Clinical Pathology (1-4) Flashcards

1
Q

name the 5 main disciplines involved with clinical pathology

A
  1. cytology
  2. hematology
  3. clinical biochemistry
  4. urine analysis
  5. serology
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2
Q

this is the examination and assessment of cells in smears and fluids

A

cytology

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3
Q

this sample collection technique is suitable for cutaneous masses, internal masses and organs, lymph nodes, etc

A

fine needs aspirates (FNAs)

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4
Q

in this FNA technique, insert the needle, apply suctions, redirect the needle, release suction and take out needle

A

suction technique

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5
Q

in this FNA technique, insert the needle, redirect, and take of the needle

A

non-suction technique

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6
Q

this sample collection technique is suitable for tissues which are not readily reached; cotton swab with 0.9% NaCl used to collect sample

A

swabs

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7
Q

name the smear prepartaion technique

sample is placed on one side of slide, spreading side on top to form cross, then gently spread towards the end of the sample slide

A

squash preparation

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8
Q

name the slide prep technique

suitable for rapid diagnosis of some external lesions and excised tissues, which may subsequently be examined by histopathology

A

touch imprints

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9
Q

name the smear preparation technique used for scrapings

A

squash technique

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10
Q

fluids are submitted in thsi type of tube for cytology and/or total cell counts

A

EDTA tube

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11
Q

name the smear preparation technique

works well with fluids of medium to high cellularity

A

blood smear technique

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12
Q

name the smear preparation technique

works best for low cellular fluid samples

A

line smear

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13
Q

name the 2 main stains used in practive for cytology

A

Diff-Quick or Rapi-Diff

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14
Q

list the 5 step approach for assessing cytology slides

A
  1. examine with naked eye
  2. use low power (x4 and x10), look for large structures
  3. use x20 and x40, look at areas of interest
  4. use x100 oil immersion, for more detail
  5. look over entire smear!
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15
Q

what 3 things should be deterimined when examining cytological preparations

A
  1. type of cell(s) present
  2. nature of process(es) present
  3. degree of abnormality
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16
Q

name the 3 main categories of cell types when evaluating slides

A
  1. epithelial
  2. mesenchymal
  3. round cell
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17
Q

name the category of cells seen on cytology slides

tend to exfoliate well and tend to be cohesive - often exfoliate in clusters, papillary structures, rows and occassionally form acinar structures

A

epithelial

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18
Q

name the category of cells seen on cytology slides

mainly connective tissue cells, do not exfoliate well, are individualized and often have an indistinct cytoplasmic border

A

mesenchymal

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19
Q

name the 5 types of round cells

A

Lymphocytes
TVT (transmissible veneral tumor)
Mast Cells
Plasma Cells
Histiocytes

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20
Q

name the category of cells seen on cytology slides

cells exfoliate in high numbers as individualized cells

A

round cells

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21
Q

name the process present based on the cytology

low protein fluid and a few cells, often reactive macrophages predominate

A

cyst

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22
Q

name the abnormal cell morphology present

may look normal or have mild anisocytosis, slightly variable nucleus to cytoplasm ratio and/or increased cytoplasmic basophilia

A

hyperplasia

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23
Q

name the abnormal cell morphology present

results from asynchronous maturation of different parts of the cell; mild to moderat anisocytosis, variation in nuclear size, increased N:C ratio, occassionally coarse chromatin

A

dysplasia

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24
Q

name 6 criteria of malignant neoplasia

A
  1. anisocytosis
  2. anisokaryosis
  3. immature features/abnormal nucleoli
  4. multinucleation
  5. abnormal mitosis
  6. nuclear molding
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25
Q

name the tube used for the blood test

routine hematology

A

EDTA

(purple top vacutainer or pink plastic tube)

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26
Q

name the tube used for the blood test

most biochemistry

A

clotted (serum)

(red top vacutainer or white plastic tube)

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27
Q

name the tube used for the blood test

coagulation tests

A

trisodium citrate

(pale blue vacutainer, purple plastic tube)

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28
Q

name the tube used for the blood test

glucose

A

fluoride oxalate

(grey top vacutainer or yellow plastic tube)

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29
Q

name the tube used for the blood test

hormone tests

A

serum or heparinized plasma

(green top vacutainer or orange plastic tube)

