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DVM 2 - 1 > HLI 3 > Flashcards

HLI 3 Flashcards

1
Q

Where are blood cells produced

A

Early embryo – yolk sac
Foetus – liver, spleen and bone marrow
Neonate – liver and bone marrow
Adult – bone marrow (spleen & liver with disease and when needed - EMH)

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2
Q

What is leukopoesis divided into and how long do they live

A
  1. Lymphopoiesis
  2. Myelopoiesis
    - Granulocytes
    - Neutrophils
    - Eosinophils
    - Basophils
    - Monocytes leads to macrophages
    Most have a life span of 2 weeks
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3
Q

granule colour of neutrophil, basophil and eosinophils

A

Neutrophils - granules cannot see
Basophils - granules blue
Eosinophils - granules red

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4
Q

Why do leukocytes undergo segmentation

A

Elongated segmented nucleus

  • Easier to get through endothelial cells into the tissues - first to arrive
  • Inactive nucleus no transcription
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5
Q

Where are neutrophils found in the body and how long in each area

A
  1. Marrow
    ○ Maturation pool
    ○ Storage pool - dogs and cats store up to 5 days
  2. Blood
    ○ Circulating neutrophil pool (free moving in vessels) - what we get in the blood sample
    ○ Marginal neutrophil pool (loosely adhered to vessels)
    - 10-12 hours
  3. Tissue - 24-48 hours
    - do not recirculate unlike lymphocytes (removal via macrophages)
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6
Q

Monocyte kinetics

A
  • Maturation in marrow is rapid (24-36hrs)
  • Don’t have to have the segmented nucleus or protein granules produced
    Lifespan - unknown
    Limited recirculating and replication capacity
    Continue to divide
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7
Q

Thrombopoeisis what regulated by, timeframe

A
  • Regulated by thrombopoeitin from liver, kidney and marrow stromal cells
  • Maturation 2-10 days
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8
Q

What is a megakaryocyte and what does it lead to

also what are macro platelets and their implications

A

Megakaryocyte
- Large mass of nuclear material
- Can be 34 times the normal amount of DNA
- Cytoplasm pinching off that become the platelets
Macro platelets or macro thrombocytes
- Produced from larger pinching of the megakaryocyte when need lots of platelets
- If platelet larger than RBC then classify as this

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9
Q

What are the 4 general mechanisms for decrease platelets and examples

A

1) production - bone marrow disease or EMH
2) consumption - inflammation
3) sequestration - splenomegaly from haemangiosarcoma
4) destruction - immune mediated

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10
Q

What percentage of platelets are sequestered in the spleen, life-span and when nucleated

A
  • 30-40% sequestered in spleen within vascular sinusoids, if get splenomegaly then holds more
  • Life-span 5 – 9 days
  • Nucleated in avians and reptiles (thrombocytes)
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11
Q

What are the 3 features of the leukogram

A
  1. Total leukocyte count
  2. Differential (individual leukocyte counts)
  3. Leukocyte morphology - human only,
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12
Q

White blood cell count what are the 3 ways

A
  1. Automated count methods
    ◦ Impedance
    ◦ Flow cytometry
  2. Manual count
    ◦ Evaluate in monolayer
    ◦ Est. WBC count x 109/L = 2.0 x average WBC per 40x field
  3. Assess morphology (40 or 100x objective in monolayer)
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13
Q

What are the 3 features of the leukogram

A
  1. Total leukocyte count
  2. Differential (individual leukocyte counts)
  3. Leukocyte morphology - human only,
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14
Q

White blood cell count what are the 3 ways

A
  1. Automated count methods
    ◦ Impedance
    ◦ Flow cytometry
  2. Manual count
    ◦ Evaluate in monolayer
    ◦ Est. WBC count x 109/L = 2.0 x average WBC per 40x field
  3. Assess morphology (40 or 100x objective in monolayer)
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15
Q

What are the 3 characterstics that automated systems determine in WBC and when should and shouldn’t it be used

A
  • Cell size - forward scatter
  • Cell fluorescence - RNA within the cell
  • Side scatter (cell complexity) - granularity
    Good with normal leukocytes but misclassifies cells that are abnormal - look at blood smear
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16
Q

Neutrophil kinetics for cows, dogs, horses and cats

A

Cows - 1:1 easily become neutropenic due to small storage pool
Dogs - 1:1 large storage pool (5 days worth)
Horses - 1:1 small storage pool not as small as cows
Cats - 3:1 most neutrophils in the marginating pool, smaller storage pool than dogs but still larger than horse and cow

