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Pathology > Diagnostic Testing > Flashcards

Diagnostic Testing Flashcards

1
Q

What does anatomic pathology include?

A

Post Mortems

Histology

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2
Q

What does clinical pathology include?

A

Biochemistry
Serology
?????????

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3
Q

Why do you have to be careful when selecting tests to be sent to NZVP or Gribbles?

A

It can be expensive!
Don’t want to waste the clients money.
e.g. full CBC costs $110 but the markup to clients can be up to $220

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4
Q

Why do you have to beware of test results and interpretations if your samples are sent to a medical laboratory?

A
  • Medical pathologists aren’t usually trained to interpret animal samples.
  • Their equipment is not set up for animal blood
  • Reference ranges will generally be unreliable e.g. what may be abnormally high in people might be normal in a horse
  • Some tests are completely unreliable in animals
  • Haem techs won’t do manual blood smear examination
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5
Q

If you suspect an exotic disease in an animal e.g. mad cow disease. who do you contact?

A

MPI Biosecurity NZ

  • They are part of the Investigation and disease centre (IDC)
  • They will come and do everything for you at no cost to ensure it isn’t an outbreak
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6
Q

What information must you provide on the form when submitting samples?

A
  • Signalment
  • Clinical signs and history
  • Any results of lab tests done in clinic

The more info the better!
Try to give them the big picture

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7
Q

What is important when vets are doing in-clinic tests?

A

Tests are only as reliable as the person who performs them

  • should do that test at least once a week to ensure its fresh in head
  • be under supervision of someone else
  • It is better to do a few tests well than heaps poorly
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8
Q

What is Quality Assurance?

A

an overall set of protocols to ensure test results are valid

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9
Q

What is Quality Control?

A

Procedures set in place to ensure a manufactured product sticks to a defined set of quality criteria

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10
Q

What is Internal QC?

A

Control samples with known values are run with test samples at least once a week

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11
Q

What is external QC?

A

Duplicate samples are sent to the lab for comparison

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12
Q

Why is QC/ QA important?

A

Absolutely necessary for reliable results

- no QC = no guarantee that results are accurate

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13
Q

What is test selection?

A

Selecting tests that you know might help, confirm or exclude major DDx

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14
Q

What might occur if you only pick one lab test?

A

Might miss a vital piece of information
- tests used in isolation might be misleading because the results might be different tomorrow or might have been different yesterday

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15
Q

Why might repeat sampling be necessary?

A

To confirm suspicious results or to assess to progress in an animal
- this is particularly important in endocrine cases

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16
Q

What units do NZ labs use?

A

S.I units
- ensure this is interpreted correctly
US publications still use US customary units

17
Q

What must you consider when interpreting results (bell curve)?

A

The reference range is the mean +/- 2 standard deviations.

- Thus 5% of healthy animals fall outside the reference range - just by chance

18
Q

What do reference intervals represent?

A

The distribution of test results in a healthy population

19
Q

What are the measures of how well tests predict the actual disease state of the animal?

A
  • Sensitivity/ Specificity
  • Accuracy
  • Predictive Values
20
Q

What is test sensitivity?

A

The frequency that a test is positive in patients that have the disease
- girl that cries about everything whether it’s actually worth crying about

TP / TP+FN x 100

High sensitivity is good for ruling diseases out - low false negatives
SN-OUTs

21
Q

What is test Specificity?

A

The frequency that a test is negative in patients that do not have the disease
- Boy that doesn’t like peas - picks every single one off his plate without missing any

TN / TN + FP x 100

High specificity is good for ruling a disease in - low false positives

SP-INs

22
Q

What is diagnostic Accuracy?

A

The frequency that a test correctly classifies an animal as having or not having the disease

TP +TN/ total # x 100

23
Q

What is a Positive Predictive Value (PV+)

A

The probability that a positive test result indicates the animal has the disease

TP /TP + FP x100
(TP / all positive results)

24
Q

What is a Negative Predictive Value (PV-)?

A

The probability that a negative test result indicates the animal does not have the disease

TN / TN + FN x 100
(TN / all negative results)

25
Q

If a test has a low specificity (44%) what does this mean for the test?

A

It is not good at ruling things in

- there are %56 false positives but these animals actually do have the disease

26
Q

If a test has high sensitivity (98%) what does this mean for the test?

A

It is very good at ruling things out

  • only 2% false negatives
  • generally if the animal has the disease it will test positive - rarely misdiagnoses those with the disease
27
Q

If a test has high specificity (92%) what does this mean for the test?

A

It is very good at ruling diseases in

  • only 8% false positives
  • rarely gives positive results in healthy patients
28
Q

If a test has low sensitivity (35%) what does this mean for the test?

A

It is not good at ruling things out

- there are 65% false negatives

29
Q

Why is it important to know the strengths and weaknesses of tests?

A
  • Every test has them!
  • Knowing the strengths and weaknesses of a test influences your interpretation of test results
  • Don’t always need to know sensitivity and specificity - just need to know how good the test is!
30
Q

PCV test

A
  • Diagnoses and monitors anaemia
  • Assesses the need for blood transfusion
  • Monitors fluid therapy
  • Examining tubes after centrifugation can give useful information
31
Q

Plasma Protein

A

Measure plasma from PCV tube using refractometer

  • Differentiates blood loss from haemolytic anaemia
  • Monitors fluid therapy
  • Detects hypo and hyperproteinaemic diseases
32
Q

Urinalysis

A

Has three components:

  • Specific Gravity
  • Chemistry
  • Sediment Exam

Measured using refractometer

  • Assesses renal concentrating ability
  • Assists in interpretation of urine chemistry results
  • SG varies in normal animals depending on state of hydration (1.008-1.012
33
Q

Urine Chemistry

A

Measured by dipsticks
- Ignore nitrate. leukocytes and SG
Interpretation depends on [urine] as determined by refractometer
- +ve blood could indicate HB, intact RBCs or myoglobin

34
Q

Urine sediment

A

Check for casts, crystals, cells, microorganisms

- Requires some experience and training

35
Q

Blood Glucose

A
  • Easily performed in clinic

- Useful for diagnosis and monitoring diabetics

36
Q

Faecal Blood

A

Kits available for detecting small amounts of blood in faeces
- False positives occur in animals on meat diets

37
Q

Faecal Smears

A

Significant numbers of neutrophils may indicate bacterial disease of large colon or ulcerative colitis
Eosinophils may suggest allergic or parasitic disorders

38
Q

Skin Scraping

A

Best performed in clinic because repeat sampling is usually needed
- Demodex and Sarcoptes easily recognised if present

39
Q

Cytology

A

Basic Interpretations of: ear swabs, effusions, joint fluids and skin lumps
- refer difficult cases to lab

Pathology (12 decks)

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