Clin Med - Intro & Bloodwork-1

drraythe's version from 2016-01-28 15:03


Question Answer
Q**What is the 1st sign of renal dz? What test should you do relating to this?INABILITY TO CONCENTRATE, NOT AZOTEMIA. So you want USG!!!! A bloodwork azotemia won’t tell you anything
Renal azotemia means you've lost how much fxn of your kidney?75%
If there is renal dz & the animal cannot concentrate, how much loss of fxn is there?66% **~just bc dilute urine =/= 66% failure, could just be a higher water intake or something else!
Explain dz vs failureDz might not have CS. But Failure ALWAYS indicates dz (still doesn't indicate if reversible or irreversible tho)
What’s important to know about CS (c/s)?They are NOT dzs, nor are they diagnoses (can't say "I have anemia"). So don't put it in your R/O list!
What’s parsimony?Having 1 thing to describe everything that is wrong w/ the animal
Q**What is the difference btwn vomiting are regurgitation?**ABDOMINAL EFFORT IN THE CASE OF VOMITING is the only true differentiation btwn the two
Polyuria vs pollikiuria in terms of what locations they indicate?Polyuria= kidneys. Pollikiuria=lower UT
DAMNIT-V → D stands for?Degenerative, developmental
DAMNIT-V → A stands for?Anomalous (aka weird stuff or idiopathic), allergic
DAMNIT-V → M stands for?Metabolic
DAMNIT-V → N stands for?Neoplastic, nutritional
DAMNIT-V → I stands for?Infectious, inflammatory, immune mediated, idiopathic, ischemic, iatrogenic
DAMNIT-V → T stands for?Trauma, toxic
DAMNIT-V → V stands for?Vascular
Whats POMC?Problem oriented medical record
What’s SOAP mean?Subjective, objective, assessment, plan
What would you be doing in the assessment portion of the SOAP?Do your DAMNIT-V for each problem on the problem list
What would you be doing in the plan portion of the SOAP?Write down which diagnostic tests you want to do


Question Answer
Q**What are the 2 major czs of REGENERATIVE anemia?Hemolysis & blood loss!!!
Q**What are the 3 major czs of NON-REGENERATIVE anemia?Inflammatory, renal dz, or bone marrow dz
Explain how protein losing nephropathy & protein losing enteropathy differ in terms of what you'd see for proteinsIn the kidney, the filter has very small holes, so if there is protein losing usually only the albumin will be lost. In the GI, the holes are much bigger, so you will see loss of albumin & globulins
If you are given a CBC w/ relative values (60%) how do you know what the absolute value (# value) is?Number of cells / microliter
Q**What do you see in a physiologic leukocytosis? Who do you think of? czd by?SCARED CAT! You'll see neutrophilia & a lymphocytosis (both go up). It is czd by catecholamines
Q**What do you see in a stress/corticosteroid leukogram? Who do you think of? czd by?Think "sick dog" w/ this one. Mature neutrophilia, monocytosis & lymphopenia (can also sometimes cz an eosinopenia). Czd by stress/corticosteroids
Q**What do you see/what are the stipulations of a inflammatory leukogram?It is >1000 band cells OR! If early or neutropenic, can be significant at 10% bands (10% of total WBCs)
What are some things that could cz an extreme neutrophilic leukocytosis?Pyometra, Ehrlichia, hepatozoanosis, fungus
How many leukocytes would be cz for suspecting leukemia?>50,000
What is a left shift?When the population of neutrophils is all together younger as a population
How does corticosteroid stress affect neutrophils?INC!
(Cyclic hematopoiesis is a problem found in what breed?)Collies
How do steroids affect lymphocytes?
(If you see a basophil on bloodwork, what might be the most likely cz?)Heartworm
Would eosinophils ↑ in HYPER or in HYPO adrenocortisism?HYPO! Bc stress-steroids ↓ eosinophils, so less steroids would mean less inhibition of eosinophils, so there would be more
How do you view reticulocytes?Use new methylene blue, bc it can stain the RNA which is residually inside of them. They are also bigger than a mature RBC
Explain the 2 types of feline retics, what they look like & which is the more mature type(1) Aggregate are the NEWER ones (think ABC order) & have bigger clumps of RNA in them
(2) Punctate are more mature & have small pinpoint dots on them
Explain how you get a corrected reticulocyte percentage & the sig. values for dog & cat.CRP is the retic percent, times the (PTx PCV/normal PCV). If it is raised it is considered regeneration.
For dogs, >1.5% is regen
For cats, >1% is regen
(Which breed tends to usually have larger RBCs on average?)Poodles
(Which breed tends to usually have smaller RBCs on average?)Akita & Shiba Inu
Czs of macrocytic RBCs?Regeneration or poodles
Czs of microcytes?Iron deficiency, or PSS (portosystemic shunt). (Also if they are an Akita or Shiba Inu)
What would be some reasons you'd see a hypochromic MCHC?Blood loss, hemolysis, iron deficiency
What would be some reasons you'd see a hyperchromic MCHC?DOESNT HAPPEN. Usually bc machine read the Heinz bodies as Hb bc they are darker
** KNOW HOW TO READ THE Volume/Hb Cytogram chart!!The tic tac toe looking thing
(Volume/Hb Cytogram) if the RBC volume is high & the Hb is low, what might cz this? (3)Regenerative!
Blood loss or Hemolysis
(Volume/Hb Cytogram) if the RBC volume is low & the Hb is low, what might cz this? (2)Fe/Cu deficiency, or a congenital portosystemic shunt (PSS)
(Volume/Hb Cytogram) what is the MCV & MCHC like in a portosystemic shunt which is congenital? Or acquired as an adult?Congenital deficiency will lead to a low volume & a low Hb content. The Adult/acquired PSS will cz low MCV but the Hb will be normal.
(Volume/Hb Cytogram) what would you think it is if the MCV was normal but the Hb was high?Heinz body! Hb is never normally elevated
(Volume/Hb Cytogram) what if the RBC volume is high & the Hb is normal? What would you think it was? (3)post anemic cats, or hyper T4 cats, or a defective/delayed maturation (weird category, weird things cz it)
In inflammation, which protein goes up & which goes down?Fibrinogen goes up & albumin goes down
What kinda "phase" protein is fibrinogen? What is it usually indicating?Acute phase, inflammation
Fibrinogen is an especially important indicator for inflammation in which sp?Horses, ESP during colic!
What might cz a false ↓ in the platelet count & who is this especially a problem in?Can ↓ due to clumping (machine will count a clump as "1") & cat's platelets are EASILY activated to clump
If the platelet looks really big, what might it indicate?Regeneration
(which breed has fewer platelets, but the ones it has are larger than average?)Cavalier King Charles Spaniel
Be able to differentiate a clot from a platelet clumpSlide 61
Infectious agents such as intracellular parasites will cz what to happen to the MCV value?Inc, bc of regeneration since body is trying to clear/shred up infected RBCs
What are 4 things which can cz a Heinz body?Oxidative damage, Denatured Hb, Onion toxicity, Tylenol toxicity
What is the main cz of agglutination?IMHA!
If you want to really determine if what you are seeing on a slide is agglutination & not clotting or Rouleaux formations, what would you do?Do saline dilutions, to see if the cells are just clotting up or if they REALLY want to be together like in agglutination
Remember to just check out how the QVC machine worksSlide 66. Has a float which separates out cells & then the machine basically flips the tube onto its side into a cart (reads changes in DNA & RNA, any change in lines in the graph indicates a new cell group)