Past Questions Flashcards
1
Q
In respiratory alkalosis a pH >7,4
pCO2 <40mmHg
pO2 >40mmHg
is expected
True or False
A
TRUE
2
Q
A puppy Arrives to the clinique and later is diagnosed with Parvo enteritis. The symptoms include severe diarrhoea and exsiccosis with hyperventilation.
A venous sample is taken and the following result are seen (reference intreval)
pH= 7,390 (7,35-7,45)
pCO2= 37,6 Hgmm (35-50)
pO2= 50Hgmm (40-50)
HCO3=18,7 Hgmm (20-28)
ABE=-7,4 mmol/L (-3,5-+3,5)
What is your conclusion?
A. Metabolic Acidosis, Compensated
B. Metabolic Alkalosis, Uncompensated
C. Respiratory Alkalosis, Uncompensated
D. Respiratory Acidosis, Compensated
E. Respiratory Acidosis, Uncompensated
F. Respiratory Alkalosis, Compensated
G. Metabolic acidosis, Uncomp
H. Metabolic Alkalosis, Compensated
A
A. Metabolic Acidosis, Compensated
Compensated = 7,35-7,45
3
Q
In metabolic alkalosis a pH > 7,4,
HCO3 concentration >28 mmol/L,
BE >+3,5 mmol/L
TRUE or FALSE
A
TRUE
4
Q
In Respiratory alkalosis pH >7,4
pCO2 < 40 mmHg
pO2 > 40 mmHg
is expected
True or false
A
TRUE
5
Q
The anion gap gets signifficantly incresed in the following case
a, In case of poor perfusion (Lactic adidosis)
b. If gamma globulins are in excess ( ununmeasured cation)
c. HCO3 is lost due to diarrhoea
A
a. In case of poor perfusion (Lactic adidosis)
Increased anion gap = Lactacidosis = Shock, hypovolaemia, poor tissue perfusion, tissue necrosis
6
Q
Creatinin is a degradation product of muscle creatine
TRUE or FALSE
A
TRUE
Creatinine is an important constituent of muscle energy stores. Creatinine is utilized to form
creatin.
7
Q
The glucose absorption test can distinguish malabsorption from diabetes mellitus
TRUE or FALSE
A
FALSE
Glucose absorption test is performed when we suspect chronic bowel disease, exocrine pancreatic insufficiency, or it can be used instead of iv glucose tolerance test.
8
Q
Multiple choice:
Total bilirubin is expected to increase in serum due to an increase in bilirubin I formation in the case of
a. Acute Hemolysis
b. Decreased conjugation in the liver
c. Extrahepatic bile duct obstruction
d. Haemotoma formation (resorbtion icterus)
e. Bile peritonitis
A
a. Acute Hemolysis
9
Q
Fill inn blank spots
Prepare 3% acetic acid solution. One-two drops of native (not centrifuged) samples must be dripped into the solution. If coagulation (smoky appearance) occurs the result is ——– due to the ———-, coagulation of labile proteins ( globulins ), as weak acid can coagulate these proteins. If coagulation is not observed but the sample is dissolved in the solution the result is ——— due to the fact that stable proteins, such as ——– does not show coagulation in weak acids.
A
- *exudate**
- *fibrinogen**
- *transudate**
- *albumin**
10
Q
Ruminal fluid PH is lower before feeding than after
TRUE or FALSE
A
FALSE
11
Q
Match the analytes with the information they can give
MCV
OSMOTIC RESISTANCE
RETICULOCYTE COUNT
RDW
MCHC
- Anisocytosis = variable cell size - iron deficiency and regenerative process
- Regeneration
- Macrocytosis
- Intravascular haemolysis
- Hypochromasia
A
MCV - Anisocytosis
OSMOTIC RESISTANCE - Regeneration
RETICULOCYTE COUNT - Macrocytosis
RDW - Intravascular hemolysis
MCHC - Hypochromasia
12
Q
Which is not a prerenal cause of increased urea concentration
a. Cardiac failure
b. Shock
c. Glomerular problem
d. Addisons Disease
e. Dehydration
A
d. Addisons Disease
13
Q
Multiple choice: Select the correct answer
THROMBOCYTHOPATHY can be found in cases of
a. Uremia
b. Anti Freeze poisoning
c. NSAID treatment
d. Rodenticide poisoning
e. Liver failure
A
a. Uremia
14
Q
Drag the words below and drop them into their places!
——-lity (body) fluids. Osmolarity is expressed in different units than osmolality______ osmolality——- expresses the osmotic pressure of the . The calculation of osmolality osmolarity——– is performed based on the formula below if all of the parameter concentrations are given in mimol/I: Osmolality (mOsm/kg) = 2(__+__)+(lucose____)
A
Osmola
kg
L
(Na+ +K)
(urea+g)
15
Q
Multiple choise
Choose the amylase isoenzymes
a. Pancreatic
b. Musculoskeletal
c. Intestinal
d. Renal
e. Salivary
A
a. Pancreatic
c. Intestinal
d. Renal
e. Salivary
16
Q
Match the lipid fraction with the apolipoproteins carrying them
Triacyl glycerol
Cholesteriol
Phospholipids
Free fatty acids
A
Triacyl glycerol - VLDL
Cholesteriol - LDL/HDL
Phospholipids - HDL
Free fatty acids - ALBUMIN
17
Q
Multiple choice
ACTH stimulation test is used for
a. Monitor treatment for hyperadrenocorticoism
b. Diagnose ectopic ACTH production
c. Screen overall pituitary hyperfunction
d. Screen for hyperadrenocorticoism
e. Diagnose hypoadrenocorticoism
A
a. Monitor treatment for hyperadrenocorticoism
d. Screen for hyperadrenocorticoism
e. Diagnose hypoadrenocorticoism
18
Q
Match the process with the expected laboratory parameter changes
- THROMBOCYTOPENIA
- DIC
- RODENTICIDE (dicumarol) Toxicosis, late
- HEMOPHILIA A
- RODENTICIDE (WAFARIN) Poisonin, early
A
- THROMBOCYTOPENIA - BMBT incr, APTT unchanged, PT unchanged
- DIC - BMBT incr, APTT incr, PT incr
- RODENTICIDE (dicumarol) Toxicosis, late - BMBT Unchanged, APTT incr, PT incr
- HEMOPHILIA A - BMBT unchanged, APTT incr, PT unchanged
- RODENTICIDE (WAFARIN) Poisoning, early - BMBT unchanged, APTT unchanged , PT incr
19
Q
A
a. VIII
d. IX
Factors involved in APTT are: XI., IX., VIII., X., V., II., I., XIII.
