Study Questions Flashcards
1
Q
What are benefits to cytologic sampling?
A
Easier to collect Less discomfort Less likely to result in serious complications Costs less Faster turn-around time
2
Q
What are the major limiting factors to cytologic sampling?
A
Low cellularity or hemodilute samples Thick preparations Not representative of lesion Rough handling Mixed cell populations Lesion requiring tissue architecture
3
Q
Which sample tube should be used for culture?
A
Plain red top tube
EDTA in purple tops may be bactericidal/static
4
Q
Which sample tube should be used for cytology (when cell counts are desired)?
A
Purple EDTA tube
Prevents cells from clumping, easier to look at sample
5
Q
Why is it important to make slides at the sime of collection for fluid samples?
A
To limit cellular swelling and artifact
Example given - macrophage erythrophagocytosis
6
Q
What is a “smear” artifact? What is the cause? What sample is most commonly affected?
A
Nuclear streaming from ruptured cells due to excessive tissue handling
Lymphoid samples most commonly affected
7
Q
When is heat fixation necessary?
A
Gram stain
8
Q
What are the steps to preparing a tissue imprint for cytology from a biopsy sample?
A
- Blot away excessive fluid on a clean paper towel or gauze before imprinting
- Imprint internal cut surface in linear fashion BEFORE exposure to formalin
Do not smear- may call cell rupture
May need to use a scalpel to grid sample
9
Q
Why is clinical history important?
A
Signalment, lesion description, medications, etc. important for interpretation and differentials
10
Q
What is kohler illumination?
A
Close condenser to see octagon
Move octagon to center, focus to make edges crisp
Open back up
11
Q
Which cell types does not stain well with Diff Quik?
A
Mast cell
12
Q
What are the five main classifications of lesions?
A
- Cystic
- Hemorrhagic
- Inflammatory
- Neoplastic
- Mixed
13
Q
What are follicular cysts composed of? When might this type of cyst become inflamed?
A
Contain keratinized cells, amorphous material, and cholesterol crystals
Becomes inflamed if they rupture into deeper tissues
14
Q
What are two types of pigment seen with hemorrhage?
A
Hemosiderin (black)
Hematoidin (golden)
Seen within macrophages
15
Q
What are primary considerations for the different types of inflammation?
A
Neutrophilis: abscess, sterile inflammation, immune-mediated disease, neoplasia
Neutrophils and macrophages: foreign bodies, injection site reactions, panniculitis, furunculosis, infectious etiologies
Eosinophils: allergy/hypersensitivity, infectious etiologies (fungal/oomycets, parasites), eosinophilic granuoma complex, neoplasms
Lymphoplasmacytic: mixed - antigenic/immune stimulation, early viral infection, chronic inflammation, regressing histiocytomas; monomorphic - neoplasia
Mixed: reactive hyperplasia
16
Q
What are degenerative changes (ie. what cell do they affect, what part of the cell, and where do they occur)? What are the implications of degenerate changes? Can degenerate changes be an artifact?
A
Affect nucleus of cell - karyolysis, karyorrhexis, pyknosis
Indicates cell death
Karyolysis - bacterial infection and rapid cell death
Karryorrhexis/pyknois - “regular” cell death
Yes, can be artifact from sitting in tube too long
17
Q
What are the four categories of tissue of origin for neoplastic lesions? Be able to describe the cytologic features of each
A
- Epithelial
- Mesenchymal
- Round
- Neuroendocrine
18
Q
What are the eight criteria of malignancy? How many are recommended to differentiate benign from malignant lesions cytologically?
A
- Anisokaryosis
- Pleomorphism
- High variable N:C ratio
- Mitotic figures
- Prominent nucleoli
- Coarse/clumped chromatin
- Nuclear molding
- Multinucleation
< 3: benign
19
Q
Why do you need to use caution when interpreting mixed cell populations?
A
Mimics malignancy
20
Q
Describe the cytologic features of epithelial cells
A
Readily exfoliate
Cohesive clusters and sheets
Distinct cytoplasmic borders with desmosomes
Round, oval, or polygonal cells
Acinar formation (glandular)
21
Q
Which specific epithelial neoplasms typically require histopathology to determine their biological behavior?
