Term
| What are the two most common causes of panhypoprotinemia? |
|
Definition
| Protein loosing enteropathy and hemorrhage |
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Term
| What is the predominant cell type in transudative effusions in dogs and cats? |
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Definition
large mononuclear cells (macrophages and mesothelial cells)
**** note: Cattle and horses may have higher numbers of non-degenerate neutrophils associated with transudative effusions |
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Term
| What is the most important diagnostic test to help confirm and characterize a case of protein loosing enteropathy? |
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Definition
| full thickness GI biopsy (cannot be obtained laproscopically <-- only mucosal biopsies) |
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Term
| What is the biggest influence on serum oncotic pressure? |
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Definition
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Term
| T/F you would expect a dog that is 7-8% dehydrated to exhibit PE findings suggestive of hypovolemic shock |
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Definition
| FALSE <-- must be SEVERELY dehydrated, remember that fluid loss due to dehydration is from the interstitial fluid volume not the intravascular fluid volume |
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Term
| What is the most common cause of a diagnosis of hemoplasmosis? |
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Definition
misinterpretation of stain precipitate when evaluating a blood smear
***remember, you can't culture hemoplasmosis |
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Term
| What disease process would result in bone marrow pathology comparable with pure red cell aplasia (PRCA)? |
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Definition
With PRCA would expect a high M:E ratio so the disease most consistent with this finding would be:
chronic renal failure (results in reduced production of erythropoitin --> erythroid hypoplasia with normal myeloid lines)
**** the degree of anemia seen with PRCA tends to be more severe than that associated with chronic renal failure |
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Term
| What bone marrow findings would you expect with a case of aplastic anemia (aka aplastic pancytopenia)? |
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Definition
| depression of all bone marrow cell lines |
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Term
| T/F a universal feline blood donor does not exist |
|
Definition
TRUE
*** ALL cats have some naturally occurring alloantibodies so blood typing for cats is ESSENTIAL |
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Term
| Which blood type is more common in cats? |
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Definition
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Term
| Oxygen therapy would not address hypoxia due to _______? |
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Definition
congenital right to left cardiac shunt
**** because the blood is bypassing the lungs (normally blood moves from right ventrical to the lungs, in this case it moves directly into the left ventrical through a septal defect) oxygen therapy will have no effect |
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Term
| What are some causes of hypoxia that would be responsive to oxygen therapy? |
|
Definition
hypoventilation
V/Q mismatch (either the alveoli are not being inflated (ex. pulmonary edema, pneumonia, asthma), or the capillaries that participate in gas exchange at the level of the alveoli are not perfused (ex. pulmonary thromboembolism)
high altitude |
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Term
| T/F autoagglutination can be normal in feline blood |
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Definition
FALSE- autoagglutination is never normal
****autoagglutination indicates there are antibodies binding to RBC |
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Term
| T/F if a patient has autoagglutination you should confirm with a coombs test |
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Definition
| FALSE, coombs test would be redundant as the end result of a positive would be autoagglutination |
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Term
| How would you classify and elevated packed cell volume associated with hypoxia/chronic pulmonary disease? |
|
Definition
secondary appropriate polycythemia (the body needs to increased RBC mass to increase oxygen carrying capacity)
terminology:
relative polycythemia (no actual change in RBC mass, ex. dehydration or splenic contraction)
primary polycythemia (indicates bone marrow involvement ex. erythroleukemia, remember, leukemia=neoplastic cells in circulation)
secondary inappropriate polycythemia (due to localized ischemia ex. renal neoplasia, so the polycthemia is inappropriate because the body isn't actualy hypoxemic) |
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Term
| What two conditions are associated with hyponatremia, hypochloremia, and hyperkalemia? |
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Definition
urobadomen
Addison's (mineralocorticoid deficiency results in electrolyte abnormalities) |
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Term
