1
Q
Animals that have prolonged activated partial thromboplastin and activated clotting times, but do not have a clinical bleeding disorder, may have a deficiency of which coagulation factor?
A
XII
Consequently, it is generally accepted that factor XII is not involved in normal hemostasis.
2
Q
Why is it advantageous that the body removes iron from the circulation during anemia of inflammatory disease?
A
Potential bacterial pathogens require iron for rapid growth and multiplication
3
Q
Somatic cell counts (SCC) and the California mastitis test (CMT) are the main diagnostic tests for mastitis in cattle. What is the main advantage of using SCC over the CMT when interpreting results?
A
SCC provides quantitative results: you receive a cell count (cells/mL), whereas the results of the CMT are interpreted subjectively
With CMT, discrepancies may arise between evaluators, and estimates of SCC that correlate with CMT score vary greatly.
4
Q
Which type of test is the Coggins test?
- A. Agar-gel immunodiffusion
- B. Enzyme-linked immunosorbent assay
- C. Immunofluorescence assay
- D. Polymerase chain reaction
A
A. Agar-gel immunodiffusion test
(AGID)
It screens for equine infectious anemia.
5
Q
This syndrome is characterized by defective collagen synthesis resulting in abnormal skin extensibility and fragility in dogs and cats.
A
Ehlers-Danlos syndrome
6
Q
Which hematological changes are typical for acute disease associated with Ehrlichia canis infection?
A
- Variable degrees of thrombocytopenia
- +/- Leukopenia
- +/- Anemia
7
Q
What is the term that describes the presence of band neutrophils in the face of increased tissue demand for neutrophils?
A
Left shift
A left shift indicates a decreased granulocyte reserve and usually denotes a tissue demand for neutrophils. In severe situations, they may be followed by neutrophilic metamyelocytes.
8
Q
The combination of proteinuria, hypoalbuminemia, hypercholesterolemia, and edema is pathognomonic for:
A
Nephrotic syndrome
9
Q
What is the mechanism by which von Willebrand factor (vWF) enables blood clotting?
A
Platelet-collagen binding
vWF binds exposed subendothelial collagen at sites of vessel injury, anchors circulating platelets, and promotes platelet–platelet aggregation to stabilize the platelet plug. It also stabilizes factor VIII in circulation.
10
Q
What is the most common cell population in healthy bronchoalveolar lavage (BAL) fluid?
A
Macrophage
(70-80% of cells)
11
Q
Which biochemical test is used for assessing the average serum glucose concentration over the preceding two to three weeks?
A
Fructosamine
12
Q
Your heparinized blood gas sample shows marked hypernatremia that is inconsistent with the clinical picture. Which error likely occurred when obtaining the sample?
A
Blood was drawn into sodium heparin rather than lithium heparin
13
Q
The prothrombin time evaluates which pathways of secondary hemostasis?
A
Extrinsic and common pathways
14
Q
Name two disorders which can cause a normal anion gap metabolic acidosis in dogs.
A
- Diarrhea
- Renal tubular acidosis
- Dilutional acidosis (rapid saline administration)
- Hypoadrenocorticism
15
Q
Which two hematologic findings on smears of peripheral blood suggest immune-mediated red blood cell damage?
A
- Spherocytes
- Agglutinated red blood cells
16
Q
Which two hematologic findings are indicative of significant oxidative damage?
A
- Heinz bodies
- Eccentrocytes
17
Q
How can you explain that an animal with ketonuria has a negative ketones result on urine dipstick?
A
High level of beta-hydroxybutyrate
Urine dipstick squares react to acetone and acetoacetate, but not beta-hydroxybutyrate.
18
Q
Which in vitro phenomena may cause false elevation of serum or plasma potassium concentration?
A
- Platelet activation during in vitro clotting
- Failure to separate serum or plasma from red cells within an hour of collection
Hemolysis (due to failure to separate sample) can cause artifactual hyperkalemia (a common mistake).
19
Q
A patient has ascites, and fluid analysis reveals that it is a pure transudate.
What is the top differential diagnosis?
A
Severe hypoalbuminemia
Other possibilities include prehepatic portal hypertension and cyst rupture. Most other causes of transudative ascites produce a modified transudate.
