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Flashcards in Intro and Bloodwork (MR) Deck (128):
1

What is a Rule Out List?

List of Differentials

2

What is the 1º Rule Out?

What you think it is the most

3

How much kidney must be lost to show clinical signs?

66%

4

How much kidney must be lost to be azotemia?

75%

5

Azotemic and can concentrate urine, do they have kidney failure?

No, they are concentrating urine. Azotemia can be: Pre, Renal, Post

6

Are Clinical Signs diseases?

NO!

7

Most CX are what?

Protective mechanisms

8

When does loss of function give you the dz?

Beyond reserve capacity of the system

9

Does inflammation require loss of function?

NO

10

What is a problem list?

Every single problem an animal has

11

What are Rule Out lists designed for?

Every single problem has its own Rule Out List

12

DAMNITV: What does D stand for?

Degenerative Developmental

13

DAMNITV: What does A stand for?

Anomalous Allergic

14

DAMNITV: What does M stand for?

Metabolic

15

DAMNITV: What does N stand for?

Neoplastic Nutritional

16

DAMNITV: What does I stand for?

Infectious
Inflammatory
Immune Mediated
Idiopathic
Ischemic
Iatrogenic

17

DAMNITV: What does T stand for?

Trauma
Toxic

18

DAMNITV: What does V stand for?

Vascular

19

What does PARSIMONY mean?

Everything comes down to one thing

20

When should you collect baseline samples?

When pet is healthy

21

What is more important (regarding severity) for kidney function, azotemia or ability to concentrate?

Ability to concentrate, take a USG (UA)

22

TQ! What tests will you always want?

CBC, Chem, UA (at least USG)

23

What is polachyuria?

Small spots all over the place

24

CKD?

Chronic Kidney Disease

25

CDI?

Central Diabetes Insipidus

26

PSS?

Portal Systemic Shunt

27

1º NDI?

Nephrogenic Diabetes Inspipidus - exceedingly rare don't have receptors for ADH, puppies

28

2º NDI?

Nephrogenic DI - inability of receptors to respond to ADH - most cases

29

When does epilepsy happen?

6 mo - 5 yrs

30

What do buff colored cocker spaniels get?
How many more times likely?

IMHA: This is your top differential.
8X more likely

31

When do we treat clinical signs?

When we know what is causing the clinical signs!
Diagnosis!

32

What does S.O.A.P. stand for?

Subjective
Objective
Assessment
Plan

33

Is CBC qualitative or quantitative?

BOTH

34

What is ALWAYS done with a CBC?

Blood Smear!!!

35

TQ! 2 Primary Rule Outs for Regenerative anemia?

Hemolysis
Hemorrhage

36

Why should you make sure tube is filled appropriately?

Anticoagulation Artifacts will change ratios of numbers

37

Immature cells are bigger or smaller?

Bigger

38

Decreased PCV is?

Anemia

39

Increased PCV is?

Polycythemia

40

What is PCV?

% of Whole blood that is RBC

41

Primary Rule Outs for Non-regenerative anemia?

Inflammatory
Renal Dz - Could be anywhere
Bone Marrow Dz

42

What comes with inflammation?

Cytokines

43

What do Cytokines do?

Turn on and turn off all kinds of cells including inflammatory cells and some of which live in the bone marrow

44

What is an increased PCV?

Polycythemia

45

Types of Polycythemia?

Relative
Absolute

46

What is Relative Polycythemia?

Dehydration

47

Total Solids is best measured how?

Refractometer

48

Acute phase proteins?
What are they turned on by?

Fibrinogen (LA!)
Haptoglobin
Liver

49

Total Solid Elevations occur due to?

Dehydration
Chronic Infections
Leukemia

50

Total Solids Decreases are due to?

Poor nutrition
Liver Disease
Malabsorption
Diahhrea
PLN/PLE
Burns

51

If something is low, what are the most possible reasons?

Using
Losing
Not making
Sequestering it

52

What are 2 smallest proteins?

Albumin
Antithrombin III

53

Why would you go into DIC with a nephropathy?

Antithrombin III leaks out and then you cant clot.

54

PLE you tend to lose which proteins?
Why?

Albumin & Globulins
Leakier than nephrons

55

Which proteins are lost in PLN?

Albumin
Antithrombin III

56

Elevations in both PCV and TS suggest?

Dehydration
Polycythemia

57

Elevated TS with low/low-normal PCV suggest?

Dehydration masking more severe anemia.
PVC will tank once rehydrated!

58

What is the difference between a Hct and PCV?

Hct is calculated
PCV is measured

59

Hemoglobin does what?

Carries O2 in g/dL

60

How do you get PCV from Hgb?

Hgb X 3

61

Leukogram relative values are?

%

62

I promise I will never do what with a leukogram?

Read relative (%) values.

63

What is the very best leukogram machine?

Flow cytometry

64

Which machine is most inaccurate?

QBC

65

How is Leukogram taken manually?

Hemocytometer

66

TQ!!! What is a Stress leukogram?

Mature Neutrophilia
Monocytosis,
Lymphopenia
(sometimes Eosinopenia)

67

What is Physiological Leukocytosis?
Why?
Who?

Neutrophilia & Lymphocytosis
Catecholamines/fear
CATS!

68

Corticosteroid Leukogram think what animal?

DOG

69

What causes Extreme neutrophilic leukocytosis?

Pyometra
Ehrlichia
Hepatozoanosis (can be really high 154,000 neuts)
Fungus
Leukemia >50,000

70

What are the levels of leukocytosis in a leukemia?

>50,000

71

TQ! What will be on every DDX list ever!

Ehrlichia
Fungus
Neoplasia

72

Why mature neutrophilia in stress leukogram?