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30
Q

this value tells you the percentage of the sample occupied by RBCs

A

packed cell volume (PCV)

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31
Q

a decrease in packed cell volume (PCV) is called this

A

anemia

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32
Q

an increase in packed cell volume (PCV) is called this

A

erythrocytosis

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33
Q

this is the white layer on top of the PCV which is composed of WBCs and platelets

A

buffy coat

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34
Q

what 4 things can be evaluated with a microhematocrit tube

A
  1. packed cell volume (PCV)
  2. Buffy coat
  3. Plasma color
  4. total solids
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35
Q

name the 6 main estimations performed to assess numerical RBC data

A
  1. total RBC count
  2. Hematocrit (Hct)
  3. Hemoglobin concentration (Hb)
  4. mean cell volume (MCV)
  5. mean cell hemoglobin concentration (MCHC)
  6. Reticulocyte count
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36
Q

name the two main types of anemia

A
  1. Regenerative
  2. Non-regenerative
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37
Q

name two examples of regenerative anemia

A

hemorrhagic anemia
hemolytic anemia

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38
Q

name the type of anemia

reticulocytosis, anisocytosis, may be macrocytic hypochromic

A

regenerative anemia

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39
Q

name the type of anemia

usually normocytic normochromic except in deficiency

A

non-regenerative anemia

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40
Q

these are immature RBCs, one stage before the mature RBC - do not have nuclei but have clumps of cytoplasmic RNA

A

reticulocyte

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41
Q

these are nucleated RBCs which are one stage less mature than reticulocytes

A

metarubriocytes

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42
Q

this value tells you the average volume of erythrocytes present

A

mean corpuscular volume (MCV)

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43
Q

this is when MCV is within the reference interval for the species

A

normocytic

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44
Q

this is when MCV (RBC size) is increased

A

macrocytic

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45
Q

this is when MCV (RBC size) is decreased

A

microcytic

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46
Q

name 4 things that can cause macrocytic RBCs

A
  1. regeneration
  2. genetic characteristics
  3. feline leukemia virus
  4. artefacs (agglutination)
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47
Q

name 5 things that can cause microcytic RBCs

A
  1. iron deficiency
  2. portosystemic shunt or liver disease
  3. age
  4. genetic characteristics
  5. marked fragmentation
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48
Q

this value is the average concentration of RBC Hb on a weight per volme basis - often calculated (Hb/Hct)x100

A

mean corpuscular hemoglobin concentration (MCHC)

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49
Q

this is when the cell Hb content (color) is decreased

A

hypochromic

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50
Q

name 2 things that can cause hypochromic RBCs

A
  1. regenerative response
  2. iron deficiency
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51
Q

name the type of RBC distribution

coin stacking of erythrocytes

A

rouleaux

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52
Q

name the type of RBC distribution

aggregation of erythrocytes due to presence of anti-erythrocyte antibodies causing immune-mediated anemia

A

agglutination

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53
Q

how to distinguish rouleaux and agglutination from each other

A

saline dispersion test (rouleaux will disperse)

54
Q

define anisocytosis

A

variation in size

55
Q

define poikilocytosis

A

variation in shape

56
Q

name the type of RBC poikilocyte

crenated RBCs with evenly arranged sharp spikes around the periphery, usually an artefact due to slow drying of the smear or ageing of the sample

A

echinocyte

57
Q

name the type of RBC poikilocyte

uneven, rounded spikes caused by damage to RBCs in the circulation

A

acanthocyte

58
Q

name the type of RBC poikilocyte

irregular fragments caused by damage to RBCs in the circulation

A

schistocyte

59
Q

name the type of RBC poikilocyte

small buttons attached to RBCs, often seen as “little noses” - presence indicates oxidative damage to the RBCs

A

Heinz bodies

60
Q

name the type of RBC poikilocyte

nuclear remnants in RBCs; high numbers can be due to increased RBC turnover, defective production, or defective splenic removal

A

Howell-Jolly bodies

61
Q

name the type of RBC poikilocyte

aka target cells; can be seen with regeneration, lipid imbalances or liver disease

