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Blood work interpretation Flashcards

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1
Q

Why may haematocrit (HCT) or RBC be increased?

A

Artifact
Concentration - Dehydration (common), splenic contraction (horses commonly)
Absolute increase in RBC mass - Polycythaemia or inappropriate erythropoietin secretion

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2
Q

Why may haematocrit (HCT) or RBC be decreased?

A

Artifact
Concentration - IV fluid dilution or splenic relaxation (anaesthetics/tranquilizers)
Anaemia - Haemorrhage, haemolysis, decreased production

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3
Q

Why may haemoglobin be increased?

A

Artifacts
Iatrogenic - Oxyglobin therapy
Concentration - Dehydration, splenic contraction
Anaemia

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4
Q

Why may haemoglobin be decreased?

A

Concentration - Iv fluid dilution, splenic relaxation
Anaemia

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5
Q

Why may mean cell volume (MCV) increase?

A

Artifact
Breed - Greyhounds, Miniature and Toy Poodles
Regenerative anaemia
Folate and Vitamin B12 deficiency
Hyperthyroidism (in some cats)

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6
Q

Why may mean cell volume (MCV) decrease

A

Artifact - excess EDTA, hyponatremia
Age - young
Breed - Akitas, Shiba Inu, Shar pei, Husky
Iatrogenic - chloramphenicol, lead
Iron deficiency/ excess zinc
Portosystemic shunts

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7
Q

Why may MCHC decrease

A

Anaemia - regenerative, iron deficiency
Portosystemic shunts
Lead poisoning, vitamin B6 or copper deficiency (uncommon)
RBC swelling

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8
Q

Why may nRBC increase?

A

Bone marrow injury - sepsis, heat stroke, endotoxemia
Dyserythropoeisis - Neoplasia, macrocytosis
Splenic dysfunction - Hemangiosarcoma, exogenous corticosteroids, post-splenectomy
Heat stroke

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9
Q

Why may reticulocytes be increased?

A

Regenerative anaemia
Compensated haemolytic anaemia
Absolute polycythaemia

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10
Q

Why may neutrophils be increased

A

Can increase in stress and inflammation.

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11
Q

When do neutrophil levels decrease

A

Acute endotoxaemia
Decreased bone marrow production
Increased tissue migration
Increased destruction

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12
Q

Why does left shift occur?

A

Severe/acute inflammation where bone marrow can’t keep up with production of WBCs to tackle pathology, This causes the release of immature neutrophils and causes ‘left shift’.

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13
Q

What causes variation in lymphocyte numbers?

A

Most common is physiologic or age-related lymphocytosis. In adults, consider leukaemia and lymphoma. Causes can be iatrogenic e.g corticosteroids

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14
Q

Why may platelet levels increase

A

Reactive or neoplastic thrombocytosis causes.

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15
Q

What causes a rise in sodium

A

Artifact
Iatrogenic - hypertonic IVFT
Water deficit
Salt gain - intake or retention

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16
Q

What causes a decrease in sodium

A

Artifact
Iatrogenic - hypotonic IVFT
Volume overload - CHF, hepatic disease, renal failure
Hypovolaemic hyponatremia

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17
Q

What causes an increase in potassium

A

Artifacts
Iatrogenic - IVFT or K+ supplementation
Transcellular shift
Decreased renal excretion

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18
Q

What causes a decrease in potassium

A

Artifact
Decreased intake - anorexia
transcellular shift - metabolic alkalosis etc.
Increased loss - V+, stasis, torsion, renal

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19
Q

What causes an increase in chloride

A

Artifact
Iatrogenic - Hypertonic IVFT
Metabolic acidosis
Bicarbonate loss - hyperchloremic metabolic acidosis

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20
Q

What causes a decrease in chlorine

A

Iatrogenic - loop diuretics, sodium-rich fluids
Loss of Cl- rich fluid

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21
Q

What are the causes of hyperglycaemia

A

Physiologic
Iatrogenic - Drugs inducing insulin resistance
Sustained - Lack of insulin, diabetes, hyperadrenocorticism, acromegaly

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22
Q

What are causes of hypoglycaemia

A

Artifact
Iatrogenic - insulin administration
Decreased production - Glycogen storage disease, juvenile hypoglycaemia, hepatic insufficiency
Decreased intake
Increased use
Increased insulin secretion

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23
Q

What are causes of increased urea nitrogen?