A
Mammary tumors
Hepatocellular tumors
22
Q
What is the most common epithelial tumor in the dog?
A
Mast cell tumor
OR
Adenexal neoplasm (when the whole group is lumped together)
23
Q
Wat is the most common route for metastatic spread of epithelial tumors?
A
Lymphatics
24
Q
What are the two types of perianal neoplasms?How do they differ cytologically and in biologic behavior?
A
1) Circumanal gland (hepatoid): look similar to hepatocytes with a lot of cytoplasm and pink hue, round nucleus with visible nucleoli, “reserve cells” may be present. Most are benign.
2) Anal sac apocrine gland: clumps or sheets with indistinct cell borders, appear lysed or “neuroendocrine”, large UNIFORM nuclei. Most are malignant.
25
What is a common paraneoplastic syndrome associated with anal sac apocrine gland adenocarcinomas?
Hypercalcemia of malignancy
26
What are the cytologic features of neuroendocrine tumors?
Exfoliate well
Free nuclei in background of cytoplasm (fragile cells)
Minimal atypia (hard to diagnose malignancy)
27
How would you determine the biological behavior of a neuroendocrine neoplasm?
Histopathology
28
What are two defining features of thyroid neoplasms?
Colloid
| Tyrosine granules
29
In what species are thyroid tumors functional?
Cat
30
What breeds are overrepresented for nonchromaffin chemoreceptor tumors?
Brachycephalic breeds (Boxers, Boston Terriers)
31
Which neuroendocrine tumor can be an incidental finding?
Pheochromocytoma
32
Which neuroendocrine tumor is typically seen with other concurrent neoplasms?
Pheochromocytoma
33
Describe the cytologic features of mesenchymal cells
```
Variable exfoliation
Cells individually arranges
Indistinct, wispy cytoplasmic borders
Spindle-shaped, fusiform, stellate cells
Oval nucleus
```
34
Which specific mesencymal neoplasms typically require histopathology to determine their biological behavior?
Muscle tumors:
Leiomyoma/sarcoma
Myxoma/sarcoma
Cartilaginous tumors:
Chondroma/sarcoma
35
What is the most common route of spread for mesenchymal neoplasms?
Hematogenous routes
36
What tissue do mesenchymal cells arise from?
Soft tissue
Bone
Cartilage
37
What other tumors can feel like a lipoma?
Mast cell tumors
| Soft tissue sarcomas (specifically perivascular wall tumors)
38
What additional cell population may be present in injection site sarcoma in cats?
Lymphoid cells
39
Why are certain soft tissue sarcomas placed into the same category and not differentiated further?
Not differentiated anymore because basic biologic behavior and treatment for all of these tumors is the same
40
Why is hemangiosarcoma poorly exfoliative?
Poorly exfoliative
Dependent on aspiration technique
Tumor cells are lining blood vessel so need to aspirate capsule of tumor to get diagnosis
41
What other tumor(s) must synovial cell sarcoma be distinguished from?
Histiocytic sarcoma
42
Know the signalment, anatomic site, and biologic behavior for mesenchymal tumors
Liposarcoma: older dogs, ventrum and extremities, malignant
Perivascular wall tumors: extremities
Fibrosarcoma: older dogs, may be associated with injection sites, malignant but slow to metastasize
Hemangiosarcoma: older, large breed dogs, spleen, lifer, R atrium, retroperitoneal space, bone, dermal. Malignant, poor prognosis
Synovial cell sarcoma: elbow, stifle, and shoulder. Locally invasive, 25% metastasis
Histiocytic sarcoma: rottweilers, stifle
Snyovial myxoma: doberman, stifle
Osteosarcoma: large breed dogs, away from elbow, towards knee, rapid metastasis (worse prognosis in appendicular skeleton than axial)
43
What are the 6 categories of round cell neoplasms?
1. Lymphoma
2. Plasma cell
3. Histiocytoma/histiocytic neoplasia
4. TVT
5. Mast cell tumor
6. Melanoma
44
How do round cell tumors typically metastasize?