A

codocytes

62
Q

name the type of RBC poikilocyte

small, round, densely-staining RBC with no central pallor

A

spherocyte

63
Q

an increase in immature neutrophils is called this

A

shift to the left

64
Q

-philia or -cytosis indicate this

A

increase

65
Q

-penia indicates this

A

a decrease

66
Q

name the WBC

increase seen in inflammation, excitment, stress, and hyperadrenocorticalism (Cushing’s disease)
decrese in overwhelming infections and endotoxemia

A

neutrophils

67
Q

name the WBC

increase may occur in hypersensitivity, parasitism, some cases of hypoadrenocorticism (Addison’s disease), neoplasia, mast cell disorders

A

eosinophils

68
Q

name the WBC

rarely seen in peripheral blood but increase may be seen in conjunction with eosinophilia and mast cell disease

A

basophils

69
Q

name the WBC

increase seen in excitement chronic infection
decrease seen in stress, lymphoma, early viral diseases and lymph loss

A

lymphocytes

70
Q

name the WBC

increase seen in inflammation, necrosis and stress

A

monocytes

71
Q

name the WBC patterns seen with the condition

adrenalin mediated stress (excitement)

A

neutrophilia and lymphocytosis

72
Q

name the WBC patterns seen with the condition

corticosteroid mediated stress

A

neutrophilia, monocytosis, lymphopenia, eosinopenia (SMILED)

73
Q

name the WBC patterns seen with the condition

inflammatory

A

neutrophilia +/- left shift, monocytosis, +/- lymphocytosis

74
Q

name the WBC patterns seen with the condition

hypersensitivity

A

eosinophilia +/- basophilia

75
Q

these participate in coagulation, and abnormalities in their numbers or function can lead to coagulopathies; appear as small, anucleated, discoid to irregular cytoplasmic fragments containing purple granules

A

platelets

76
Q

as a rule of thumb, there should be this many platelets per 100xHPF in healthy dogs and cats

A

15-20

77
Q

name the change in platelet numbers seen with these conditions

inflammation, regenerative anemia, paraneoplastic, many others

A

thrombocytosis

78
Q

name the 5 main types of routine biochemical assays

A
  1. proteins
  2. enzymes
  3. metabolites
  4. electrolytes
  5. hormones
79
Q

what two types of serum and plasma proteins make up the total protein concentration

A

albumin and globulins

80
Q

what is the only difference between serum and plasma

A

plasma contains fibrinogen, serum does not

81
Q

where are most proteins synthesized?

A

liver

82
Q

name the 4 main types of globulins

A
  1. immunoglobulins
  2. transport proteins
  3. acute phase proteins
  4. enzymes
83
Q

name the type of globulin

bind to specific antigens
ex: IgA, IgM, IgG

A

immunoglobulin

84
Q

name the type of globulin

ex: transferrin (binds iron) & lipoproteins (carry lipids)

A

transport proteins

85
Q

name the type of globulin

synthesized in the liver in response to inflammation; synthesis may be increased or decreased

A

acute phase proteins (APPs)

86
Q

increased serum albumin is most commonly due to this

A

dehydration

(also glucocorticoid therapy)

87
Q

increased globulins is usually due to this

A

inflammation or an immune response

(also neoplasia of B-cells and plasma cells)

88
Q

this test shows more detail of the main protein groups present - sample is placed on thin gel and a current is passed along it; proteins migrate towards anode and pattern of bands allows main groups to be quantified

A

serum protein electrophoresis

89
Q

most alpha and beta globulins are this type of globulin

A

APPs and transport proteins

90
Q

gamma globulins are this type of globulin

A

immunoglobulins

91
Q

name 6 causes of decreased serum protein

A
  1. liver disease
  2. inflammation
  3. protein-losing nephropathy
  4. protein-losing enteropathy
  5. protein-losing dermatopathy
  6. whole blood loss
92
Q

which serum protein(s) is decreased?

in liver disease

A

mainly albumin

93
Q

which serum protein(s) is decreased?

in inflammation

A

albumin

(globulins often increased)

94
Q

which serum protein(s) is decreased?

in protein-losing nephropathy

A

albumin more than globulins

(sieving effect)

95
Q

which serum protein(s) is decreased?

in protein-losing enteropathy

A

albumin and globulins

(no sieving effect)

96
Q

which serum protein(s) is decreased?

in protein-losing dermatopathy

A

albumin and globulins

(no sieving effect)

