Random Test Questions Flashcards
a. Briefly contrast the major features that distinguish the two most commonly identified forms of intestinal lymphoma of cats. (3 marks)
1⁄4 mark per point = 2 marks per dx max.
Small cell, low grade / few mitoses, slow progression OR good response to therapy
Large cell, high grade / more mitoses, diffuse or multifocal intestinal lesions, extension to mesenteric lymph nodes and liver.
b. Briefly define the difference between lymphadenopathy and lymphadenitis. (1 mark)
lymphadenopathy = reactive lymphoid hyperplasia or any disease affecting the lymph node; lymphadenitis = inflammation targeting the lymph node.
Moderate normocytic hypchromic regenerative anemia; consider
hemorrhage vs hemolysis, latter perhaps more likely since TSP not decreased, but internal bleeding also possible
–> Would a bone marrow biopsy be indicated? Why or why not? (2 marks)
No. The dog has a regenerative anemia, rubricytosis, moderate thrombocytopenia and leukocytosis with left shift. These findings are most consistent with hemolysis or hemorrhage and consumptive thrombocytopenia, and bone marrow biopsy would only be indicated if a cause for the anemia or thrombocytopenia cannot be identified.
A cat is presented with acute onset of anorexia and lethargy, and on physical examination is very dehydrated. The cat is vomiting repeatedly in hospital. During the diagnostic workup, it is determined that the cat has acute renal failure. Calculated serum osmolality is 345 mmol/L (ref interval 290-320).
What acid-base disturbance(s) might you expect in this patient and why? (3 marks)
Vomiting is expected to result in metabolic alkalosis due to loss of HCl. Dehydration can produce hypoxia in tissues and result in metabolic acidosis from lactate accumulation. Acute renal failure will additionally add to acidosis due to retention of uremic acids, which will increase the anion gap.
List two molecules that could be contributing to hyperosmolality in this cat AND indicate whether transcelluar fluid shifts would occur for each. (2 marks)
Urea – doesn’t usually cause fluid shifts Sodium – could cause fluid shifts
Measured serum osmolality was 370 mmol/L. What is your interpretation of this finding? (1 mark)
There is an osmolar gap – very concerning for poisoning such as ethylene glycol
The cat had a decreased calcium concentration at 2.02 mmol/L (ref interval 2.22 – 2.78). Suggest two possible reasons for hypocalcemia in this cat AND indicate which is the most likely. (2 marks)
Due to decreased albumin for binding Complexing with ethylene glycol metabolites*
You submit a liver biopsy from a 5 year-old MN dog with a 2 week history of hypersalivation, weight loss and lethargy, based on a high index of suspicion of hepatic disease from a clinical chemistry report. The histopathology report indicates that the findings are consistent with ‘chronic macronodular hepatic cirrhosis’.
a)
Briefly describe the pathogenesis of cirrhosis. (2 marks)
b) What is the long term prognosis for complete recovery for this animal? (1 mark)
After an initial insult, usually involving hepatocellular necrosis and inflammation, cirrhosis is characterized by ongoing attempts at repair (fibrosis) and nodular regeneration, which can become so expansive as to reduce the amount of hepatic parenchyma to the point where functional capacity of the liver is severely reduced. The architecture of the liver is altered, there is increased resistance to blood flow (portal hypertension), and blood starts to bypass the liver.
Prognosis:
Poor. Cirrhosis is not reversible, although there are treatments which can delay further progression, and manage the symptoms.
What specific clinical chemistry results might have given you a strong index of suspicion of underlying chronic liver disease in this dog? (2 marks)
Chronic liver disease is supported by increased enzymatic activity (ALP, GGT, ALT), increased bilirubin, and altered variables effected by decreased liver function (decreased total protein/albumin, decreased urea, prolonged clotting times)
b)
Briefly compare and contrast the pathogenesis of maldigestion vs malabsorption as general causes of gastrointestinal disease in animals.
answer
