Blood Transfusions

Q: What are the five types of blood products used in transfusions?

A:

·         -Packed red blood cells

·         -Whole blood

·         -Stored, fresh, or fresh-frozen plasma

·         -Platelet rich plasma

·         -Cryoprecipitate (rarely used)

Blood Transfusions

Q: When would you transfuse with whole blood?

Blood Transfusions

Q: When would you transfuse with stored plasma?

A: Parvo puppies, hypoalbuminemia, hypovolemia, rodenticide.

Blood Transfusions

Q: When would you transfuse with fresh frozen plasma?

Blood Transfusions

Q: When would you transfuse with packed RBC’s?

Blood Transfusions

Q: What are the requirements for a canine blood donor?

Blood Transfusions

Q: What are the requirements for a feline blood donor?

Blood Transfusions

Q: What is the “universal donor” type for dogs?

A: DEA 1.1-

Blood Transfusions

Q: What is the “universal recipient” type for dogs?

A: DEA 1.1+

Blood Transfusions

Q: Why must cats be cross matched before any transfusion?

A: Cats already have antibodies to foreign erythrocyte antigens.

Blood Transfusions

Q: What is the most common feline blood type?

A: Type A

Blood Transfusions

Q: What blood types are involved in feline neonatal isoerythrolysis?

A: Type A or AB kittens with type B queen.

Blood Transfusions

Q:  How many bovine blood types are there? and what are they?

A: 11 (A, B, C, F, J, L, M, R, S, T, Z)

Blood Transfusions

Q: How many blood types for sheep? Goats? and what are they?

A: 7 for sheep (A, B, C, D, M, R, X),

5 for goats (A, B, C, M, J)

Blood Transfusions

Q: Which type for cows and goats has naturally occurring antibodies?

a)      Type A

b)      Type J

c)       Type M

d)      Type C

A: a) Type J

Blood Transfusions

Q: How many equine blood types are there? and what are they? Why must precautions be taken with any transfusion involving a horse?

A: There are 8 blood groups (A, C, D, K, P, Q, T). Horses have natural occurring antibodies, and any transfusion reaction in a horse is usually fatal.

Blood Transfusions

Q: How do blood typing kits work?

A: They determine the blood type by evidence of hemolysis or agglutination in the patient well.

Blood Transfusions

Q: Is it possible to have incompatibility even with the same blood type?

A: Yes

Blood Transfusions

Q: What blood products are required for cross matching?

A: Whole blood and serum samples from both donor and recipient.

Blood Transfusions

Q: Is it okay to administer a transfusion to a dog, cat or horse without cross matching first?

A: Cross matching MUST be done in cats and horses, and any time after the first transfusion in a dog.

Blood Transfusions

Q: What precautions must be taken when administering blood products?

Blood Transfusions

Q: What are the three possible routes of administration for blood products?

A: Intravenously, Intramedullary (for neonates), Intraperintoneal (but slow absorption)

Blood Transfusions

Q: What are some signs of a transfusion reaction?

A: Restlessness, anxiety, incontinence, fever, facial edema, pruritis, apnea/tachypnea, muscle tremors, tachycardia, nausea/vomiting, seizures, stretching of legs, death.

Immunology and Serology

Q: What is an immune response?

A: How the body reacts to foreign bodies.

Immunology and Serology

Q: What are the two major systems of immune response?

A: Innate and Adaptive

Immunology and Serology

Q: What is the innate immune system and what does it do?

A: It is the immunity that an animal is born with. It acts as a barrier to keep foreign amterials from entering the body.

Immunology and Serology

Q: What is the difference between a monocyte and a macrophage?

A: Monocytes circulate in blood, macrophages live in the tissues.

Immunology and Serology

Q: What are Natural Killer cells and what do they do?

A:  They are a subset of lymphocytes in blood and peripheral organs, they kill host cells that become infected from foreign invaders, and release interferon to stimulate phagocytes.

Immunology and Serology

Q: What is an interferon?

A: Cytokines or soluble proteins that initiate/ mediate the immune response.

Immunology and Serology

Q: What is the compliment cascade?

