Midterm 1 (1-7)

Question 1

How to determine BT, BMBT

Answer 1

Use a sharp, sterile blade, make 0.1-0.2mm deep, 0.5cm long incision on inner ear skin. Wipe the blood flowing from under the wound in 20-30 second intervals. Measure time from appearance of first drop till the end of bleeding.
Normal BMBT- 3-5mins
for vasculopathies, thrombocytopathies and thrombocytopenias

Question 2

What is normal BT?

Answer 2

3-5 mins

Question 3

What is DIC

Answer 3

Disseminated intravascular coagulopathy
common acute disorder (+FDP or D-dimer= sign)
Fibrinolysis and microthrombus function are present in diff parts of the body simultaneously due to severe tissue damage and blood vessel injury- initiation of intrinsic pathway (coag factors and platelets- consumpted quickly)

Question 4

Lab signs of DIC

Answer 4

increased coagulation time, bleeding time, PT, APTT, TT, FDP
decreased platelet count
appearance of schysocytes and/ or Burr cells in blood smear

Question 5

What is thrombocytopathy?

Answer 5

Decreased ability of platelets to aggregate and adhere to the site of injury- forms primary thrombocyte-thrombus

Question 6

Causes of thrombocytopathy?

Answer 6

Improper development of platelets, von Willebrand disease (doberman), uremia, liver failure, NSAID treatment, myelo- or/ and lympho-proliferative disease.

Question 7

Regular sizes of thrombocytes

Answer 7

1-2um, centre is granulomer and edge is hyamoler
eq, bo, sheep= 3-5fl
ca, su= 7-8fl
fe= 10-15fl

Question 8

Causes of thrombocytopenia

Answer 8

Causes-
decreased production in bone marrow
increased utilisation: DIC
increased loss, destruction (AITP), sequestration (chronic splenomegaly)

Question 9

ESR

Answer 9

Erythrocyte sedimentation rate- increased sedimentation is due to inflammatory processes (also checked with glutaric aldehyde test). Increased sedimentation means that the APP and other globulins attach to the surface of the RBC.
It is faster in eq, so must evaluate after 20 mins (decreases due to inflammation, opposite of other species).
ESR is inversely proportional with Ht
ESR is directly proportional with viscosity, total protein and fibrinogen concentration.

Question 10

Causes of hyperlipidemia

Answer 10

increased fat content in diet, DM, hypothyroidism, hyperadrenocorticism, nephrotic syndrome, septicemia, pancreatitis.

Question 11

Causes of hypolipidemia

Answer 11

starvation (long term), chronic liver failure

Question 12

Causes of hypercholesterolemia

Answer 12

Increased dietary fat content, hypothyroidism, hyperadrenocorticism, nephrotic syndrome, DM

Question 13

causes of hypocholesterolemia

Answer 13

liver failure, neoplastic disease, hyperthyreosis, malnutrition and malabsorption

Question 14

What is the total cholesterol and cholesterol ester?

Answer 14

2-6mmol/l (ester is 40% of this)

Question 15

Causes of hyperglycemia?

Answer 15

Transient- Lab errors, stress (fe), food intake (ca, humans), xylazine effect, cranial trauma/inflammation (Aujeskzy disease, rabies), after/during glucose fluid therapy
Constant- DM, hyperadrenocorticism, progesterone effect, enterotaxemia (sheep)

Question 16

Causes of hypoglycaemia?

Answer 16

Lab error, decreased energy (ketosis in Ru, growing pigs, racing, starvation), insulin overdose, liver failure, hypoadrenocorticism, septicaemia, hyperthyroidism

Question 17

What is monoclonal gammopathy?

Answer 17

one protein fraction derived from one clone- immune mediated or neoplastic conditions

Question 18

What is polyclonal gammopathy?

