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Clin Path > review > Flashcards

review Flashcards

1
Q

Increased bands

A

inflammation

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2
Q

Spherocytes

A

IMHA

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3
Q

Increased reticulocytes

A

> 60,000 moderatley regenerative

>200,000 maximal regeneration

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4
Q

“penia”

A

decreased concentration of cells

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5
Q

“philia” or “cytosis”

A

increased concentration

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6
Q

Left shift

A

increased concentration of immature WBCs in blood

increased bands

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7
Q

2x fold increase in leukocyte concentrations (leukocytosis), no left shift

A

excitement (cats mainly)

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8
Q

Lymohopenia with neutrophilia (2x fold increase of upper limit of neutrophils), no left shift

A

Stress response = low lymphs

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9
Q

Left shift or a neutrophil conc greater than 2x

A

Inflammation

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10
Q

Neutrophilia

A

inflam
excitement
stress

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11
Q

Neutropenia

A

consumption within inflam lesion
immune mediated destruction
lack of production by bone marrow

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12
Q

Lymphopenia

A

steroid response
acute viral infections
immunodeficiency (rare)

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13
Q

Monocytosis

A

inflam

stress response

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14
Q

Eosinophilia

A

parasitism
hypersensitivity
mast cell tumor

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15
Q

Macrocytic anemia

A

regenersation

immature RBCs are bigger than mature

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16
Q

Microcytic anemia

A

Fe def anemia

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17
Q

Echinocytes

A

crenation
electrolyte imbalances
non specific dz (kidney dz)
rattlesnake venom

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18
Q

Acanthocytes

A

cats: hepatic lipidosis
dogs: hemangiosarcoma

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19
Q

Schistocytes

A 
IV trauma (DIC, vascular tumor)
Iron def anemia
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20
Q

Keratocyte

A

iron def anemia

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21
Q

Spherocytes

A

IMHA

normal volume

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22
Q

Eccentrocytes

A

oxidative damage
onions
-often seen with heinz body formation

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23
Q

Heinz body anemia

A 
oxidatively denatured HB
Acetaminophen, propylene glycol (cats)
Onions, garlic
Cephalosporin (dogs)
Zinc toxicosis (pennies)
Wilted red maple leaves (horses)
Kale, onions (cattle)
Copper (sheep)
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24
Q

Basophilic stippling

A

normal in ruminants
regen anemia in dogs/cats
If a significant amount think lead poisoning

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25
Q

nRBCs and Howell Jolly bodies

A

regenerative anemias
non functioning spleen or splenectomy
increased corticosteroids
lead poisoning

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26
Q

Agglutination

A

IMHA

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27
Q

Rouleaux

A

normal in horses

increased globulin in small animals

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28
Q

Platelets and the spleen

A

1/3 platelet mass is in the spleen

when spleen contracts, increases # in the body circulation

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29
Q

What is the order of events in platelet plug formation?

A

adhesion, activation, aggregation

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30
Q

Increased numbers of enlarged platelets suggests

A

active platelet production

check blood smears for platelet clumping, don’t rely on machine

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31
Q

Patients are at risk for spontaneous hemorrhage when the platelet count is

A

<30,000uL

patients with immune mediated thrombocytopenia ITP

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32
Q

What three things suggest PLT regeneration?

A

macroplatelets on blood smear
increased MPV
increased megakaryocyte #s (BMA: bone marrow aspirate)

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33
Q

Bleeding tests are abnormal when

A

decreased platelet function and/or decreased platelet numbers

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34
Q

Mechanisms of thrombocytopenia

A 
(PDSLC)
production
destruction
sequestration
loss 
consumption
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35
Q

The degree of thrombocytopenia depends on the extent of

A

bone marrow dz

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36
Q

T/F Hemorrhage alone can cause significant thrombocytopenia

A

FALSE

thrombocytopenia causes hemorrhage

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37
Q

3yr SF cocker spaniel presents lethargic, weak, tachycardic, with pale mm and petechiation:
PCV Low 15%
TP norm
PLT Low-severe

A 
DIC (consumption)
Multiple myeloma (decrease production)
Immune mediated thrombocytopenia (destruction)
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38
Q

On a blood smear, macrothrombocytisis is seen. On the hematology analyzer, this finding correlates with what type of reading?