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17
Q

what occurs to neutrophils during the stress response

A

SUPPRESS IMMUNE SYSTEM
lymphocytes release from bone marrow is decreased
movement of RBC from marginating into circulating pool
- mature neutrophilia
Move red blood cells from marginating into circulating
Neutrophils are also released from the bone marrow

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18
Q

What occurs to neutrophils during inflammation

A

neutrophilia - degree varies

pull from storage pool into circulating and marginating +/- increased marrow production

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19
Q

what occurs to neutrophils during excitement (adrenalin mediated)

A

Mainly in young animals
neutrophilia
- increase in lymphocytes and neutrophils movement from marginating into circulating pool

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20
Q

List 4 causes of neutropenia and how occurs

A
  1. Overwhelming inflammatory demand
    - Generally a septic process with a lot of puss formed - pyometra
    - Less disease needed for cows as they have a lower storage pool
  2. Transient margination (endotoxaemia)
    - More towards edges of the vessels so not detecting them in the sample
  3. Bone marrow disease
    - Make less neutrophils
  4. Immune-mediated destruction of neutrophils
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21
Q

what results in a neutrophil left shift and the types

A

= immature neutrophils in blood
• Usually bands
• Regenerative left shift
○ ◦ Mature (segmented) neutrophils > immature (band) neutrophils
• Degenerative left shift
○ ◦ Immature neutrophils > mature nature neutrophils
Can have with normal neurophils

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22
Q

What does a degenerative left shift indicate

A

Tells us bone marrow is desperate - no longer have mature left
More likely to be septic and life threatening - severe inflammation

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23
Q

List 2 causes of neutrophil left shift

A
  1. Inflammation
    = High tissue demand for neutrophils
    - Reflects release from maturation pool
  2. Can also occur with myeloproliferative disease e.g. chronic myeloid leukaemia (serious bone marrow disease) and neoplasia (paraneoplastic syndrome)
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24
Q

List 4 differentials that lead to lymphocytosis

A 
1. Chronic antigenic stimulation
◦ Vaccination
2. Adrenaline/Excitement (young animals)
3. Lymphoid neoplasia
4. Hypoadrenocorticism - lack of cortisol
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25
Q

List 3 differentials that lead to lymphopenia

A 
1. Glucocorticoids/Stress - most common 
◦ Reduced release from LN and spleen
◦ Lympholysis
2. Acute inflammation
- Generally increased stress so get lympholysis or due to movement of lymphocytes into tissues - less circulating 
3. Loss of lymphatic fluid
◦ Chylothorax
◦ Enteric neoplasia
◦ Protein losing enteropathy
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26
Q

List characteristics of monocytes

A

1) variable nuclear morphology
2) blue-grey cytoplasm
3) larger than neutrophils
4) cytoplasmic vacuoles
5) nuclear never as dense as neutrophils

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27
Q

List function of monocytes

A

1) phagocytosis - foreign material, daed cells
2) source of cytokine and chemotactic factors
3) present antigen to T cells
4) perform antibody-dependent cytotoxicity

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28
Q

List 4 differentials that lead to monocytosis and what does mnocytopenia mean

A
  1. Acute inflammation
  2. Chronic inflammation
  3. Glucocorticoids/stress (dogs)
  4. Myeloproliferative disease e.g. myeloid leukaemia
    clinically insignificant - mainly healthy animals have low numbers
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29
Q

List 3 differentials for eosinopenia

A
  1. Glucocorticoids/stress response

2. Can be clinically insignificant

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30
Q

What are the 4 functions of basophils and what are they associated with

A
  1. Histamine release
  2. Promote lipid metabolism
  3. Haemostasis
  4. Parasite control
    Generally occur with eosinophils
    - Eosinophilia generally get basophilia
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31
Q

How does a scatter plot work for WBC differentiation

A

each cell going through the analyser gets placed on graph based on fluorescence and granularity - so each type of leukocyte will be placed in a certain area - look at how many dots in that area to see the amount of neutrophils, basophils etc.

