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Diagnostics Midterm

Terms in this set (175)

Plasma
The fluid portion of whole blood. It contains 90% water and 10% dissolved constitutes; protein, carbohydrates, vitamins, lipids, salts, etc. It contains clotting factors.
Serum
Plasma without fibrinogen. It does not contain clotting factors.
Anticoagulant
Required when whole blood or plasma is needed. The sample should be refrigerated if it is not used within an hour.
Heparin
Green top tube
Ethylenediaminetetraacetic acid (EDTA)
Lavender top. Preferred for hematologic studies; it does not alter cell morphology. It is used with blood smears.
Oxalates
Sodium, potassium, ammonium, or lithium salts.
Citrates
Sodium or lithium salts
Sodium fluoride
Grey top tube. It is used as a glucose preservative.
Well-hydrated PT PCV
50%
50% cells, 50% fluid
Dehydrated PT PCV
70%
70% cells, 30% fluid
Order of draw
1. Blue (citrate)
2. Red top tube
3. Tiger top (serum separator)
4. Green (heparin)
5. Lavender (EDTA)
6. Grey (potassium oxalate or sodium fluoride)
Accuracy vs. Precision
Biologic errors
Inherent to the patient; age, breed, gender. Collection error would be a non fasted patient.
Non biologic errors
Errors NOT related to the patient; incorrect labeling, sample collection and handling.
Analytic variables
These affect the procedure by the instrument measuring; improper equipment maintenance.
Post analytic variables
Data entry; inaccurate record keeping.
SOP
Standard operating procedure
Parasite sample labeling
Client name, date of collection, species, animal identification
Gross fecal examination
Consistency, color, presence of blood, mucous, odor, adult parasites, foreign bodies.
Direct smear
Visulization of trophozoite stages of protozoal parasites. i.e. Giardia
Fecal flotation
Ova will float to the surface. Fluke eggs have a higher specific gravity and will sink.
Centrifugal flotation
Similar to flotation but sample is strained to remove excess debris. It recovers more eggs and cysts in less time.
Sedimentation
Used when suspected ova are too large to be recovered w/ standard flotation. i.e. fluke ova
Cellophane tape prep
Used to recover oxyuris pinworms and tapeworms
Baermann technique
Used to recover larvae from fecal samples. It is used when lungworm infections and strongyloides are suspected.
Modified McMasters technique
Provides an estimate of the number of eggs or oocysts per gram of feces.
Modified Knott test
Used to concentrate microfilariae. It can help in differenetaiton of Dirofilaria and Acanthocheilonema.
Acid fast staining
Used to identify Cryptospordium (parasite of the intestinal tract of many animals, including humans. It is carried by pigeons)
Diff-Quik staining
Can be used to aid in identification of Isospora sp.
Phylum Nematoda
ROUNDWORMS
•Multicellular
•Cuticle: a body wall composed of an external, acellular, protective later
•Hypodermis: cellular layer beneath the cuticle
•Digestive tract: one straight tube from mouth to anus
•Reproductive organs: tubular but longer than the body, wrap and coil around the intestinal tract
•No respiratory system
Nematode life cycle
•Developmental stage: egg, four larval stages, sexually mature adult
•Infective stage: egg containing a larva, free-living larva or within a intermediate host.