Answer 18

beta and gamma globulins derived from different clones- inflammatory processes or some immune mediated diseases

Question 19

Hyperglobulinemia

Answer 19

polyclonal gammopathy- broad peak in gamma and beta region
common causes- chronic inflammation, liver disease, FIP, occult heartworm disease, Ehrlichiosis
Beta- gamma bridging- disorders with increased IgA and IgM- heartworm, lymphoma, chronic active hepatitis
Monoclonal gammopathy- sharp spike in beta/gamma region, neoplastic or non-neoplastic
Neoplasia- common cause- myelomas
other causes- chronic lymphocytic leukemia (IgG), lymphoma (IgM, IgG), extramedullary plasmacytomas (solid tumor with plasma cells) in GI tract, skin and liver (Car)
Increase of IgM= macroglobulinemia (Waldenstrom, neoplasm of B-cells accompanied by splenomegaly or/and hepatomegaly, but lacking osteolytic lesions)
Multiple myelomas- disorder of plasma cells that have undergone antigenic stimulation in peripheral lymph nodes, with osteolytic lesions)
Non neoplasmic (rare)- occult heartworm, FIPV, Ehrlichia canis, lymphoplasmacytic enteritis and dermatitis, amyloidosis.

Question 20

Hypoglobulinemia

Answer 20

decreased intake (in neonates before drinking colostrum, absorption disorders)
decreased synthesis- liver failure, or inherited immunodeficiency
increased loss- PLE, PLN, skin (burning, inflammation), bleeding

Question 21

Reticulocytes

Answer 21

young but differenciated RBC with basophil punctuates stained by brylliant-cresil blue (big blue= younger), have same function, can carry O2.
Not in eq, Ru (only in bone marrow)
Appearance is sign of regenerative function of bone marrow.
If they’re nucleated, they’re too young and can’t carry O2.
In case of maturation arrest (vit B12, folic acid deficiency or feline leukemia) they won’t turn into reticulocytes.
Fresh EDTA blood and Brylliant cresil (in same proportion), physiological saline and 3.8% Na-citrate and mix. Incubate 2-3 hours, prepare smear.
2-3% reticulocytes per 100-1000 RBCs.
CRC, CRP
Increased count- acute blood loss (3-5 days needed for bone marrow to increase reticulocyte count), haemolytic anema, chronic blood loss, some nutrient deficiency anemia.

Question 22

Staining for reticulocytes

Answer 22

.04g Brylliant-cresol blue+ 8ml physiological saline solution. Mix
Add 2ml 3.8% Na-citrate and mix.
Mix equal amount of fresh EDTA blood
Make blood smear

Question 23

Normal number of reticulocytes?

Answer 23

In 100-1000 RBC, 2-3% are reticulocytes

Question 24

Typical changes in derived parameters? MCHC, MCV, MCH etc

Answer 24

macrocytic, hypochromic (increased MCV, decreased MCHC) with increased reticulocytes= regenerative anemia
normocytic, normochromic (normal MCV and MCHC, possible decreased MCH)= non regenerative
microcytic, hypochromic (decreased MCV and MCHC)= iron, copper, pyridoxine deficiency anemias, liver failure, portosystemic shunt (with normochromic- normal for Akita)
macrocytic, normochromic (impaired DNA synthesis)- Bit12, cobalt or folic acid deficiency, erythroleukemia, poodle macrocytosis)

Question 25

RDW of dog an cat?

Answer 25

Red Cell Distribution Dog- 12-16% Cat 14-18%

Question 26

What does short RDW mean?

Answer 26

Non regenerative processes

Question 27

Normochromic value (MCHC)

Answer 27

300-350g/l

Question 28

Hyperchromasia effects?

Answer 28

erythroleukemia vitamin B12, cobalt or folic acid deficiency splenectomy lead poisoning

Question 29

Hypochromasia effects?

Answer 29

iron, copper, pyridoxine deficiency anemias, newborn animals, liver failure

Question 30

How to measure Hbg?

Answer 30

Spectrophotometer method (drabkin method)

Question 31

Describe spectrophotometer method for Hgb measurement

Answer 31

Put 20ul whole blood sample to 5ml reagent (K3SE(SCN))6 haemolyses RBC and forms Fe3+ from Fe2+, which is further oxidised by KCN to cianidmethaemoglobin. Mix and measure amount of orange end product.

Question 32

Normal Hbg amount?