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32
Q

How does a scatter plot work for WBC differentiation

A

each cell going through the analyser gets placed on graph based on fluorescence and granularity - so each type of leukocyte will be placed in a certain area - look at how many dots in that area to see the amount of neutrophils, basophils etc
- Analyser needs to know the species as the cells change characteristics in different species so certain cells may be identified as something they are not

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33
Q

What is toxic change, Why and when does it occur

A

What?
- Neutrophils that show signs of cytoplasmic immaturity
- Was able to divide the nucleus but cytoplasm wasn’t divided properly
Why?
- Hastened or disordered maturation in the bone marrow
When?
- Infections or intense inflammation or myeloproliferative disease
Can be associated with nuclear immaturity (left shifting) or seen in cells with mature segmented nuclei

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34
Q

What are the 3 main signs of toxic change

A

1) increase basophilia
2) dolhe bodies
3) vacuoles

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35
Q

Ring form neutrophils when seen

A

low numbers in normal rodents
◦ intense inflammation
◦ chronic myeloid leukaemia
◦ myelodysplasia.

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36
Q

hypersegmented neutrophils how many segments considered and causes

A
  • > 5 segmentations = Older neutrophils
  • Chronic glucocorticoid exposure - MOST COMMON
    ○ decreased tissue emigration - less margination more circulating neutrophils - age in the blood
  • Seen more in horses - normally have some with higher segmentation - 6
  • Can also be seen with myeloproliferative disease e.g. chronic granulocytic leukaemia
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37
Q

Describe botyroid nucleus and barr body

A

Botryoid nucleus - hyperthermia - heat stroke
- Cooking of the neutrophils
- Can be high fever
Barr body
- Only found in females as need two X chromosomes
- One X chromosome is inactivated and forms the barr body
- Present in all female neutrophils but won’t see every time due to orientation of nucleus

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38
Q

Describe reactive lymphocytes and what are they hard to differentiate between

A

Larger than normal
- (nucleus 2x rbc)
Increased basophilic cytoplasm
- May have few magenta cytoplasmic granules
- Reflect increased antigenic stimulation
- Non-specific, often seen in health
Hard to differentiate between REACTIVE and NEOPLASTIC

39
Q

What are 2 types of cytoplasmic inclusions and conditions that lead to them

A 
1, erythrophagia 
2. sideroleukocyte 
What conditions might lead to these cells in the blood?
1.. Previous blood transfusion 
2. IMHA
40
Q

What occurs with Pelger-Huet Anomaly

A

failure of nuclear segmentation

  • lots of band and no segmental neutrophils - weird
  • still functional and NO TOXIC CHANGE
41
Q

What characteristics define an acute inflammatory leukogram and why

A

Neutrophilia*
- Sometimes don’t have neutrophilia yet - snapshot in time
+/- Toxic change - most important
+/- Left shift
+/- Monocytosis
*most common indicator but not always present
Neutrophilia with Inflammation
= Release of neutrophils from storage pool +/- release from maturation pool (bands) + increased production (with time)

42
Q

What disease might cause an acute inflammatory leukogram

A 
A focus of suppurative inflammation or sepsis e.g.
Not heaps of puss 
- Infected wound
- Pneumonia
- Pyelonephritis
- Tissue damage and necrosis
43
Q

List some species variation in response to acute inflammation: cat and dogs, cattle and horses

A

1) Cats and dogs often have WBC 10-30 x 109/L with inflammation
○ Due to the large storage pool
2) Cattle may only show hyperfibrinogenaemia with no inflammatory leukogram with acute infections
○ Cattle often show transient leukopenia (small storage pool)
3) Horses have moderate leukocytosis and left shift response, often WBC 7-20 x 109/L with acute inflammation

44
Q

At what level of neutrophilia do you start getting worries about leukaemia

A

50-100 x 109/L

○ Above 50 start getting worried about leukaemia

45
Q

What characteristcs define a severe acute inflammatory leukogram

A

“Leukaemoid response”
- Marked Neutrophilia - 50-100 x 109/L
○ Above 50 start getting worried about leukaemia
- Regenerative left shift - pooling out mature cells
○ Bands - less
○ Metamyelocytes - even less
○ +/- Myelocytes

46
Q

What diseases might cause a severe acute inflammatory leukogram

A

A focus of intense suppurative inflammation or sepsis
- Pneumonia
- Pyothorax
- Peritonitis
- Pyometron
- Necrotic tumour (within tumour)
○ DDx: Myeloid Leukaemia, Paraneoplastic syndrome - produce cytokines - increase inflammation

47
Q

what characteristics define overwhelming inflammatory leukogram

A

Neutropenia and or degenerative left shift (not putting out mainly mature now also immature)

  • +/- Lymphopenia - don’t leave lymph node as quickly
  • +/- Monocytosis
48
Q

What diseases might cause an overwhelming inflammatory leukogram and what prognosis

A

A focus of acute sepsis e.g. - pouring pus
1. Intestinal perforation - gut rupture
2. Ruptured Pyometron
3. Endotoxaemia, Gram –ve infections
= Marrow unable to meet demand - potential for animal to die is higher
DDx: Bone Marrow Disease

49
Q

What characteristics define chronic inflammatory leukogram

A
  • Neutrophilia - mature
  • +/- Slight regenerative left shift
  • +/- Lymphocytosis
  • Monocytosis (high)
50
Q

what diseases might cause chronic inflammatory leukogram

A

A focus of chronic inflammation e.g.