A

increased MPV (mean platelet volume)

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39
Q

What dx test is commonly used to assess platelet function?

A

buccal mucosal bleeding time

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40
Q

von Willebrand DIsease (vWD) is a decrease in

A

platelet adhesion
platelets are usually normal
platelets float away, platelet plug not formed

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41
Q 
Why are the plateletes increased in the bloodwork from the following adult dog?
PCV low
MCV (mean corpuscular vol) low
PLT high
MPV (mean platelet vol) high
10% macroplatelets
A

MCV low so microcytic
PCV low so anemia
MPV high so actively being produced

IRON DEF ANEMIA

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42
Q

Blue vs red microhematocrit tubes

A

red is heparinized

blue isn’t

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43
Q

PCV is the % whole blood composed of

A

erythrocytes

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44
Q

5 solutes that interfere with artificially increased TP:

A 
CHUGL
Cholesterol
Hemolysis
Urea
Glucose
Lipemia
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45
Q

If the PCV and TP are proportionally increased, the the patient is ____

A

dehydrated

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46
Q

If the PCV and TP are proportionally decreased, then the patient ____

A

has blood loss

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47
Q

Red or pink plasma indicates:

A

intravascular hemolysis

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48
Q

With severely low PCV, it must be ____ if the P walks thru the door

A

gradual onset/chronic (lack of production)

if acute, then animal probably can’t walk (blood loss/ destruction)

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49
Q

CS of anemia

A 
pale mm
lethargy
increased respiration, dyspnea
increased HR
murmurs
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50
Q

Acute blood loss shows a decrease in ___ as well as decreased PCV

A

protein

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51
Q

Examples of chronic blood loss

A 
Iron def anemia
GI bleeding
Bleeding GI tumor
Parasites
*loss via intestine most common*
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52
Q

Iron def in adults is almost always due to

A

CHRONIC BLOOD LOSS

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53
Q

Dx of iron def anemia

A

anemia
low serum iron
microcytosis
RBC have increased central pallor

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54
Q 
10 yr MC yellow lab
4 episodes of weakness
PCV 16% low
RBC low
Hgb low
Retics high
TP dropped since last visit
Segs high
Bands high
nRBCs high
PLT low
Acanthocytes, schistocytes
A 
low PCV=anemia
high retics = regeneration
TP drop = blood loss
high segs = inflam
high nRBCs = regnerative
PLT low = thrombocytopenic blood loss

found mass on liver & spleen, prob hemangiosarcoma

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55
Q 
Low PCV
Low Retics
Low MCV
Increased bands
Triple segs
keratocytes, schistocytes, blister cells, giant platelets
A 
Low PCV = severe anemia
Low retics = non regenerative
microcytic = chronic blood loss
Increased bands and triple segs = inflam
Decreased MCV, RBC morphology = Fe def anemia
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56
Q 
17 yr old cat lethargy, enlarged abdomen
PCV low
MCV low
Bands high
Lymphs low
Keratocytes on blood smear
A 
PCV low= anemia
MCV low= microcytosis
Bands high= inflam
Lymphs low= stress
Keratocytes= Fe def

Iron def anemia

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57
Q

Examples of blood destruction

A

IMHA
Heinz body anemia
RBC parasites

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58
Q

Signs of blood destruction

A 
anemia
splenomegaly
hyperbilirubinemia, icterus
hemoglobinemia
hemoglobinuria
norm TP
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59
Q

IMHA

A

often secondary
antibodies against own RBCs
infection, neoplasia (lymphoma), drugs
more common in dogs, females
cocker spaniels*
Findings: anemia, usually regenerative, Spherocytes, monocytes phagocytizing RBCs, ghost cells, agglutination, thrombocytopenia, inflam leukogram, azotemia
Tx: glucocorticosteroids (prednisone), immune suppressive drugs

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60
Q 
5yr cocker spaniel, lethargic, pale, cant stand, icteric mm
PCV low
Hgb low
Retics high
Increased segs &amp; bands
Agglutination, spherocytes
BUN, bili, ALP increased
A

PCV low= anemic
Retics high= acute regenerative anemia
inflam leukogram
increased bili= RBC destruction

