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Clinical Pathology > Clin Path Final - Kubuusu TS > Flashcards

Clin Path Final - Kubuusu TS Flashcards

0
Q

How much of the kidney must be damaged for creatinine to show up in blood?

A

80%

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1
Q

How much of the kidney must be damaged for Urea to show up in blood?

A

75%

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2
Q

Term for raised urea OR creatinine OR both and is likely caused by dehydration

A

Azotemia

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3
Q

Term for raised urea and creatnine plus clinical signs

A

Uremia

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4
Q

What is the molecule used for measuring renal failure in birds?

A

uric acid

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5
Q

Which molecules most significantly influence specific gravity of urine?

A

salts/electrolytes

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6
Q

What term is used to describe specific gravity of urine that is lover than glomerular filtrate?

A

hyposthenuria

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7
Q

What are some causes of hyposthenuria?

A

overhydration, pyometra, renal failure

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8
Q

What term is used for urine having a fixed low SG?

A

isosthenuria

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9
Q

What are the ranges for isosthenuria?

A

1.008 - 1.012

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10
Q

What percent of the kidney is damaged before they lose their ability to concentrate urine effectively?

A

loss of 60-65%, early indicator

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11
Q

What are some causes of hypersthenuria?

A

dehydration, hypovolemia, heart disease

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12
Q

What is pre-renal uremia a result of?

A

decreased renal perfusion

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13
Q

How is pre-renal uremia presented in tests?

A

mild to moderate raised urea and creatinine, SG is high

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14
Q

How does renal uremia present in tests?

A

Urea is moderate to marked, so is creatinine, and isosthenuria

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15
Q

What can cause post renal uremia?

A

urinary tract obstruction from urolithiasis or rupture

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16
Q

How does post renal uremia present clinically?

A

creatinine is markedly raised, specific gravity is variable

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17
Q

What chemicals on reagent strips are NOT accurate for animals?

A

nitrates, urobilinogen, specific gravity, leukocytes

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18
Q

What conditions cause aciduria?

A

carnivores, protein catabolism (pregnant, exercise)

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19
Q

What conditions lead to alkalinuria?

A

herbivores, stale urine, UTI/cystitis

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20
Q

What test can be used to confirm a positive protein on a urine strip?

A

sulphosalicylic acid test

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21
Q

What are some causes of trace positive readings for protein on a urine strip?

A

strenuous exercise, fever, convulsions, colostrum

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22
Q

What are some causes of true proteinuria?

A

hemoglobinuria, hemorrhage, inflammation, protein losing neuropathies

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23
Q

Why must you interpret the protein finding in urine with the SG?

A

the lower the SG, the more significant is the finding of a positive protein result

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24
Q

What rare congenital disease can cause glycosuria?

A

congential fanconi’s syndrome, a tubular disease

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25
Q

What tests can be used to confirm glucose in the urine?

A

Fehlings or Benedicts test

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26
Q

What can cause glycosuria besides DM?

A

marked stress in cats, admin of ketamine or xylazine

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27
Q

What are the RELIABLE tests on a urine strip for animals?

A

pH, protein, glucose, ketones, blood, bilirubin

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28
Q

What number and type of cells indicate active urine sediment?

A

trace rbcs (5-8) or higher
trace WBCs or higher
high numbers of epithelial cells

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29
Q

What conditions usually lead to high RBCs in urine?

A

estrus, UT inflammation/trauma, urogenital neoplasm, some coagulopathies

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30
Q

What are the most consistent and reliable hallmarks of urinary tract inflammation?

A

WBC and protein

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31
Q

What are the urinanalysis hallmarks of cystitis/pyelonephritis?

A

4+ WBC, 4+ RBC, strong protein, bacteria

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32
Q

What size are tubular epithelial cells of the urinary tract?

A

same as WBC size

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33
Q

What does dysplastic epithelial cellls in the urine point to?

A

chronic inflammation

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34
Q

What do really high numbers of epithelial cells in urine without any WBC or RBCs indicate?

A

neoplasm

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35
Q

What 3 minerals make up struvite?

A

mg, ammonium, phosphate

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36
Q

What kind of crystal looks like a wagon wheel or dumbell shaped?

A

calcium carbonates

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37
Q

What kind of crystal looks like a coffin lid or brick shaped?

A

struvite

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38
Q

What conditions do struvite crystals tend to accumulate?

A

alkaline urine of dogs and cats, UTI, especially in urease bacteria,

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39
Q

What species most commonly have calcium carbonate crystals?