20
Q
Bloodsmares are used to check
a. Platelet Roleauxformation indicating immune mediated thrombocytopenia
b. Platelet number estimation
c. Wether the hematology analysers platelet count is valid or not
d. Platelet aggregate/clump formation
e. Macrothrombocytopenia
A
b. Platelet number estimation.
c. Whether the hematology analysers platelet count is valid or not
d. Platelet aggregate/clump formation
21
Q
A
- BMBT and Thrombocyte count unchanged and aPTT and PTT Increased
= late stage of dicumarol- toxicosis
- BMBT increased, aPTT may be increased, others unchanged
= Von Willebrand
- BMBT, Thrombocyte count, aPTT, and PTT all INCREASED (Plateletcount decreased)
= DIC
- BMBT increased, Thrombocyte # and aPTT and PTT unchanged
= Thrombocytopathy
- BMBT as well as thrombocyte count and aPTT unchanged, PTT INCREASED
= Dicumarol Toxicosis 1st stage
- BMBT increased, Thrombocyte # DECREASED, aPTT and PTT unchanged
= Thrombocytopenia
22
Q
A
23
Q
A
TRUE
24
Q
A
a. Anticoagulated sample (Citrate 1:9)
25
Haemophilias are leading to a defect of the
26
Dicumarol is a competetive antagonist to VIT K
True or False
TRUE
27
Breeds affected by von Willebrands disease
Doberman Pinscher
28
Match the Changes with the alterations
VASOPATHY
THROMBOCYTOPATHY
THROMBOCYTOPENIA
COAGULOPATHY
1.
29
Changes expected in von Willebrands disease are
a. Increased/Unchange aPTT
b. Increase BMBT
c. Decreased/Unchanged aPTT
d. Decreased PTT
e. Increased PTT
a. Increased/Unchange aPTT
b. Increase BMBT
30
Patients suffering from von Willenbrands disease may present with an increased PTT
True or False
True
31
ESSAY
**Methode nr 1:**
If you measure both **TP** for the **plasma** and the **serum** **concentration** – you will have the **fibrinogen TP** concentration by the **difference between them.**
Methode nr 2: Is **based on the heat labile character of fibrinogen**. Take **one part of the plasma,** and measure the **TP** (Biurette test). For the **other part of the plasma**, you will **heat it and centrifuge it**, then **measure the TP**. The TP **concentration for fibrinogen will be the difference between the regular plasma and the heated+centrifuged plasma.**
Method 3
The test used for **thrombin time (TT)** can be used for **establishing fibrinogen concentration**, as in this test the values are p**rimarily dependent on the fibrinogen** **concentration.**
The reagent contains **bovine thrombin and Ca2+.**
The clot formation can be determined by using **standards of different fibrinogen concentrations.**
Causes of fibrinogen conc change:
**Increase in case of**
* Acute inflammation
* Dehydration
**Decrease in case of**
* Liver function impairment
* Advanced protein deficiency
* DIG
* Chronic bleeding
* Blood loss
32
ESSAY
1. **Characterize the change of cholesterol concentration in plasma**
Cholesterol measurements for the **detection of increased fat mobilization**
- Total cholesterol value **INCREASES**
In case of:
**hypothyroidism,**
**hyperadrenocorticism,**
**nephrotic syndrome,**
**diabetes mellitus**
* cholesterol catabolism decreases.
* **Decreased esterification of cholesterol is a result of impaired liver function** together with decreased apolipoprotein production. This causes decreased total cholesterol concentration.
**Causes of hypocholesterolaemia:**
**· malnutrition**
**· liver failur**e (decreased synthesis)
· neoplastic disease
**· hyperthyreosis** (increased usage)
· decreased apolipoprotein synthesis Causes of hypercholesterolaemia:
**· increased dietary fat content**
**· hypothyroidism**
**· hyperadrenocorticism**
**· diabetes mellitus**
· nephrotic syndrome (concurrent low TP)
· cholestatic diseases (increased leakage from liver due to bile duct obstruction)
· idiopathic - primary dyslipidosis
33
# Choose the Hemopoietic tumor(s) presenting with leukemia
a. Acute Myelogenous Leukemia
b. Polycythemia absoluta vera
c. Leukemoid Reaction
d. Lymphoma, Stage IV
e. Acute Lymphocytic Leukemioa
a. Acute Myelogenous Leukemia
b. Polycythemia absoluta vera
34
ESR in horses is considerably faster than in other species
True or False
TRUE
35
Immature NEUTROPHILS can appear in the circulation due to the following cases
a. Perlger-Huet anomaly
b. Addison's Disease
c. Acute Lymphoblastic Leukemia
d. Right Shift
e. Hyperadrenocorticism
f. Left Shift
**a. Perlger-Huet anomaly**
**b. Addison's Disease**
**f. Left Shift**
36
A left shift is characterized by
a. Neutrophilia (high neutrophil count)
b. Decreased number of lymphocytes in circulation
c. The appearance of immature neutrophils in large proportion in the circulation
d. The appearance of mature, hypersegmented neutrophils in the circulation
**c. The appearance of immature neutrophils in large proportion in the circulation**
37
Pair the changes with the category
A. Stresslaukogram
B. Very high # of Neutrophil cells in the circulation
C. Leukopenia (low WBC), Neutropenia (low neutrophil #), Appearance of bands/metamyelocytes
D. Leukocytosis (high WBC), neutrophilia (high neutrophil #), appearance of bands/metamyelocytes
E. Appearance of highly segmented neutrophil cells (3-4 segments)
1. Regenerative left shift
2. Degenerative left shift
3. Right Shift
4. Leukemoid reaction
5. **Right shift, Leukocytosis**, **Neutrophilia**, **lymphopenia**, and **eosinopenia**
A. STRESS LEUKOGRAM
= **5. Right shift, Leukocytosis**, **Neutrophilia**, **lymphopenia**, and **eosinopenia**
B. Very high # of NEOTROPHIL cells in the circulation
**= 4. Leukemoid reaction**
C. **Leukopenia (low WBC),** Neutropenia (low neutrophil #), Appearance of bands/metamyelocytes
= **1. DEgenerative left shift**
D. **Leukocytosis (high WBC),** neutrophilia (high neutrophil #), appearance of bands/metamyelocytes
**= REgenarative left shift**
E. Appearance of highly segmented neutrophil cells (3-4 segments)
**= 3. Right Shift**
38
1. How to determine BT, BMBT - What causes prolongation of bleeding time
Use a sharp, sterile blade and make an 0,1-0,2 mm deep and 0,5 cm long incision on the skin on inner part of external ear or on buccal mucosal surface.