IMHA

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61
Q

Heinz body anemia

A

oxidatively denatured hemoglobin
mostly cats
occurs with lymphoma, hyperthyroidism, diabetes mellitus
Plants: Wilted red maple leaves, onions, garlic, kale, cabbage
Drugs/Chemicals: Acetaminophen, Propylene glycol, zinc, copper/selenium

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62
Q

Aplastic Anemia

A

generalized bone marrow suppression

Caused by: infectious agents (ehrlichia, FeLV), immun-mediated destruction, drugs, chemicals

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63
Q

Anemia of Renal Dz

A 
insufficient erythropoetin
uremic toxins
excess PTH
hypocalcemia
bleeding tendencies
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64
Q

Anemia of Inflam Dz

A

mild to moderate
low serum iron
increased storage iron
eruthroid suppression

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65
Q

Endocrinopathy-related anemia

Hypothryroidism

A

most common
mild anemia
decreased metabolic rate

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66
Q

Endocrinopathy-related anemia

Hypoadrenocorticism

A

mild anemia, often masked by dehydration

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67
Q 
10yr cat, lethargy, polydypsia
PCV low
Retics high
Heinz bodies
Glu high
Phos low
Ketones high
A

Heinz bodies & low phos= hemolytic anemia

high glu & ketones = Diabetic ketoacidosis

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68
Q 
11yr mal cat, diabetic
PCV low
TP high
Retics high
nRBCs
Smear showed RBCs with several small dots in them
A

blood destruction bc TP is not low
think Hienz bodies bc of diabetes
nRBCs= regenerative
Blood smear= Mycoplasma hemofelis

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69
Q 
15yr Staffordshire terrier
PCV low
Retics high
Glob increased
Lymphs high
Bands high
Segs high

changed to a non reg thrombocytopenia after 10ms
saw chains of dots in RBCs on smear

A

high retics= regen
high glob with increased lymphs –> think erhlicia
high bands= inflam

Mycoplasma haemocanis on smear
Ehrlichia titer ++++

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70
Q

What sets off the coagulation cascade?

A

Tissue factor III initiates the coagulation

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71
Q

Fibrinogen to fibrin requires ____

A

thrombin

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72
Q

What drives amplification?

A

thrombin (IIa)

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73
Q

Increases in FDPs adn D dimers indicate increased intravascular coag with ____

A

clot breakdown

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74
Q

Patients with protein losing nephropathies (PLN) are ____

A

hypercoaguable!

antithrombin is not breaking clots down

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75
Q

Intrinsic vs extrinsic

A

brad PiTT is my PeT
intrinsic PTT
extrinsic PT

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76
Q

Vitamin K deficiency

A 
Warfarin
2,7,9,10
CS: bleeding, anemia, weakness, hypovolemia, shock, dyspnea, lame, neuro signs, death
CBC: reg anemia, PLT norm
Prolonged PT and PTT
Tx: give vit K, transfusion
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77
Q

Which factor has the shortest half life?

A

factor 7

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78
Q

Disseminated Intravascular Coagulation (DIC)

A

continued activation of coagulation and fibrinolysis
-decreased PLT bc they are all used
Causes: sepsis, tissue necrosis (saddle thrombus), neoplasia, endothelial damage, proteolytic enzymes venom
Two phases: hypercoaguable phase (thrombosis) & consuptive phase (bleeding)
CS: organ dysfunction due to thrombus, bleeding, mucosal (petychia), hemorrhage

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79
Q

What is the cardinal (first) change in DIC?

A

thrombocytopenia

80
Q

A 3yo NM basset hound presents after owners found an empty package of chewed up rat poison . What dx test would you want to do?

A

PT: prothrombin time

81
Q

Prior to biopsying a liver, screen for

A

coagulation abnormalities. Don’t want them to bleed out

82
Q 
6yr SF cocker spaniel. Lethargy, mucosal petchiae &amp; ecchymoses, occulat hemorrhage. 
PLT low
BMBT prolonged
PT norm
PTT norm
FDP norm
A

Idiopathic thrombocytopenia (ITP)

83
Q

If you transfuse a DEA 1.1 positive dog with DEA 1.1 neg blood you can expect

A

no rxn

will be fine the 1st time, not the 2nd time

84
Q

If you transfuse a type B cat with a type A, you can expect

A

a severe transfusion rxn

85
Q

Agglutination is a ____ rxn

A

positive rxn

agglutination = blood type

86
Q

Major crossmatch

A

patient serum + donor RBCs

87
Q

A positive crossmatch results in agglutination so we

A

DO NOT transfuse

BAD

88
Q

Safe to transfuse when

A

there is NO agglutination

89
Q

A new dog presents with IMHA. The P is stable but needs a transfusion today. You have no hx so what do you do?