Answer 32

18-20mmol/l

Question 33

How does O2 binding capacity of Hgb increase?

Answer 33

``` decreased 2,3-DPG levels in RBC, CO2 levels (resp alkalosis), temperature (hypothermia) increased pH (met/resp alkalosis) ```

Question 34

How does O2 binding capacity of Hbg decrease?

Answer 34

``` Increased 2,3-DPG level of RBCs, Co2 (resp acidosis), temp (hyperthermia) Decreased pH (met/resp acidosis) ```

Question 35

When does Hgb conc. increase?

Answer 35

relative (dehydration) or absolute polycythemia

Question 36

When does Hgb conc. decrease?

Answer 36

Relative (hyperhydration) or absolute anema

Question 37

TWC, EC, IC

Answer 37

600-650ml/kgbw 250-300ml/kgbw 350-400ml/kgbw

Question 38

Blood clotting parameters

Answer 38

Na2-citrate as anticoagulant- suitable for blood smears and binds calcium reversibly

Question 39

Citrate blood ratio for homeostasis?

Answer 39

1:9 (but in RBC sedimentation test, 1:4)

Question 40

Blood biochemistry parameters measured in...?

Answer 40

Serum, without anticoagulant or blood plasma with heparin (anticoagulant)

Question 41

Volume disturbances?

Answer 41

Perfusion and hydration disorders, PCV and Ht (increase for dehydration), Hb conc (increases for dehydration), TP/Talb conc (increase for dehydration), MCV or RBCs

Question 42

Evaluation of perfusion (IV deficit and circulation problems)

Answer 42

CRT (hypo/hypervolemia) color of mucous membranes (pale, livid) strength of pulse heart rate (increased BP)

Question 43

Evaluation of hydration

Answer 43

skin and eye turgor mucous membranes (wet, shiny, dry etc) skin around oral/anal cavity (signs of water loss) sunken eyes (enophthalmos), prolapse of 3rd eyelid (fe) changing of weight urine volume

Question 44

Examining blood in Ht tubes after centrifuging

Answer 44

1. plasma color change- usually transparent (eq and bo yellow due to bilirubin and carotenoid) dark yellow- hyperbilirubinemia red- haemolysis white- hyperlipidemia chocolate (methaemoglobinema) 2. buffy coat (width changes w/ WBC count) 3. microfilaria larvae- on top of buffy coat, sometimes visible

Question 45

Volume loss in acute bleeding?

Answer 45

5-15% no change in BP 15-25% vasoconstriction, initial increase in BP, tachycardia 35-45%- severe decrease in BP, oliguria/anuria, vasodilation leading to shock 50%- death

Question 46

PCV methods

Answer 46

1. microcapillary- homogenous and fill almost full, plug one end with cold plasticine and centrifuge 3-5min 2. automated cell counter- MCVxRBC/1000 3. Handheld HCT meter- Ht and Hgb in whole blood. species chip and test strip into meter and add drop of whole blood to test strip.

Question 47

Normocytic, hypovolemia?

Answer 47

during acute blood loss or immediately after- shock!

Question 48

normocytic, hypervolemia?

Answer 48

overdosing on blood transfusion/chronic stress (high BP)

Question 49

Polycythemia, normovolemia

Answer 49

1. False- long time in EDTA, swelling 2. Physiological- congenital, newborn or long term hypoxia 3. Absolute- increase in RBC primary (w/o EPO)- bone marrow neoplasia, chronic leukemia secondary (w/ EPO)- True (long term hypoxia, RAO in eq, brachycephal syndrome in ca) or Not true (w/o hypoxia) EPO produces tumor in kidney and liver.