Vipe the blood drop flowing under the wound with a cotton wool tissue in 20-30 sec intervals
(avoid touching the wound itself)
Measure the time from the appearance of first blood drop till the ceasing of bleeding
**Normal BMBT = 3-5min.!**
**Prolongation** of bleeding time is caused by **thrombocytopenia, thrombocytopathies and vasopathies**
So dependent on thrombolytic function, platelet count and capillary function.!
39
Lab signs of DIC disseminated intravascular coagulopathy
Increased
* Coagulation time (CT)
* Bleeding time (BT)
* Prothrombin time (PT)
* Activated partial thromboplastin time (APTT),
* Thrombin time!(TT)
* Fibrin degradation products (FDP).
- Decreased Platelet count
* The appearance of schistocytes and or burr cells in blood smear
40
**Thrombocytopenia** causes and disorders
* Decreased **production** of thrombocytes in the **bone marrow!**
* Increased **utilization** of thrombocytes; **DIC** (disseminated intravascular coagulopathy)
* Increased **destruction** of thrombocytes Autoimmune thrombocytopenia (**AITP**)
* Increased **sequestration** of thrombocytes in case of **chronic splenomegaly**
* Increased **loss** of thrombocytes **subacute/chronic bleeding**
41
**Glutaric aldehyde test:**
Examine the **Increase** of **fibrinogen** and **globulin** concentration in **plasma**
42
**ESR** (erythrocyte sedimentation rate)
The theory is the i**ncreased sedimentation of RBCs** due to **inflammatory processes**, as **acute-phase proteins** and other **globulins** tend to **attach onto the surface of RBCs**
43
(ER) Sedimentation Rate in Horses
* **Very fast**
* ESR must be evaluated after **20 minutes**.
* It is found that the **speed of the sedimentation decreases due to inflammatory processes** contrary to other species.
* ESR is **inversely proportional with the HT** and **proportional** with the **serum viscosity, total protein and fibrinogen concentration.**
44
Causes hyperlipidemia & decreased lipid content
* **Hyperlipidemia**
1. Increased fat content in **diet**
2. **Diabetes** Mellitus
3. **Hypothyroidism**
4. **Hyperadrenocorticism** - **Cushings**
5. **Nephrotic** syndrome
6. **Septicaemia**
7. **Pancreatitis**
* **Hypolipidemia**
**DECREASED** lipid content
**1. Starvation**
**2. Chronic liver failure**
45
**Causes hyper/hypo–cholesterolemia**
* **Hypercholesterolaemia**
**1. Increased dietary fat content**
**2. Hypothyroidism**
**3. Hyperadrenocorticism** - C**ushings**
**4. Nephrotic syndrome**
**5. Diabetes Mellitus** **(DM)**
6. Cholestatic diseases
7. Primary dyslipidosis
* **Hypocholesterolaemia**
* *1. Protein-losing enteropathy**
* *2. Liver failure**
* *3. Malnutrition**
4. Neoplastic disease - **Tumor**
5. Decreased **apolipoprotein synthesis**
46
**Increased/Decreased glucose concentration**
* **Increased glucose conc.**
1. Laboratory **errors**
2. **Stress** & exercise
**3. Cranial trauma, inflammation (rabies**, aujeszky disease)
4. **Acute liver failure** (fast depletion of liver glucogen)
5. **Diabetes** mellitus (DM)
6. **Hyperadrenocorticism** - **Cushing/HAC**
* **Decreased glucose conc.**
1. **Laboratory error**
2. Decreased **energy status** (pregnancy, milking period, exercise etc.).
3. **Insulin overdose**
4. **Receptor blocker**
5. **Anabolic steroids**
6. **Liver failure, terminal stage**
7. Hypoadrenocorticism - Addison's
8. **Septicaemia**
9. **Hyperthyroidism**
47
Monoclonal gammopathy
**= Condition when Abnormal proteins found in the blood = Fight infections**
Seen as a **sharp spike in the beta or gamma region(globulin)**
* Can be compared to the **albumin peak** (they are both as narrow).
* Both **neoplastic** and **non-neoplastic disorders** can produce **monoclonal gammopathy.**
**Neoplasia:** Most common cause - it multiple myeloma (producing IgG or IgA monoclonal)
48
Determine M**alabsorption, Maldigestion, Chronic bowel disease**
**Starved for 24 hours: "**
blood sample + 3ml/kg bw **corn oil orally**
Blood sampling after **1,2,3,4,5 hours**
Should show **lipemic** and **TG should rise 2 fold**s from the normal value
If not = REPEAT test
But with **predigested corn oil** - **Incubate at 37 degrees**
1. if **increased TG and lipaemia**= **exocrine pancreatic insufficiency**
2. if **no change in TG and lipaemia**= **Intestinal absorption defect!**
49
Suspect: **DM**, **Insulinoma**
Take two times at starving blood sample = If it is **\> 11mmol/l its DM**
Test:
* Starved for 24 hour
* **Blood sampling** then **glucose solution i.v.** (30-45sec)
* Take blood every **5,15, 30,45, 60 min**!
* Blood glucose should be normalized at **30-60min**!
50
**Polyclonal gammopathy:** (beta and gamma globulins derived from different clones)
* **"Broad" based peak in beta and/or gamma region**
* *Causes:**
- Chronic inflammatory diseases,
- Liver disease,
- FIP,
- Occult heartworm disease,
- Ehrlichiosis
51
Polyclonal Gammopathy Increased and decreased by
Increased by:
* decreased 2,3 DPG level in RBCs;
* decreased pCO2 level in blood;
* increased pH of blood;
* decreased temperature of blood.