A

blood type and crossmatch the P!

he is stable and we have no hx

90
Q

A dog presents anemic after hemorrhage from a HBC. You are planning a transfusion.
Donor blood type: DEA 1.1 neg
Recipient Blood type: DEA 1.1 neg
Major Crossmatch: neg

A

Blood types match=good!
no crossmatch rxn=good!

go ahead and transfuse!

91
Q

A dog being managed post-transfusion. Overnight P continues crystalloid fluid therapy. On physical exam the patient is BAR, with normal mm color and stable vitals. There are no PE findings. Why is PCV decreased?
Before transfusion: 18%
After transfusion: 24%
Today: 23%

A

dilution from intravenous fluid therapy

92
Q

Red tube

A

biochem profile

serum

93
Q

EDTA

A 
CBC- preserves cell morphology**
fibrinogen
retic count
buffy coat
fluid analysis
94
Q

Heparin

A

inhibits thrombin
chem panel
avian/reptile CBC & chem

95
Q

Citrate

A

coagulation tests

96
Q

Oxalate tube

A

plasma glucose

97
Q

Which tube contain calcium chelators?

A

blue, purple, grey

98
Q

When filling tubes, be careful not to contaminate the

A

red top tube with EDTA contents

99
Q

What electrolyte abnormalities are expected in a chemistry sample that contains EDTA?

A

increased K, decreased Ca

100
Q

When an EDTA tube is underfilled, what changes to the RBCs are seen on the CBC?

A

decreased PCV & MCV

101
Q

Low PCV
High MCV
Low MCHC
Low TP

A

Low PCV=anemia
High MCV=regeneration
Low TP=blood loss

regenerative anemia due to blood loss

102
Q

A test with a high PPV (positive predictive value) has very few ____

A

false positives

confidence in a positive test result is high

103
Q

A test with a high NPV (negative predictive value) has very few ____

A

false negative results

confidence in a neg test result is high

104
Q

Prevalence of a dz will affect the ___ & ___ and therefore, your interpretation of test results

A

PPV & NPV

105
Q

MCHC is a ____ parameter

A

calculated

106
Q

The tail to the right of RBC peak indicates

A

larger, immature RBC precursors

Increased RDW- red cell distribution width

107
Q

What happens to RBCs that stand out at room temp too long?

A

swell & falsely elevate MCV

best to run samples immediately

108
Q

If lymphocyte conc >35,000ul =

A

leukemia

109
Q

If lymphocyte conc >15,000ul and tick dz negative =

A

leukemia

110
Q

Acute lymphoblastic leukemia (ALL)

A

CS: pale mm, splenomegaly, hepatomegaly, lethargy, weight loss
CBC: anemia, thrombocytopenia, lymphocytosis, lymphoblasts in blood
Prognosis is poor

111
Q

Chronic lymphocytic leukemia

A

more common in dogs

lymphocytes maybe smaller

112
Q

Multiple Myeloma

A

proliferation of plasma cells
CS: lethargy, anorexia, lameness, bleeding from nares, PU/PD
Lab: >20% plasma cells in bone marrow, monoclonal gammopathy, lytic lesions in bones, increased TP from globulin

113
Q

Isosthenuria

A

1.008-1.012

kidney is not adjusting urine conc

114
Q

Hyposthenuria

A

dilute

<1.007

115
Q

Oliguria

A

decreased urine production

116
Q

Stranguria

A

straining to urinate

117
Q

Azotemia

A

increased urea nitrogen w/ or w/o increased creatinine

118
Q

Uremia

A

excessive urea in blood with CS of renal failure

119
Q

Renal Functions

A 
Produces erythropoietin, renin
activate vit D (Ca, Phos)
Regulate blood pressure (RAAS)
Excrete waste
Conserves important substrates
120
Q

With the loss of nephrons, kidneys first lose the ability to _____ and then become ____

A

conc urine

azotemic

121
Q

BUN is filtered by the ____ therefore, it is an indicator of ___

A

glomerulus

GFR

122
Q

BUN varies with the rate of:

A

production by the liver
reabsorption by kidney (& GI-ruminants)
excretion

123
Q

Liver: Increased production of BUN leads to a ___ serum BUN

A

increased

increased protein in upper GI- upper GI bleed

124
Q

When GFR decreases, BUN ____ in blood.

