Clinmed Midterm High Points 1

kelseyfmeyer's version from 2015-10-08 19:54


Question Answer
right sign of renal dz?inability to conc
DIFF between regurg and 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 / Metabolic / Neoplastic, nutritional / Infectious, inflammatory, immune mediated, idiopathic, ischemic, iatrogenic / Trauma, toxic / vascular
KNOW WHAT FITS WHERE IN SOAP (what's soap mean?)Subjective, objective, assessment, plan
risks with being young, old, middle aged?YOUNG: congenital, infectious. MIDDLE: immune mediated diseases, epilepsy, IVDD. OLD: neoplasia, degenerative diseases
REASONS FOR NON-REGENERATIVE ANEMA?inflammatory, 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 inc in both the PCV and 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 low and you'll know what it is)
which is more sensitive, HCT or PCV?hct
inc PCV/HCT could be from?polycymthemia- relative (dehydration) or absolute (inc in RBCS)
**EXPLAIN WHAT IS HAPPENING TO THE LEUKOGRAM in PHYSIOLOGICAL LEUKOCYOSISphsysiological response=FEAR. fear causes in in catecholamines(like epi), and this results in neutrophilia and 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 and eosinophils go down (more specific things inc, too sick and stressed to worry about the details!)
**how is a inflammatory leukogram charaterized?>1000 BANDS (immature neutrophils...think about how neutrophils are needed in inflammation, but so many that you run out and 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 inc neutros and WBCs)Pyometra, Ehrlichia, hepatozoanosis, fungus
how many leukocytes would be considered a leukemia?>50,000
how does stress affect neutrophils?stress=corticosteroids=INC 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 with the demand
what's a DEGENERATIVE LEFT SHIFT?it's BAAAAAD. MORE IMMATURE BANDS THAN MATURE NEUTS. this is because the bone marrow ISNT able to keep up with 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 and monos go UP (inc non-specifc response) but lymphs and eosinos go DOWN.
basophil on bloodwork? check for...heartworm
how does stress affect eosinophils?dec
Feline retics--> punctate and aggregate. which is the newer and 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 and then is mature
***CRP= Corrected Reticulocyte %. What is this, and 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, and 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 and shibas has microcytes-- think that japanese people and dogs are tiny)
check out the cytogram chart on 57 and graph on 58get the jist of it
what's happening to fibrinogen and albumin in inflammation?fibrinogen goes UP and albumin does DOWN (think like inflammation=cytokines=clotty crap might happen so need fibrinnogen, 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.
first thing to check with any platelet??HOW MANY ARE THERE?
how can platelets be falsely dec, and who is prone for this?CLUMPING dec it. and CAT PLATELETS are easily activated to clump
reasons for heinz bodies?oxidative damage, denatured hgb, onion tox, tylenol tox
when would you usually see agglut in the body?IMHA
in a case: low WBCs, low neutrophils with a lot of bands, low lymphocyteslow lymphos= inflammation/stress. but the neutrophils are low and the bands are high= degenerative stress leuko

serum chem

Question Answer
LIVER FUNCTION ASSESSMENTSalbumin, BUN, glucose, chlosterol
what is the ONLY THING that inc 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 inc (bc when else would a mito be in the blood). suggestive of liver/kidney damage, myocardial infarction, mm damage (2-3x inc sig, except in cats, then any inc)
ALT is where? indicates what?CYTOPLASMIC ENZYME which indicates HEPATOCYTE INJURY (aLt Liver). (max 48hrs post injury). any inc 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 inc by steroids in dogs), inc in GGT and ALP= hepatic lipidosis
which bili do you measure in small animals? horses?small animal= total. in 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 inc due to kidney dz). can be inc with high protein intake/GI bleed (nitrogen comes from protein), renal dz (75% damage), dehydration, exercise. DEC in poor diet, malabsorption, liver dz, duiresis (medullary wash out)
creatinine inc why?renal dz (75% damage), mm degen/damage, drugs, dehydration, GREYHOUNDS (comes from mm, and greyhounds are pure mm)
what's azotemia?inc in BUN OR CREATNINE...OR BOTH (consider: is it pre, renal, or post? MUST eval with USG)
HYPERCALCEMA-- hyperkids? GOSHDARNITG: granulomatous dz. O- opsteopathy S- spurious H- hyperparathy D- hypervit.d A- addisons R- renal dz N-neoplasia (lympsarc, anal sac, mult myel) I- idiopathic- cats T- temp rare in cats
HYPERCALCEMIA= what CS? inhiibits neurons and mm cells (dec excitability, raises threshold), mineralization of tissues, weakness, vomiting, constipation (too much Ca-- slower stuff bc raise threshold...the high amount outside the cells makes the amount in the cells count for less)
HYPOCALCEMIA-- gonna feel LOW if you have HERPESH- hypoparathyroid E-eclampsia (think cows) R- renal dz P- pancreas or phosphorous E- ethylene glycol S- spurious
HYPOCALCEMIA clinical signs?low calcium- calcium in cells seems relatively higher= excitability! inc excitability (lower threshld), nervousness, bh changes, facial itchiness***, muscile cramping, stiff gaint, tetany, seizures
itchy face might mean?hypocalcemia
check out calcium graph on slide 84understand it
do growing pups have high or low P?high, because more atP for energy
elevations in P?renal failure (ethyleen glycol), growth, diet, hypoparathyroidism, hemolysis
dec in P?hyperparathyroidism , HHM, ecclampsia
K+--> when does it inc?renal dz, hemolysis (principal intracellular ion!!!!), acidosis, addisons, diabetes (acidosis OR lack of insulin)
Cl likes to move with and against what?Cl moves with Na, moves against Bicarb. Inc Cl=decbicarb=acidosis, for example
Mg likes to move with/work like?Ca. Mg usually a cofactor. So if Mg dec, its like ca dec, so inc excitability.
ANION GAP:whats the equation and what does it mean?POSITIVES MINUS NEGATIVES (Na+K)-(Cl+HCO3) INC means ACIDOSIS, dec 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 with?creatinine. so UPC= urine creatinine ratio
why is UPC important?because +1 protein in concentrated urine is less worrisome than +1 in dilute urine. need to acct for USG. Comparing creatnine (a constant value) with protein helps eliminate the GFR factor
when looking at ketones on dipstick, keep in mind?

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