Decreased by:
* increased 2,3 DPG level in RBCs:
* increased pCO2 level in blood;
* decreased pH of blood;
* increased temperature of blood
52
Increased Hgb is usually associated with
Different types of **relative (dehydration)** or **absolute polycythemia.**
**Decreased Hgb:**usually associated with **relative (hyperhydration)**or **absolute (anemia) oligocythaemia!**
53
Regenerative anemia, RBC parameter affected:
Diseases with **favorable prognosis**
- Because **enough new RBC's are produced in the bone marrow** to regenerate the anemia, to replace the RBC loss, and to reach normal RBC count quick
→**Corrected reticulocyte count**, **CRC** = **reticulocyte %** x **RBC count**
→ **Corrected reticulocyte percentage, CRP!**= **Ht(patient)**/**Ht(average)** x **reticulocyte %**
54
**Non regenerative anemia**, RBC parMCV definition, when can it be increased:
**Bone marrow** is not producing new RBC.
**Not able to regenerate the anemi**a
→ MCV: indicates the average size of RBC's
(**macro**,**normo** or **microcytic**)
**PCV/RBC count x 1000 = MCV (fl),**
**normal:60–70fl**
→ Increased:
* regenerative anemias,
* FeLV infection,
* Vit B12,
* Co or folic acid deficiency,
* Erythroleukamia,
* poodle
* macrocytosis
55
MCHC definition and changes:
Indicates
Indicates the **average concentration of hemoglobin in erythrocytes** (Hb concentration),
- Decreased(**hypochromasia**): **newborns**, **regenerative anemia** or **iron deficiency anemia.**
- Increased **(hyperchromasia):**
* **Erythroleukemia**(polycythemia absolute vera);
* **Vit B12, folic acid, cobalt deficiency;**
* **Immunhemolytic anaemia (spherocytosis) IMHA,**
* **lead poisoning,**
* **splenectomy**
56
MCH indicates
**Average Hb content of RBCs.**
**Hgb(g/l)/RBC count x 10^12/l**
- Decrease, Hypochromasia: **newborn animals, regenerative anaemias, iron deficiency.**
- Increase, hyperchromasia:
* **Erythroleukaemia**;
* Vitamin **B12**, **folic** **acid**, **cobalt** deficiency;
* **Immunohemolytic anaemia; IMHA**
* **Lead poisoning**
57
Cl and HCO3-
= **Most important anion of plasma** (**buffer**)
**Decrease Cl:**
* abomasal displacement,
* **vomiting,**
* diarrhea,
* **sweating (horses)**
**Increase Cl:**
* **salt poisoning,**
* Conn`s disease,
* **infusion overdose!**
58
**Elevated APT**T(activated partial thromboplastin time) and PT (prothrombin time),!
(when can you see)??
**Increased APTT and PT**
= Common pathway problem
**Increased APTT and equal PT**
= intrinsic pathway problems
**Equal APTT and increased PT**
= Extrinsic pathway problem
59
Normocytic, normochromic:
MCV?
MCHC?
MCH?
**MCV and MCHC normal**,
**MCH normal** or **decreased**
60
In a leukogram, what is a regenerative left shift and when can it be observed?
**Increased WBC count**, **neutrophilia** and **left shift**
**Favorable** prognosis after the first neutropenic phase
61
Polyclonal gammopathy, (definition, causes)
Abnormal levels of immunoglobulin production
* Swelling of the liver,
* Chronic diseases
62
What do you see in a chronic inflammation leukogram (right shift)
More adult lymphocytes appear.
It gets inhibited the young blood cells proliferation and also strengthens the membrane
63
Difference between laboratory and clinical signs in case of dehydration and hyperhydration
**Clinical**: **skin tent, mucous membrane, capillary refill time**
**Laboratory**: **pack cell volume**, TPc, MCV!
64
Acid/base pH evaluation stuff,
(also included values for ion amount, Na+, K+, Ca2+)
**135-150!mmol/l!**
**K 2-5!**
Ca2+: **2,2-3,3!**
pO2, pCO2, ABE, SB
65
Non regenerative anaemia + the effect on calculated values:
MCV, MCH, MCHC!
MCH small,
66
Test for primary haemolysis, reasons for primary haemolysis
**- Osmotic resistance test:**
- **Dilution line from NaCl** with one drop of blood in everyone,
Then **incubation 10 mins**
**Centrifuge,** and then take a look at the **upper layer for hemolysis!**
**Primary hemolysis:** bc the membrane of the eyes is damaged!
(nephropathy, specific membrane damage, increased physical damage)!
67
WBC count, reasons for leucopenia
With machine with the **laser technique** and **hematology analyzer,** with **bürker chamber**
**Leucopenia**: **autoimmune sickness,** **first time of inflammation**
68
Hyperkalemia and hypokalemia!!
**1. Hyperk = Neuromuscular irritability is higher,**
**Low heart rate**
* **increased PO intake,**
* **acute kidney failure,**
* **rupture of the urinary bladder,**
* **hypoadrenocorticism,**
* **acidosis.**
* *2. Hypok = Neuromuscular irritability is lower**
* *Low heart function**
* **Decreased intake,**
* **longterm polyuria**( eg. Chronic Kidney insufficiency),
* **administration of loop diurettics** (eg. furosemide),
* **enteral K-loss (**diarrhoea, enteral bleeding),
* Prim/second **CUSHINGS**
69
Laboratory signs of DIC (disseminated intravascular coagulation)
**Decreased platelet count** and **appearance of burr cells** in blood smear
70
MCV(definition),
When can it be increased
Vitamin B12,
Polycythemia absolute vera
71
Left regenerative shift (WBC,inflammation)
Acute inflammation, higher WBC!
72
How do we determine PCV in the case of hypovolaemia, How can we interpret different PCV results?
Microhaematocrit, or automatic cell counter, Normocytamic Hypov.
Shock, bleeding, oligo h.Anemia Water loss,
Polyc H.dehydration
73
How do we determine blood glucose level,
How can we detect if the glucose level are long term?
GOD POD reaction, long term:
Check the fructoseamine concentration
This is a complex of protein and glucose
**The physiologic concentration of fructosamine: 207-340 micromol/l!**
74
How can we distinguish regenerative and non-regenerative anemias?
- Appearance of **microcytic/hypochromic anemia --\> nonregenerative**
- Appearance of **macrocytic/hypochromic anemia --\> Regenerative**
75
B-Test
```
PH = 7.48
pCo2 = 43
```
pO2=38
HCO3=29
ABE= +11 Acidic state, Compensation, electrolyte value,1-2clinical signs
Decompensated metabolic alcalosis (you give ammoniumchlorid)
With metabolic acidosis (ABExBWx0.3(small animals) 0.2(big animals))mmol/HCO3- dosis!
Hypokalaemia: Hypoventilation muscleweakness!
76
How to determine bleeding time,
What cause prolongation of bleeding time?
Cut in the ear etc.