| What is the best way to identify uroabdomen based of fluid collected by abdominocentesis? |
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Definition
| Measure the creatinine of the abdominal fluid, if it's urine the creatinine should be 1,5-2X greater than the serum creatinine value |
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Term
| Why is it not useful to quantify urea in abdominal fluid when trying to r/o uroabdomen? |
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Definition
urea translocates rapidly across biological membranes
*** if the abdominal fluid has a higher (1.5-2X) creatinine value than the serum this is consistent with uroabdomen |
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Term
| What is the best type of crystalloid fluid for rehydration and maintenance of a patient with hypoadrenocorticism? |
|
Definition
normal strength (0.9%) NaCl because it does not contain potassium
**** remember, patients with Addison's are hypochloremic, hyponatremic and hyperkalemic |
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Term
| What is the most appropriate mechanistic interpretation of a degenerative left shift + toxic change with normal PCV and platelet count? |
|
Definition
Inflammation with overwhelming tissue demand
**** remember, dogs and cats have a large bone marrow storage pool of neutrophils so a degenerative left shift is a poor prognostic indicator (vs. cattle and horses that have a small neutrophil storage pool and more commonly have degenerative left shifts associated with less significant inflammation) |
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Term
| How should you interpret an elevated serum fructosamine value in a cat? |
|
Definition
A period of persistent hyperglycemia (weeks)
*** this allows you to distinguish persistent hyperglycemia associated with metabolic disease from transient hyperglycemia associated with stress (very common in cats) |
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Term
| What three clinical abnormalities are most consistent with a diagnosis of pancreatitis in a cat? |
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Definition
abdominal pain, hypercholesterolemia, mature neutrophilia
*** remember that elevated serum lipase and/or elevated serum amylase ARE NOT RELIABLE indicators of pancreatic pathology in cats!!! |
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Term
| T/F The presence of bilirubin in cat urine is ALWAYS significant |
|
Definition
TRUE
***** as opposed to dogs, where mild bilirubinuria may be clinically insignificant |
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Term
| T/F bilirubinuria may occur secondary to blood contamination of a urine sample during collection |
|
Definition
FALSE
**** Bilirubin is formed through the degradation of hemoglobin by tissue macrophages so blood contamination of a urine sample during collection would be appreciable as intact RBC or hemoglobin if the erythrocytes were lysed in the process. |
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Term
| What are some indicators of renal tubular disease appreciable on urinalysis? |
|
Definition
protinuria, glucosuria (remember, these should be completely reabsorbed by the renal tubules)
casts (formed by sloughing of tubular epithelial cells, associated with pathology) |
|
|
Term
| T/F bilirubin is NOT absorbed through the GI tract |
|
Definition
TRUE
*** so GI bleeding does NOT result in hyperbilirubinemia or bilirubinuria |
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Term
| What is the best way to deliver insulin to a diabetic cat that is anorexic secondary to GI obstruction? |
|
Definition
administer crystalline (ie. regular) insulin SQ as needed to maintain blood glucose between 100-300 mg/dl
**** because the normal reference range for blood glucose is so narrow, aiming for this interval increases the risk of the patient becoming hypoglycemia as a result of insulin therapy |
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Term
| What three clinical abnormalities are most consistent with a diagnosis of primary hyperparathyroidism? |
|
Definition
| elevated ionized calcium, hypophosphatemia, elevated serum PTH |
|
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Term
| What is the mechanism for the development of PU/PD in a case of primary hyperparathyroidism? |
|
Definition
| renal tubular resistance to ADH |
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Term
| T/F stress induced endogenous corticosteroids are not sufficient to increase serum ALP |
|
Definition
| TRUE, must consider endocrinopathy or exogenous corticosteroid therapy |
|
|
Term
| What is the most important test for diagnosing primary hyperparathroidism? |
|
Definition
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Term
| T/F resting serum cortisol is a good test to r/o hyperadrenocorticism |
|
Definition
FALSE
*** can be used to r/o Addisons (baseline cortisol below 2 micrograms/dl is consistent with Addisons) <-- need to confirm Dx with ACTH stimulation test, so only use baseline cortisol if Addison's is low on the list of differentials |
|
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Term
| What result following a low dose dex test is consistent with a diagnosis of hyperadrenocorticism? |
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Definition
low dose dex is very good for diagnosing Cushings disease and can distinguish pituitary dependent from adrenal dependent in about 40% of cases.