20
Q
What are the characteristics of anemia typically seen in “anemia of chronic disease”?
A
Normocytic, normochromic, non-regenerative anemia
21
Q
When collecting a blood sample for a complete blood count, an adequate sample volume must be drawn into the anticoagulant tube.
Otherwise, which false result can be expected?
A
Decreased hematocrit because of excess volume of EDTA solution (compared to sample volume)
22
Q
How can autoagglutination be differentiated from rouleaux formation?
A
Through examination of a saline-diluted wet preparation of fresh blood
(if clumping is still present, autoagglutination is confirmed)
23
Q
Name the most common laboratory test abnormalities identified in acute canine Anaplasma phagocytophilum infection.
A
- Thrombocytopenia
- Lymphopenia
- Elevated serum alkaline phosphatase and/or amylase activities
24
Q
Which substance is typically present in abnormally high concentrations in chylous effusions?
A
Triglycerides
25
Is the **ELISA** test for **Johne's disease** more sensitive when used in clinically diseased animals or in subclinically infected animals?
More sensitive for detecting Johne's disease in clinically diseased animals
26
Which **avian blood cell** (granulocyte) is analogous to the mammalian **neutrophil**?
Heterophil
27
Patients with acute **hemorrhagic** diarrhea can rapidly lose large amounts of fluid from the GI tract. What is a **common abnormality** noted initially on a **CBC** in such patients?
Elevated HCT
| (relative polycythemia from hemoconcentration)
28
What is the difference between an **osteophyte** and an **enthesiophyte**?
Location:
* Osteophytes: bony outgrowths caused by abnormal joint wear in osteoarthritis, seen at articular cartilage margins
* Enthesiophytes: bony outgrowths at an enthesis (where soft tissue inserts on bone [tendon, joint capsule, ligament or fascia])
29
A normal prothrombin time (PT), prolonged partial thromboplastin time (PTT) and a normal thrombin time (TT) fits with an abnormality in **which part of the coagulation cascade** - common, extrinsic or intrinsic?
Intrinsic
30
Would **severe hemophilia A** be expected to result in a prolonged prothrombin time (PT), a prolonged partial thromboplastin time (PTT), or both?
Prolonged partial thromboplastin time
| (PTT)
## Footnote
Hemophilia A is factor VIII deficiency
31
What is the most sensitive and specific blood test for the diagnosis of canine and feline **pancreatitis**?
Species-specific (canine or feline) serum pancreatic lipase (pLI) concentration
32
In a case of **septic peritonitis**, is the blood **glucose** concentration higher or lower than the glucose level in the free abdominal fluid?
Higher, generally > 20 mg/dL difference
| (>1.1 mmol/L)
## Footnote
This is attributed to anaerobic glycolysis by leukocytes in the abdominal cavity plus bacterial metabolism of glucose.
33
Which diagnostic procedure differentiates **hematuria** from **hemoglobinuria** and myoglobinuria?
Analysis of urine sediment
## Footnote
In hematuria, there are red blood cells in the sediment. Red blood cells are absent in cases of pure hemoglobinuria or myoglobinuria.
34
What is the most common cause of **macrocytosis**?
Reticulocytosis
| (typically as part of a regenerative anemia)
35
What does an elevated serum **lactate** value indicate? How would this affect the **anion gap**?
* Poor tissue perfusion, decreased oxygenation, anaerobic respiration
* Results in an increased anion gap
36
Besides the liver, elevations in **aspartate aminotransferase** (AST) may originate from which other tissue?
* Muscle
* Minuscule quantities from kidney
* Red blood cells
* Brain
* Placenta
37
Which age group normally has high levels of serum **alkaline phosphatase** (ALP)?
Young, growing animals
| (bone isoenzyme)
38
A prolonged prothrombin time (PT), normal activated partial thromboplastin time (aPTT), and a normal thrombin time (TT) fit with an abnormality in **which part of the coagulation cascade** - common, extrinsic, or intrinsic?
Extrinsic
39
What is a simple, rapid, in-hospital test that can detect clinically significant levels of **methemoglobin**?