BMBT test
Trombocytopenia, Trombocytopathy, Vasculopathy
- Prolongation through thrombocytopathies thrombocytopenia, vasculopathy
77
What is the diff between regenerative and degenerative left shifts?
When do we see them?
**1. Regenerative:** **Increased WB**C and **Neutrophilia,**
**= Bone marrow** regenerate the **utilized neutrophiles**
**2. Degenerative**: **low or normal WBC** and **neutrophil count,**
= The **rate of the utilization** is **bigger than the production of the new cells**
78
Method to measure K+ and times it may be elevated
**Ion selective electrodes** or **atomic absorption weight spectrometri**c or **flame photometric**
* Increased intake,
* haemolysis,
* necrosis
79
Observations in blood test for DIC
* Bleeding time higher,
* coagulation time = **Higher**
* **TT**, **PT**, **ATPP**, Fibrin degradation Products(**FDP**) and **Ddimer** = ALL HIGHER
* **Platelet count down**
80
In a leukogram what is a regenerative left shift and when might it be observed?
Mainly **young granulocytes** and they can be **regenerated, neutrophilia, increased WBC,**
* automatic!cell!counting!
81
Tests for TP
1, **Biuret method** = which is generally used or the
2. **Refractometric method** is 20-100!g/l.
The sensitivity of these methods cover the **average TP of plasma (60-80g/l)**
**3. For smaller TP!**
Concentrations of **urine, Cerebrospinal fluids or the body cavity fluids or tissue homogenates**
= **Lowry method** which works with the **Folin-phenol reagent or Ultrasensitive**
82
**Regenerative anaemia:**
Diseases with **favorable prognosis,**
= because **enough new RBC's are produced in the bone marrow to regenerate the anaemia,** to replace the RBC loss and to reach normal RBC count quickly.
83
1. please drag and drop words in their correct places.
A left shift is found when immature cells (younger form:..**X1**..older, still immature:...**X2**...) are found in proportionally larger populations than ...**X3**.. forms. this is most often seen in the second phase (post-...**X4**...) of inflammation along with...**X5**...
**Neutropenia, Segmented, Neutrophilia, Stab (band), Jugend (metamyelocyte)**
X1.jugend (metamyelocyte)
X2 stab(band)
X3 Segmented
X4 neutropenia
X5 neutrophilia
84
Antifreeze poisoning leads to the formation of ...**X1**.. crystals in urine.
**X1 = calcium oxalate**
85
3. which parameter decreases in every anemic patient?
* a) MCH X
* b) MCHC
* c) MCV
* d) PCV X
* e) WBC number
a) MCH X
d) PCV X ?
86
Combination
1. Haemolysis — ...total bilirubin increases, PCV decreases, bile acids are unchanged...
2. Hepatocellular damage is indicated by —
3. Liver function tests — ..
4. Only found in dogs —
5. In case of cholestasis — .
* ALT, AST, GLDH elevation
* heat stabile (steroid induced) alkaline phophatase...
* bile acids, total bilirubin, ammonia
* .bile acids and total bilirubin increases...
* total bilirubin increases, PCV decreases, bile acids are unchanged...
1. .total bilirubin increases, PCV decreases, bile acids are unchanged...
2. ...ALT, AST, GLDH elevation
3. .bile acids, total bilirubin, ammonia
4. ...heat stabile (steroid induced) alkaline phophatase...
5. ..bile acids and total bilirubin increases...
87
In case of respiratory acidosis with metabolic compensation
pH decreases,
pCO2 increases,
HCO3- concentration increases.
true or false
True
88
Write down the expected changes (increase/decrease) in laboratory parameters in patients suffering from chronic kidney disease!
- increased Na
- decreased Ca
- increased urea
- increased creatinine
- decreased TP
- increased inorganic phosphate - decreased specific gravity
- decreased pH
89
7. the upper limit of pCO2 in canine venous blood is (number + unit)...
40mmHg...
90
8. in case of DIC:
a) thrombocyte number increases
b) APTT decreases
c) APTT increases
d) PTT increases
e) platelet number decreases
f) PTT decreases
c) APTT increases X
d) PTT increases X
e) platelet number decreases X
91
**9. short answer:** principles of **ammonia measurement** (source of ammonia in blood, sample type, measurement indications, causes of increased ammonia concentration in blood, without ammonia tolerance test)
**- ammonia concentration measurement as a liver function test**
- before taking blood sample the animal should **starve for 24 hours**
- **blood sample in tubes with anticoagulants** + avoid air contamination
- perform determination right after sampling or store the sample in **ice bath for max. 20 min**
- measurement method: ammonia with alpha-ketoglutaric acid & NADH+H+ & GLDH produces glutamic acid & NAD+
- **reduction of absorbancy can be measured spectrophotometrically**
- **plasma samples are needed** for the standard method, **whole blood samples can be used with**
**the ammonia-checker**
**- causes of increased ammonia concentration in blood:**
* impaired liver function,
* ruminal alkalosis,
* congenital enzymopathies,
* ammonia toxicosis,
* intestinal overgrowth of ammonia producing bacteria
92
**10. characterise left shift: description, types, occurence, cell types**
- more young WBC appear in the circulating blood
- cells are mobilised from the marginal pool, then differentiated forms are migrating to the bone
marrow, later younger cells enter the blood stream
- increased tissue requirements —\> very young cells are going out from the mitotic pool
- regenerative left shift: increased WBC count, neutrophilia, sign of favourable prognosis
- degenerative left shift: low or normal WBC count, neutrophil, sign of poor prognosis —\>
disease is very serious and needs immediate treatment
- young metamyelocytes and band forms are visible
- inflammatory process
93
11. write down the causes of metabolic acidosis!
* diarrhoea,
* ileus,
* kidney tubular disturbance,
* DM,
* hyperkalaemia,
* increased acid intake,
* increased acid production,
* renal failure,
* increased ketogenesis
94
12. what are the causes of hyperkalaemia?
* increased per os intake,
* **acute kidney failure,**
* rupture of urinary bladder,
* acidosis,
* hypoaldosteronism (Addison’s disease),
* overdose of potassium-containing fluids
95
13. unconjugated bilirubin (bilirubin I) is expected to increase in serum in patients with prehepatic causes of icterus.