97
Q

which serum protein(s) is decreased?

in whole blood loss (hemorrhage)

A

albumin and globulins

(no sieving effect)

98
Q

give 2 examples of positive acute phase proteins

A
  1. C-reactive protein (dogs)
  2. serum amyloid A (cats, horses)
99
Q

what is the main negative acute phase protein

A

albumin

100
Q

this is a protein that is increased because of increased production by the liver during inflammation

A

positive acute phase proteins

101
Q

this is a protein that is decreased because of decreased production by the liver during inflammation

A

negative acute phase protein

102
Q

these increase in the serum due to escape from damaged cells or increased synthesis and only relatively large changes are considered significant

A

enzymes

103
Q

which enzyme to choose?

for hepatocellular damage?

A

ALT (dog, cat);
GLDH, AST (horse, ruminant)

104
Q

which enzyme to choose?

for cholestasis?

A

ALP, GGT

(dog, cat, ruminant, horse)

105
Q

which enzyme to choose?

for increased synthesis?

A

SIALP (dog);
GGT (horse, ruminant)

106
Q

which enzyme to choose?

for muscle damage?

A

CK, AST

(dog, cat, horse, ruminant)

107
Q

what enzyme does the abbreviation stand for?

ALT

A

alanine aminotransferase

108
Q

what enzyme does the abbreviation stand for?

ALP

A

alkaline phosphatase

109
Q

what enzyme does the abbreviation stand for?

AST

A

aspartate aminotransferase

110
Q

what enzyme does the abbreviation stand for?

CK

A

creatine kinase

111
Q

what enzyme does the abbreviation stand for?

GGT

A

gamma glutamyl transferase

112
Q

what enzyme does the abbreviation stand for?

GLDH

A

glutamate dehydrogenase

113
Q

what enzyme does the abbreviation stand for?

SIALP

A

steroid-induced isoenzyme of ALP

114
Q

which metabolite?

increased by: dehydration, decr. cardiac output, renal disease, post-renal obstruction
decreased by: liver disease

A

urea

115
Q

which metabolite?

increased by: renal disease, post-renal obsruction, Greyhounds
decreased by: low muscle mass

A

creatinine

116
Q

which metabolite?

increased by: post-prandial, impaired liver function

A

bile acids

117
Q

which metabolite?

increased by: hemolysis, liver disease, bile duct obstruction

A

bilirubin

118
Q

which metabolite?

increased by: Diabetes mellitus, hyperadrenocorticism, stress
decreased by: insulinoma, hypoadrenocorticism, liver disease

A

glucose

119
Q

which metabolite?

increased by: Diabetic ketoacidosis, pregnancy toxemia

A

beta hydroxybutyrate

120
Q

which metabolite?

increased by: post-prandial, hypothyroidism, hyperadrenocorticism, diabetes mellitus

A

triglycerides

121
Q

which metabolite?

increased by: post-prandial, hypothyroidism, hyperadrenocorticism, diabetes mellitus, protein-losing enteropathy/nephropathy
decreased by: liver disease

A

cholesterol

122
Q

name 4 important electrolytes

A

sodium, potassium, chloride, bicarbonate

123
Q

what is the percent of calcium that is:
ionized
protein bound
complexed with anions

A

50% ionized
40% protein bound
10% complexed with anions

124
Q

which form of Calcium is the biologically active fraction

A

ionized form

125
Q

what is a common cause of increased Ca

A

malignancy (ex: lymphoma)

(tumors produce PTH-related protein)

126
Q

what is a common cause of decreased Ca?

A

hypoalbuminemia and renal disease

(hypoalbuminemia does not affect ionized Ca)

127
Q

this type of test can confirm the presence of endocrine disease

A

hormone assays

128
Q

what hormone assay(s) should be used for the disease?

hyperadrenocorticism (Cushings’ disease)

A
  1. cortisol in dexamethasone suppression test
  2. ACTH stim test
  3. plasma ACTH
129
Q

what hormone assay(s) should be used for the disease?

hypoadrenocorticism (Addison’s disease)

A

ACTH stimulation test

130
Q

what hormone assay(s) should be used for the disease?

hyperthyroidism

A

Total T4

131
Q

what hormone assay(s) should be used for the disease?

hypothyroidism

A

T4 and TSH