First look at 8 hour post sample --> if it's not suppressed than the dog has Cushings
Then look at the 4 hour post sample, if cortisol is not suppressed we cannot distinguish between pituitary or adrenal, if it is suppressed this is consistent with pituitary dependent disease |
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Term
| What is the most appropriate empirical antibiotic for treating an uncomplicated case of UTI? |
|
Definition
TMS <-- broad spectrum, good gram negative activity
*** clavamox as a wider spectrum of action and should be saved for more resistant infection |
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Term
| What is the most appropriate interpretation of the presence of 5-10 nRBC on a peripheral blood film? |
|
Definition
bone marrow endothelial damage
*** can be associated with regenerative anemias but only during ACUTE phases |
|
|
Term
| T/F hepatic lipidosis does not present as a clinical disease in dogs |
|
Definition
TRUE
**** important disease of CATS (and mink...) |
|
|
Term
| What two heritable diseases are associated with the cavalier king charles spaniel? |
|
Definition
| mitral valve disease and syringomyelia |
|
|
Term
| What type of urinary crystals are associated with liver disease? |
|
Definition
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Term
| What is the relationship between the degree of increase in serum bile acids with the severity of liver dysfunction? |
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Definition
| The relationship is not linear; however, as long as serum bile acids are outside of the reference range we can still infer liver dysfunction. Once serum bile acids are back within ref intervals we know liver function has normalized |
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Term
| Liver aspirate is most specific for a diagnosis of what type of liver disease? |
|
Definition
neoplasia
*** inflammatory disease can be associated with non-specific cytology, often challenging to determine in inflammatory cells are due to blood contamination <-- histopathology via liver biopsy is best for characterizing inflammatory liver disease |
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Term
| Urine production encompasses what type of fluid loss? |
|
Definition
sensible (ie. fluid losses that are easily measured)
*** insensible losses include water vapor associated with respiration, cutaneous fluid losses, and fecal fluid loss |
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|
Term
| What constitutes normal urine output in a dog? |
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Definition
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|
Term
| T/F studies on efficacy of anti-emetics in dogs are largely limited to chemotherapy induced vomiting and motion sickness |
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Definition
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Term
| What are the two chemistry abnormalities are most specific for a diagnosis of sepsis when present in concert with each other? |
|
Definition
hypoglycemia and hyperbilirubinemia
**** hyperglobulinemia (suggests antigenic stimulation) and elevated ALP can be seen in septic patients but are less specific and can be seen with many other diseases as well |
|
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Term
| What is the first step in the pathogenesis of DIC? |
|
Definition
widespread activation of coagulation
*** we don't have a good way to quantify this, lab diagnosis of DIC (prologed PT/PTT, increased FDPs, and thrombocytopenia) are associated with the later stages of DIC |
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Term
| What is the best interpretation of decreased BUN with elevated Creatinine? |
|
Definition
decreased GFR
*** BUN can be influenced by many things (diet, liver function, GFR) but creatinine is only influenced by GFR (caveat: massive muscle damage) |
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Term
| Low blood cortisol levels are associated with what chemistry abnormality? |
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Definition
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Term
| What is the most likely cause of reticulocytosis in the absence of anemia? |
|
Definition
decreased RBC lifespan
*** can also be seen in association with polycythemia vera, but this is an extremely rare condition |
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Term
| What is the most important diagnostic test to perform in an otherwise healthy dog with a history of chronic cough? |
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Definition
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