Spot test
## Footnote
Place one drop of the patient's blood on absorbent white paper next to a drop of control blood.
If the methemoglobin content is ≥10%, the patient's blood will have a noticeably brown coloration compared with the bright red color of the control blood.
40
Normal adult mammalian **plasma protein concentrations** vary slightly by species, but are generally in which range?
6 - 8 g/dL
| (60-80 mg/ml)
41
Patients with **multiple myeloma** typically have an **immunoglobulinemia** characterized as monoclonal, biclonal, or polyclonal?
Monoclonal
42
Which of the following results is **LEAST** likely with **end-stage fibrosing/cirrhotic liver disease** in small animals?
* A. Elevated prothrombin time
* B. Hypoalbuminemia
* C. Hypoglycemia
* D. Increased alanine aminotransferase (ALT)
* E. Low serum urea level
D. Increased alanine aminotransferase (ALT)
## Footnote
The other changes are consistent with poor hepatic synthetic functions; with end-stage disease, markedly reduced hepatocyte mass means ALT and AST often are not high.
43
Free abdominal fluid with a protein concentration of <2.5 g/dL (<25 mg/mL) would be classified as which type of **effusion**?
Transudate
| (pure)
44
The hematology and blood smear from a cat who hemorrhaged during surgery yesterday shows no signs of regeneration.
**What is the most likely reason?**
It takes three to five days to see signs of regeneration in mammalian veterinary species
| (so acute onset anemia of any cause does not look regenerative at first)
## Footnote
Usually reach maximum regeneration approximately seven days post-onset of hemorrhage.
45
Name **two** conditions that lead to abnormally **high** concentrations of **Howell-Jolly bodies** on blood smears.
* Accelerated erythropoiesis
* Post-splenectomy
46
In **small animals**, which of one these **three tests** on a routine biochemistry best reflects **liver function**?
* A. Bilirubin
* B. Aspartate aminotransferase (AST)
* C. Alanine aminotransferase (ALT)
A. Bilirubin
| (synthesized by the liver and thus reflects liver function)
## Footnote
Additional parameters to assess liver function include bile acids, ammonia, albumin, glucose, and coagulation factors.
The other two are intracellular enzymes, and elevations in serum levels merely reflect hepatocyte leakage.
47
Why is it that the **protein** concentration in **plasma** is usually about 0.2 to 0.5 g/dL (2 to 5 mg/L) higher than that in **serum**?
Due to the presence of fibrinogen in plasma, which is consumed during coagulation
| (in serum the fibrinogen has been consumed)
48
In which type of cell death are **cellular shrinkage** and **condensed chromatin** initial features?
Apoptosis
| (not necrosis)
49
**Immune-mediated polyarthritis** is the result of which type of immune reaction?
Type III hypersensitivity reaction
| (immune complexes are deposited in the synovial membrane)
## Footnote
Can be idiopathic or secondary to drugs (e.g., sulfonamides, vaccines), tick-borne diseases, etc.
50
Which are the **vitamin K-dependent** clotting factors?
* II
* VII
* IX
* X
51
What are the major **hemostatic alterations** seen in advanced cases of **disseminated intravascular coagulation**?
* Thrombocytopenia
* Prolonged prothrombin time (PT) & activated partial thromboplastin time (APTT)
* Increased fibrin[ogen] degradation products (FDPs)
* Decreased fibrinogen & antithrombin
52
Which product accumulates in **stored blood** that makes the blood unsuitable for use in patients with **hepatic encephalopathy**?
Ammonia
53
Are **acquired portosystemic shunts** usually single or multiple in nature?
Multiple
## Footnote
They are portosystemic anastomoses that normally are closed, but become patent due to acquired portal hypertension.
54
**Virchow's triad** includes which three **abnormalities**?
* Hypercoagulability
* Vascular injury
* Abnormal blood flow
## Footnote
These factors contribute to a predisposition to blood clot formation.
55
Over what **time period** do rapidly-administered IV crystalloid fluids leave the vasculature (dispersing into the interstitium), and which **fluid type** can be given concurrently to offset this effect?