Lymphatics
45
What are defining features of plasma cells?
Dark blue cytoplasm
| Perinuclear colorless area (their golgi)
46
Know signalment and biologic behavior differences between histiocytoma and histiocytic sarcoma
Histiocytoma: young dogs, usually on head or trunk, benign
Histiocytic sarcoma: bernese mountain dogs, rottweilers, flat-coated retrievers, goldens, skin of extremities, spleen, LNs, lung, BM, meninges, periarticular, can be disseminated
47
What are the hematologic and biochemical changes that can be seen with the hemophagocytic variant of histiocytic sarcoma?
Hematologic: anemia, thrombocytopenia
Biochemical: hypoalbuminemia, hypocholesterolemia
48
What are the typical locations for TVT? Why?
Nasal cavity and mucus membranes of external genitalia
Sniffing butts
49
Which round cell tumor may be difficult to diagnose using quick type stains (Diff Quik)?
Mast Cell Tumors
50
What 4 components may be seen with mast cell tumors?
1. Mast cells
2. Eosinophilic inflammation
3. Reactive fibroblasts
4. Collagen lysis
51
Know about signalment and anatomic site differences for the round cell tumors.
Lymphoma: lymph nodes (dogs), GI (cat), horse
Plasma cell tumor: dogs > cats; extramedullary = digits, ears, oral, GI, liver, spleen
Histiocytoma: pink, hairless region on trunk/head; young animals; regress
Histiocytic sarcoma: Bernese Mtn Dogs, Goldens, Flat Coats, Rotties; skin, spleen, LN, lung, marrow, meninges, periarticular; met everywhere
TVT: dogs; on nose, external genitalia, anus
MCT: can see in young animals; more aggressive in dogs than cats/horses; poorer prognosis if nails, scrotum, mucocutaneous sites; cats can get visceral form
Melanoma: dogs/horses; oral/digit more aggressive than trunk; horses get at the base of the tail, perineum, lips, eyelids
52
Cytologic description of reactive lymphoid hyperplasia
Predominately small, well-differentiated lymphocytes
Increased number of intermediate lymphocytes, large lymphoblasts, plasma cells, neuts, eos, macrophages
Low numbers of mast cells
Lymphoglandular bodies
53
Cytologic description of lymphadenitis
Inflammatory cells
Look for etiologic agent
54
For lymphoma of peripheral lymph nodes in dogs, what percent of blasts can lead to a reliable diagnosis of lymphoma?
> 50%
55
Cytologic description of metastatic neoplasia
Presence of cells not normally seen or not seen in large numbers in lymph nodes
Usually display malignancy
56
What signalment and clinical findings are important with Feline Hodgkin’s-like lymphoma?
Adult
| Enlarge LN in neck, then moves down to thorax
57
What signalment information is important with distinctive peripheral lymphoid hyperplasia of cats?
Young cats (< 2 years old) with diffuse lymphadenomegaly
58
What signalment and clinical findings are important with feline small-cell lymphoma?
Older, geriatric cats
FeLV neg
59
In an animal with generalized lymphadenopathy, what does the FNA cytology finding of reactive lymphoid hyperplasia in multiple nodes imply?
Non-specific
Indicates antigenic stimulation with many etiologies possible
60
What is a lymphoglandular body?
Cytoplasmic fragments
61
Which tests are useful to phenotype lymphoma?
Flow cytometry
| IHC, ICC
62
What condition can be associated with a “false-positive” PCR for antigen receptor rearrangement (PARR)?
Chronic antigenic stimulation
63
What test is required to diagnose feline Hodgkin’s-like lymphoma?
Histology and IHC
64
Which type of feline ailmentary lymphoma often occurs in the stomach or colon as a solitary mass?
Large cell (typically B cell)
65
Which type of feline ailmentary lymphoma is most common?
Small cell, well-differentiated lymphoma
66
Feline lymphocytic inflammatory bowel disease and ____ lymphoma can be difficult to distinguish cytologically and histologically
Ailmentary
Small cell, well-differentiated
67
Can lymph node FNA cytology definitively diagnose that a lymph node is completely free of metastatic neoplasia? Why or why not?