ONLY INFECTIVE WITH LARVAL STAGE
•Direct: No intermediate host is needed for developmental stage
•Indirect: An intermediate host is needed for developmental stage
Diagnostic stages of nematodes
•Most found in feces, blood sputum or urine
•Some in lungs, kidney, bladder or heart
Taxonomic superfamilies in veterinary medicine
•Ascaroidea
•Strongyloidea
•Trichostrongyloidea
•Rhabditoidea
•Metastrongyloidea
•Trichuroidea
•Oxyuroidea
•Spiruroidea
•Dracunculoidea
•Dioctophymoidea
•Filaroidea
Ascaroidea
**Roundworm
•Toxocara canis, T. cati and T. leonina
•Found in intestinal tract of dogs and cats
•Prepatent period for T. canis is 21-35 days; T. leonina is 74 days
Parascaris equorum
Equine roundworm
Toxocara vitulorum
Cattle roundworm
Ascaris suum
Swine roundworm
Strongyloides
SMALL INTESTINE NEMATODE; HOOKWORM
•Produce severe anemia in puppies and kittens
•Fresh feces needed for diagnosis
•Standard fecal flotation
Ancylostoma caninum
Canine hookworm
Ancylostoma tubaeforme
Feline hookworm
Ancylostoma braziliense
Canine and feline hookworm
Uncinaria stenocephala
Northern canine hookworm
Bunostomum phlebotomum
Ruminant hookworm
Strongyloides life cycle
•Eggs are oval or ellipsoid with thin walls and 8 to 16 cells
•Eggs larvate rapidly in the external environment
Trichostrongyloidea
Ollulanus tricuspis
Feline trichostrongyle
•Vomiting in cats
•Mostly identified by examination of vomitus under microscope
Rhabditoidea
INTESTINAL THREADWORMS
•Only a parthenogenetic female is parasitic
•Larvae have a club-shaped esophagus
•Fresh fecal flotation diagnosis
Metastrongyloidea
HAIR LUNGWORMS
•Adults are found in the bronchioles
•Eggs develop in the lungs of the definitive host and the first stage larva are coughed up, swallowed, and passed out with the feces.
Trichuroidea
WHIPWORM
•Found in the cecum and colon
Trichuris vulpis
Canine whipworm
Trichuris campanula and T. serrata
Feline whipworm
Capillaria plica
Found in urine and feces of cats and dogs
Trichinella spiralis
•Often associated with raw or undercooked pork; ingest infective larval stage in meat.
Oxyuroidea
PINWORM
•Adult worms found in cecum, colon, and rectum.
•Pinworms are parasites of omnivores and herbivores but never carnivores.
Oxyuris equi
Equine pinworm
Habronema sp. and Draschia megastoma
**Spiruroidea
•Parasite of horses
•Found in the stomach
•May parasitize skin lesions
Thelazia californiensis
Eyeworm of cats and dogs
Dioctophyma renale
**Dioctophymoidea
•Giant kidney worm of dogs
•Infects the right kidney
Stephanurus dentatus
**Dioctophymoidea
•Swine kidney worm
Filaroidea
Dirofilaria immitis: CANINE HEARTWORM
•Adult heartworms found in right ventricle, pulmonary artery, and the fine branches of that artery.
•Prepatent period is 6 months
Filaroidea lifecycle
Filaroidea diagnosis
Observing microfilariae in blood samples:
•Modified Knott test
•Commercially available filter techniques
•Immunodiagnostic tests
Voided or free catch urine sample
•Easiest to collect
•Limited diagnostic value because it has been contaminated by genital tract
•Has increased WBC counts
Voided urine stimulation
•Cattle: rub straw or hand ventral to the vulva in circular fashion
•Sheep: occlude nostrils
•Horses: warm cloth rubbed on ventral abdomen or place in a clean stall with fresh hay
Catheterization
•Avoid first portion collected
•May have increased RBC's and epithelial cells
•4- to 10- polypropylene catheter most commonly used in dogs
Cystocentesis
•Sterile samples
•Must have a sufficiently distended bladder
•Standing or ventral
•May have RBC's due to insertion of needle
Specimen storage and handling
•Analyze w/in 30 minutes to an hour
•If not possible, refrigerate for up to 6-12 hours.
•Warm to room temperature before evaluation
-If not refrigerated: increased pH, breakdown of RBC's and casts, bacterial growth increases.
Pollakiuria
Frequent urination
Polyuria
Increased production
Oliguria
Decreased urine output
Anuria
Absence of urine production
Equine/lagomorph urine
High concentration of calcium carbonate crystals and mucous
Ammonia
This may indicate cystitis or a sample left standing too long
Sweet smelling urine
This indicates presence of ketones
Specific gravity
Weight of a quantity of liquid compared to that of an equal amount of distilled water
High SG
•Decreased water intake
•Fluid loss through sweating, panting, diarrhea
•Acute renal failure, dehydration and shock
Low SG
•Kidneys cannot absorb water
•Pyometra, diabetes, liver disease etc.
Isosthenuria
When urine SG approaches that of glomerular filtrate
•Not concentrated or diluted by kidneys
•Chronic renal disease
•The closer the isosthenuria, the more kidney function is lost.