A

horses and rabbits

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40
Q

What urine crystal looks like an envelope or maltese cross?

A

calcium oxalate dihydrate

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41
Q

Where do calcium oxalate dihydrate crystals occur?

A

acid urine in dogs

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42
Q

What crystals look like a picket fence or spindle shape?

A

calcium oxalate monohydrate

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43
Q

What conditions cause calcium oxalate monohydrate crystals to occur?

A

ethylene glycol poisoning (along with hypocalcemia)

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44
Q

What crystals look like a thorn apple?

A

ammonium (bi)urate

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45
Q

What breeds may have naturally occuring ammonium biurate crystals?

A

dalmatians and english bulldogs

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46
Q

What are the pathological causes of ammonium biurate crystals?

A

portocaval shunts, chronic severe liver dz

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47
Q

What is seen in bird and reptile urine?

A

urates

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48
Q

What do cysteine crystals look like?

A

large clear hexagons

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49
Q

What crystal looks like brown needles or tufts?What do large numbers indicate?

A

billirubin crystals

hemoytic or hepatic dz

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50
Q

What crystals are consistent with adulterated pet food?

A

melamine-cyanuric

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51
Q

What crystals look like sheaf of wheat and indicate congenital hepatic problem?

A

leucine and tyrosine

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52
Q

What doe hyaline casts indicate in a urinanalysis?

A

proteinuria –> mild renal disease

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53
Q

What do granular casts indicate?

A

moderate renal dz

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54
Q

What do cellular casts of RBC or WBC indicate?

A

severe renal disease

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55
Q

Is the following casts acute or chronic? Hyaline, cell, granular.

A

Hyaline -chronic

cell/granular - acute

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56
Q

What is the sensitivity/specificity for ALP enzyme in dog and cat seperately?

A

Dog - good sensitivity, fair specificity

Cat - poor sensitivity, mild increases are significant

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57
Q

What conditions can lead to an increase in ALP enzyme?

A

growing animals, osteosarcoma, corticosteroids (dogs only), may or may not be elevated in chronic liver dz

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58
Q

What is ALP enzyme always interpreted with?

A

ALT enzyme

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59
Q

What is the specificity and sensitivity of ALT enzyme?

A

excellent sensitivity and specificity

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60
Q

What is the half life of ALT for dogs and cats?

A

dogs - 2 days

cats - 4 hours

61
Q

What can cause an increase in ALT enzyme?

A

primary hepatocyte injury - hepatitis, hepatocellular carcinoma

62
Q

What liver enzyme is fairly sensitive in large animas but increases in myocyte injury in all species?

A

AST

63
Q

What enzyme is paired with AST to interpret results?

A

GGT

64
Q

What could be some causes of increased AST enzyme?

A

liver dz, muscle dz, hemolysis (found in RBCs)

65
Q

What enzyme increases are induced mostly by cholestasis?

A

GGT (gamma glutamyl transferase)

66
Q

What is the sensitivity and specificity for GGT?

A

good sensitivity, fair specificity

67
Q

What enzyme is just as good as GGT in measuring liver disease in small animals?

A

ALP

68
Q

What liver enzyme is the best indicator of chronic liver problems?

A

GGT

69
Q

What should be suspected if a cat has an increased ALP but GGT is within RI?

A

hepatic lipidosis

70
Q

What should be suspected if there is a significant increase in cALP but mild increase in other liver enzymes in a dog?

A

cushings

71
Q

What liver enzymes would indicate bone disease?

A

raised bALP, hx of trauma, lameness

72
Q

What liver enzymes would be elevated in muscle disease?

A

AST, CPK

73
Q

What is the sensitivity and specificity for CPK for muscle injury?

A

very sensitive, very specific

74
Q

What other enzyme is muscle specific and offers no advantages over CPK?

A

aldolase

75
Q

What would be seen in the clinical pathology of a horse with rhabdomyolysis?

A

inflammatory hemogram, acidosis, dehydration, low Na, high K, myoglobinnuria

76
Q

What is the gold standard to test for myoglobinuria?

A

immunoelectrophoresis

77
Q

What are the drugs that can have an effect on liver enzymes?

A

corticosteroids, NSAIds, antineoplastics, anticonvulsants, antimicrobials

78
Q

What may a mild bilirubin level indicate?(3)

A

starvation (horses), septicemia, toxemia

79
Q

What are the 2 causes of prehepativ hyperbillirubinemia?