True or false
True
96
14. B12 concentration increases while folate concentration decreases in plasma in case of malabsorption.
true or false
False
97
15. in case of prehepatic icterus an increased urobilinogen (UBG) concentration is expected in both serum and urine.
true or false
True
98
16. choose the amylase isoenzymes!
a) intestinal
b) renal
c) musculoskeletal
d) pancreatic
e) salivary
a) intestinal X
d) pancreatic X
e) salivary X
99
17. predigested lipid absorption (lipid + pancreatic extract fed after incubation) from the intestines leading to lipaemia and hypertrygliceridaemia indicates an intestinal absorption defect.
true or false
True
100
18. select the negative acute phase proteins!
a) albumin
b) haptoglobin
c) fibrinogen
d) CRP
e) transferrin
a) albumin X
e) transferrin X
101
19. single choice: which sample type can be used for ammonia determination?
plasma sample for standard methods
whole blood sample for portable ammonia-checker
102
20. cavity effusions can form as a result of hydrostatic pressure change in the vascular system. ?
true or false
True
103
21. single choice: which is not a prerenal cause of increased urea concentration?
* a) cardiac failure
* b) shock
* c) glomerular problem
* d) addison’s disease
* e) dehydration
d) addison’s disease
104
22. match the parameters with the processes
1. hemophilia A —
2. DIC —
3, Thrombocytopenia —
4. rodenticide (warfarin) poisoning, early —
5. rodenticide (dicumarol) toxicosis, late —
A. BMBT increased, APTT increased, PT increased...
B. BMBT unchanged, APTT unchanged, PT increased..
C. BMBT unchanged, APTT increased, PT unchanged
D. BMBT unchanged, APTT increased, PT increased...
E. BMBT increased, APTT unchanged, PT unchanged...
1. BMBT unchanged, APTT increased, PT unchanged...
2. BMBT increased, APTT increased, PT increased...
3. BMBT increased, APTT unchanged, PT unchanged...
4. BMBT unchanged, APTT unchanged, PT increased...
5. BMBT unchanged, APTT increased, PT increased...
105
23. renal tubular cell damage causes increased alkaline phosphatase (ALKP, AP) concentration in the blood.
true or false
False
106
24. acid-base: when compensatory effect is visible, it is easily detected, because the parameter causing the primary changes is shifted in opposite direction compared to the pH.
true or false
True
107
25. match the lipid fractions with the apolipoproteins carrying them!
triacyl-glycerols —
cholesterol — ...
phospholipids —
free fatty acids —
1. LDL/HDL
2. Albumin
3. HDL
4. VLDL
triacyl-glycerols — ..4.VLDL...
cholesterol — ..1.LDL/HDL...
phospholipids — ..3.HDL...
free fatty acids — ..2,.albumin...
108
26. the following organs are called vital buffers: kidney, bone, liver, lungs
true or false
False
109
27. multiple choice: urine pH decreases in the following conditions:
a) incontinence
b) pyometra
c) ethyleneglycol toxicosis (antifreeze poisoning)
d. ) acidosis, vomiting, hypokalaemia, acidifying drugs (ammonium chloride), abomasal displacement
c) ethyleneglycol toxicosis (antifreeze poisoning)
110
28. urine pH in carnivores is mostly acidic while in herbivores it is alkaline.
true or false
true
111
29. rivalta test
Prepare 3% acetic-acid solution. one-two drops of native (not centrifuged) sample must be dripped into the solution. if coagulation (smoky appearance) occurs the result is ....X1.. - due to the coagulation of labile proteins (...X2..., globulins) as weak acid can coagulate these proteins. if coagulation is not observed but the sample is dissolved in the solution the result is ...X3... - due to the fact that stabile proteins, such as ...X4... does not show coagulation in weak acids.
X1 = exudate.
X2 = fibrinogen
X3 = transudate
X4= albumin..
112
30. match the etiologies with the consequences!
1. endotoxin effect —
2. right sided congestive heart failure —
3. lymphangiectasia, intestinal — .
4. protein losing entropathy — ...
1. hydrostatic pressure increases...
.2.increased vascular permeability...
4. decreased plasma colloid oncotic pressure...
3. .lymph stasis...
113
31. an increase in plasma colloid oncotic pressure can result in cavity effusion formation
true or false
False
114
32. decreasing pH will lead to increased haemoglobin oxygen binding capacity (right shift of the oxygen dissociation curve)
true or false
False
115
33. single choice: which is not formed in the liver?
* a) IgE
* b) Haptoglobin
* c) albumin
* d) prothrombin
* e) fibrinogen
a) IgE
116
34. multiple choice: which conditions lead to an increased bile acid concentration in serum?
* a) intravascular haemolysis
* b) cholangiohepatitis
* c) colitis
* d) portosystemic shunt
* e) bile duct obstruction
b) cholangiohepatitis
d) portosystemic shunt
e) bile duct obstruction
117
35. multiple choice: ACTH stimulation test is used to:
a) screen for hyperadrenocorticism
b) monitor treatment for hyperadrenocorticism
c) screen overall pituitary hyperfunction
d) diagnose ectopic ACTH production
e) diagnose hypoadrenocorticism
a) screen for hyperadrenocorticism
b) monitor treatment for hyperadrenocorticism
e) diagnose hypoadrenocorticism
118
36. multiple choice: total bilirubin is expected to increase in serum due to increases in bilirubin I formation in case of:
* a) acute haemolysis
* b) haematoma formation (resorption icterus)
* c) extrahepatic bile duct obstruction
* d) decreased conjugation in the liver
* e) bile peritonitis
* a) acute haemolysis
* b) haematoma formation (resorption icterus)
* d) decreased conjugation in the liver
119
37. analysis of effusions: which analytes are measured in the conditions given to prove their presence?
1. chylous effusion — .
2. bile peritonitis — .
3. acute pancreatitis —
4, urinary tract rupture —
5. tumor related effusion — .
1. .increased triglycerides with normal cholesterol...
5. ..LDH...
3. ...amylase, lipase...
2. ..total bilirubin...
4. ...urea, creatinine...
120
38. pH is defined as the negative base 10 logarithm of hydrogen ion concentration.
true or false
True
121
39. the glutaric aldehyde test determines the presence of acute inflammation in ruminants.
true or false
True
122
40. single choice: which one is not a urinary cast type?
* a) waxy
* b) hyaline
* c) white blood cell
* d) transitional cell
* e) granular
a) waxy X
* c) white blood cell ?
* d) transitional cell ?
123
41. match the analytes with information thy can give!
* 1. MCV — .
* 2. reticulocyte count —
* 3. MCHC — ...
* 4. RDW — ..
* 5. osmotic resistance — .
* A. anisocytosis...
* B. extravascular haemolysis...
* C. average concentration of haemoglobin in erythrocytes...