A: It describes the release of proteins in order to stimulate an immune response.

Immunology and Serology

Q: What are the two parts of the Adaptive Immune System?

A: Humoral and Cell Mediated Immunities

Immunology and Serology

Q: What does APC stand for?

A: Antigen presenting cell

Immunology and Serology

Q: Where do T and B lymphocytes mature?

A: T lymphocytes mature in the thymus, B lymphocytes mature in the bone marrow.

Immunology and Serology

Q: What is another name for antibodies?

A: Immunoglobulins

Immunology and Serology

Q: What are the three stages of lymphocytes maturity?

A: Lymphoblasts, prolymphocytes, mature lymphocytes.

Immunology and Serology

Q: What is a cytokine?

A: Soluble proteins that mediate the immune response.

Immunology and Serology

Q: What is the purpose of memory cells?

A: To mediate a faster immune response to infections and foreign bodies.

Immunology and Serology

Q: What are the 5 different immunoglobulin classes?

 A:

·           IgM:1st to respond -5% circulating Ig

·           IgG: found in colostrum, most abundent and resilient 75%

·           IgE: during allergies, Structures similiar to IgG - very small concentrations

·           IgA: cell mediated immunity, 20%

·           IgD: Low numbers

Immunology and Serology

Q:  How are passive immunity and immunization different?

A: Passive immunity is acquired by a newborn from its mother and is short acting. Immunization occurs when an animal is exposed to a substance which stimulates the immune system, antibodies are produced to protect the animal the next time it encounters the disease.

Immunology and Serology

Q: What are the four types of immune system disorders?

A:

·         Type 1 Hypersensitivity: immediate reaction after antigen enters circulation

·         Type 2 Hypersensitivity: host destroys its own RBCs

·         Type 3 Hypersensitivity: occurs when antibodies and antigens form precipitates

·         Type 4 Hypersensitivity: t-cells react with self antigens in tissues (plastic allergy)

Immunology and Serology

Q: What does ELISA stand for? What do they test for?

A: Enzyme-Linked Immunosorbent Assays test for viruses, bacteria, parasites, serum antibodies or hormones, heartworm, FeLV, FIV, parvo, progesterone (pregnancy test)

Immunology and Serology

Q: How does the ELISA test work?

A: Antibodies are found in the walls of the well, test pad. If antigen present in sample, it will bind to the antibody specific for that antigen, and to a marker to cause colour change.

Immunology and Serology

Q: What is CELISA and what does it test for? How does it work?

A: Competitive ELISA tests for patient antigen levels. Wells are coated with monoclonal antibodies for specific antigen, intensity of colour change indicates level of antigen present.

Immunology and Serology

Q: What does Latex Agglutination test for?

A: Tests for serum antibodies (ex. Brucellosis testing in bovine)

Immunology and Serology

Q: What is RIM? How does it work?

A: Rapid Immunomigration works when colloidal gold is joined with antibodies. Any antigens present will bind to conjugated antibodies in the cassette membrane and migrate to results window. Second antibody specific to wanted antigen present in reading area which binds to entire complex and causes a colour change.

Immunology and Serology

Q: What does Immunodiffusion test for? How does it work?

A: Used to test whether animal has been exposed to a disease by presence of antibodies in serum. Kit contains antigen to the desired antibody, both samples are placed on agar media, if band of precipitation forms, result is positive.  (ex. Equine infectious anemia)

Immunology and Serology

Q: What does Coomb’s Testing test for?

A: Direct Coombs test for IMHA  (Immune Mediated Hemolytic Anemia), Indirect Coombs tests for the circulating antibodies against “self”.

Immunology and Serology

Q: How are Intradermal tests administered?

A: Allergens injected intradermally, IgE molecules are detected after the patient has been subjected to allergens. Patients monitored closely for anaphylactic reactions and localized reactions indicating positive result.

Immunology and Serology

Q: What samples are needed for serology?

A: Serum or plasma

Immunology and Serology

Q: How would you properly handle a serum sample?

Serum Assays

Q: How much kidney function must be lost before serum chemistry changes are seen?