Question 50

Polycythemia, hypovolemia

Answer 50

Relative- decreased plasma vol, dehydration eg. vomit, diarrhea

Question 51

Polycythemia, hypervolemia

Answer 51

Complex- life threatening, acute stress, extreme exercise

Question 52

anemia, normovolemia

Answer 52

absolute- several hours post acute bleeding (plasma replaces faster than cells), decreased RBC- lack of nutrients and suppression of bone marrow, decreased life span eg IHA, ectoparasitosis, sequestration of RBCs in spleen- hypersplenismus

Question 53

anemia, hypovolemia

Answer 53

Complex- causes refusal of water, diarrhea, vomiting

Question 54

anemia, hypervolemia

Answer 54

1. Physiological- increase in plasma volume in 3rd trimester pregnancy 2. Relative- increase in plasma volume, hyperhydration ie overdose fluid therapy

Question 55

Serum osmolality mathematical method

Answer 55

2(Na+K)+urea+glucose | osmometer

Question 56

Osmolality normal values

Answer 56

270-310mOsm/kg

Question 57

Isotonic dehydration

Answer 57

blood, plasma loss, vomiting, diarrhea, chronic renal failure

Question 58

hypertonic dehydration

Answer 58

primary water loss eg diarrhea, hyperventilation, chronic renal failure, ADH function loss, henle loop diuretics

Question 59

hypotonic dehydration

Answer 59

enhanced sweating in eq, hypotonic infusion overdose: drinking lots of water after loss, hypoadrenocorticism, chronic kidney disease, diarrhea

Question 60

isotonic hyperhydration

Answer 60

concurrent Na+ and H20 retention, overdose of IV plasma or isotonic infusion, cardiac or hepatic disorders

Question 61

hypertonic hyperhydration

Answer 61

salt poisoning, primary and secondary hyperaldosteronism, enhanced glutocorticosteroid effect

Question 62

hypotonic hyperhydration

Answer 62

water poisoning (excessive water intake- haematuria in calves), hypotonic infusion overdose: increased ADH function, hypothyreosis

Question 63

Sodium normal value

Answer 63

140-150mmol/l

Question 64

Potassium normal value

Answer 64

3.5-5.5mmol/l

Question 65

Chlorine normal value

Answer 65

100-125mmol/l

Question 66

Magnesium normal value

Answer 66

0.8-1.5mmol/l

Question 67

Calcium normal value

Answer 67

2.1-3mmol/l (ionised is 45-50% of this)

Question 68

Causes of hypernatremia

Answer 68

- Decreased water intake, polyuria, vomiting, diarrhea, hyperthermia - Increased retention in kidneys- primary (conn) and secondary (liver disease) hyperaldosteronism - Overdose hypertonic salt solution - Salt poisoning

Question 69

Causes of hyponatremia

Answer 69

- Increased water intake per os in Ru - Overdose on hypotonic fluid - Retention of water- renal/hepatic insufficiency - Enhanced Na+ loss- diarrhea, hypoadrenocorticism - Sweating (eq) - Sequestration in body cavities - Hyperosmolality

Question 70

Hyperkalemia

Answer 70

increased per os intake, urinary bladder rupture, overdose K+ fluids, acute kidney failure, hypoaldosteronism, acidosis

Question 71

hypokalemia

Answer 71

alkalosis, primary and secondary hyperaldosteronism, insulin, anorexia, long term polyuria

Question 72

when do you measure chloride?

Answer 72

vomiting, diarrhea, polyuria/polydypsia and when there is an acid base disturbance

Question 73

hyperchloremia

Answer 73

excessive per os intake, iv overdose, decreased excretion (hyperaldosteronism) and other cases with hypernatremia

Question 74

hypochloremia

Answer 74

abomasal displacement, vomiting, diarrhea, sweating (eq), sequestration in body cavaties, hypoadrenocorticism

Question 75

tCa is measured with what sample?

Answer 75

spectrophotometer with serum or heparinised plasma and ortocresolphtalein

Question 76

how many forms of calcium are there in the blood plasma?