No
Early metastatic disease might be missed on cytology (starts as focal accumulations)
68
Is it possible for a lymph node to contain metastatic neoplastic cells and still be normal sized?
Yes
Metastasis starts as focal accumulations of abnormal cells
69
Is prognosis worse for B cell or T cell lymphoma?
B is better than T
70
What substage of lymphoma is better ( A or B)?
A
```
A = not clinical
B = clinically ill
```
71
Which lymphoma phenotype is more commonly associated with hypercalcemia?
T cell lymphomas
72
Is it possible to definitively phenotype lymphoma using routine FNA cytology alone?
No
73
For a cat with enlarged mesenteric lymph nodes from which FNA cytology revealed a small lymphoid population, could the small lymphocytes be a reactive cell population?
Yes
74
For a cat with enlarged mesenteric lymph nodes from which FNA cytology revealed a small lymphoid population, could the small lymphocytes be a neoplastic population?
Yes
75
For a cat with enlarged mesenteric lymph nodes from which FNA cytology revealed a small lymphoid population, could one use flow cytometry of the LN FNA to tell if vells are likely reactive or neoplastic?
Yes, but less reliable than PARR
76
For a cat with enlarged mesenteric lymph nodes from which FNA cytology revealed a small lymphoid population, could one use PCR for PARR of LN to tell if cells are reactive or neplpastic?
Yes
77
For a cat with enlarged mesenteric lymph nodes from which FNA cytology revealed a small lymphoid population, what type of info is provided by flow cytometry and other immunodiagnostics?
Phenotype
78
For a cat with enlarged mesenteric lymph nodes from which FNA cytology revealed a small lymphoid population, what type of info is provided by PARR?
Clonality of lymphocytes
79
What lymphoid populations are expected in the spleen?
Mixed lymphoid populations - predominance of small, some intermediates, some large cells
80
What is extramedually hematopoiesus and what is the clincal signficance?
Blood elements produced outside bone marrow, most commonly in liver and spleen
Similar cell populations to bone marrow
Benign
81
What are the three types of feline ailmentary lymphoma?
1. Small cell, well-differentiated
2. Large granular lymphoma
3. Large cell (typically B cell)
82
Which type of hepatic biopsy yields a sample most representative of hepatic architecture?
Wedge biopsy
83
What diseases are most likely to yield a diagnostic sample when blind FNA is used to collect the sample?
Diffuse disease
Hepatic lipidosis
Vacuolar hepatopathy
Lymphoma
Neutrophilic hepatitis
84
What is the utility of ultrasound-guided FNA of focal hepatic lesions?
Useful to distinguish inflammatory, hyperplastic, and neoplastic lesions
85
What is the significane of nuclear crystals identified in hepatic cytology?
No real significance
86
When can hepatocellular binucleation be observed?
Hyperplasia or well-differentiated carcinoma
87
What are the two typs of hepatocellular vacuolar degeneration and why does each occur?
1. Distinct - lipid accumulation
| 2. Indistinct - water or glycogen
88
What type of vacuolar degeneration is observed more commonly in cats?
Distinct
89
What type of vacuolar degeneration is observed more commonly in dogs?
Indistinct
90
What liver pigments are most commonly observed?
Bile
Lipofuscin
Hemosiderin
Copper
91
What are bile casts and why do they occur?
Cholestasis
92
With cytology, is it possible to tell the difference between hepatitis and cholangitis?
No
93
What is the most common type of inflammation in the liver and is cytology relatively insensitive or sensitive for detecting it?
Non-neutrophilic inflammation
Insensitive
Usually very focal
94
What is the significance of a small cell lymphoid infiltrate into a liver?
Inflammation or lymphoma
95
Compare and contrast nodular hyperplasia with hepatocellular regeneration
```
Nodular hyperplasia:
Idiopathic, older dogs
No clinical signs, inc ALP
Vacuolar degeneration
Pigment
EMH
```
```
Hepatocellular regneration:
Result of chronic hepatitis
Bile in vacuoles
Bile casts
Clumped fibroblasts
```
96
What are the metastatic rates of the three morphologic forms of canine hepatocellular carinoma?
