of DIC disseminated intravascular coagulopathy
Increased
- Coagulation time (CT)
- Bleeding time (BT)
- Prothrombin time (PT)
- Activated partial thromboplastin time (APTT),
- Thrombin time!(TT)
- Fibrin degradation products (FDP).
- Decreased Platelet count
- The appearance of schistocytes and or burr cells in blood smear
Thrombocytopenia causes and disorders
- Decreased production of thrombocytes in the bone marrow!
- Increased utilization of thrombocytes; DIC (disseminated intravascular coagulopathy)
- Increased destruction of thrombocytes Autoimmune thrombocytopenia (AITP)
- Increased sequestration of thrombocytes in case of chronic splenomegaly
- Increased loss of thrombocytes subacute/chronic bleeding
Glutaric aldehyde test:
Examine the Increase of fibrinogen and globulin concentration in plasma
ESR (erythrocyte sedimentation rate)
The theory is the increased sedimentation of RBCs due to inflammatory processes, as acute-phase proteins and other globulins tend to attach onto the surface of RBCs
(ER) Sedimentation Rate in Horses
- Very fast
- ESR must be evaluated after 20 minutes.
- It is found that the speed of the sedimentation decreases due to inflammatory processes contrary to other species.
- ESR is inversely proportional with the HT and proportional with the serum viscosity, total protein and fibrinogen concentration.
Causes hyperlipidemia & decreased lipid content
-
Hyperlipidemia
1. Increased fat content in diet
2. Diabetes Mellitus
3. Hypothyroidism
4. Hyperadrenocorticism - Cushings
5. Nephrotic syndrome
- Septicaemia
- Pancreatitis
- Hypolipidemia
DECREASED lipid content
1. Starvation
2. Chronic liver failure
Causes hyper/hypo–cholesterolemia
- Hypercholesterolaemia
1. Increased dietary fat content
2. Hypothyroidism
3. Hyperadrenocorticism - Cushings
4. Nephrotic syndrome
5. Diabetes Mellitus (DM)
- Cholestatic diseases
- Primary dyslipidosis
* Hypocholesterolaemia
- *1. Protein-losing enteropathy**
- *2. Liver failure**
- *3. Malnutrition**
4. Neoplastic disease - Tumor
5. Decreased apolipoprotein synthesis
Increased/Decreased glucose concentration
-
Increased glucose conc.
1. Laboratory errors
2. Stress & exercise
3. Cranial trauma, inflammation (rabies, aujeszky disease)
- Acute liver failure (fast depletion of liver glucogen)
- Diabetes mellitus (DM)
-
Hyperadrenocorticism - Cushing/HAC
* Decreased glucose conc. - Laboratory error
- Decreased energy status (pregnancy, milking period, exercise etc.).
- Insulin overdose
- Receptor blocker
- Anabolic steroids
- Liver failure, terminal stage
- Hypoadrenocorticism - Addison’s
- Septicaemia
- Hyperthyroidism
Monoclonal gammopathy
= Condition when Abnormal proteins found in the blood = Fight infections
Seen as a sharp spike in the beta or gamma region(globulin)
- Can be compared to the albumin peak (they are both as narrow).
- Both neoplastic and non-neoplastic disorders can produce monoclonal gammopathy.
Neoplasia: Most common cause - it multiple myeloma (producing IgG or IgA monoclonal)
Determine Malabsorption, Maldigestion, Chronic bowel disease
Starved for 24 hours: “
blood sample + 3ml/kg bw corn oil orally
Blood sampling after 1,2,3,4,5 hours
Should show lipemic and TG should rise 2 folds from the normal value
If not = REPEAT test
But with predigested corn oil - Incubate at 37 degrees
1. if increased TG and lipaemia= exocrine pancreatic insufficiency
- if no change in TG and lipaemia= Intestinal absorption defect!
Suspect: DM, Insulinoma
Take two times at starving blood sample = If it is > 11mmol/l its DM
Test:
- Starved for 24 hour
- Blood sampling then glucose solution i.v. (30-45sec)
- Take blood every 5,15, 30,45, 60 min!
- Blood glucose should be normalized at 30-60min!