Answer 76

3. | 47% to albumin, 13% chelated, free ionised 40%

Question 77

hypocalcemia

Answer 77

decreased intake, hypofunction of parathyroid gland (Mg deficiency), in fe after thyroidectomy, lactating animals, seizures

Question 78

hypercalcemia

Answer 78

increased intake, hyperfunction of parathormone, hyper A vitaminosis in fe, damages bone, soft tissue calcification

Question 79

Magnesium

Answer 79

``` ATP metabolism (ATP bound to MG2+)-catalysator actin-myosin activator (maintains neuromuscular irritability) facilitates synthesis and breakdown of Ach ```

Question 80

Magnesium indications

Answer 80

hypocalcemia, hypokalemia, muscle weakness, tremors, dysphagia, dyspnoa

Question 81

Hypomagnesemia

Answer 81

``` decreased intake (grass tetany), reduced concentration of tMg in CSF- hyper, muscle spasms, convulsions, respiratory distress, collapse, death adults lactating are more susceptible increased excretion (renal, enteral) eg chronic diarrhea ```

Question 82

hypermagnesemia

Answer 82

increased absorption after laxative agents, overdose of Mg, decreased excretion- milk fever, dehydration, addisons disease, muscle weakness, paralysis

Question 83

inorganic phosphate normal amount

Answer 83

ca, eq- 0.8-1.8mmol/l fe, bo, sheep- 1-2.4mmol/l su, goat- 1-3mmol/l

Question 84

inorganic phosphate

Answer 84

plasma buffer system, energy of RBC in acidic environment- phophorus and ammonium molybdate- yellow phosphate molybdic acid increases when meat/grains are fed rate of absorption increases under Vit D effect and decreases with EPI (intestinal inflammation and Vit D deficiency) Decreases with liver dysfunction and kidney failure decreases with primary and secondary hyperparathyroidism decreases with PTH (induces Ca2+ and phosphate mobilisation) and calcitonin. decreases with pH value

Question 85

How to measure coagulation time

Answer 85

use fresh, native blood samples (2 syringe method) NO EDTA make precise venipuncture, otherwise damaged cells will trigger tissue factor 3 and initiate the coagulation cascade. Appearance of 1st fibrin strand- 1-2mins CT on watch glass (treated with paraffin)- 7-15mins CT in plastic syringe- 10-12mins CT in glass tube- 4-5mins CT in ACT tube (with SiO2) put in thermostat 37 degrees and check complete coag time, slowly move tube every 20-30 seconds (3 mins)

Question 86

Platelet count normal amount

Answer 86

200-800x10^9/l 1. Burker chamber (x10^9) nor accurate 2. Blood smear (finding 1 in 1000x magnification= 20x10^9/l finding aggregates means proper platelet function 3. ACC- particles between 5-30fl volume are taken as platelets

Question 87

Clot retraction test

Answer 87

Blood clot gets smaller over time and serum appears around in 1hr- serum volume of 25% of original clot size if clot reaction is slow- thrombocytopathy

Question 88

Prothrombin time factors

Answer 88

1,2,5,7,10,13

Question 89

prothrombin normal time

Answer 89

10-15 seconds

Question 90

how to calculate prothrombin time (PT)

Answer 90

within 1 hr sampling 3.8% Na2-citrate in 9:1 dilution and centrifuge for 10 mins. separate citrated plasma from sediment (keep at 37 degrees) reagent contains rat uterus homogenate as tissue thromboplastin (3) and CaCl2 measure time of coagulation

Question 91

APTT normal time

Answer 91

20-30 seconds

Question 92

APTT factors

Answer 92

1,2,5,8,9,10,11,13

Question 93

how to calculate APTT

Answer 93

reagent contains rabbit brain homogenate as PF3 and micronised silica as contact activator 100ul citrated plasma and 100ul reagent and 100ul 0.025mmol CaCl2 measure coag time

Question 94

what is dicumarol

Answer 94

antagonist of Vit K. Vit K is responsible for gamma carboxylation or proconvertin (VII), Christmas (IX), Stuart Prower (X) and Prothrombin (2) as they as Ca dependent factors . Factor VII has shortest life, prothrombin in time increases with factor VII decreasing.