A: 75%

Serum Assays

Q: Name the Kidney Assays:

A: Blood Urea Nitrogen (BUN), Serum Creatinine, BUN/Creatinine Ratio, Urine Protein/Creatinine Ratio, Uric Acid.

Serum Assays

Q: What is Creatinine? What will influence its levels?

A: Creatinine is a byproduct of muscle metabolism, which is filtered out by the glomeruli. Levels will be increased because of non-functional glomeruli, or because of shock. Levels will be decreased because of urethral obstruction.

Serum Assays

Q: What is BUN? What will influence its levels?

A: BUN is an end product of protein metabolism excreted by the kidneys. Increased levels could have non-renal causes such as the amount of protein ingested, fever or corticosteroids; or by renal causes such as renal insufficiency, shock, dehydration, UT obstruction. Levels could be decreased by anorexia, liver disease, or tubular injury.

Serum Assays

Q: How are water deprivation tests carried out? What are they testing for?

A: Gradually deprive H₂O over 3-5 days to stimulate ADH release. If they fail to [] urine, they have insufficient ADH, or tubular dysfunction.

Serum Assays

Q: Name the Pancreas Assays:

A: Amylase, Lipase, Trypsin, Glucose, Insulin.

Serum Assays

Q: What can increased or decreased blood glucose indicate?

A: Increased blood glucose can indicate DM, stress, Cushing’s. Decreased blood glucose can indicate malabsorption, severe liver disease, storing whole blood.

Serum Assays

Q: What is Amylase? What can increased levels mean?

A: Amylase breaks down starches and glycogen. Levels increase with acute, chronic % obstructive pancreatitis, Cushing’s, liver disease, upper GI inflammation/ obstruction, or renal failure.

Serum Assays

Q: What is Lipase? What can increased levels mean?

A: Lipase breaks long chain fatty acids of lipids into fatty acids & alcohols. Increased levels can indicate acute & chronic pancreatitis, renal failure, Cushing’s, dexamethasone tx (not sure if that means treatment or toxicity), bile tract ds.

Serum Assays

Q: WHT is TLI? What does it test for?

A: TLI stands for Trypsinlike Immunoreactivity. It is a specific and sensitive assay for exocrine pancreatic insufficiency in dogs. It measures for trace amounts of trysinogen, a trypsinlike substance that is synthesized in the pancreas.

Serum Assays

Q: How much of the liver must be non-functional before changes are seen?

A: 70%

Serum Assays

Q: What is bilirubin and what do increased levels mean?

A: Bilirubin is produced by metabolism of heme. Increased levels on unconjugated bilirubin can be caused by pre-hepatic jaundice. Increased levels of conjugated bilirubin can be caused by hepatic jaundice or cholestasis.

Serum Assays

Q: How do we test for bilirubin?

A: We use the Ictotest tablets, Ictostix, or Multistix. We use non-lipemic, non-hemolyzed serum/ plasma.

Serum Assays

Q: What is the relation between an animal’s hydration status and its Total Protein?

A: With dehydration, TP is increased. With overhydration, TP is decreased.

Serum Assays

Q: What is Albumin, and what do low levels indicate?

A: Albumin is the main binding and transport protein in the blood. Low levels can indicate chronic liver ds, starvation/ malnutrition, malabsorption, enteritis/ colitis/ parasites, pregnancy, fever, DM, trauma, ascites, etc.

Serum Assays

Q: Why does Parvo cause low TP?

A: Parvo destroys the mucosal membranes, and allows leaking of plasma proteins.

Serum Assays

Q: How are Globulins measured?

A: The difference between the total protein and the albumin concentrations.

Serum Assays

Q: What does ALT stand for? What do the levels mean?

A: Alanine Aminotransferase. Levels are increased if hepatocytes are damaged. Levels are low if isolated incident, high if it’s chronic.

Serum Assays

Q: What does AST stand for?

A: Aspartate Aminotransferase.

Serum Assays

Q: What is AP and when are the levels high?

A: AP is Alkaline Phosphatase. Levels are high in young animals and in adults with bone injury or obstructive liver ds.

Serum Assays

Q: What do LDH, GGT, SD stand for?