1. Severe pyoderma
2. Necrotic neoplasia
3. Chronic hepatitis
4. Fungal infections
51
Q

What are the characteristics of a glycocorticoid/stress leukogram and the reason for each

A 
Lymphopenia
◦Decreased release from nodes
◦Margination
Neutrophilia (Heterophilia in birds)
◦Increased release from storage pool
◦Shift from marginating to circulating pool (express less adhesion factors)
Eosinopenia
◦Decreased release from marrow
Monocytosis (dogs)
◦Shift from marginating to circulating pool
NO LEFT SHIFT OR TOXIC CHANGE
52
Q

list the magnitude for the stress leukogram in cats, dogs, equine, bovine

A

○ Feline 3:1
○ Canine, equine, bovine 1:1
- Expect mature neutrophilia up to 3x neutrophil upper reference interval in cats
- Expect mature neutrophilia up to 2x neutrophil upper reference interval in dogs, horses, cows

53
Q

what is a physiologic leukocytosis and what characteristics define it

A 
= Adrenalin/excitement mediated - short duration and generally younger animals 
- Neutrophilia
- Lymphocytosis
- +/- Monocytosis
- Young animals
NO left shift or toxic change
54
Q

why do you see a neutrophilia, lymphoctytosis

A

Neutrophilia
•Shift marginating to circulating pool (Increased blood pressure and HR) - very temporally - take two time apart and may go back to normal
Lymphocytosis
- Shift marginating to circulating pool

55
Q

Granulocytic hypoplasia leukogram what is it, what is it caused by

A

Persistent Neutropenia with no left shift (>5 days) - bone marrow takes 4-6 days to produce
- Caused by bone marrow production problem e.g.
◦Immune mediated neutropenia
◦Drug toxicity - chemotherapy

56
Q

How long should we wait before doing bone marrow evaluation on a neutropenic patient?

A

5-7 days

57
Q

what is the point at which neutropenia is dangerous

A

once get below 1.5x10^9 put on antibiotics as risk of getting infection and not being able to fight

58
Q

Hypoadrenocorticism Leukogram (Addisons syndrome) what characteristics define and the electrolyte

A
  • Lack of stress leukogram despite chronic or severe illness - consider this in dogs
    ○ Could also be excitement - more likely in cats
  • +/- Lymphocytosis-
  • +/- Eosinophilia
  • Hyperkalaemia
  • Hyponatraemia and hypochloridaemia
  • Low Na: K ratio (<27:1)
59
Q

where are most plasma proteins produced and which ones aren’t

A

synthesised in the liver

- immunoglobulins are produced by B cells

60
Q

What are the main functions of plasma proteins

A 
• Exert colloidal osmotic pressure
– maintains intravascular fluid volume
• Antibodies (immunoglobulin)
• Coagulation factors
• Hormones
• Enzymes
• Help maintain acid-base balance
• Transportation of substances
61
Q

What are the 2 types of plasma proteins, how much do they compromise of and examples

A

1) albudmin - 55% of total protein, accounts for 75% of colloid osmotic activity
2) globulins - diverse group divided into 3 main groups
1. alpha
2. beta - complement, IgM, IgA
3. gamma, IgG, C-reactive protein

62
Q

What are the 3 main ways to measure plasma proteins and what do they measure

A
  1. Using plasma via refractometer
    – Total Solids (an estimate of total protein)
  2. Using serum via laboratory analyser
    – Total Protein + albumin
  3. By serum protein electrophoresis - uncommon
63
Q

Refractometer what measures in terms of protein, what tube used, what is the issue and what else does it measure

A
  • using plasma (from whole blood) - use EDTA tube
  • measured total solids
  • false increase can be due to glucose, urea, sodium, chloride, lipaemia
  • fibrinogen is present - used to estimate fibrinogen - heat preipitation to remove solids and leave fibrinogen
64
Q

biochemistry analyser what does it measure and what else can you measure

A
  • measures total protein and albumin - so learn more about proteins
    globulins are then calculated [Globulins] = [Total Protein] – [Albumin]
65
Q

serum protein electrophoresis (SPE) what is involved and how used

A

nout a routine test but allows quantification and separation of globulins
- patterns help with differential diagnoses

