Clin Med - Midterm - Fast Review

drraythe's version from 2016-03-14 22:53


Question Answer
Right sign of Renal Dz?Inability to conc
DIFF btwn regurg & vomit?VOMIT = ABDOMINAL EFFORT
polyuria vs pollakauria..where's the problem?Poly = Kidney
Polak = Lower UT
What's DAMNIT-V stand forDegenerative, Developmental
Anomalous, Allergic
Neoplastic, Nutritional
Infectious, Inflammatory, Immune mediated, Idiopathic, Ischemic, Iatrogenic
Trauma, Toxic
KNOW WHAT FITS WHERE IN SOAP (what's soap mean?)Subjective
Risks w/ being young, old, middle aged?YOUNG: Congenital, Infectious
MIDDLE: Immune mediated dzs, epilepsy, IVDD
OLD: Neoplasia, Degenerative dzs
Renal Dz
Bone Marrow Dz
Which protein is important to measure in the horse?Fibrinogen
**Protein-losing problems: if losing just albumin, what do you think? If losing globulins too?Albumin: Smaller, nephropathy
Globulins: Bigger, prolly enteropathy
If there is a ↑ in both the PCV & TS, what does it prolly mean?Dehydration (relative polycythemia) (if correct fluid deficit, both go back to normal)
What do you think is happening if the TS is raised but there is a low/low-normal PCV?Dehydration + severe anemia (if correct fluid deficit, PCV will fall REALLY↓& you'll know what it is)
Which is more sensitive, HCT or PCV?HCT
↑ PCV/HCT could be from?Polycymthemia - Relative (dehydration) or absolute (↑ in RBCS)
**EXPLAIN WHAT IS HAPPENING TO THE LEUKOGRAM in PHYSIOLOGICAL LEUKOCYOSISPhysiological response = FEAR. fear czs in in catecholamines(like epi) & this results in neutrophilia & lymphocytosis (so, think that the cat was so scared ALL its defenses went up)
**EXPLAIN THE LEUKOGRAM IN a STRESS/CORTICOSTEROID LEUKOGRAM(Think stress of sickness). Dog is sick, so MATURE neutrophils go up, monocytes go up (general defense) but lymphocytes & eosinophils go down (more specific things ↑, too sick & stressed to worry about the details!)
**How is a inflammatory leukogram characterized?>1000 BANDS (immature neutrophils...think about how neutrophils are needed in inflammation, but so many that you run out & need to make a bunch of babies). If this is an early inflammatory response, or in a neutropenia, if it's not >1000 can still be sig. at 10% bands
What would be some reasons for a EXTREME neutrophilic leukocytosis? (so ↑ neutros & WBCs)Pyometra
How many leukocytes would be considered a leukemia?>50,000
How does stress affect neutrophils?Stress = Corticosteroids = ↑ NEUTROPHILS (less will be in the manginated pool...just think that th body thinks its sick so its general defenses are up)
What's a REGENERATIVE LEFT SHIFT?LESS bands than mature neutrophils. Indicates a regeneration but a regen that is still able to keep up w/ the demand
What's a DEGENERATIVE LEFT SHIFT?It's BAAAAAD. MORE IMMATURE BANDS THAN MATURE NEUTS. this is bc the bone marrow ISNT able to keep up w/ demand, so it just starts dumping the baby bands into the blood instead
How do steroids affect lymphocytes?Remember, steroids = stress, in stress leukogram neuts & monos go UP (↑ non-specifc response) but lymphs & eosinos go DOWN.
Basophil on bloodwork? check for...Heartworm
How does stress affect eosinophils?(eosinopenia)
Feline retics → punctate & aggregate. Which is the newer & which is the older retics? Explain what they look likeAGGREGATES: NEWLY RELEASED from BM. the RNA is still in big clumps = aggregate clumps.
PUNCTATE: Aggregates mature into punctates. the RNA tht was in clumps is now broken into smaller pieces, this RBC circ for ~7 days & then is mature
***CRP = Corrected Reticulocyte %. What is this & How do you calculate it?More accurate for describing a regeneration. it's the ~retic % times the (pt PCV/normal PCV) (if dogs >1.5%, indicates regen. Cats >1% is regen)
Physiological reason for macrocyte & sp. diff?Regeneration or poodle (poodles are big fans of regenerative efforts)
2 physiological reasons for microcytes? (sp diff?)Iron deficiency, or PSS (portosystemic shunt) (....Akitas & shibas has microcytes-think that japanese people & dogs are tiny)
Check out the cytogram chart on 57 & graph on 58Get the jist of it
What's happening to fibrinogen & albumin in inflammation?Fibrinogen goes UP & albumin does DOWN (think like inflammation = cytokines = clotty crap might happen so need fibrinogen, whereas in inflammation that liver has more important things to do than make albumin)
Inflammation indicator proteinFibrinogen
If you see a huge platelet, what are you thinking?Regeneration
******1st thing to check w/ any platelet??HOW ANY ARE THERE?
How can platelets be falsely ↓ & who is prone for this?CLUMPING ↓s it & CAT PLATELETS are easily activated to clump
Reasons for Heinz bodies?Oxidative damage
Denatured Hb
Onion tox
Tylenol tox
When would you usually see agglut in the body?IMHA