A

Increased protein catabolism
Increased protein digestion
Decreased GFR

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24
Q

What are causes of decreased urea nitrogen

A

Decreased protein intake - diet, young animals
Decreased production - Hepatic disease
Increased excretion - Causes of polyuria
Increased GFR - Portosystemic shunts

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25
What are causes of increased Creatinine?
Artifact Physiologic Decreased GFR
26
What are caused of decreased creatinine?
Physiologic Decreased production - starvation, decreased muscle mass Increased GFR - Portosystemic shunts
27
Causes of increased uric acid
Artifact Renal disease - decreased GFR, loss of >70% functional renal capacity Increased deposition - articular gout
28
What are causes of increased bilirubin?
Physiologic Increased production Decreased hepatic uptake Decreased hepatic conjugation Inherited
29
What are the causes of increased ALP?
Physiologic - young, breed Iatrogenic - liver injury, anticonvulsants, thyroxine Hepatobiliary - cholestasis Endocrine - Hyperthyroidism Bone - Hyperparathyroidism
30
What causes increased GGT?
Physiologic - neonates Iatrogenic - Biliary injury or cholestasis, anticonvulsants Hepatobiliary - hyperplasia, cholestasis
31
Causes of increased ALT
Artifact Iatrogenic - liver injury from drugs Hepatic injury - Many causes Muscle - Severe muscle injury, aortic thromboembolism, myopathies, trauma
32
What are the causes of increased AST?
Artifact Iatrogenic - liver injury, anticonvulsants Physiologic Liver - Injury of any cause Muscle - Myopathies, trauma, WMD, dystrophy
33
What causes increases of CK?
Artefact Physiologic - age, post-exercise, anorexia Iatrogenic - muscle injury, I/M injection, irritant drugs, post-surgery Muscle injury - nutritional, inherited, toxin
34
What causes an increase in LDH?
Artifact Physiologic - exercise Liver injury Muscle injury Neoplasia
35
What causes an increase in total protein?
Dehydration Increased albumin Increased globulins
36
What causes a decrease in total protein?
Blood loss Protein-losing enteropathy Overdilation with fluids Decreased albumin Decreased globulins
37
What causes an increase in albumin?
Artifact Physiologic - haemoconcentration Increased production - hepatocellular carcinoma, corticosteroids
38
What causes a decrease in albumin?
Iatrogenic - excessive fluid administration Decreased production - malnutrition/starvation, hepatic insufficiency Increased loss - protein-loss, severe haemorrhage etc.
39
What causes an decrease in immunoglobulins?
Immunodeficiencies Failure of passive transfer Blood loss Protein-losing enteropathy
40
What are the most common causes of hyercalcaemia?
Humoral hypercalcaemia of malignancy Hypoadrenocorticism
41
What are the most common causes of hypocalcaemia?
Low albumin Renal disease Pancreatitis GI disease
42
What are causes of increased phosphate?
Artifact Iatrogenic - phosphate enemas Physiological - post-prandial, young animals Increased intake - rodenticides, supplements Transcellular shift - skeletal muscle injury Decreased excretion - GFR, hyperthyroidism
43
What are causes of decreased phosphate?
Artifact Iatrogenic - diuretics, steroids, antacids Decreased intestinal absorption Transcellular shifts Increased loss Hepatic lipidosis
44
What causes an increase in magnesium?
Artifact Iatrogenic - excessive supplementation Increased absorption Decreased excretion - GFR, hypocalcaemia Release from cells - myopathy, soft tissue necrosis Increased PTH
45
What causes a decrease in Magnesium?
Artifact Physiologic - age Iatrogenic - administration of Mg-poor fluids Decreased albumin Decreased intake - anorexia, high potassium diet Translocation into cells - insulin, hypothermia Excess loss
46
What causes an increase in cholesterol
Increased production Decreased lipolysis, abnormal processing Inherited Decreased excretion - cholestasis Endocrine disorders - Diabetes mellitus, pancreatitis, hyperadrenocorticism
47
What are causes of decreased cholesterol
Artifact Decreased absorption Decreased production - liver disease Altered metabolism Increased lipoprotein uptake
48
What are common causes of increased triglycerides?
Post-prandial fasting Diabetes mellitus Hyperadrenocorticism Hyperlipidemia
49
What causes increased amylase?
Acute pancreatitis Decreased GFR Intestinal disease or obstruction
50
What causes increased lipase
Corticosteroids Acute pancreatitis Peritonitis, gastritis, obstruction, manipulation Decreased GFR
51