A

hemolysis or decreased uptake of Bu

80
Q

What is the major cause of hyperbilirubin in cattle? What about horses?

A

cattle - decreased uptake of Bu

horses - starvation

81
Q

What bilirubin pattern indicates hepatocellular hyperbilirubinemia?

A

Bu and Bc but Bc predominates

82
Q

What bilirubin pattern is comprised of neither Bu or Bc predominating?

A

posthepatic/extrahepatic

in long notes says Bc is the only one present but ppt says neither predominate

83
Q

Which species has a low renal threshold for Bc, therefore making it easier to detect in urine?

A

dog

84
Q

Where is Bc easiest to detect in cats?

A

blood

85
Q

How great is the damage to the liver if ammonia is present in the blood?

A

> 85%

86
Q

What diseases cause hyperammonemia?

A

portal vascular shunts, advanced liver failure

87
Q

What indicates a disease when post prandial blood ammonia is compared to pre prandial blood ammonia?

A

post prandial is 3x the base value

88
Q

What is probably the most sensitive liver test?

A

Serum bile acids

89
Q

What diseases do increased serum bile acids indicate?

A

cholestasis, hepatitis, fatty infiltration, necrosis, steroids, vascular shunt, cirrhosis

90
Q

Why are serum bile acids the test of choice for portal vein shunts?

A

because serum bile acids will be taken up even in chronic liver failure but wont be if there is a shunt

91
Q

What can increase the sensitivity and specificity for serum bile acids in detecting hepatic insufficiency?

A

pre and post analysis (before and after eating)

92
Q

What cells make gamma globulins?

A

lymphoid cells

93
Q

What is the most accurate and quantitative method for protein measurement?

A

electrophoresis

94
Q

What term is used for “an abnormal condition of proteins”?

A

protein dyscrasia

95
Q

What term is used for “abnormal concentrations of protein in blood”?

A

dysproteinemia

96
Q

What 2 conditions cause an absolute hyperproteinemia?

A

inflammation

B-cell neoplasia

97
Q

What i it called when refractometer measures greater than 0.3g/dl difference between plasma and serum?

A

pseudohypoproteinemia (due to high glucose, urea, etc)

98
Q

Which 2 conditions are true hypoproteinemia is also a selective dysproteinemia?

A

failure of passive transfer of maternal immunoglobulins
hypoalbuminemia from renal problem
all others are non-selective

99
Q

What are the only 2 causes of hyperalbuminemia?

A

hemoconcentration

dehydration

100
Q

What is the specificity and sensitivity for albumin to indicate dehydration?

A

high specificity, lower sensitivity (some dehydrated animals have it WRI)

101
Q

What are the 3 acute phase proteins?

A

serum amyloid A
Hatoglobin
ceruloplasmin

102
Q

What are the 3 beta globulins?

A

fibrinogen
C reactive protein
transferrin

103
Q

When can acute phase proteins first be detected?

A

within several hours to days after the onset of inflammation

104
Q

When does the concentration of negative phase proteins such as albumin and transferrin decrease?

A

within weeks

105
Q

What can cause polyclonal gammopathies?

A

chronic inflammation, liver dz, FIP, parasites, ehrlichia, IM dz, lymphoma

106
Q

What can cause monoclonal gammopathies?

A

multiple myeloma

107
Q

What 3 conditions can cause the body to lose more albumin than globulins and therefore lower the AG ratio?

A

protein losing nephropathy, enteropathy, dermatopathy

108
Q

What may a high A/G ratio indicate?

A

rare - immunodeficiency or in neonates before suckling

109
Q

What is important to determine in large animals when they have a high concentration of fibrinogen?

A

can be inflammation or dehydration

must do plasma protein: fibrinogen ratio (TPP:F)

110
Q

What is the equation for the TPP:F ratio in large animals?

A

TPP-Fibrinogen

divided by fibrinogen

111
Q

What TPP:F ratio indicates active inflammation in cattle? horses?

A

cattle: <15

112
Q

What does a ratio of 10-15 for TPP:F indicate in cattle?

A

non-diagnostic

113
Q

What TPP:F ratio indicates dehydration in cattle? horses?

A

cattle: >15
Horses: >20

114
Q

How can you check the globulin content in mares colostrum?

A

SG should be > 1.060, also can use electrophoresis or radial immunodiffusion

115
Q

What test can be used to measure globulin content in neonate serum?

A

turbidity test - serum is turbid if globulin present

116
Q

What are some causes of acute exocrine disease?