Sulfosalicylic acid turbidity test
Determines urine production levels by acid precipitation
•Measures Bence Jones proteins
Proteinuria
•Renal disease
•Excessive amounts of protein
Hematuria
Usually a sign of disease causing bleeding somewhere in the urogential tract
Bilirubinuria
Bile duct obstruction, hemolytic anemia, and liver disease.
Constitutes of urine sediment
Normal: few casts, cyrstals, epithelial cells, RBC's, WBC's, mucus threads, sperm and fat droplets.
Abnormal: More than a few RBC's and WBC's, parasite ova, bacteria and yeast.
Erythrocytes
Leukocytes
The larger cells are RBC's. Note the difference.
Epithelial cells
A. SQUAMOS
B. TRANSITIONAL
•Many cells indicate inflammation
-Transitional, sqamous, renal
Transitional cells
From the bladder, ureters, renal pelvis and proximal urethra.
•Usually pear shaped.
Squamous cells
From the distal urethra, vagina, vulva or prepuce.
Renal cells
From renal tubules.
•Smallest epithelial cells
•Round and contain a large nucleus
Cast cells
Formed in the lumen of the distal and collecting tubules of the kidneys.
Hylaline casts
Indicates poor renal fusion, exercise, or general anesthesia.
Granular casts
Most commonly seen. May indicate acute nephritis.
Epithelial casts
Acute nephritis and degeneration of the renal tubular epithelium.
Erythrocyte casts
Indicate renal bleeding
Waxy casts and fatty casts
Crystalluria
Presence of crystals in the urine.
Struvite
AKA triple phosphate crystals or coffin lids.
•Found in alkaline to slightly acidic urine
Calcium oxalate crystals
Dihyrate or monohydrate
Dihydrate
Found in acidic to neutral urine.
•X across the crystals
Monohydrate
Found in ethylene glycol poisoning
Uric acid
Not common in dogs or cats, except dalmatians
Calcium carbonate
No clinical significance
Ammonium biurate
AKA thorn apple crystals
Common in animals with severe liver disease.
Pearsonema plica
Bladder worm
Dictophyma renale
Kidney worm of dogs
Microfilaria immitis
Baby heartworm
CBC
•Total RBC count
•PCV
•Plasma protein concentration
•Blood film examination
•Reticulocyte count if anemic
•Hemoglobin concentration
•Erythrocyte indices
Packed cell volume
Percentage of whole blood composed of RBC's
•Microhemocrit tubes
-Red ring: hepranized
-Blue ring: not treated (use with blood that is already hepranized)
MEASURED IN g/dL
Plasma layers
•Normal: clear to pale yellow
•Cloudy: lipemic (fat)
•Reddish: hemolyzed
•Deep yellow: icteric
Low PCV
Anemia or inadequate volume of blood to anticoagulant ratio
High PCV
Polycythemia or dehydration
Hemoglobin testing
Oxygen level in the blood
Oxyhemoglobin
Oxygen replaces CO2 in respiration
Methemoglobin
Occurs naturally
Sulfhemoglobin
Results from cell aging
Mean Corpuscular Volume (MCV)
Measures average size of RBC's
•Divide PVC by RBC concentration and multiply by 10
Mean Corpuscular Hemoglobin (MCH)
Mean weight of hemoglobin contained in the average RBC
•Divide the hemoglobin concentration by the RBC concentration and multiply by 10
Mean Corpuscular Hemoglobin Concentration
Concentration of hemoglobin in the average RBC
•Divide the hemoglobin concentration by the PCV and multiply by 100
Methylene blue
Stains the acidic components of the cell
Relative blood count
A minimum of 10 WBC's are counted, identified and recorded.
Neutrophil
•1st line of defense
•Primary function is phagocytosis
Heterophil
Found in birds, reptiles and some fish.