Massive - 5%
Nodular - 90%
Diffuse - 100%
97
What is the most common hepatic neoplasm?
Lymphoma
98
What is the most common primary hepatic tumor of dogs and what is its site predilection?
Massive hepatocellular carcinoma
Left lateral liver lobe
99
What is the most common primary hepatic tumor of cats?
Bile duct carcinoma
100
A large amount of distinct vacuolar degeneration is identified in the hepatic FNA of a cat. Which of the following is the most appropriate interpretation?
A. Incidental finding of lipid accumulation within hepatocytes
B. Incidental finding of glycogen accumulation within hepatocytes
C. Hepatic lipidosis
D. Steroid hepatopathy
E. Vacuolar degeneration due to toxic insult
Hepatic lipidosis
101
What sample tube do you need to put body cavity fluid in for cytology? Culture?
Cytology: EDTA purple top
Culture: plain red top tube
102
If there will be a delay in processing a fluid sample (eg. Transport >30 min), what two things should you do?
1. Prepare direct smear immediately after collection
| 2. Keep fluid refrigerated
103
What are the four parts of body cavity effusion analysis?
1. Physical features (color/clarity)
2. Protein concentration
3. Cell count
4. Microscopic evaluation
104
What is the predominant cell type in normal body cavity fluid of the following species:
Dogs/cats?
Equine?
Dogs/cats = mostly mononuclear phagocytes, low number of small lymphs/neuts, mesothelial cells
Equine = neutrophils predominate (low numbers), minimal reactive mononuclear
phagocytes, small lymphs, mesothelial cells
105
How do transudates form and what are some common clinical conditions that result in their formation?
Decreased oncotic pressure or increased hydrostatic pressure
Liver, intestinal, renal disease or iatrogenic (fluid overload) = anything that causes decreased abumin
106
What biochemical test can you perform to daignose a chylous effusion?
Triglycerides
107
Which is the least useful fluid classification and why?
Modified transudate
Can be caused by many clinical conditions
108
How do exudates form and what sare come common clinical conditions that result in their formation?
Exudative processes = increased vascular permeability and inflammation
Non-septic: chemical peritonitis, FIP, sterile FB, neoplasia, pancreatitis, abscess
Septic: puncture wounds, bite wounds, perforation, abscess
109
What are 3 common causes of a non-septic exudate and how would you diagnose each one?
Uroperitoneum: fluid:serum creatinine ratio (>2:1)
Bile peritonitis: fluid:serum bilirubin ratio (>2:1)
FIP: very high protein concentration, A:G ratio <0.8
110
What must be present to diagnose a septic exudate?
Intracellular organisms
111
How would you distinguish between true and iatrogenic hemorrhage in effusion?
Erythrophagocytosis +/- hemosiderin
Presence of platelets (true hemorrhagic effusions - will NOT see platelets)
112
What are the common neoplastic effusions?
```
Lymphoma
Hemangiosarcoma
Carcinoma
Mesothelioma
MCT
```
113
True or False: Synovial fluid analysis usually yields a specific clinical diagnosis
False
114
What are some causes of decreased synovial fluid viscosity?
Breakdown by bacterial or WBC proteases
Dilution
Decreased production from synovium damage
115
What are the 3 ways one can assess the viscocity of synovial fluid?
String test
Mucin clot test
Microscopic exam
116
What is the cytologic appearance of synovial fluid that has normal viscosity?
Dense, granular, eosinophilic background
“Pink shag carpet”
117
What leukocyte count and cytologic appearance (background, predominant nucleated cell) can be seen with each of the following?:
Normal synovial fluid
Synovial fluid from an animal with non-inflammatory joint disease
Synovial fluid from an animal with inflammatory joint disease
Normal synovial fluid:
Mononuclear cells predominate, dense eosinophilic background. Most species <500 cells/uL
Synovial fluid from an animal with non-inflammatory joint disease
Increased numbers of mononuclear cells (may be reactive)
Synovial fluid from an animal with inflammatory joint disease
Neutrophils predominate
118
True or False - definitive diagnosis of degenerative joint disease (DJD) can be made with synovial fluid analysis alone?