Within one hour; colloids
56
An animal tests positive for a given disease. The specificity of the test is 95%. The incidence of disease in the area is 1 in 1000.
**What is the likelihood that the animal has the disease (i.e., predictive value positive or PVP)?**
2%
| (even with high sensitivity, the PVP remains low because low prevalence)
## Footnote
If 1 in 1000 animals is diseased, a 98%-sensitive and 95%-specific test will produce about 1 true positive and 50 false positives per 1000 animals.
So among all positive tests, the chance the animal is truly diseased is about 1 out of 51 (~2%).
57
What are features that distinguish **hematochezia** from **melena**?
* Hematochezia: caused by large bowel disease; results in passage of frank red blood; and may be associated with tenesmus, mucoid feces, and increased urgency/frequency of defecation
* Melena: caused by gastric or small intestinal hemorrhage; is associated with black, tarry, digested blood; and rarely causes tenesmus, mucoid feces, or urgency
58
The coagulation factors are all proteins, except for **factor IV**. What is the other **name** for factor IV?
Calcium
| (Ca2+)
59
What is the earliest **erythrocyte-specific precursor** recognizable in the bone marrow?
Rubriblast
## Footnote
Blast-forming unit-erythroid (BFU-E) —> colony-forming unit-E (CFU-E) —> rubriblast —> prorubricyte —> rubricyte —> metarubricyte —> reticulocyte/polychromatophil —> erythrocyte
Each type is smaller and contains more hemoglobin.
60
Name two types of blood products appropriate for a patient with **disseminated intravascular coagulation** (DIC), and why?
* Fresh frozen plasma (FFP)
* Platelet-rich plasma (PRP)
* Whole blood
## Footnote
All are optimal products because they contain coagulation factors, and PRP and whole blood contain platelets.
61
Which test characteristic measures the proportion of **truly diseased individuals** who are **correctly identified as positive** by the test?
Test sensitivity
62
Approximately which percentage of the **functional hepatocytes** must be lost before alterations of hepatic function are detectable by **serum biochemical testing**?
70%
## Footnote
Remember that indicators of hepatic *function* (e.g., bilirubin, albumin, cholesterol, glucose, clotting factors, BUN) are distinct from indicators of hepatic *damage* (ALT, AST, SDH, etc.).
63
Which coagulation test is first to be **abnormal** in **anticoagulant rodenticide toxicosis** in dogs or cats?
PT
| (prothrombin time)
## Footnote
The vitamin K–dependent clotting factors II, VII, IX, and X are depleted by rodenticides, and factor VII has the shortest half-life. Factor VII is part of the extrinsic coagulation cascade, evaluated by PT.
64
Why is a **urine cortisol:creatinine** ratio a **suboptimal** test for diagnosing **hyperadrenocorticism**?
Poor specificity
## Footnote
Many nonadrenal disorders cause a (false) positive result.
65
When testing bile acids in horses, only one sample is taken as compared to dogs and cats in which two samples are taken. **Why only one sample in horses?**
Horses lack a gallbladder
## Footnote
Meals stimulate gall bladder contraction in dogs/cats, so pre- and post-prandial samples can be compared. In contrast, horses' bile acid levels remain fairly consistent throughout the day.
66
How would you **confirm** a tentative diagnosis of **myasthenia gravis**?
Identify the presence of serum acetylcholine receptor antibodies
## Footnote
Edrophonium (Tensilon®) is a screening, not confirmatory test.
67
How can you grossly differentiate hemorrhagic pericardial effusion from cardiac or peripheral blood most reliably?
It does not clot
## Footnote
This helps distinguish if the sample you obtain during pericardiocentesis is actually pericardial fluid/effusion vs. peripheral blood or intracardiac (which clots).
68
Which common characteristic of **herbivore urine** can cause a false positive result for **urinary protein**?
Strongly alkaline urine falsely creates trace or "+" protein on the dipstick
## Footnote
Use urine protein:creatinine ratio to differentiate.
69
Name **two causes** of **increased anion gap metabolic acidosis**.
* Ethylene glycol toxicity
* Ketonemia
* Uremia
* Hyperlactatemia
* Metaldehyde toxicosis
* Hyperphosphatemia
70
What is the **anticoagulant** of choice for coagulation testing?