Eosinophil
•Main function is controlling the immune system
•Increased numbers in PT's with allergies and parasitic infections
•PINK
Basophil
•Function in meditation of immune system
•Increased numbers indicate inflammation or infectious conditions
•PURPLE
Lymphocyte
•Most abundant WBC in ruminants
•Production of antibodies
•Increased numbers indicate viral infection
Monocyte
•Largest WBC
•Function in phagyocytosis
•Increased numbers indicate chronic infection
Llama erythrocyte
Nuclear hyposegmentation
•Congenital defect
•Hyposegmentaion of all granulocyte nuclei
Nuclear hypersegmentation
•Very common
•Nuclei with 5 or more lobes
•Can be due to aging neutrophils
Toxic neutrophil
Associated with inflammation, infection, and drug toxicity
Intracytoplasmic inclusions
Atypical lymphocyte
Reactive lymphocyte
AKA immunocytes
•Usually caused by antigenic stimulation
Lysosomal storage disorders
•Rare inherited diseases
•A substance abnormally stored in cells
•Clinical signs vary
•Most skeletal or neurologic disease
Chédiak-Higashi Syndrome
•Neutrophils have large, fused lysosomes with the cytoplasm
•Affected animals may bleed due to abnormal platelet function
•Persian cats, cattle, foxes
Siderotic Granules
•Present in neutrophils and monocytes of animals with hemolytic anemia
•DOHLE BODIES
Smudge cells
•BASKET CELLS
•Degenerative leukocytes that have ruptured
Karyolysis
Degenerative change to the nucleus by dissolution of the nuclear membrane
•Septic exudate
Pyknosis
Condensing of the nucleus as the cell dies
Karyorrhexis
Fragmentation of the nucleus after cell death
Rouleaux
•Stacking of erythrocytes
•Normal in horses
•Artifact of prolonged storage
Autoagglutination
Occurs in immune mediated disorders
•Differentiate from rouleaux by a drop of saline
Anisocytosis
Variation in RBC size
Polychromasia
RBC's with a bluish tint. Usually young cells
Hypochromasia
RBC's with decreased color
•Normochromatic is normal staining intensity
Hyperchromatophilic
Darkly stained RBC's
•Usually microcytes or spherocytes
Poikolocytes
Abnormally shaped (P)
Schistocytes
RBC fragments. Trauma due to intravascular shearing
Acanthocytes
SPUR CELLS
•Cats: hepatic lipidosis
•Dogs: hemangiosarcoma
Echinocytes
BURR CELLS
•Artifact of slow drying
•Dogs: renal failure, lymphosarcoma and snake bites
Drepanocytes
SICKLE CELLS
•Deer and angora goats
Keratocytes
HELMET CELLS OR BLISTER CELLS
Spherocytes
Small, dark staining RBC's with reduced or no central pallor
•Immune-meditated hemolytic anemia
Leptocytes
TARGET CELLS OR CONDOCYTES
•Anemia, liver disease and inherited disorders
Stomatocytes
Knizocytes
BARR CELLS
Elliptocytes (ovalocytes)
Normal in camelids and non mammals
Eccentrocytes
Diabetes, neoplasia, Babesia, ingestion of garlic, onions or tylenol
•Hemoglobin is pushed to one side
Dacryocytes
Basophilic stippling
•Residual RNA
•Cats responding to anemia
•Lead poisoning
Howell-Jolly bodies
•Basophilic nuclear remnants in young RBC's in response to anemia
•Increased numbers= splenic disorders
Heinz bodies
•Oxidant drugs and chemicals
•Normal in cats but increased amounts indicate lymphosarcoma, hyperthyroidism, diabetes
Nucleated erythrocytes
Immature cells during anemia. Normal in non mammals
Dirofilaria immitis
Mycoplasma haemofelis
Hemobartonellosis or feline infectious anemia
Reticulocytes
Immature erythrocytes
•Polychromatic staining
•Cats have 2 forms of retics: Normal is 0.4% aggregate and 1.5% to 10% punctate
Aggregate
Large clumps of reticulum
Punctate
Unique to cats; 2-8 small singular basophilic granules
Reticulocyte count
Expression of the percentage of RBC's that are retics
•Percentage per 1,000 RBCs
•Done on all anemia animals EXCEPT HORSES because they do not release retics
Corrected reticulocyte count
Multiply observed retics by the observed PCV then divide by the normal PCV
•Normal: dog 45% cat 35%
Bone marrow evaluation
Valuable tool for diagnosis and prognosis in specific cases
•Need for this test is determined by the findings of the differential blood count
Acellular
Aplasia
Hypercellular
Hyperplasia
Hypocellular
Hypoplasia
Cells in bone marrow
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