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Applied Clinical Veterinary Nursing > Practical Lab > Flashcards

Practical Lab Flashcards

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1
Q

what is the red blood tube?

A

serum/”plain” tube

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2
Q

whicg colour is the serum/”plain” tube?

A

red

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3
Q

what is a serum tube used for?

A

biochemistry

hormonal assays (e.g. T4)

serology (e.g. antibodies)

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4
Q

what colour is a heparin tube?

A

orange
OR big with green lid

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5
Q

what is the orange (/big green) tube?

A

heparin

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6
Q

what is heparin?

A

anti-coagulant

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7
Q

which is better to use in an emergency, serum or heparin?

A

heparin - can run quickly

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8
Q

what is the pink (/big purple) tube?

A

EDTA

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9
Q

what is a heparin tube used for?

A

in-house biochemistry

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10
Q

which colour tube should be used for haematology?

A

pink (/big purple)

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11
Q

what is the lilac tube?

A

citrate

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12
Q

which colour tube contains citrate?

A

lilac

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13
Q

what is a citrate tube used for?

A

coagulation profiles

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14
Q

what is the yellow (/big grey) tube?

A

oxalate

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15
Q

what colour are oxalate tubes?

A

yellow (/big grey)

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16
Q

what is oxalate used for?

A

glucose

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17
Q

are oxalate tubes used regularly?

A

rarely used - glucose measured in biochemistry (heparin)

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18
Q

which type of blood tube doesn’t contain clotting factors?

A

serum tubes

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19
Q

why do all the blood tubes (minus serum) obtain plasma, rather than serum?

A

contain an anticoagulant

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20
Q

what is the difference between serum and plasma?

A

serum is the liquid that remains after clotting of blood

plasma is the liquid that remains when anticoagulant is added to prevent clotting

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21
Q

which blood tube should always be filled last?

A

EDTA

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22
Q

why should EDTA always be filled last?

A

contamination with EDTA in other samples will prevent clotting - EDTA chelates calcium

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23
Q

how does EDTA contamination affect biochemistry?

A

low calcium
high potassium

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24
Q

what does a reference range mean?

A

includes 95% of healthy animals

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25
Q

which blood tube should you elect for emergency biochemistry?

A

heparin (orange/big green)

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26
Q

how can we tell whether a blood result is a mild, moderate or marked change from the reference?

A

calculate value of the reference range (e.g. 58-78 = 20)

if within reference range either side = mild

more than 20 either side = moderate

more than 40 either side = marked

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27
Q

why might an animal have high ALT?

A

primary hepatopathy

secondary to cholestasis

artefact

due to muscle damage

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28
Q

what can we check to differ between liver and muscle damage in the presence of high ALT?

A

creatinine kinase

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29
Q

what are the markers of hepatocellular damage?

A

ALT, AST, GLDH, SDH

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30
Q

what are the markers of cholestasis?

A

ALP, GGT

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31
Q

what can we look at to establish function of the liver?

A

substances produced in the liver

substances conjugated and excreted by the liver

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32
Q

what substances are produced in the liver?

A

cholesterol
urea
glucose
albumin
some globulins
coagulation factors

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33
Q

which substances are conjugated and excreted by the liver?

A

bile acids
bilirubin

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34
Q

what can cause primary hepatocellular disease?

A

trauma
toxins, drugs
inflammation/infection
neoplasia
intrahepatic cholestasis
bile toxicity

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35
Q

what can cause secondary hepatocellular disease?

A

you name it - the liver is very sensitive to secondary causes

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36
Q

which increased liver parameters reflect decreased hepatic function?

A

bilirubin
bile acids

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37
Q

which decreased liver parameters reflect decreased hepatic function?

A

albumin
cholesterol
urea
glucose
clotting factors

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38
Q

what is the result of xylitol toxicity?

A

acute hepatic failure
hypoglycaemia

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39
Q

how can xylitol toxicity be treated?

