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Internal Medicine > Thresholds > Flashcards

Thresholds Flashcards

1
Q

Blood smear materials

A

EDTA blood sample, microhematocrit/capillary tubes, slides

need to stain it- blue 30 sec, pink 30 sec, purple 60 sec

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2
Q

Why do blood smears?

A

Manual platelet count and other microscopic examination of blood (RBC morphology, blood parasite check, etc.)

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3
Q

how to do a manual platelet count

A

in normal animals, will have 10-30 platelets in each oil immersion and check the monolayer, the number of platelets within 10 consecutive fields and divide by 10 to get the avg number per field and then multiply that by 15 for the lower range and 20 for the upper range of the platelet counts

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4
Q

what species has the common event where platelets clump following storage of the blood for hours? What is this artifact (spurious event) called?

A

Cats; pseudothrombocytopenia

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5
Q

what are megathrombocytes? What are macrothrombocytes?

A

Megathrombocytes are “stress” or “shift” platelets that are larger than normal and are present when there are immature platelets released (regenerative anemia) whereas macrothrombocytes are large platelets that occur as harmless findings in Cavalier King Charles spaniels and some other dog breeds

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6
Q

what are the collection sites of dogs for bone marrow cytology/biopsy?

A

dorsal iliac crest
intertrochanteric fossa of the femur
lateral aspect of the greater tubercle humeral shaft
costochondral jxn
sternum

(cats are usually humerus)

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7
Q

Bone marrow BIOPSY tool =
Bone marrow CYTOLOGY tool =

A

Biopsy tool is Jamshidi marrow biopsy needle and cytology is Illinois marrow aspiration needle

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8
Q

B lymphocytes vs. T lymphocytes

A

B lymphocytes are larger antibodies and are apart of humoral immune response; T lymphocytes are helper T cells, NK cells, and are apart of cell mediated immune response

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9
Q

Stress leukogram

A

SMILED
Segs and monocytes are increased lymphocytes and eosinophils are decreased

Usually also has high glucose

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10
Q

reversed stress leukogram means what disease process may be occurring???

A

Addison’s Disease

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11
Q

Is PCV or hct more accurate?

A

PCV is more accurate because PCV is manual and hct is the machine computer based on RBC size

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12
Q

what is RDW?

A

Red cell distribution width
so variation in size

If low= they are all about the same size, if high then they are all different sizes, in vet med we rarely care about this but will be on boarded vet exams
Just know variation of size of RBC

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13
Q

Azotemia notes –

A

Azotemia means 65% of kidney function is loss and kidney failure is more than 65% loss of kidney functioning
Azotemia means increased BUN and creatinine

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14
Q

What is normal USG?

A

dogs USG > 1.030
cats USG > 1.035

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15
Q

Hyposthenuria is USG

A

USG < 1.008

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16
Q

Isosthenuria is USG

A

1.008-1.012 and means there is renal damage, so > 65% of kidney function is loss

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17
Q

what is SDMA?

A

SDMA is a biomarker for kidney function and accurately reflects glomerular filtration rate in dogs and cats, SDMA increases as early as 25%-40% loss of kidney function which makes SDMA more reliable for both acute and active kidney infections as well as chronic kidney infections

Creatine cannot ID kidney issues until almost 75% of the kidney function is lost

SDMA is specific for kidney function and is less impacted by extra-renal factors than creatinine, including BCS and age and disease states

can detect kidney issues from many things like obstruction, infection, exposure to toxins, nephrotoxic drugs, bp elevation, and thyroid status causing kidney injury
Remember some cats will become azotemic after treatment for hyperthyroidism

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18
Q

UPC notes

A

Creatinine is lost at a constant rate from the kidneys, so we can compare protein to creatinine which is lost at a steady state whereas protein is not

Can diagnose protein losing nephropathy

Should be less than 0.5 in dogs and 0.4 in cats, we usually do not start worrying until more than 1 in dogs and cats, badddd newssss

If more than 1 that means there is likely PLN, and do Chem and see if albumin and globulins are low too

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19
Q

Liver values measured are…

A

ALT, ALP, Tbilirubin, and BUN are all liver indicators, Cholesterol, globulin

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20
Q

What are some things that make ALP levels increase?

A

endogenous or exogenous steroids (Cushing’s, oral steroids, cream steroids, etc.), growing animals, bone fractures and/or osteosarcoma, kidneys, GI tract, placenta, and bone routes as well

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21
Q

IF we have a p with elevated bilirubin and we see they are icteric, the bilirubin has to be more than what value?

A

More than 2 because the liver is now overloaded

22
Q

what are some causes of increased bilirubin?

A

inflammation, hepatocellular issues, congested liver, gall bladder mucocele, intra or extravascular hemolysis like IMHA or putting your hemolyzed blood sample in a tube with a small bore syringe needle, hepatic lipidosis (usually in fat cats that are not eating), very anemic, etc.