66
Q

What are the two types of abnormal protein concetrations

A
  1. Selective
    • one is changed in a different direction than the other
    eg glomerular disease (albumin is lost – hypoalbuminemia)
  2. Non-selective
    • both change in the same direction - hypoalbuminemia and hypoglobulinaemia
    • A/G ratio remains unchanged
    eg haemorrhage (both lost – panhypoproteinemia)
67
Q

Give a cause of increased TS and decrease TS

A

Increased TS = hyperproteinaemia
- dehydration
Decreased TS = hypoproteinaemia
- haemorrhage

68
Q

List 3 reasons for hyperglobulinaemia

A

1) Dehydration
– relative increase due to plasma water loss
2) Inflammation
– absolute increase due to production of positive acute phase proteins and immunoglobulins
3) Less commonly see with B-lymphocyte neoplasia - use serum protein electrophoresis to determine
eg multiple myeloma or less commonly B-cell lymphoma

69
Q

What are the characteristics in a serum protein electrophoresis for inflammatory disease and neoplasia

A

inflammatory
- polyclonal gammopathy = wide-based immunoglobulin peak on electrophoresis - more than one cell line increased
neoplasa
- monoclonal gammopathy = narrow-based immunoglobulin peak on electrophoresis

70
Q

What are the 3 main mechanism for hypoalbuminaemia and give 2 examples

A

1) increased albumin loss
- haemorrhage, gastrointestinal.renal loss
2) decreased albumin production
- hepatic insufficiency, inflammation, malabsorption
3) haemodilution - uncommon

71
Q

List clinical effects of hypoalbuminaemia and at what concentration does that occur

A 
When plasma albumin loss is marked ie < 15 g/L:
• Colloid osmotic pressure decreases
• Can lead to vascular fluid loss into tissues:
- Peritoneal effusion (ascites)
- Pleural effusion
- Pericardial effusion
- Pulmonary oedema
- Submandibular oedema
72
Q

What are the 4 main mechanisms of hypoglobulinaemia and examples

A
  1. • Increased loss
    - haemorrhage, GIT, skin, effusions
  2. • Decreased production
    - malabsorption, maldigestion, malnutrition
  3. • Failure of passive transfer
    - inadequate colostrum intake in the newborn - measure immunoglobulins
    • horses and cattle
  4. • Severe combined immunodeficiency syndrome (SCID) - rare
    - Horses such as arabs are pre-disposed as well as some dog breeds - jack Russell
73
Q

List 4 positive acute phase proteins

A

1) fibrinogen - moderate APP, rises slowly, readily available
2) haptoglobin (cattle)
3) serum amyloid A
4) C-reactive protein - dogs
Bottom 3 are major and rapidly rise and also rapidly decrease resulting in them being very sensitive

74
Q

List the main negative APP ad what is the APP testing used for

A
  • decreases with inflammation
    Albumin
  • can take several days to decrease due to longer half-life
    Testing
  • monitor for post-operative infection - cheap way, should follow normal increase-decrease pattern
75
Q

What are the 2 main causes of hyperfibrinogenaemia

A 
1. Inflammation
• positive acute phase protein
§ useful in horses and cattle
§ may increase before leukogram changes
2. Dehydration
• relative increase due to plasma water loss
76
Q

what are the 2 main causes for hypofibrinogenaemia

A
  1. Decreased synthesis
    - reduced functional hepatic mass
    • more than 70-80% loss of function
  2. Increased consumption
    - intravascular coagulation ie DIC
77
Q

when are you clinical suspicious of bone marrow disease

A

haematologic abnormalities are present persistent and not readily explained
such as 1. decrease in blood cell line or increase, atypical immature cells, hypercalcaemia

78
Q

when are you clinical suspicious of bone marrow disease and list the 6 abnormalities

A

haematologic abnormalities are present persistent and not readily explained

  1. Decrease in a blood cell line
  2. Severe increase in a blood cell line
  3. Atypical or immature cells
  4. Marked hyperproteinemia
  5. Hypercalcaemia
79
Q