Serum Chem

Question Answer
What is the ONLY THING that ↑ albumin???Dehydration!!
AST is where? what can it indicate?IN MTOCHONDRIA (think of the S-shaped squiggle when you draw a mito), so it's a marker for DAMAGE if it's ↑ (bc when else would a mito be in the blood). suggestive of liver/kidney damage, myocardial infarction, mm damage (2-3x ↑ sig, except in cats, then any ↑)
ALT is where? Indicates what?CYTOPLASMIC ENZYME which indicates HEPATOCYTE INJURY (aLt Liver). (max 48hrs post injury). any ↑ in this is worrisome in a cat (their half life for this enz is much shorter than a dogs)
ALK-P is where? indicates what?BILE DUCT. indicate cholestasis
GGT is where/says what?Bile duct epithelium, like ALP (but less falsely ↑ by steroids in dogs), ↑ in GGT & ALP = Hepatic Lipidosis
Which bili do you measure in small animals? horses?Small animal = total
HORSE, conj or unconj is super important to know
BUN is where? What does it say?MADE BY liver. So IS LIVER FXN. (need 75% damage in kidneys before we see ↑ due to kidney dz). can be ↑ w/ ↑ protein intake/GI bleed (nitrogen comes from protein), Renal Dz (75% damage), dehydration, exercise. ↓ in poor diet, malabsorption, liver dz, diuresis (medullary wash out)
Creatinine ↑ why?Renal Dz (75% damage)
MM degen/damage
Dehydration GREYHOUNDS (comes from mm & greyhounds are pure mm)
What's azotemia?↑ in BUN OR CREATNINE...OR BOTH (consider: is it pre, renal, or post? MUST eval w/ USG)
HYPERCALCEMA czs?D - Hypervitminosis D
R - Renal Dz
A - Addision’s
G - Granulomatous dz
O - Osteopathy
N - Neoplasia (lympsarc, anal sac, mult myel)
S - Spurious
H - Hyperparathy
I - Idiopathic - cats
T - Temp rare in cats
HYPERCALCEMIA = What CS?Inhibits neurons & mm cells (↓ excitability, raises threshold)
Mineralization of tissues
Constipation (too much Ca-slower stuff bc raise threshold... The ↑ amount outside the cells makes the amount in the cells count for less)
HYPOCALCEMIA czsHypoparathyroid
Eclampsia (think cows)
Renal Dz
Pancreas or Phosphorous
Ethylene glycol
S - Spurious
HYPOCALCEMIA CS?↓ Calcium - Calcium in cells seems relatively ↑er = excitability!
↑ excitability (lower threshld)
BH changes
Facial itchiness***
Muscle cramping
Stiff gait
Itchy face might mean?Hypocalcemia
Do growing pups have ↑ or ↓ P?↑, bc more ATP for energy
Elevations in P?Renal failure (Ethylene Glycol)
↓ in P?Hyperparathy
K+ → when does it ↑?Renal Dz
Hemolysis (principal intracellular ion!!!!)
Diabetes (acidosis OR lack of insulin)
Cl likes to move w/ & against what?Cl moves w/ Na, moves against Bicarb. ↑ Cl = ↓ Bicarb = Acidosis
Mg likes to move w/work like?Ca. Mg usually a cofactor. So if Mg ↓, its like ca ↓, so ↑ excitability
ANION GAP:whats the equation & what does it mean?POSITIVES MINUS NEGATIVES (Na+K)-(Cl+HCO3) ↑ means ACIDOSIS, ↓ hypoalbuminemia


Question Answer
Her isosthenuria range is about....1.008-1.012
Magic line for max conc1.030
Urine protein must be evaluated in conjunction w/?Creatinine. So UPC = Urine:Creatinine Ratio
Why is UPC important?Bc +1 protein in concentrated urine is less worrisome than +1 in dilute urine. need to acct for USG. Comparing creatinine (a constant value) w/ protein helps eliminate the GFR factor