* D. macrocytosis...
* E. regeneration...
4A. .anisocytosis...
5B. ..extravascular haemolysis...
3C. average concentration of haemoglobin in erythrocytes...
1D. ..macrocytosis...
2E...regeneration...
124
42. acid-base: the primary process (metabolic or respiratory) is the one that leads to the acid-base disturbance - this parameter is always shifted in the same direction as the pH and usually this shift is significant!
true or false
True
125
43. single choice: which tube can be used for the coagulation factor measurement?
* a) EDTA
* b) Na-citrate 9:1 (blood to citrate)
* c) Na-citrate 4:1 (blood to citrate)
* d) Li-heparine
* e) NaF
b) Na-citrate 9:1 (blood to citrate)
126
44. fibrinogen free plasma is called (blood) serum.
True or false
True
127
45. the reference interval and unit of actual base excess (ABE) is:
....+/-3,5mmol/l...
128
46. decreasing pH (acidosis) results in an increased oxygen unload from haemoglobin (right shift in the oxygen dissociation curve)
true or false
True
129
47. AST is a liver specific enzyme (ie only produced in the liver)
true or false
False
130
48. the canine steroid induced hepatic alkaline phosphatase (ALKP, AP) isoform is heat stabile.
true or false
True
131
49. urine specific gravity (USG): measurement results and their interpretation.
- to analyze the USG you need a refractometer and a urine sample
- you take one drop of urine on the field and close the cover, after this you look threw the ocular and then you can see the scale
- scale is from under **1008-1045g/l**
- hypersthenuria: **1015-1045 g/l**
- isosthenuria: **1008-1012g/l**
- hyposthenuria: **\<1008g/l**
132
50. match the conditions with typical expected changes!
1. vit B12/folate deficiency — .
2. regenerative anaemia — .
3. nonregenerative anaemia — ...
4. iron deficiency anaemia —
5. breed: akita — .
* A. MCV unchanged, MCHC unchanged...
* B. MCV increased, MCHC unchanged...
* C. MCV increased, MCHC decreased...
* D. MCV decreased, MCHC decreased...
* E. MCV decreased, MCHC unchanged...
3C..MCV unchanged, MCHC unchanged...
1A. MCV increased, MCHC unchanged...
2B. ..MCV increased, MCHC decreased...
4D. ...MCV decreased, MCHC decreased...
5E. ..MCV decreased, MCHC unchanged...
133
51. what causes the following changes?
1. relative polycythaemia, hypervolaemic —
2. absolute oligocythaemia, normovolaemic —
3. relative oligocythaemia, hypovolaemic —
4. relative oligocythaemia, hypervolaemic — .
5. relative polycythaemia, hypovolaemic —
6. absolute polycythaemia, normovolaemic — .
* A. .acute stress...
* b. .hypoxia...
* C. iatrogenic infusion overdose...
* D.immune-mediated haemolytic anaemia...
* E.chronic kidney injury AND diarrhea...
* F.burns...
1A. ...acute stress...
6B. ..hypoxia...
4C. ..iatrogenic infusion overdose...
2D. ...immune-mediated haemolytic anaemia...
3E..chronic kidney injury AND diarrhea...
5F. ...burns...
134
52. match the diseases with acid-base disorders!
* 1, diarrhea — ..
* 2. pneumonia — .
* 3. fever, hyperventilation —
* 4. vomiting — .
A. metabolic acidosis...
B. respiratory alkalosis...
C. respiratory acidosis...
D. metabolic alkalosis...
1A. .metabolic acidosis...
3B...respiratory alkalosis...
2C. ..respiratory acidosis...
4D. ..metabolic alkalosis...
135
53. multiple choice: select the causes of metabolic alkalosis!
a) hepatic insufficiency
b) diarrhea
c) vomiting
d) ruminal bloat
e) chronic kidney disease
f) abomasal displacement
a) hepatic insufficiency
c) vomiting
d) ruminal bloat
f) abomasal displacement X
136
54. multiple choice: select the keton bodies!
* a) acetone
* b) propanone
* c) acetoacetate
* d) beta hydroxibutyrate
* e) glucagon
a) acetone X
c) acetoacetate
d) beta hydroxibutyrate X
137
55. ...X1..-lity expresses the osmotic pressure of the (body) fluids. osmolarity is expressed in different units than osmolality: osmolality - ...X2.., osmolarity - ...X3.. . the calculation of osmolality is performed based on the formula below if all of the parameter concentrations are given in mmol/l: osmolality (mOsm/kg) = 2 (...X4..+..X5..) + ...X6 + X7..
X1= osmola.
X2= kg
X3= l.
X4= Na+
X5= K+
X6 = Urea
X7= Glucose
138
56. creatinine is a degradation product of muscle creatin.
true or false
False
139
57. describe AST: which tissues produce it, causes of increased activity, causes of decreased activity!
- AST = aspartate-aminotransferase
- produced in the liver
- converts alpha-keto-glutaric acid to L-glutamic acid and L-aspartate to oxalic acetic acid
- causes of increased activity:
- muscle: intensive exercise, training, muscle necrosis, muscular inflammation, myocarditis, muscle injury, neoplasm of the muscle
- liver: ethanol consumption, hepatopathy, parenchymal damage
- haemolysis of RBCs
- causes of decreased activity: metronidasol, vitamin B6 deficiency
140
58. short answer: urine specific gravity. definition, measurement methods
- SG is an indicator of concentrating ability (tubular function) of the kidneys
- ratio of the weight of the liquid to an equal volume of distilled water
- SG increases with increasing concentration of dissolved ions, glucose, lipids, contrast
materials, proteins
- measurement: urinometer, refractometer, test strip GENAUER?
141
59. characterise diagnostic tests to diagnose exocrine pancreatic insufficiency (EPI) with a focus on TLI and its changes. TLI characterisation worth 4 pts while the other tests worth alltogether 1 pt.
- EPI is developed due to chronic necrotic or atrophic damage to the pancreas or inherited
- decreased production of digestive enzymes or enzymes do not get out of the organ TLI = trypsine like immunoreactivity
- TLI: species specific parameter, determined by RIA-method or ELISA methods
- antibodies are produced against one part of trypsinogen
- radioisotope marked antibodies are bound to the trypsinogen of the sample -\> increased radioactivity that can be measured by a specific analyser
- examination of TLI is very useful in disgnosis of chronic recurring pancreatitis in cats
- most specific method
- if EPI is caused by obstruction of the pancreatic duct, TLI level is normal or high other methods: BT-PABA test, dyed agar-gel digestion and schwachmann-filmtest, lipid absorption test & faecal elastase test GENAUER?