What causes an increase in bile acids?
Physiologic Decreased clearance from the portal circulation Decreased excretion
52
What causes a decrease in bile acids
Physiologic - prolonged fasting Enterohepatic - malabsorption
53
What parts of the biochemistry panel are used to look at liver health?
Leakage enzymes: ALT, AST, SDH, GLDH Inducible enzymes: ALP, GGT Bilirubin, Urea nitrogen, glucose, albumin, cholesterol, bile acids, ammonia
54
What parts of the biochemistry panel are used to look at kidney health?
Urea Creatinine Electrolytes: Sodium, Chloride, Potassium, Calcium, Phosphate, Magnesium
55
What part of the biochemistry panel are used to look at pancreas health?
Amylase Lipase
56
What part of the biochemistry panel is used to look for muscle health?
AST, CK and LDH
57
What markers look at carbohydrate metabolism?
Glucose and fructosamine
58
What markers can be used for lipid metabolism?
Triglyceride Cholesterol NEFA (non-esterified fatty acids) B-hydroxybutyrate (BHB)
59
What is anaemia?
Decreased haemocrit/packed cell volume or haemoglobin
60
What are the signs of anaemia?
Inadequate perfusion/oxygenation - pale mms, lethargy, exercise intolerance Tachypnoea/tachycardia Poor pulse quality, flow heart murmur Underlying pathology
61
Where does apparent anaemia occur?
Young animals, anaesthesia, overhydrated
62
What are some abnormal cell types seen with anaemia?
Nucleated RBCs, reticulocytes, basophilic stippling, Howell-Jolly body, Heinz bodies
63
In what condition is neutrophilia and spherocytes seen with anaemia?
IMHA
64
What is the most common form of non-regenerative anaemia?
Inflammation - normocytic normochromic
65
What type of anaemia is absolute iron deficiency?
Microcytic hypochromic
66
What is poikilocytosis?
Alteration in cell shape
67
What conditions are seen with acanthocytes (spur cells)? What do they look like?
Diffuse liver disease, splenic hemangiosarcoma, portosystemic shunts. Rounded projections of variable diameter and lenghh
68
What are spherocytes an indicator of? What do they look like?
Immune-mediated haemolytic anaemia Small, densely staining spherical RBCs
69
What are schistocytes?
Irregular fragmented erythrocytes through mechanical trauma to circulating erythrocytes
70
What are Heinz bodies indicative of?
Oxidative damage - paracetamol and onion toxicity Associated with diabetes mellitus, lymphoma and hyperthyroidism
71
What is basophilic stippling indicative of?
Signs of regeneration. Associated with lead poisoning.
72
What are Howell-Jolly Bodies indicative of?
Signs of regeneration. Can be seen with splenectomy or suppressed splenic function
73
What can babesiosis lead to?
Haemolytic anaemia Systemic inflammatory response syndrome (SIRS) Multiple organ dysfunction syndrome (MODS)
74
What pathologies relate to normocytic normochromic anaemia?
Illness, pre-regenerative or occasionally non-regenerative anaemia.
74
What pathologies relate to normocytic normochromic anaemia?
Illness, pre-regenerative or occasionally non-regenerative anaemia.
75
What pathologies link to macrocytic hypochromic anaemia?
Highly regenerative anaemia
76
What pathologies link to microcytic hypochromic anaemia?
Classic iron deficiency, chronic external blood loss.
77
What factors can cause a shift of cells from the marginal to the circulating pool?
Epinephrine, glucocorticoids, infection, stress
78
What are causes of neutrophilia?
Inflammation Steroid Physiological Chronic neutrophil leukaemia Paraneoplastic
79
What causes the appearance of foamy cytoplasm?
Dispersed organelles
80
What causes the appearance of diffuse cytoplasmic basophilia?
Persistent cytoplastic RNA
81
What causes the appearance of Dohle bodies?
Focal blue-grey cytoplasmic structures
82
What causes the appearance of asynchronous nuclear maturation?
Finely granular nuclear chromatin in segments
83
What are causes of neutropenia?
Inflammation Decreased production Rare
84
What are the causes of lymphocytosis?
Physiological Chronic inflammation Young animals and recent vaccination Lymphoproliferative disorders Hypoadrenocorticism
85
What are the causes of lymphopenia?
Stress/steroids Acute inflammation Loss of lymph Cytotoxic drugs, radiation Immunodeficiency syndrome Lymphoma
86
What are the causes of monocytosis?
Inflammation Steroid/stress Monocytic/myelomonocytic leukemia
87
What are the causes of eosinophilia?
Hypersensitivity Parasitism Hypoadrenocorticism Paraneoplastic Idiopathic eosinophilic syndrome Eosinophilic leukaemia

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