Citrate
| (blue top tube)
71
Why is the **blood glucose** reading **falsely low** if whole blood is left at **room temperature** for longer than 60 minutes?
Red blood cells consume glucose via glycolytic pathways
## Footnote
This is a common cause of spurious hypoglycemia on bloodwork.
72
What **coagulation test** evaluates the **intrinsic** coagulation pathway?
Activated partial thromboplastin time
| (aPTT)
73
Creatine kinase (CK) and aspartate aminotransferase (AST) are associated with muscle damage in large animals.
**Which enzyme has the shorter half life?**
CK
## Footnote
Two hours in horses, four hours in cattle.
In horses, it peaks at four to six hours.
74
Small numbers of **Howell-Jolly bodies** are a normal finding in which large animal species?
Equine
## Footnote
In small animals: cats.
75
What does **serum protein electrophoresis** do?
Quantitates the individual **protein fractions** that make up the total protein content of serum
## Footnote
Useful to distinguish monoclonal from polyclonal gammopathies.
76
How is **isosthenuria** defined?
Urine specific gravity 1.008 - 1.012
| (kidney is neither concentrating nor diluting urine)
## Footnote
With severe dehydration, specific gravity up to 1.020 is still consistent with isosthenuria, since plasma osmolality may be markedly increased.
77
On a fresh **blood smear**, what morphologic changes indicate **toxic changes in neutrophils**?
1. Diffusely basophilic cytoplasm
2. Cytoplasmic vacuolation (foamy appearance)
3. Döhle bodies (pale blue cytoplasmic inclusions)
4. Abnormal nuclear shapes (karyorrhexis or immature/giant forms)
## Footnote
Toxic changes in neutrophils reflect accelerated bone marrow release during severe inflammation or infection.
78
Which disease in **dogs and cats** is characterized by **polyarthritis**, **proteinuria**, and a positive antinuclear antibody (**ANA**) test?
Systemic lupus erythematosus
## Footnote
It is an autoimmune disease that can affect multiple organ systems, causing joint, kidney, and immune-mediated abnormalities.
79
In **dogs and cats**, what is the most reliable blood test for detecting **cholestatic liver disease**?
Serum bile acids
| (elevated post-prandial bile acid level)
80
Which cytologic changes in **nuclear morphology** are characteristic of neoplastic cells and are **criteria for malignancy**?
* Variation in cell and nuclear size and shape
* Increased cell exfoliation
* Increased nuclear size
* Increased nucleus:cytoplasm ratio
* Increase in multinucleated cells
* Increased mitosis with abnormal mitotic figures
* A coarse and often clumped chromatin pattern
* Nuclear moulding
* Large and often multiple nucleoli of irregular and abnormal shape
81
What does a major **cross-match** assess?
**Antibodies** in the recipient's serum that are directed against the donor's erythrocytes
## Footnote
These antibodies could result in early hemolysis of the RBCs.
82
A whole blood sample from a **dog or cat** contains a **small clot**. What **two artifacts** in the complete blood count (CBC) might result from this clot?
* Spurious (false) thrombocytopenia
* Anemia
## Footnote
Leukopenia may also occur. Clotting in the sample can trap platelets and erythrocytes, causing falsely low CBC values.
83
What substance **accumulates** in hepatocytes in a dog with **glucocorticoid-induced hepatocellular degeneration**?
Glycogen
84
# Define:
Myelophthisis
Obliteration of bone marrow by non-marrow tissue
| (often fibrosis)
85
Name **three** types of **transfusion reactions**.
1. Anaphylactic
2. Acute hemolytic (pre-existing anti-erythrocyte antibodies in recipient)
3. Delayed hemolytic (development of anti-erythrocyte antibodies)
4. Febrile non-hemolytic
5. In vitro hemolytic (improper handling)
6. Volume overload (excessive volume administered)
7. Citrate toxicosis and hypocalcemia (large volumes in small patients or those with liver failure)
8. Transmission of infectious disease from donor
86
How does **tumor lysis syndrome** affect blood phosphorus levels?