142
60. multiple choice: which leads to a prerenal increase of urea concentration in serum?
* a) intestinal bleeding
* b) urinary tract obstruction
* c) impaired liver function
* d) poor ruminal energy status
* e) cardiac failure
a) intestinal bleeding
c) impaired liver function
d) poor ruminal energy status
e) cardiac failure
143
61. acetic acid is the largest fraction of volatile fatty acids on a neutral pH in ruminal fluid.
True or false
True
144
62. single choice: which sample type can be used for ammonia determination?
a) serum
b) plasma
b) plasma
145
63. which buffer is NOT a part of the intra/extracellular buffer systems? ?
* a) hydrochloric acid
* b) phosphate
* c) albumin
* d) protein
* e) hämoglobin
a) hydrochloric acid ?
c) albumin
146
64. thrombocytopenia is a thrombocyte count over the upper reference limit (the upper end of the reference interval)
true or false
False
147
65. expected acid-base changes in various forms of ileus: distal ileus - metabolic acidosis, proximal ileus (initially) - metabolic alkalosis
true or false
True
148
66. ruminal fluid pH is lower before feeding then after it.
true or false
False
149
67. multiple choice: select the metabolic parameters! ?
* a) partial O2 pressure
* b) partial CO2 pressure
* c) actual base excess
* d) standard base excess (SBE)
* e) bicarbonate concentration
a) partial O2 pressure
d) standard base excess (SBE)
e) bicarbonate concentration
150
68. the upper limit of pCO2 in canine venous blood is (number + unit):
...40mmHg...
151
69. single choice: which factor’s function is independent of vitamin K?
a) von willebrand factor
b) X (sturat-prower)
c) VII (proconvertin)
d) II (prothrombin)
e) IX (christmas)
a) von willebrand factor
152
70. creatinine is filtrated through the glomeruli and then partially reabsorbed in the tubuli.
true or false
False
153
71. the glucose absorption test can distinguish malabsorption from diabetes mellitus.
true or false
True
154
72. multiple choice: select the correct answers! thrombocytopathy can be found in case of:
* a) uraemia
* b) NSAID treatment
* c) antifreeze poisoning
* d) liver failure
* e) rodenticide poisoning
a) uraemia
b) NSAID treatment
d) liver failure
155
73. characterise transudates: causes of development, protein content (compared to other types of effusions), specific gravity (compared to other types of effusions), cell types, counts etc.
- **specific gravity: \< 1,017**
- causes of development: bloody: heart failure, stasis of vessels, watery or yellowish: liver failure
- small lymphocytes, macrophages and reactive mesothelial cells, increase in neutropjils and macrophages
**- nuclear cell count: \< 1-10**
**- TP \< 25**
156
74. proteinuria: describe the prerenal causes.
occurs within neonates **below 40 hours of age:** a
fter strenuous **exercise**, extreme **heat or cold**, **stress**, related to **increased tubular permeability**
157
75. alkaline phosphatase: changes in its concentration
**- tubular cell damage causes increased activity in urine**
- increased activity: **young dogs**, **pregnant animals**, **bone tumour**, **osteomyelitis, bone fracture,**
paraneoplastic processes, cholestasis, bile acids, acute hepatic necrosis, liver cirrhosis, biliary
obstruction, **chronic stress**
- decreased activity: **very severe cirrhosis**
158
76. ESR (erythrocyte sedimentation rate) is directly proportional to increased WBC (white blood cell) count.
true or false
True
159
78. write down the causes and characteristics of various gammopathies!
- polyclonal gammopathy: occurs during inflammatory processes or immune mediated diseases - causes: chronic inflammatory diseases, liver disease, FIP, heartworm disease, ehrlichiosis
- broad-based peak in the beta and/or gamma region
- beta-gamma bridging occurs in disorder with increased IgA and IgM
- monoclonal gammopathy: occurs during immune mediated or neoplastic conditions
- causes: neoplastic and non-neoplastic disorders
- sharp spike in the beta or gamma region (peak can be compared to the albumin peak)
160
79. prehepatic icterus mostly leads to an increase in bilirubin II (conjugated bilirubin) (sample: serum)
true or false
True
161
80. match the measurement methods with the analytes/processes!
1. thrombocyte number —
2. extrinsic pathway — ...
3. intrinsic pathway — ...
4. fibrinogen concentration —
5. thrombocyte function —
A. PTT...
B .impedance count...
C. APTT...
D. TT...
E. aggregometry...
2A. PTT...
1B. ...impedance count...
3C. APTT...
4D. ...TT...
5E. ...aggregometry...
162
81. fibrinogen free plasma is called (blood) serum
true or false
True
163
82. write at least 5 causes for an increased amylase concentration measured in serum!
* acute pancreatitis,
* acute or subacute kidney failure,
* FIP,
* myeloma,
* DM,
* ileus,
* chronic enteritis
164
83. characterise the LDDS test: what is it used to, how to perform it, result interpretation.
- used to: screen for HAC
- low dose of dexamethasone will suppress normal pituitary gland but in HAC, not used in cats
- start at 8-9am with hospitalized patient, heparin sample after 0 hours, IV dexmethasone, blood
sample 4 and 8 hours after dexmethasone treatment, measure plasma cortisol
- interpretation: pituitary hyperadrenocorticism: 4 hours plasma cortisol, 8 hours: similar to basal
concentration
165
84. describe 3 methods used for red blood cell counting and the information gained with their use!
**1- Bürker-chamber method:** mix 0,05ml blood sample with 9,95ml physiological saline (0,9% NaCl)
- put 1 drop of the solution onto the Bürker chamber and count cells in 20 rectangles or 80 small
squares
- counted number divided by 100 gives RBCx10^12 per liter
- poor accurancy: 10-25% error estimated
**2- estimated RBC-count:** we suspect normal average RBC volume
- ((Ht1/1) / 5) x 100 = RBC count x10^12 / liter
**3- RBC count measured by automatic cell counter:** based on the electric impendance of particles
- impendance is in correlation with the size
- based on electical impendance change due to transmission of particles through an aperture
- RBC are impeding the electrical flow
- particles taken as RBCs if their size is 40-100 fl
- x-axis: size
- y-axis: number of counted cells
- aggregated RBCs are not counted - you could warm the blood sample to 37° before the
counting to separate the aggregated RBCs
166
