Quick Notes Clinical Pathology, Exams of Pathology

Quick Notes Clinical Pathology

Typology: Exams

2023/2024

Available from 06/25/2024

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Quick Notes Clinical Pathology
Sensitivity of a Test -
* The frequency of a test that is positive when the patient truly has the disease.
* If the sensitivity is 91% - 91% of animals have positive results and 9% have a false negative
* Increased sensitivity means lower number of false positives
* snOUT - used to rule out disease
* Good for screening tests
Specificity of a Test -
* The frequency of a test that is negative when the patient does not have the disease.
* If the specificity is 95% - 95% have negative test results and 5 % of false positives
* spIN - used to rule in disease
* Good for confirmatory tests
Difference between plasma and serum -
Plasma - has clotting factors
Serum - does not have coagulation proteins
Blood mixing -
The rocker does not adequately mix the blood, must tip tube back and forth 10-15 times
before running tests.
Order Of Filling Tubes -
1 - Blue citrate
2 - Red serum
3 - green heparin
4 - purple EDTA
5 - gray sodium fluoride
Blue Citrate Tube -
Has sodium citrate
Used for coagulation biochemistries
Red Serum Tube -
No anticoagulant
Used for biochemical profiles
Green Heparin Tube -
Has heparin
Used for certain biochemical tests
Purple EDTA Tube -
Has EDTS
Preserves cel volume and is used for hematologic tests, CBC
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Quick Notes Clinical Pathology

Sensitivity of a Test -

  • The frequency of a test that is positive when the patient truly has the disease.
  • If the sensitivity is 91% - 91% of animals have positive results and 9% have a false negative
  • Increased sensitivity means lower number of false positives
  • snOUT - used to rule out disease
  • Good for screening tests Specificity of a Test -
  • The frequency of a test that is negative when the patient does not have the disease.
  • If the specificity is 95% - 95% have negative test results and 5 % of false positives
  • spIN - used to rule in disease
  • Good for confirmatory tests Difference between plasma and serum - Plasma - has clotting factors Serum - does not have coagulation proteins Blood mixing - The rocker does not adequately mix the blood, must tip tube back and forth 10-15 times before running tests. Order Of Filling Tubes - 1 - Blue citrate 2 - Red serum 3 - green heparin 4 - purple EDTA 5 - gray sodium fluoride Blue Citrate Tube - Has sodium citrate Used for coagulation biochemistries Red Serum Tube - No anticoagulant Used for biochemical profiles Green Heparin Tube - Has heparin Used for certain biochemical tests Purple EDTA Tube - Has EDTS Preserves cel volume and is used for hematologic tests, CBC

Gray Fluoride Tube - Has sodium fluoride Stops metabolism of glucose Used to measure glucose or lactate Decreased RBC or PCV - Indicated Anemia MCV or Mean Cell Volume - Used to evaluate anemia Microcytic - 1 - Iron deficiency 2 - Portosystemic shunt 3 - Akitas & Shiba inus Macrocytic - 1 - Regenerative anemia 2 - agglutination - IMHA - artifact 3 - โ†‘ vitamin b12/folic acid - not really a cause in domestic animals 4 - FELV - a myeloproliferative disease/erythroid dysplasia due to virsus 5 - Poodles - hereditary stomatocytosis - effected dogs are nor anemic 6 - Drugs - phenobarb, phenytoin, primodone MCHC or Mean Cell Hemoglobin Concentration - Used to classify anemias Causes of Increased MCHC - 1 - Hemolysis 2 - Lipemia 3 - Large #'s of heinz bodies in cats 4 - Icterus 5 - Oxyglobin 6 - Extreme leukocytosis Causes of Decreased MCHC - 1 - Severe iron deficiency 2 - Regenerative anemia Reticulocyte Count -

  • Immature nucleated RBCs in circulation
  • Suggests regenerative anemia
  • Horses do not release reticulocytes in response to anemia *Aggregationtain with methylene or brilliant cresyl blue
  • Made 24-48 hours after start of anemia Plasma - White or Opaque - Lipemia
  • Can be due to chylomicrons, Increased cholesterol, increased triglycerides