Causes hyperphosphatemia
## Footnote
This is due to lysis of large numbers of tumor cells and release of their intracellular phosphorus.
87
In a milk sample, a somatic cell count (**SCC**) > ? is consistent with **mastitis** in cattle and other livestock.
Over 200,000 cells/ml suggests mastitis
## Footnote
Milk from a healthy mammary gland contains < 100,000 cells/ml, which are mostly macrophages. Infection of the mammary gland results in significantly higher SCC, mostly as a result of neutrophil recruitment.
88
What is **rouleaux formation** in **horses**, and what can excessive rouleaux indicate?
* Rouleaux are stacks of red blood cells
* Excessive rouleaux can indicate hyperglobulinemia due to inflammation or neoplasia
| (normally seen in healthy horses and cats)
## Footnote
Horse RBCs naturally form stacks because of decreased negative charge.
89
Under what **platelet count** (per µL) does the risk of **spontaneous hemorrhage** notably increase in animals?
Below approximately 30,000/µL
90
In which species do **platelets** most commonly **clump**, leading to spurious (false) thrombocytopenia on automated counts?
Cats and horses (less common)
## Footnote
Their platelets clump readily during or after sample collection, often causing falsely low platelet counts, so smear review is essential to confirm true counts.
91
What are three things that can cause a **positive “blood” (heme) reaction** on a urine dipstick?
* Hematuria (RBCs in urine)
* Hemoglobinuria (from intravascular hemolysis)
* Myoglobinuria (from muscle injury)
* Rarely, false positives from peroxidases in contaminants
## Footnote
The dipstick reacts to any heme-containing molecules.
92
If a **urine dipstick** is positive for “blood” (**heme**), how can you **differentiate** hematuria from pigmenturia?
Centrifuge the urine:
* hematuria forms an RBC pellet with clear supernatant
* pigmenturia leaves the urine colored; then check bloodwork for hemolysis or muscle injury
93
Which **blood collection tubes** yield **plasma** after centrifugation?
* Green-top (lithium heparin)
* Blue-top (citrate)
* Lavender-top (EDTA)
## Footnote
These tubes contain anticoagulants that prevent clotting, allowing centrifugation to separate plasma from blood cells.
94
Which **blood collection tube** is recommended for performing a **CBC** and preparing **blood smears**?
EDTA (lavender-top)
## Footnote
It prevents clotting and preserves cellular morphology, allowing accurate CBC analysis and blood smear preparation.
95
What are **Heinz bodies** composed of, and what is the **best stain** to visualize them?
* Heinz bodies are precipitated hemoglobin resulting from oxidation of sulfhydryl groups
* Best seen using a supravital stain such as new methylene blue
96
What does **toxic change** in neutrophils indicate?
* A. Bacterial toxins directly damaging neutrophils
* B. Accelerated neutrophil maturation due to inflammation or cytokine stimulation
* C. Viral infection of neutrophils
* D. Systemic toxin ingestion or exposure
B. Accelerated neutrophil maturation due to inflammation or cytokine stimulation
## Footnote
Toxic change reflects morphologic abnormalities acquired when neutrophils mature rapidly in response to inflammation or cytokines, not direct “toxicity.”
97
What are **Howell-Jolly bodies**, and when are they normally observed in animals?
* Small nuclear remnants in red blood cells
* Normal in cats and horses
* In any species can indicate regenerative anemia or splenic dysfunction
98
What does **basophilic stippling** of erythrocytes indicate?
It represents aggregated ribosomal RNA and is seen with regenerative anemia
| (especially in ruminants or in lead poisoning)
BCSE
flashcards
Decks in class (22)
# Cards
-
Anesthesia60
-
Behavior10
-
Clinical Anatomy67
-
Cardiology64
-
Clinical Pathology98
-
Dermatology22
-
Endocrinology33
-
Imaging52
-
Microbiology54
-
Neurology50
-
Oncology18
-
Ophthalmology22
-
Parasitology52
-
Pathology20
-
Pharmacology76
-
Physiology102
-
Preventive Medicine30
-
Surgery62
-
Theriology16
-
Toxicology49
-
Urology/Renal23
-
Virology20