What is the most common indicators of bone marrow disease and give 3 examples

A

Decreased cell numbers
can be one, two or all three - pancytopenia
1. persistent non-regenerative anemia - no polychromasia
2. persistent neutropaenia - no left shift or toxic change
3. thrombocytopaenia - no large or giant platelets, run coag panel to rule out DIC

80
Q

List 5 causes of decreased cell numbers

A

1) infectious - parvovirus, FeLV
2) toxins - bracken fern - ruminants
3) immune-mediated disease - IMHA
4) endocrine disease - hypothyroidism
5) neoplasia - replace bone marrow

81
Q

List 3 examples of what cause severe increase in cell numbers

A
  1. Erythrocytosis, rubricytosis
    • no evidence of splenic contraction, dehydration, hypoxia, renal disease
  2. Leukocytosis
    • no evidence of inflammation
  3. Thrombocytosis
    • no evidence of Fe deficiency, inflammation
82
Q

Differences between leukaemia and lymphoma

A
  1. Leukaemia
    • neoplastic haematopoietic cells originate in bone marrow but often seen in circulation
    ○ Could be red blood cell, platelet, neutrophil
    ○ acute vs chronic
    ○ lymphoid vs myeloid (all cell lines except lymphoid)
  2. Lymphoma
    • neoplastic lymphocytes originate in solid tissue
    lymphoid tissue outside the bone marrow eg lymph node, spleen, liver, intestine, skin
83
Q

How to differentiate between lymphoma and leukaemia

A

Look for original site of lymphoma - lymph nodes huge!
Happy dog as lymph nodes not painful
Chemotherapy can increase quality of life for 1-2years
Leukaemia dog - very sick, dead within a couple of weeks

84
Q

What are 2 types of atypical cells and what do they indicate

A

indicate bone marrow disease

  1. immature cells - abscence of regnerative response
  2. abnormal cell
85
Q

Marked hyperproteinaemia what does it support bone marrow evaluation for

A
  1. Lymphoid neoplasia
    • B-cell chronic lymphocytic lymphoma
    • Multiple myeloma (plasma cell neoplasia)
  2. Systemic fungal and protozoal infections - can see in bone marrow aspirates
    • Histoplasmosis, Leishmaniasis
    ○ both exotic to Australian domestic animals
86
Q

hypercalcemia what 3 main neoplasms lead to this

A
  1. lymphoid neoplasms
    - production of PTH-related protein
  2. multiple myeloma
    - localised osteolysis
  3. metastatic neoplasia (eg histiocytic sarcoma)
    - production of PTH-rp or VitD
87
Q

what are the two main bone marrow collection and what are they good for

A

Simultaneous evaluation of bone marrow cytology (aspirates - great for cell morphology)) and histology (core biopsy - evaluate architecture) is recommended

88
Q

What are the 4 site selections for bone marrow

A 
1. Pelvis
• iliac crest; medium/large size dogs
2. Proximal femur
• trochanteric fossa; cats and small dogs
3. Proximal humerus - go to site 
• common site especially in obese animals
4. Sternum
• site of choice for horses
89
Q

When do you need to make the smears for bone marrow collection and what must you submit

A
  • smears are made immediately after collection
  • submit several unstained smears
  • must be submitted with an EDTA blood sample within 24 hours
90
Q

multiple myeloma what type of neoplasm and what characteristics present

A
  • plasma cell neoplasia - malignant - specialised B-lymphocyte
    Diagnostic
    1. neoplastic plasma cell in bone marrow
    2. monoclonal gammopathy
    3) oesteolytic lesions
    4) light chain proetinuria
91
Q

List the lymph nodes associated area of drainage

1) Axillary lymph node
2) Mediastinal lymph node
3) Mesenteric lymph node - intestine
4) Popliteal lymph node
5) Prescapular lymph nodes
6) Retrophoryngeal lymph node
7) Submandibular lymph node

A

1) distal forelimb
2) lungs
3) intestine
4) distal hind limb
5) shoulder
6) pharynx
7) mandible

92
Q

what is different about total calcium in the blood and what effects this

A

70% bound to albumin (not active form) so if get increase in albumin will get increase in calcium
If albumin is high due to many reasons such as dehydration

93
Q

What interferes with ADH

A
  • Lack of ADH production or issue with kidneys response to ADH (determine final concentration of urine - can draw in huge amount of water)
  • Corticosteroids, toxins released by bacterial infections (pyometra), hypercalcaemia
  • This can be due to hypercalcaemia - also causes alterations in renal blood flow - decreased filtration rate, renal mineralisation overtime - leads to full renal problems

DVM 2 - 1 (31 decks)

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