Slow flow rate thru tubules, ___ BUN resorbed which means ___ serum BUN

A

increases (backs up)

increases
increased

125
Q

Liver: decreased BUN can be from

A

portosystemic shunt PSS
decreased protein in diet
hepatic insufficiency (>80%)

126
Q

Decreased BUN with ___ tubular flow, ____ GFR

A

increased
increased

less time to resorb BUN means decreased BUN

127
Q

Creatinine (Crea)

A

muscle cells release Crea into plasma
filtered by glomeruli and excreted
NOT reabsorbed by kidney
higher in animals with high muscle mass

128
Q

Creatinine is an excellent indicator of

If crea is increased in blood, it implies:

A

GFR

decrease GFR, altered nephron function

129
Q

Decreased Crea may represent

A

poor muscle mass

not clinically significant

130
Q

The conc of BUN is dependent upon what 3 things?

A

dietary protein
liver function
GFR

131
Q

SDMA Symmetric Dimethylarginine increases with ___% of renal tubular damage

A

40%

early indicator of kidney dz

132
Q

USG: the kidney’s ability to concentrate and dilute urine requires ____% functional nephrons

A

33%

133
Q

The higher the USG, the __ concentrated the urine

A

more

134
Q

Hypersthenuria

A

concentrated urine
>1.035 cat
>1.031 dog

135
Q

Urine specific gravity should always be interpreted with

A

hydration status

136
Q

Polyuria

A 
increased urination
kidney loses ability to conc urine
implies 66% loss of functional renal mass
isosthenuria
will also have polydipsia
137
Q

Azotemia

A

increased BUN and/or increased Crea

implies 75% (2/3) loss of renal tubular function

138
Q

Pre-renal azotemia

A 
increased BUN, crea, USG
-dehydration 
-shock
-upper GI bleed
Decreased GFR
139
Q

Renal azotemia

A

Increased BUN, Crea and Decreased USG
from decreased GFR
loss of kidneys conc ability, isosthenuria
-infectious, toxins, hypoxia, neoplasia, neoplasia, congenital

140
Q

Post-renal azotemia

A

increased BUN, crea and variable USG
Obstruction of urinary outflow distal to nephron
-FLUTD, goat urolithiasis
-uroabdomen (leaks into peritoneal cavity), trauma
BLOCKED TOM, straining

141
Q

What occurs first: azotemia or polyuria?

A

polyuria

142
Q

Azotemia + Isosthenuria =

A

renal dz until proven otherwise

143
Q

There is a risk of mineralization of soft tissues if Ca X Phos > ____

A

70

144
Q

As renal failure progresses, ___calcemia develops

A

hypo

Ca starts out normal in renal dz

145
Q

hypocalcemia stimulates ___ to release ____

A

parathyroid
PTH
(decrease Ca, increased PTH)

146
Q

___kalemia in chronic renal failure

A

hypo

147
Q

In acute renal failure and urethral obstructions, ___kalemia can be life threatening

A

hypo

decreased HR

148
Q

Sodium and Chloride are normal in most cases of renal failure but ___ in chronic renal failure

A

low

149
Q

Protein strips are best at detecting what in the urine?

A

albumin

150
Q

Most common cause of proteinuria is

A

UTI

151
Q

4 yr old male goat is straining to urinate. What category of azotemia does he have?

A

post renal

152
Q

Urine protein:crea ratio
< 0.5 is ___
> 0.5 is ___
> 1.0 is ____

A

normal
tubular or glomerular
glomerular

153
Q

Glomerulonephropathy

A

hypoalbuminemia
proteinuria
renal insufficiency

154
Q

____ differentiates acute from chronic renal failure

A

speed of development, not severity

155
Q

Uroabdomen

A

hyperkalemia*
hyponatremia*

caused by trauma or chronic urethral obstruction

156
Q

The kidneys ___ sodium and chloride and ___ crea, urea, potassium

A

conserve

excreted

157
Q

Increased TP means

A

dehydration

158
Q

Big sign of Chronic renal failure vs acute

A

low BCS

159
Q

What level of bili is normal in dogs?