23
Q

ALT half life in dogs vs. cats

A

ALT half life in dogs is about 3 days and is about 3-6 hours in cats

24
Q

Patient in liver failure labwork findings–

A

BUN would be low because urea is not produced, glucose would be low because not being broken down/produced, albumin would be low because liver is not producing it also inflammation (albumin is a negative acute phase protein so albumin decreases in face of disease/inflammation), globulins will be normal to high (associated with inflammatory responses), total protein may be low or normal because high globulins and low albumin might balance out total protein but usually albumin lower so total protein low. Albumin less than 1.6 is badddd and will cause effusion from low osmotic pressure since not enough proteins. Tbilirubin will be high because it cannot be filtered/converted so it builds up, cholesterol will be low because not fully converted in the liver

25
Q

explain MCHC and MCV

A

MCHC and MCV because if you have a ton of large (immature) RBC (called reticulocytes), and a ton of older, mature RBC- they color will be not too red and not too pale red (reticulocytes are paler because they are large and immature so they have more cell surface to hgb ratio unlike mature/older RBC that shrink down as they age and therefore are more red because have more hgb to cell ratio) and for MCV- if you have a ton of larger cells (Reticulocytes) and a ton of smaller/mature RBC that are older, it will look like you MCV is normal/uniform because it is a mean value

26
Q

___ is a LEAKAGE enzyme that tells you about liver DAMAGE not necessarily failure

A

ALT

27
Q

some reasons for increased Alkphos?

A

mild to moderate elevations and thrombocytosis could be Cushings disease, but mild alk phosphorus mild to moderate without any other changes may be inflammation (like gingivitis or OA or something else)

Recheck in 6 months if concerned (like if moderately elevated)

Or if starting a supplement, recheck in 60-90 days

28
Q

what labwork tells you it may be cushings disease?

A

increased ALP, thrombocytosis, protein in urine, decreased BUN, may have increased platelets, increased cholesterol

29
Q

kidney disease labwork notes

A

anemia occurs bc decreased EPO, increased WBC and SDMA, isosthenuria, increased BUN and creatinine

30
Q

PVC = volume of ____

A

RBC’s

31
Q

reasons for high AST may be…

A

muscle damage or liver damage

32
Q

reasons for increased bilirubin???

A

can be pre-hepatic injury like bleeding or hemolysis, hepatic injury like liver damage or disease, or post hepatic like GI issues, PSS or a blocked bile duct

33
Q

treat PLE with…

A

Angiotensin converting enzyme (ACE) inhibitor like benazepril

34
Q

BUN increases with…

A

decreased kidney function, dehydration, heart disease, shock, urinary obstruction, high protein diet

(will be decreased in liver failure p)

35
Q

BUN decreased…..

A

with severe liver disease or malnutrition/starvation

36
Q

Creatinine increased…

A

decreased kidney function

37
Q

phosphorus increased…

A

decreased kidney loss with kidney disease, tissue injury, growing animals/young

38
Q

calcium increases from….

A

kidney disease, cancer, toxins, parathyroid disease, addions’s disease, vitamin D toxicosis, idiopathic (mostly in cats), spurious (false artifact), bone disease

39
Q

causes of high ALKP?

A

cholestasis, Cushing’s disease, active bone growth in young. osteosarcoma, nonspecific

40
Q

amylase and same with lipase increased causes….

A

pancreatitis, renal disease, GI disease, steroids/other drugs

41
Q

causes of increased total protein

A

dehydration, inflammation

loss due to things like blood loss, GI loss, kidney loss, decreased liver function

42
Q

low sodium causes…

A

diarrhea, vomiting, Addison’s disease, kidney disease

43
Q

Increases in K+ causes….

A

renal disease, Addison’s disease, dehydration, dehydration, kidney obstruction

44
Q

Increased cholesterol causes…

A

Diabetes mellitus, hypothyroidism, Cushing’s disease, pancreatitis, kidney disease

decreases may be seen with liver insufficiency and GI disease

45
Q

causes of increased triglycerides…

A

Cushing’s disease, pancreatitis, diabetes, hypothyroidism, and in mini Schnauzers….

46
Q

Cortisol increases with…

A

Cushing’s disease, decreased with Addison’s disease

47
Q

Lactate increases with ….

A

increases indicate either local or general decreased perfusion and can potentially serve as a prognostic indicator for critical patients

48
Q

high MCV-

A

regenerative anemia, larger because immature

49
Q

What is MCH?

A

MCH (mean cell hemoglobin) and MCHC (mean cell hemoglobin concentration)—increases
suggest the presence of hemolysis or an interference in hemoglobin measurement; decreases
suggest decreased hemoglobin concent

50
Q

What are Reticulocytes???

A

increases indicate growing numbers of immature RBCs, indicating a
response to a peripheral demand for RBCs; decreases indicate few or no immature RBCs,
indicating the body is unable to respond to a demand for RBCs (nonregenerative anemia)

51
Q

What is MPV?

A

(mean platelet volume)—increases indicate presence of larger than normal platelets
commonly associated with response to need for platelets (not significant in the cat)

52
Q

___ mean increased break down of lipids within the body

A

ketones

Internal Medicine (3 decks)

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