A

acute pancreatitis, pancreatic necrosis, pancreatic neoplasia

117
Q

What is an example of chronic exocrine disease?

A

exocrine pancreatic insufficiency - EPI

118
Q

What is the sensitivity and specificity for amylase and lipase to detect acute pancreatic disease?

A

sensitivity is good, but specificity is poor to moderate

119
Q

What could also increase amylase or lipase besides pancreatic disease?

A

renal failure, gastroenteritis, hyperadrenocorticocism, stress

120
Q

What is used to diagnose pancreatic disease in cats?

A

feline pancreatic lipase immunoreactivity or ultrasound

121
Q

What clinical abnormalities are seen in a dog with pancreatic disease?

A

inflammatory CBC, increased globulin
increase in amylase and lipase in blood and peritoneal fluid
moderate liver increases
increased TLI, cPLI, and TAP

122
Q

What is the only definitive test for exocrine pancreatic insufficiency?

A

a low serum TLI

123
Q

What should be checked in older cats that have diarrhea?

A

blood T4 levels

124
Q

Where is vitamin B12 absorbed in the gut? what about folate?

A

Vit B12 - distal small intestine

Folate - proximal small intestine

125
Q

What would low folate with normal B12 suggest?

A

upper small intestine problem

126
Q

What would high folate and normal or low B12 suggest?

A

small intestinal bacterial overgrowth (SIBO)

127
Q

What may low folate and low B12 suggest?

A

diffuse small intestinal problem

128
Q

What medium should blood be taken in to analyze for absorption test for GI tract?

A

fluoride oxalate ( establish blood glucose)

129
Q

What will rumenal fluid look like in grain overload or rumenal atony?

A

gray and maladorous

130
Q

When does normal sedimentation take place in normal rumen fluid?

A

< 8 minutes

131
Q

What is the normal pH of rumen fluid?

A

5.5 - 7

132
Q

How long does a methylene blue reaction take in a normal rumen fluid sample?

A

6 minutes

133
Q

What is the major cation intracellularly?

A

K+

134
Q

What is the major cation extracellulary? anion?

A

cation - Na

anion - Cl

135
Q

What are the 5 conditions that could cause abnormal electrolyte results?

A
  1. inc/dec in water or electrolyte uptake
  2. shift from ICF
  3. renal retention
  4. loss thru gut, kidney,skin, resp
  5. acid base disturbance
136
Q

When may an animal get hypotonic dehydration?

A

just replenishes water, not salt lost

horse - sweating

137
Q

What are some causes of hyperkalemia?

A

IV destruction of RBC +platelets

renal failure, iatrogenic, hypoadrenocorticocism,metabolic acidosis

138
Q

What happens to K in inorganic acidosis?

A

only H+ enters cells, with K+ going into ECF

139
Q

What are some causes of hypokalemia?

A

anorexia (cats), increased renal excretion, increased loss thru the gut, metabolic alkalosis, iatrogenic insulin

140
Q

What organ regulates the HCO3- concentration?

A

kidneys

141
Q

What ions does TCO2 consist of?

A

bicarbonate (HCO3-), carbonic acid (H2CO3), and CO2

142
Q

What is the bicarbonate-carbonic acid buffer equation?

A

HCO3- + H+ H2CO3 H2O + CO2

143
Q

What is tCO2 a indirect measure of?

A

HCO3- (TQ!)

144
Q

What is HCO3- inversely related with?

A

Cl

145
Q

Metabolic acidosis will be an increase or decrease in sodium?

A

hypernatremia

alkalosis - hyponatremia

146
Q

How can you determine a selective loss of Cl-?

A

Na - Cl > 42-45

147
Q

What can cause a selective loss of chloride ions?

A

vomiting, obstruction at pylorus, abomasal displacement

148
Q

What does loss of NaHCO3 rich fluid in intestinal secretions lead to in regards to chlorine and sodium?

A

hyperchloremia, but NOT hyperanetremia

149
Q

What does a Na:K ratio of less than 15:1 indicate?

A

semi diagnostic for hypoadrenocorticocism

150
Q

What does a increased anion gap indicate?

A

metabolic acidosis or increase in unmeasured ions (ketones, uremic acids, ethylene glycol, lactic, and salicyclic acid

151
Q

What does a positive BE (base excess) indicate? negative BE?

A 
\+ = metabolic alkalosis
- = metabolic acidosis

Clinical Pathology (7 decks)

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