False
119
What are the four general differentials for a non-inflammatory joint fluid?
Trauma
DJD
Hemarthrosis
Neoplasia
120
Why is it useful to radiograph the affected joint(s) in an animal that has a non-inflammatory joint fluid?
DJD cannot be diagnosed via fluid analysis – requires rads
121
What joint is usually affected in dogs that have lymphoplasmacytic synovitis and with what specific orthopedic finding is this often associated with?
Stifle; generally reflect CCL disease
122
How many joints does one need to sample (i.e., how many joints need to be arthrocentesed) to diagnose the most common inflammatory joint disease of dogs?
3
123
What is the most common inflammatory joint disease of dogs and how does it present radiographically?
Idiopathic immune-mediated non-erosive polyarthritis
Only radiographic changes if erosive?
124
Is the polyarthropathy observed in an E. canis-infected dog likely due to primary joint infection or secondary immune attack/complex deposition?
Secondary immune attack/complex deposition
125
How does one definitively diagnose the most common inflammatory joint disease of dogs?
(Idiopathic)
Must exclude all other causes
126
True or False – the rheumatoid factor (RF) test has good sensitivity and specificity for the diagnosis of idiopathic erosive polyarthritis (rheumatoid arthritis) in dogs.
False
127
True or False – a positive antinuclear antibody (ANA) test along with other specific clinical signs is necessary to diagnose systemic lupus erythematosus (SLE).
True
128
What is the most common inflammatory joint disease of cats and what are some specific factoids about this disease (Re: etiology, gender predisposition, radiographic presentation)?
Feline chronic progressive polyarthritis; young male cats, viral infections (feline syncytium-forming virus is often isolated); often co-infected with FeLV; radiographically = erosive disease
129
What is the most common inflammatory joint disease of large animals?
Septic joint
130
Why is it useful to radiograph affected joints and potentially other body parts (e.g., thorax, abdomen) in a dog that has an inflammatory polyarthropathy?
Radiograph joint to assess erosive or non-erosive (differential list changes).
Radiograph other parts to see if there is an inciting cause (pneumonia, neoplasia etc).
131
Synovial fluid was collected from the swollen left carpus of a 6 year old mixed breed dog that
was febrile, had a stiff, stilted posture, and was reluctant to walk. The results are summarized
below:
Color/clarity: colorless/slightly cloudy
Protein: 4.0 g/dL
Viscosity: moderately decreased
Nucleated cells: 25,000/mL, predominantly mature, nondegenerate, windrowing
neutrophils
The above results are best interpreted as
A. Within normal limits
B. Consistent with non-inflammatory joint disease; considerations include DJD, neoplasia,
trauma, hemarthrosis
C. Consistent with inflammatory joint disease; considerations include infectious, immunologic
(nonerosive vs. erosive), nonimmunologic causes
C
132
Normal nucleated cell counts of synovial fluid from most species, dog, cats, cattle
Most species: <500 cells/uL
Dogs: <3000
Cats: <1000
Cattle: <1000
133
Respiratory washes are typically most useful for what type of infiltrate?
a. Interstitial disease (interstitial pattern)
b. Peribronchial infiltrate (bronchial/alveolar pattern)
c. Nodular disease (mass)
B. Peribronchial infiltrate
134
Why is it important to make slides at time of collection with fluid samples?
Cells absorb water, swell, and lyse with time – altered morphology
135
What is the preferred additive for preserving respiratory wash samples during transport >24 hours?
Serum
136
List differentials for following types of respiratory wash samples:
Neutrophilic
Mixed
Eosinophilic
Hemorrhagic
Neutrophilic: septic or non-septic – tissue irritation/necrosis, acute respiratory distress syndrome, inflammatory airway disease, neoplasia
Mixed: persistent infection/inflammation (bronchitis, recurrent airway obstruction, fungal/protozoal sepsis, viral), foreign material, lipid pneumonia
Eosinophilic: allergic/hypersensitivity, parasitic, eosinophilic
bronchopneumopathy, lymphatoid granulomatosis, inflammatory airway disease
Hemorrhagic: EIPH, asthma, trauma, coagulopathy, thromboembolism, neoplasia
137
What are the common tumors of small animal eyelids?