A

low level/ trace

160
Q

Trypsin like immunoreactivity (TLI)

A

Sensitive and specific test for EPI
>5 norm
<2.5=EPI (Exocrine pancreatic insufficiency)

161
Q

Increase in folate makes us think

A

bacterial overgrowth

162
Q

PTH increases serum ___ by increasing renal tubular reabsorption and by promoting activation of vit D

A

Ca

163
Q

Calcitonin inhibits ___ which decreases serum __ levels

A

PTH

Ca

164
Q

Decreased ionized Ca is ____

Increased ionized Ca is ____

A

acidosis

alkalosis

165
Q

Common causes of hypocalcemia

A 
renal dz
ethylene glycol
pancreatitis
eclampsia
sepsis
(hypoparathyroidism)
166
Q

When you have low Ca and low PTH the animal probably has what?

A

primary hypoparathyroidism

PTH hasn’t kicked in to replace Ca yet so its not working properly

167
Q

Low Ca and high Cholesterol make us think what dz?

A

pancreatitis

168
Q

Addisons dz, hypoadrenocorticism lab data

A

lymphocytosis
Na (low) /Potassium (high) ratio
mild hypercalcemia

169
Q

Lymphoma lab data

A

hypercalcemia

lymphocytosis

170
Q

Hypermagnesemia

A

seen only when renal function is compromised

171
Q

Insulinoma

A

if BG <60 (low glucose) and insulin is high
inappropriate insulin release
insulin producing tumor

172
Q

Fructosamine is used to rule out

A

excitement hyperglycemia

173
Q

Barn cat, increased glu, increased lymphocytes

A

excitement

174
Q

Very old cat, vomiting, high glu

A

intestinal adenocarcinoma

175
Q

Creatine Kinase (CK)

A

muscle specific
increased from necrosis, IM injections, trauma, exercise, down cows, anorexic cats
SHORT HALF LIFE, increases rapidly after injury
not good to check for heart attack since it has short half life

176
Q

Aspartate Aminotransferase (AST)

A

muscle or liver
increases slower than CK but stays longer
better to check for heart attack

177
Q

ALT

A

liver specific but can increase with SEVERE muscle damage

178
Q

Myoglobin

A

pos Hgb dipstick
cleared from serum
evidence of muscle injury

179
Q

Hemoglobin

A

pos Hgb dipstick
remains in serum
evidence of hemolysis

180
Q

SDH

A

liver specific

large animals

181
Q

GLDH

A

liver specific

large animals

182
Q

GGT

A

associated with bile duct

cholestasis, steroids, hepatic injury

183
Q

ALP

A

bile surface-cholestasis
hyperthyroidism
increase w/o increase bili suspect steroids or anticonvulsant meds

184
Q

Increased bili

A

RBC destruction
food deprivation
cholestasis

185
Q

ALB

A

chronic liver dz

increase >60% function loss

186
Q

GLOB

A

chronic liver dz

187
Q

Cholesterol increase

A

cholestasis

188
Q

Cholesterol decrease

A

liver failure

189
Q

Most common liver dz in dogs

A

primary chronic hepatitis

190
Q

Breed predispositions in chronic hepatitis with Cu

A

doberman pinscher
west highland terrier
sky terrier

191
Q

Amylase

A

3-4x upper limit suggests pancreatic injury

192
Q

Lipase

A

2x upper limit suggests pancreatic injury

dogs receiving steroids

193
Q

Pancreatic lipase immunoreactivity PLI

A

good sensitivity
use for pancreatitis
best test!!!!

194
Q

Pure transudates

A

lack of oncotic pressure
low ALB
<6,000 NCC

195
Q

Modified transudate

A

inpaired blood flow

heart dz, obstruction, portal vein issues

196
Q

Exudates

A

inflam
TP >3
NCC >6,000
cloudy/cellular

197
Q

Cat high protein, low cell conc

A

FIP

Clin Path (6 decks)

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