Question 95

Thrombin Time (TT)

Answer 95

citrated plasma with reagent with thombin only. coagulation depends on fibrinogen and Factor XIII in plasma. -Intrinsic (haemophilia A factor 8 and B factor 9 def and Von Willebrand)- Incr APTT, same PT -Extrinsic (dicumarol, factor VII def)- same APTT, incr PT -Common (liver dys, dicumarol, DIC, Factor X,V,II,I def)- incr APTT and PT

Question 96

what is D-dimer used for

Answer 96

detects increased fibrinolysis (only fibrin) | very good for early detection of DIC

Question 97

diagnosis of von willebrand

Answer 97

deficient in factor VIII 3 main parts- VW (responsible for platelet adhesion and aggregation) VIIIc (antihaemolytic) VIII related antigen (binds strongly to VW factor) Dogs with this have increased BT, BMBT and decreased clot retraction ability specific diagnosis- lack of VW antigen

Question 98

methods for RBC count

Answer 98

1. Burker chamber- anticoagulated blood with EDTA and homogenis, put 50ul blood into 9.95 phys saline and mix, add one drop into haemocytometer and count cells in 20 squares. No of counted RBC/100= RBC x10^12/l 2. ACC- if particles are 40-100fl we assume they're RBC Normal RBC count= 4.5-8x10^12/IT/l

Question 99

MCH normal size

Answer 99

12-30pg (younger animals bigger)

Question 100

MCV normal size

Answer 100

``` 60-70fl fe,eq= smaller young RBC= bigger Japanese akita has small (55-65fl) some poodles large (75-80fl) ```

Question 101

MCHC normal size

Answer 101

300-350g/l

Question 102

Osmotic resistance of RBC is dependent on....

Answer 102

pH plasma and reagents, temp, osmotic conc of plasma and reagents, RBC membrane status, regenerative status, HbF content of RBC

Question 103

what is regenerative anemia

Answer 103

bone marrow releasing reticulocytes to make up for absence of RBC

Question 104

Size of RBCs

Answer 104

macrocytosis, microcytosis, anisocytosis, polkylocytosis

Question 105

RBC types in maturation order

Answer 105

``` Proerythroblast Basophil erythroblast Polychromatophil erythroblast Acidophil erythroblast young, mature w/o nucleus- reticulocyte ```

Question 106

reason for appearance of young RBCs

Answer 106

increased production (regen anemia), spleen or bone marrow disease, leukemia, extramedullary erythrocyte production, Pb toxicosis, hyeradrenocorticism

Question 107

reason for reticulocyte appearance

Answer 107

regen anemia, Fe deficiency anemia, haemolysis, acute and chronic blood loss

Question 108

Inclusion bodies in RBCs

Answer 108

Heinz body- NMB- denatured Hbg Howell-Jolly body- nuclear membrane remnants Basophilic punctuates- nuclear membrane remnants

Question 109

Is iron metabolism open or closed?

Answer 109

normally closed, meaning a very low amount is lost, most is reutilised.

Question 110

Iron in feed (up tp duodenum)

Answer 110

Iron in feed is in the form Fe3+, which is not absorbable, so gastric acid frees it from these complex molecules, reducing it to Fe2+ by ascorbic acid, cysteine or glutathione in duodenum.

Question 111

what happens to iron in the mucosa

Answer 111

it is bound to apoferritin and stored as ferritin, from here it can be absorbed to plasma or faeces. Iron is stored in easily available form ferritin in spleen, bone marrow, liver 80-90% iron reutilised for Hgb synthesis in bone marrow

Question 112

how do we lose iron?

Answer 112

when the 'circle' opens due to chronic blood loss, the iron storages deplete- iron deficiency anemia.

Question 113

why do we have to use serum for iron measurement?

Answer 113

if we dont use serum, fibrinogen content may disturb

Question 114

method for serum iron measurement

Answer 114

fe3+ reduced to fe2+ by ascorbic acid. it reacts with ferrosin and forms red color chelate (complex) and is measrued photometrically *must be performed with TIBC analysis

Question 115

TIBC

Answer 115

measure serumFe then add Fe-solution to the plasma (allows transferrin to be fully saturated, then put absorbent to solution and centrifuge (binds to free Fe sediments) use upper layer and check seFe again. TIBC= serum iron level (saturated)+ free transferrin (unsaturated)

Question 116

causes of low TIBC

Answer 116

chronic inflammation, chronic liver failure, neoplastic diseases

Question 117

causes of high TIBC

Answer 117

iron def anemia (not severe if normal iron level and high TIBC)