Body releases neutrophils (mature bc not infection)

73

If all neutrophils are young and numbers are decreased what is this?

Degenerative Left Shift

74

Why Lymphopenia in stress leukogram?

They're marginated

75

What causes Monocytosis?

Chronic Inflammation
Necrosis
Steroids (stress leukogram),
Neoplasia

76

Why would there be an elevation in Mature Neutrophils?

Inflammation
Infection
Immune Mediated Dz
Stress - corticosteroids
Fear
Neoplasia

77

Why would there be a decrease in Mature Neutrophils?

Overwhelming infection
Overwhelming inflammation
Destruction
Neoplasia
Bone Marrow Dz, (Dysfunction or Suppression)
Cyclic Hematopoisis

78

What is a Regenerative Left Shift?
Is it a normal reaction?
What cells will you see?

Neutrophil response to inflammation and are adequately responding to demand.
Yes
There are mature and immature cells.

79

What is degenerative left shift?
Is it a normal reaction?
What cells are present?

Neutrophil production where release is not meeting the demand.
Abnormal response.
You will see bands but not mature/segmented neuts.

80

What are lymphocytes?
What are they markers for?
Which cells are lymphocytes?

Circulating immune system cells
Antigenic stimulation
B & T cells

81

What do B cells produce?

Ab
Cytokines

82

What do T cells produce/do?

Cytokines
Assist B cells
Can be cytotoxic/killer
Specialized duties

83

What causes elevations in Lymphocytes?

Chronic inflammation
ESPECIALLY Rickettsial infections!!!!!,
Neoplasia
Catecholamines
HYPOadrenocorticism - it's a balance thing - absence of steroids

84

What causes decreases in lymphocytes?

Steroids - suppress immune system cause margination
Acute inflammation
Effusions
Lymphoid Hyperplasia/aplasia

85

What are Monocytes in the blood?
What are they markers of?

Traveling to their designated site in tissue to become macrophages. Chronic inflammation

86

Who shows up first neuts or monos?

Neuts ya twit!

87

What type of cells are eosinophils and basophils?

Granulocytes

88

What are eosinophils and basophils markers for?

Allergic and Parasitic Dzs
Eosinophil dzs,
Mast cell neoplasia
HYPOadrenocorticism
Neoplasia

89

Eosinopenia is caused by?

Steroids, Acute Inflammation
Bone Marrow Dz

90

Eosinophils and Mast cells share what?

Same Cytokines (IL5) turns them on!

91

Who gets eosinophilic dzs?

Cats & Horses

92

What is the stain for reticulocytes?
What are you staining?

New Methylene Blue
RNA Precipitates

93

% retic based on what cell count?

1000

94

Two types of Feline Retics?

Aggregate & Punctate

95

Which Feline Retics are newly released from marrow?

Aggregate (Lots of dots)

96

What are aggregate retics specific from?

Bone Marrow Response

97

What are Punctate Retics?
How long do they circulate?

Mature aggregates
7 days

98

Corrected Reticulocyte % tells you what?

If it is regenerative enough
If bone marrow is responding appropriately to the severity of the PCV.

99

What is the absolute retic count for dogs?

>80,000

100

What is the absolute retic count for cats?

>40,000 aggregates

101

What % of corrected reticulocyte % (CRP) indicates regeneration in a dog?

> 1.5%

102

What % of corrected reticulocyte % (CRP) indicates regeneration in a cat?

>1%

103

What is Retic Production Index?

CRP/lifespan of retics

104

What is MCHC for all species with discoid RBCs?

33 g/dL

105

What is RDW?

Population spread

106

Bimodal RDW signifies?

Regeneration

107

MCV: Macrocytic RBCs signify?

Regeneration or you're a poodle!

108

MCV: Microcytic RBCs signify?

Fe deficiency
PSS (Portal Systemic Shunt)
Cu Deficiency
You're an Akita or Shibu Inu

109

MCHC measures what?

[Average Hgb]

110

MCHC: What does HYPOchromia signify?

Hemorrhage
Hemolysis
Fe Deficiency

111

MCHC: What does HYPERchromia signify?

DOESN'T HAPPEN, if machine reads this think HEINZ BODIES look at your blood smear

112

What do congenital PSS animals tend to have for RBC indicies?

Microcytic hypochromic

113

What is fibrinogen?
How long does it take to show up in blood after inflammation?

Acute Phase Protein
24 - 72 hours

114

TQ!!! Which species activate platelets easily?

CATS!
Like Rough Stick!

115

Which breed has larger platelets than others?

Cavalier King Charles
Sometimes they even have less of them

116

When can platelets be artificially decreased?

Clumping

117

Thrombocytopenia occurs due to?

Use it
Lose it,
Don't make it
Sequestration

118

What size are young platelets?

Bigger

119

Thrombocytosis happens when?

Rare
Canine HYPERadrenocorticism

120

Blood Smear: What changes morphology?

Regeneration
Hgb content
Membrane compostition
Structural Proteins
Oxidative Damage = Heinz bodies
Fragmentation
Platelet Clumping

121

Why do a smear?

Helps decide if regenerative

122

On Blood Smear what would RBC with low Hb look like?

clear

123

Blood Smear: Heinz bodies happen due to?

Oxidative Damage
Denatured Hgb
Onion Toxicity
Tylenol Toxicity

124

Blood Smear: Agglutination occurs due to?

IMHA
Rouleaux formation is NOT agglutination!

125

How should you do Saline Dilution to decipher Rouleaux from Agglutination?

1/2 drop of blood with 4-5 drops of saline

126

If bands are under 10,000 what scenario could their number be significant?

if > 10% total neuts

127

QBC: Dark black line is?

DNA

128

QBC: Thinner line is?

RNA/LP