Purpose of Blood Films - 1 - Determination of the [ ] of individual leukocytes 2 - Assessment of cell morphology Technique Used To Make Blood Films - Push technique Artifacts Associated With Slow Drying of Blood Films - 1 - Crenation 2 - Refractile artifacts - can look like hemo-parasites 3 Areas of A Blood Film - 1 - Body 2 - Counting Area 3 - Feathered Edge Blood Films - Body -

  • Cells are superimposed, makes counting difficult *evaluate rouleux formation 1- Common in cats, horses and sometimes dogs 2 - Diseased states 3 - Hyperproteinemia Blood Films- Counting Area -
  • Monolayer of cells, makes evaluation optimal
  • Complete differential cell count of leukocytes and observe RBC morphology Blood Films - Feathered Edge - *Not used for counting or cell morphology
  • Contains artifacts, broken leukocytes, and you are unable to evaluate RBC central pallor
  • Can find: 1 - Microfilaria 2 - Platelet clumps 3 - Unusual large cells Platelet Evaluation -
  • Normal - 6-10 per HPF
  • If platelet count is low check for platelet clumping in feathered edge
  • Presence of macro-platelets 1 - Accelerated platelet regeneration - dogs 2 - Cats this does not apply Leukogram or Differential Count of Leukocytes -
  • Leukogram - a tabulation of leukocytes/WBCs Convertion of Leukogram Count To Absolute Count -
  • Multiply each number counted x total leukocyte count found by hemocytometer or CBC.

Neutrophil - Metamyelocyte -

  • Should not be present in normal blood
  • Very immature neutrophil
  • Bean shaped nucleus Band -
  • A immature neutrophil Lymphocyte - Monocyte -
  • Migrate into tissues to become macrophages Eosinophil - Basophil - Neutrophils - Produced by: 1- Bone marrow in healthy adults 2 - Spleen in healthy juveniles 3 - Liver and lymph nodes during chronic inflammatory diseases Neutrophil Storgage Capacity and Reserve - Dogs > Cats > Horse > Ruminants Regulation of Neutrophil Production - Regulate production by cytokines and growth factors 1 - LPS and inflammatory mediators 2 - G-CSF - Key stimulation of granulopoiesis, maturation precursors and mobilization from bone marrow Neutrophils Progenitor Cells - Myeloblasts If more primitive neutrophils than mature think myeloproliferative disorders. Orderly Maturation - The amount/concentration of each cell increases w/ degree of maturity Terminology: - penia -
  • Decreased concentration of cells Terminology: - philia or cytosis -

*If seen in blood it is an artifact of aged blood prepared 12 hours after collection Neutrophils Abnormalities - Inherited Abnormalities - 1 - Pelger-Huet anomaly 2 - Briman cat neutrophil granulation anomaly 3 - Lysosomal storage disorder 4 - Chediak Higashi syndrome 5 - Cyclic hematopoiesis in gray collies Pelger-Huet Anomaly -

  • Mature hyposegmented neutrophils *NO segmented neutrophils are seen on blood film
  • Eosinophils are also affected Briman Cat Neutrophil Granulation Anomaly -
  • Neutrophils have eosinophilic/magenta colored granules *Neutrophil function is normal and cats are healthy Lysosomal Storage Disorder -
  • Deficiency of lyosomal enzymes to degrade glycoaminoglycans
  • Metachromatic granules in blood leukocytes
  • Other symptoms: dwarfism, bone disease, DJD, hip subluxations, facial dysmorphia, hepatomegaly, corneal clouding, enlarged tongue, heart valve thickening, excess glycoaminoglycans in urine Chediak Higashi Syndrome -
  • Large eosinophilic granules in cytoplasm of neutrophils
  • Cats w/ persian ancestry
  • May bleed due to platelet function abnormalities
  • Rare Cyclic Hematopoiesis In Grey Collies -
  • Fluctuations in blood cell numbers every 10-12 days
  • Dramatic drop in neutrophils and then it rebounds
  • Have increased susceptibility infections correlating to dip in 8 neutrophil numbers
  • Color dilution and bone marrow disorder are possibility inherited on the same gene Lymphocyte Abnormalities - 1 - Vacuolation
  • Vacuolation can be acquired or inherited Acquired Lymphocyte Vacuolation - 1 - Ingestion of swainsonine/locoweed ingestion in horses & cattle
  • Inhibits lysosomal enzymes causing acquired lysosomal storage disease - alpha mannosidosis Inherited Lymphocyte Vacuolation -
  • Lysosymal storage disorder โ†‘ Neutrophils & โ†‘ Bands - 1 - Chronic inflammatory response lasting at lest 5 days