A: LDH is Lactate Dehydrogenase, GGT is γ-Glutamyltransferase, SD is Sorbitol Dehydrogenase.

Serum Assays

Q: Where are bile acids formed? What do they suggest?

A: Formed in liver, secreted in bile, stored in gall bladder, secreted into duodemun to aid in fat absorption & digestion. Presence can suggest nonspecific liver ds.

Endocrine System Assays

Q: Which three types of steroid hormones are produced in the adrenal glands?

A: Glucocorticosteroids, mineralcorticoids, sex hormones.

Endocrine System Assays

Q: How would you perform an ACTH stimulation test?

A: Collect plasma sample, administer synthetic ACTH by IV, collect second plasma sample after 30 minutes, and another at one hour after injection. Results can be either normal, Hyperplastic or Hypoplastic.

Endocrine System Assays

Q: What do the elevated or reduced levels mean, and why would you retest a normal result?

A: Elevated cortisol levels can indicate hyperadrenocorticism. Reduced levels can indicate hypoadrenocorticism or iatrogenic Cushing’s. Normal results do not always indicate non-Cushing’s, so should be retested in 1-2 months if clinic signs are concurrent with Cushing’s.

Endocrine System Assays

Q: How would you perform a dexamethasone suppression test?

A: Collect blood sample, administer IV dexamethasone, obtain second blood sample 8 hours after injection.

Endocrine System Assays

Q: What can the normal or hyperadrenal results mean?

A: Normal will indicate pituitary-dependant hyperadrenocorticism. Hyperadrenal values can indicate adrenal-dependant hyperadrenocorticism.

Endocrine System Assays

Q: Why is it important to get a complete history when analyzing Thyroid assays?

A: Insulin, estrogen, glucocorticoids, anticonvulsants, antithyroid drugs, penicillins, sulfas, and diazepam can decrease T₄ concentrations.

Endocrine System Assays

Q: How would you perform a TSH response test?

A: Obtain baseline blood sample, administer TSH, collect another blood sample after 4-6 hours. T₄ values should be twice the baseline value.

Endocrine System Assays

Q: What is Euthyroid Sick Syndrome?

A: T₃ and T₄ levels are low with low to normal TSH levels. Thyroid is functioning normally but levels are decreased due to other factors/illness.

Endocrine System Assays

Q: Of cats and dogs, which one is more likely to have hyperthyroidism? Hypothyroidism?

A: Cats- hyperthyroidism, dogs- hypothyroidism.

Endocrine System Assays

Q: How would you perform a T₃ suppression test in a cat?

A: Collect blood sample on day 0, evaluate serum thyroid levels. Give cat oral dose of T₃ supplementation and another blood sample is taken 2-3 days later.

Endocrine System Assays

Q: What will a decrease in levels or no change in levels indicate?

A: A normal functioning thyroid will send a message to the pituitary to stop production of T₃ and levels will drop. Patients with hyperthyroidism will not show a decrease in the levels.

Endocrine System Assays

Q: What are the most common plasma/ serum electrolytes? What are their ionic formulas?

A: Sodium Na⁺, potassium K⁺, calcium Ca²⁺, magnesium Mg²⁺, chloride Cl^-, bicarbonate HCO₃^-, inorganic phosphorus (phosphate) PO₄^3-.

Endocrine System Assays

Q: How are calcium and phosphate levels related?

A: They are reciprocal. High calcium equals low phosphate.

Endocrine System Assays

Q: Why can’t you use EDTA, oxalate or citrate in blood tubes for testing calcium levels? What are the terms for high and low calcium?

A: They chelate or bind to calcium. Hyper-/ hypocalcemia.

Endocrine System Assays

Q: What will cause false elevated values of phosphate? What are the terms for high and low phosphate?

A: Hemolysis will cause false elevations because it is found in erythrocytes. Hyper-/ hypophosphatemia.

Endocrine System Assays

Q: Which electrolyte is responsible for maintaining osmotic pressure? What are the terms for high and low concentrations?

A: Sodium, hyper-/ hyponatremia.