A

multiple plasma transfusions
vitamin K therapy
liver supportive treatment
gastroprotective treatment
fluid therapy
antibiotics

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40
Q

what are the features of a stress leukogram?

A

neutrophilia

monocytosis

lymphopaenia

eosinopaenia

41
Q

how can the features of a stress leukogram be remembered?

A

SMILED

Segmented nucleus (neutrophilia)

Monocytes Increased

Lymphocytes and Eosinophils Decreased

42
Q

does a stress leukogram need to have all 4 derangements?

A

no

43
Q

what are acanthocyes?

A

spiculated red cells

44
Q

when are acanthocytes seen?

A

almost exclusively seen as an artifact - usually from old blood

can be from toxins effects on cell membranes

45
Q

what is anisocytosis?

A

different cell sizes

46
Q

what urine concentration is indicative of kidney disease?

A

isosthenuria

47
Q

what is the treatment for antifreeze toxicity?

A

supportive care - IVFT important

ethanol IV

48
Q

why might there be an absence of stress leukogram?

A

chronic disease
immunosuppression
bone marrow disease

49
Q

what biochemistry abnormalities will likely be seen with kidney disease/injury?

A

marked azotemia (creatinine)
marked increase in ALT

electrolyte derangements - marked hypocalcaemia
mild hyponatremia/hypochloremia/hyperkalaemia

50
Q

what is cytology?

A

screening test to look for cells in:
fluid (BAL, CSF, synovial fluid, body cavities)
tissue samples (lumps, bumps, LNs)

51
Q

what clinical information do we need when presented with a lesion?

A

clinical history and lesion evolution
any previous treatment
characteristics of the lesion

52
Q

how can we define the characteristics of a lesion?

A

localisation
dimension
firm/soft
painful/non-painful
ulcerated/non-ulcerated
cutaneous/sub-cutaneous
adherent/non-adherent
how does the aspirate look?

53
Q

when would you use suction technique for FNA?

A

hard cutaneous or subcut masses

bone lesions

when non-suction technique is unsuccessful

54
Q

when would you use non-suction technique for FNA?

A

soft cutaneous or subcut masses

lymph nodes

vascular lesions/organs

55
Q

what is important to remember when performing suction FNA?

A

make sure to relax plunger before exiting mass in order to avoid pulling debris from more superficial layers of tissue

56
Q

what is the aim of the squash/smear technique for FNA cytology?

A

trying to create a monolayer

57
Q

what are the idea techniques for creating FNA slides?

A

line (like blood smear)
squash
twist

star and spatter not ideal but sometimes necessary/no choice

58
Q

what other collection methods may be used for cytology?

A

impression smear

scraping (mites)

ear swab - imprint (roll)

biopsy - imprint

59
Q

what might we see from an ear swab which indicates infection?

A

malassezia fungis - yeast
peanut-shaped

60
Q

is malassezia a normal finding?

A

present in low numbers on normal skin, less normal in ears

multiple organisms per HPF indicate significant infection

61
Q

what should we do with the cytology slides after collection?

A

dry slide rapidly - air fixation/cool hairdryer

make sure completely dried before staining /packaging to send away

label (pencil) the smears - ID/site/date

62
Q

what is the most common staining technique in practice?

A

Diff-Quick

63
Q

what other staining techniques may be used in practice?

A

Giemsa/modified wright

methylene blue

toluidine blue (MCTs)

ziehl/nielsen

64
Q

what are the different solutions in Diff-Quick and what are their roles?

A

A - methanol - fixation

B - eosin - eosinophilic (base) staining

C - methylene blue - basophilic (acid) staining

65
Q

what are the considerations for Diff-Quick staining?

A

replace stains regularly (esp methylene blue)

keen a clean and “dirty” set - separate set for derm cytology

thick smears may require longer staining times and more time to dry

66
Q

what is the magnification of the eyepiece itself in a microscope?

A

x10, so

x10 = x100
x40 = x400 etc

67
Q

what can be seen under low magnification (x10)?