โ†‘ Neutrophils & โ†“ Lymphocytes -

  • Due to increased glucocorticoids 1 - Stress response - Endogenous 2 - Patients being administered glucocorticoids - Exogenous
  • โ†“ L, โ†‘ x2 N, โ†‘ M, โ†“ E
  • Note - a lack of steroid response in sick animals, think hypoadrenocorticism/Addison's โ†‘ Neutrophils & โ†‘ Lymphocytes - 1 - excitement response due to epinephrine
  • < 20,000 lymphocytes/ul
  • Most common in cats โ†‘ Neutrophils, โ†‘ Bands & โ†“ Lymphocytes - 1 - Steroid response w/ inflammatory response combined โ†“ Neutrophils & โ†‘ Bands -
  • Not anemic or thrombocytopenic 1 - Acute inflammation
  • Consumption of neutrophils by inflammatory lesion
  • May see toxic changes to neutrophils
  • Can be immune mediated with no demonstrable inflammatory lesions โ†“ Neutrophils only or w/ โ†“ Lymphocytes - 1 - Acute virual infection
  • k9 parvovirus, Feline panleukopenia 2 - Acute bone marrow injury 3 - Drugs - estrogen overdose
  • phenylbutoazone administration 4 - Canine ehrlichioisis โ†“ Neutrophils w/ any combination of non regenerative anemia, thrombocytopenia, neoplastic cells - 1 - Chronic marrow injury 2 - FELV 3 - idiopathy hypo-proliferative disorder 4 - myelodysplasia 5 - myeloproliferative disorder โ†‘ Lymphocytes - 1 - Excitement response when w/ โ†‘ Neutrophils
  • Lymphocyte count up to 20,000 in dogs and 12,000 in cats 2 - canine ehrlichiosis *Dogs w/ large granular lymphocytes between 30,00 and 40, 3 - Lymphocytic leukemia
  • Lymphocyte count greater than 20,000 in dogs and 12,000 in cats 4 - Bovine Leukemia virus
  • Concentrations greater than 7500 cells/ul on 2 or more hemograms โ†“ Lymphocytes -
  • RBC fragments due to intravascular trauma 1 - DIC 2 - Hermangiosarcoma Keratocytes -
  • RBC with two or more spicules
  • Fragments into schistocytes Acanthocytes -
  • Irregular spiculated RBCs due to changes in cholesterol and phospholipids of RBC membrane 1 - hermangiosarcoma 2 - rarely seen in dogs w/ liver disease 3 - Hepatic lipidosis in cats Echinocytes -
  • Spicules are shorted than acanthocytes 1 - Artifactual from pH change during slow drying of blood film 2 - Renal disease 3 - Lymphoma 4 - Rattle snake envenomation 5 - Chemotherapy in dogs 6 - Exercise in horses Spherocyte -
  • Darkly staining RBC that lacks central pallor 1 - IMHA 2 - Blood transfusion w/ mismatched blood 3 - Bee stings 4 - Zinc toxocosis 5 - Heinz body anemia Eccentrocytes -
  • Shifting of Hb to one side, loss of central pallor 1 - Seen w/ heinz body anemia 2 - Inherited RBC enzyme deficiency 3 - Glucose-6-phosophate dehydrogenase deficiency Leptocytes or Codocytes -
  • Folded and target cells 1 - Excessive EDTA Stomatocytes -
  • Mouth like clear are in center of RBC
  • A few are insignificant 1 - Hereditary stomatocytosis -
  • Membrane of RBC leaks sodium and potassium ions
  • Alaskan malamutes, miniature schnauzers, drentse partrijishond

Heinz Body Anemia -

  • Oxidatively denatured Hb 1 - Acetaminophen in cats 2 - propyleen glycol in cats 3 - Lymphoma in cats 4 - Hyperthyroidism in cats 5 - Onion or garlic powder toxicity - all species 6 - Cephalosporins in dogs 7 - Zinc toxicosis - penny ingestion Basophillic Stippling - ...