Endocrine System Assays

Q: Which major intracellular electrolyte is responsible for muscle function, respiration, cardiac function, nerve impulses, and carbohydrate metabolism? What are the terms for high and low []?

A: Potassium, hyper-/ hypokalemia.

Endocrine System Assays

Q: What are the terms for high and low magnesium levels?

A: Hyper-/ hypomagnesemia.

Endocrine System Assays

Q: Which electrolyte is closely involved with sodium and bicarbonate? What are the terms for high and low []?

A: Chloride, hyper-/ hypochloremia.

Endocrine System Assays

Q: Which electrolyte plays a role in the acid/ base balance?

A: Bicarbonate.

Cytology

Q: What are some sample collection methods?

A: Swab, scrape, imprint, fine needle aspirate, biopsies, centesis, transtracheal/ bronchial wash.

Cytology

Q: How would you collect a swab sample?

A: Premoisten swab with saline, place pre moistened swab into cavity, roll the swab in a single stroke in layers down a clean slide, air dry before staining. (page 289)

Cytology

Q: How would you collect a scrape sample?

A: Use a scalpel blade to expose a fresh piece of tissue, hold blade at 90 degree angle and scrape across tissue, spread the sample onto a clean slide, air dry before staining. (page 290)

Cytology

Q: How would you prepare an imprint sample?

A: Expose a fresh piece of tissue, blot until nearly dry, touch repeatedly in rows along a clean slide, air dry before staining. (page 291)

Cytology

Q: How would you perform a fine needle aspirate biopsy aspiration?

A: Stabilize mass, insert needle, retract plunger, redirect needle several times, maintain negative pressure, remove needle from mass, remove syringe from needle, fill syringe with air, reattach syringe to needle, gently force sample from needle onto clean slide, air dry before staining.

Cytology

Q: How would you perform a fine needle biopsy non-aspirate technique?

A: Stabilize mass, insert needle (either without syringe or with a syringe without plunger), redirect needle several times, remove needle from mass, fill syringe with air, replace syringe or plunger, reattach needle, gently force sample from needle onto clean slide, air dry before staining.

Cytology

Q: What would you evaluate a fluid sample for?

A: Volume, colour, turbidity, cell types present, nucleated cell count, total protein.

Cytology

Q: How is histopathology different from cytology?

A: Histopathology observes cells in relation to neighbouring cells, and their cellular architecture. Cytology observes cells individually or in small groups, randomly distributed, no evidence of in vitro relationship.

Cytology

Q: What is inflammation? What are the categories?

A: Inflammation is a normal response to tissue damage or invasion by micro-organisms. They can be suppurative/ purulent, pyogranulomatous, granulomatous, or eosinophilic.

Cytology

Q: What is the difference between benign or malignant?

A: Benign means the same cell type, relatively uniform cytoplasm & nuclei, hyperplasia, no criteria of malignancy. Malignant means morphologic changes in cytoplasm & nuclei, minimum of three of the nuclear criteria of malignancy.

Cytology

Q: What are the nuclear criteria for malignancy?

A: Pleomorphism (anisocytosis), macrokaryosis, anisokaryosis, multinucleation, increased nucleus to cytoplasm ratio, increased mitotic activity, coarse chromatin pattern, nuclear molding, macronucleoli.

Cytology

Q: What types of samples would be analysed for cytology?

A: Peritoneal & pleural fluid, lymph, cerebrospinal fluid, aqueous & vitreous humor, synovial fluid, tracheal wash, nasal flush, ear swabs, vaginal cytology, semen evaluation, prostatic secretions, milk.

Microbiology

Q: Which is largest: fungi, viruses, or bacteria?

A: Fungi is largest, then bacteria, then viruses.

Microbiology

Q: What parts of the body should normally be free of bacteria?

A: Spinal column, blood, and urinary bladder.

Microbiology

Q: What is the difference between mesophiles, psychrophiles, & thermophiles?

Mesophiles prefer a temperature of 20-40 degrees, psychrophiles prefer lower temperatures, thermophiles prefer warmer temperatures.

Microbiology

Q: What are obligate aerobes, obligate anaerobes, and facultative anaerobes?