A

cellularity
preservation
staining
haemodilution
cell distribution
background

68
Q

what does cell preservation refer to?

A

how well the staining process has worked

69
Q

what can we look at under high magnification (x40)?

A

cellular vs non-cellular elements

inflammatory vs neoplastic

malignant vs benign

70
Q

what can we look at under the highest magnification (x100)?

A

presence of cytoplasmic granules

nuclear detail

presence of pathogens - bacteria, fungi, protozoa

71
Q

what do neutrophils on cytology indicate?

A

inflammation

72
Q

what do normal neutrophils look like?

A

crisp nuclear outlines with dark purple chromatin

cytoplasm is pale, clear to slightly eosinophilic (pink)

73
Q

what do degenerate neutrophils indicate?

A

usually indicate presence of bacterial infection - affected by toxic change

74
Q

what do degenerate neutrophils look like?

A

loss of segmentation

lighter coloured ‘fluffy’ nuclear chromatin and a swollen appearance

75
Q

can we assume no infection if degenerate neutrophils present but no bacteria?

A

no - culture if suspicious

76
Q

what are the advantages of cytology?

A

easy, quick and cheap

relatively non-invasive

several collection methods and smear techniques

can be stained in practice

77
Q

is cytology confirmatory?

A

no - histology required

78
Q

how can we ensure results produced in the lab are reliable?

A

correct setup of the system

maintenance of analysers and system

accurate interpretation of results

checks carried out to ensure the values are acceptable

accurate record-keeping

79
Q

what are the advantages of in-house labs?

A

fast turn-around time

potential for improved monitoring

smaller volume of sample needed

available OOH

available in more remote areas

may save costs

80
Q

what are the 2 major factors affecting lab results?

A

biological factors

analytical factors

81
Q

what are the overall biological factors which might affect total variability?

A

inter-individual factors

intra-individual factors

82
Q

what are inter-individual factors?

A

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

83
Q

what are intra-individual factors?

A

transient differences in the same animal, often due to environmental/external factors

84
Q

give some examples of intra-individual factors

A

diet (e.g. recent meal)

stress/excitement

reproductive status/lactation

drugs

method/site of blood sampling

85
Q

what are the overall analytical factors which can affect total variability?

A

pre-analytical

analytical

post-analytical

86
Q

give some examples of pre-analytical factors

A

poor blood sampling technique

haemolysed, lipaemic or icteric plasma

wrong anticoagulant:blood ratio

transportation

storage

87
Q

how should postal samples be processed?

A

50mL limit
sealed container in leakproof bag
absorptive padding
all packaged in rigid container

88
Q

what are the main types of analytical equipment?

A

laboratory vs patient-side (e.g. glucometers)

results vary significantly and therefore cannot be directly compared

89
Q

what are analytical factors?

A

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

90
Q

give some examples of analytical factors

A

equipment - proper function, maintenance etc

technician - correct training, pipetting etc

analytical procedure - validated technique, reagents, calibrations

laboratory - temperature, humidity etc

91
Q

is quality control mandatory?

A

no - voluntary process

there are no regulations, just recommendations

92
Q

what happens during quality control?

A

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

93
Q

when is quality control performed?

A

during the analysis to ensure the validity of the result

94
Q

is control the same as calibration?

A

no - controls are not to calibrate the machine but to check the tests are being run accurately

95
Q

what should you do if a control fails?

A

check for obvious problem (reagent depletion/expiry, mechanical faults, clots)

use another aliquot of control materials

repeat control

96
Q

what should you do if the control fails again?

A

use new reagent, recalibrate equipment, repeat control

run routine machine/instrument maintenance and repeat control assay

consult manufacturer

97
Q

what are the post-analytical factors which can affect total variability?

A

transfer of results to patient record

archiving results

storing specimen (e.g. for follow-up tests)

98
Q
A

Applied Clinical Veterinary Nursing (31 decks)

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