Meibomian gland adenoma, sebaceous epithelioma
138
Which species are affected by:
Ocular Chlamydiosis?
Viral conjunctivitis? What type of inflammation?
Eosinophilic conjunctivitis/keratitis?
Ocular Chlamydiosis?
Cats, horses, guinea pigs
Viral conjunctivitis? What type of inflammation?
Feline herpes, canine distemper, equine adenovirus; lymphocytic/plasmacytic → neutrophilic with chronicity
Eosinophilic conjunctivitis/keratitis? What cells types may be present?
Cats, horses; may see mast cells
139
What cells types may be present with eosinophilic conjunctivitis/keratitis?
Eosinophils
| Mast cells
140
Which species more commonly are affected by squamous cell carcinoma of the cornea?
Horses
141
Normal leukocyte count for CSF samples
< 5 WBC/uL
| 0 RBC/uL
142
True or False - CNS disease causes consistent changes to CSF that are reproducible from animal to animal and correspond to the specific cause and severity of the disease.
False
143
What specific sample handling issues apply to CSF?
Process or preserve within 60 min – cells rapidly degrade; preserve with serum
144
When can one observe an increased protein concentration in the CSF, but a normal leukocyte count?
Damage to BBB (leakage)
CSF obstruction
Localized tissue damage/necrosis
Infectious/neoplastic etiology for ↑protein production
145
When can one observe an increased percentage of neutrophils in the CSF, but a normal leukocyte count?
Early/mild inflammatory disease – IVDD, fracture, severe seizures, CNS necrosis, cervical stenotic myelopathy
146
What is the most common type of pleocytosis seen with the following diseases?
Bacterial infection in CNS of most species (e.g., abscess, meningitis)
Viral infections
Acute alphaviral (EEE, WEE, VEE) infection
Granulomatous meningoencephalomyelitis (GME)
Aberrant parasitic migration
FIP
Chronic FIP
Necrotizing, nonsuppurative meningoencephalitis of toy breed dogs
Feline polioencephalomyelitis
Meningioma
Bacterial infection in CNS of most species (e.g., abscess, meningitis) – neutrophilic
Viral infections – lymphocytic
Acute alphaviral (EEE, WEE, VEE) infection – neutrophilic
Granulomatous meningoencephalomyelitis (GME) – neutrophilic, mixed
Aberrant parasitic migration – eosinophilic
FIP – neutrophilic
Chronic FIP – mixed cell
Necrotizing, nonsuppurative meningoencephalitis of toy breed dogs – lymphocytic
Feline polioencephalomyelitis – lymphocytic
Meningioma – neutrophilic
147
What are the possible pleocytoses seen with steroid responsive meningitis arteritis (SRMA) in dogs, and which one is most common?
Neutrophilic (acute stage), mixed cell (chronic stage
148
In the situations below, which site (AO vs LS) would abnormal CSF tap more likely?
A Dachshund with acute T3 - L3 signs due to intervertebral disc rupture at T13
LS – collect fluid caudal to lesion
149
A colorless and clear AO CSF sample was collected from a dog with a history of seizure.
PROTEIN = 50 mg/dL
WBC = 250/µL, predominantly small, well differentiated lymphocytes
The results are best interpreted as
A. Lymphocytic pleocytosis with normal microprotein concentration
B. Within normal limits
C. Lymphocytic pleocytosis with increased microprotein concentration
D. Increased microprotein concentration with normal cell count
E. Increased microprotein concentration with increased neutrophil percentage
C. Lymphocytic pleocytosis with increased microprotein concentration
150
The neurologic signs and CSF analysis results are most consistent with which of the following
CNS diseases?
A. A bacterial abscess within the cerebrum
B. Aberrant parasitic migration
C. A fungal infection
D. Rabies, canine distemper, or necrotizing, nonsuppurative meningoencephalitis
E. An extradural compressive lesion, such as IVDD
F. The CSF analysis results are normal; therefore the patient does not have CNS disease
D. Rabies, canine distemper, or necrotizing, nonsuppurative meningoencephalitis