Polyclonal gammopathy: (beta and gamma globulins derived from different clones)
- “Broad” based peak in beta and/or gamma region
- *Causes:**
- Chronic inflammatory diseases,
- Liver disease,
- FIP,
- Occult heartworm disease,
- Ehrlichiosis
Polyclonal Gammopathy Increased and decreased by
Increased by:
- decreased 2,3 DPG level in RBCs;
- decreased pCO2 level in blood;
- increased pH of blood;
- decreased temperature of blood.
Decreased by:
- increased 2,3 DPG level in RBCs:
- increased pCO2 level in blood;
- decreased pH of blood;
- increased temperature of blood
Increased Hgb is usually associated with
Different types of relative (dehydration) or absolute polycythemia.
Decreased Hgb:usually associated with relative (hyperhydration)or absolute (anemia) oligocythaemia!
Regenerative anemia, RBC parameter affected:
Diseases with favorable prognosis
- Because enough new RBC’s are produced in the bone marrow to regenerate the anemia, to replace the RBC loss, and to reach normal RBC count quick
→Corrected reticulocyte count, CRC = reticulocyte % x RBC count
→ Corrected reticulocyte percentage, CRP!= Ht(patient)/Ht(average) x reticulocyte %
Non regenerative anemia, RBC parMCV definition, when can it be increased:
Bone marrow is not producing new RBC.
Not able to regenerate the anemia
→ MCV: indicates the average size of RBC’s
(macro,normo or microcytic)
PCV/RBC count x 1000 = MCV (fl),
normal:60–70fl
→ Increased:
- regenerative anemias,
- FeLV infection,
- Vit B12,
- Co or folic acid deficiency,
- Erythroleukamia,
- poodle
- macrocytosis
MCHC definition and changes:
Indicates
Indicates the average concentration of hemoglobin in erythrocytes (Hb concentration),
- Decreased(hypochromasia): newborns, regenerative anemia or iron deficiency anemia.
- Increased (hyperchromasia):
- Erythroleukemia(polycythemia absolute vera);
- Vit B12, folic acid, cobalt deficiency;
- Immunhemolytic anaemia (spherocytosis) IMHA,
- lead poisoning,
- splenectomy
MCH indicates
Average Hb content of RBCs.
Hgb(g/l)/RBC count x 10^12/l
- Decrease, Hypochromasia: newborn animals, regenerative anaemias, iron deficiency.
- Increase, hyperchromasia:
- Erythroleukaemia;
- Vitamin B12, folic acid, cobalt deficiency;
- Immunohemolytic anaemia; IMHA
- Lead poisoning
Cl and HCO3-
= Most important anion of plasma (buffer)
Decrease Cl:
- abomasal displacement,
- vomiting,
- diarrhea,
- sweating (horses)
Increase Cl:
- salt poisoning,
- Conn`s disease,
- infusion overdose!
Elevated APTT(activated partial thromboplastin time) and PT (prothrombin time),!
(when can you see)??
Increased APTT and PT
= Common pathway problem
Increased APTT and equal PT
= intrinsic pathway problems
Equal APTT and increased PT
= Extrinsic pathway problem
Normocytic, normochromic:
MCV?
MCHC?
MCH?
MCV and MCHC normal,
MCH normal or decreased
In a leukogram, what is a regenerative left shift and when can it be observed?
Increased WBC count, neutrophilia and left shift
Favorable prognosis after the first neutropenic phase
Polyclonal gammopathy, (definition, causes)
Abnormal levels of immunoglobulin production
- Swelling of the liver,
- Chronic diseases
What do you see in a chronic inflammation leukogram (right shift)
More adult lymphocytes appear.
It gets inhibited the young blood cells proliferation and also strengthens the membrane
Difference between laboratory and clinical signs in case of dehydration and hyperhydration
Clinical: skin tent, mucous membrane, capillary refill time
Laboratory: pack cell volume, TPc, MCV!
Acid/base pH evaluation stuff,
(also included values for ion amount, Na+, K+, Ca2+)
135-150!mmol/l!
K 2-5!
Ca2+: 2,2-3,3!
pO2, pCO2, ABE, SB
Non regenerative anaemia + the effect on calculated values:
MCV, MCH, MCHC!
MCH small,
Test for primary haemolysis, reasons for primary haemolysis
- Osmotic resistance test:
- Dilution line from NaCl with one drop of blood in everyone,
Then incubation 10 mins
Centrifuge, and then take a look at the upper layer for hemolysis!
Primary hemolysis: bc the membrane of the eyes is damaged!
(nephropathy, specific membrane damage, increased physical damage)!