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156 Cards in this Set
- Front
- Back
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Diagnostic cytology is the analysis of the cell & protein content of body fluids and cell content of tissues. Why do we diagnostic cytology?
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in order to find the cause of a problem and to differentiate b/w inflammatory, infectious & neoplastic lesions
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Name 6 types of specimens that are collected for diagnostic cytology?
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fluids (peritoneal, pleural, pericadial, urine, bile, chyle)
CSF & joint fluids lavages (nasal, tracheal, bronchial, urinary bladder, vaginal) FNA touch imprints |
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What 3 kinds of tubes are required for collection of diagnostic cytology specimens?
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EDTA
heparizined plain |
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Why would cytology of body fluids be done?
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when there is abnormal accumulation of fluid in a body cavity - esp in pleural, peritoneal & pericardial spaces
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Name the 4 primary pathophysiological mechanisms responsible for body cavity effusions.
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1 - loss of plasma colloid oncotic pressure (hypoalbuminemia) - transudate/ascites
2 - increased hydrostatic pressure - modified transuate, heart failure & neoplasia 3 - increased vasc perm - inflammatory exudates 4 - obstruction of lymphatic flow causing decreased removal of fluid from body cavity |
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Can fluid be collected from body cavities of normal, healthy animals?
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no - in healthy animals there is only a small amount of fluid present (not enough to be collected)
Exception: horses - 5-20 ml m/b collected |
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Name 2 indications for paracentesis (abdominocentesis) in dogs & cats.
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1 - for diagnostic purposes - ascitic fluid
2 - therapeutic purpose (rare) - eg. to remove excess thoracic fluid to relieve dyspnea |
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Name 3 risks associated with paracentesis/abdominocentesis.
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1 - sepsis (eg. peritonitis)
2 - hemorrhage 3 - organ laceration *risks are rare if adequate restraint is used along with local/general anesthesia |
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When performing a paracentesis/abdominocentesis,how should the animal be positioned?
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standing on table OR in lateral recumbency
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Where is the site of collection for a paracentesis/abdominocentesis?
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around umbilicus
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What should the tube contain when taking fluid via a paracentesis/abdominocentesis?
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collect 1st few ml in EDTA & some in plain sterile tube
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When performing a paracentesis/abdominocentesis,what should be done to relieve dyspnea?
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larger bore cannula can be used if fluid accumulated is in large quantity - relieves dyspnea
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What should you do if the 1st tap is dry when performing a paracentesis/abdominocentesis?
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further attempts m/b made 2 cm caudally or cranially
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What should you do if the fluid is clear initially & becomes blood stained when performing a paracentesis/abdominocentesis?
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it should be terminated and attempted at a different site
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Decribe the procedure for performing a paracentesis/abdominocentesis.
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introduce 21 or 22 gauge needle gently thru abdominal wall at an oblique angle & bevel towards abdominal floor at collection site - apply negative pressure as soon as skin is penetrated
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Turbid urine is found in which healthy animal?
a) Horse b) Dog c) Rabbit d) Pig e) None of the above |
A
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All of the following can cause acidic urine EXCEPT
a) Starvation b) Fever c) Nursing d) Low Protein Diet e) High Protein Diet |
D
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Ketones are found in the urine of healthy______:
a) Horse b) Dog c) Rabbit d) Pig e) Sheep |
C
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Which of the following might cause urine to be a deep yellow color?
a) Pu/Pd b) Blood c) Dehydration d) All of the above e) None of the above |
C
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Turbity in urine is caused by which the presence of which of the following?
a) Crystals b) Blood cells c) Tissue cells d) Bacteria e) All of the above |
E
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All of the following can cause primary proteinuria EXCEPT
a) Hemorrhage b) Fever c) Inflammation d) Infection e) Protein losing nephropathy |
B
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The lower the specific gravity is the less important the protein levels are.
a) True b) False |
B
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Hematuria is usually caused by which of the following?
a) Fever b) Inflammatory disease c) Jaundice d) Pregnancy e) Mastitis |
B
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Marked bilirubinuria is caused by what?
a) Obstructive jaundice b) Inflammatory disease c) Neoplasia d) Estrus e) None of the above |
A
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Which of the following results obtained from a reagent test strip are not acceptable or reliable in animal urine?
a) Specific Gravity b) WBC c) Nitrites d) Urobilinogen e) All of the above |
E
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Which of the following is a significant finding in urine sediment
a) Sperm b) Yeast c) Fat droplets d) Calcium oxalate monohydrate crystals e) All of the above are normal findings in healthy animals |
D
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Raised numbers of RBC are found in which of the following conditions?
a) Starvation b) Urinary tract inflammation c) Dehydration d) Low Protein Diet e) Mastitis |
B
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A urine sediment analysis of a dog yields a large number of epithelial cells but few WBC, what is the next appropriate step?
a) Radiograph bladder b) Euthanize animal c) Nothing this is normal d) Examine a stained smear e) None of the above |
D
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You choose to examine a stained smear of a dog with a high number of epithelial cells but few WBC in a urine sediment, what are you looking for?
a) Bacteria b) Cystine Crystals c) Bilirubin crystals d) Sperm e) Evidence of neoplasia |
E
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All of the following statements are true EXCEPT
a) Crystals are a normal finding in all species b) Calcium carbonate crystals are common in horses and rabbits c) Calcium oxalate dihydrate is the most common crystal found in dog urine d) Crytalluria is a reliable guide to the type or urolith which may or may not be present e) Ammonium biurate crystals occur in healthy dalmatians and English bulldogs |
D
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If bacteria found in a sediment are significant, they are usually accompanied by which of the following?
a) karyolysed neutrophils b) inflammatory cells c) cell debris d) All of the above e) None of the above |
D
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At what number would you start to view the presence of casts per 40x field pathological?
a) more than 6 b) more than 0 c) less than 2 d) more than 3 e) less than 1 |
D
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Which of the following is the MOST reliable indicator of nephron damage?
a) Blood Urea b) Blood Creatine c) Azotemia d) Glucosuria e) None of the above |
A
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A nonregenerative anemia would be indicative of chronic renal disease.
a) True b) False |
A
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Endogenous creatine clearance is deemed ______________________ if uremia, dehydration or urinary tract obstruction are already shown to be present.
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Endogenous creatine clearance is deemed UNNECESSARY if uremia, dehydration or urinary
tract obstruction are already shown to be present. |
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Ketonuria is seen pathologically in Diabetes mellitus in __________________________, __________________ in sheep, acetonemia in ____________.
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small animals, pregnancy, cattle
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Glucose is absent in the urine of healthy animals except ______________________________, ___________________________________, ___________________________________, __________________________, ___________________________________
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post prandially, after severe
exertion, admistration of IV fluids, stressed cats, adminstration of xyazine/ketamine |
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________________________ is the ONLY specific diagnostic kidney test.
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Renal biopsy
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Struvite crystals usually resemble ______________________ and occur in ________________ urine of dogs and cats in ____________ and also with uroliths
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coffin lids
alkaline health |
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Calcium carbonates occur in ______________ and ____________ in health and have a ______________________ appearance. They are of ____________ clinical significance.
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rabbits & horses
wagon wheel little significance |
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___________________________________ crystals have an envelope or maltese cross shape. They are the most common crystals in ________ urine of dogs.
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Calcium oxalate dihydrate
acidic |
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(calcium oxalate monohydrate] usually have a picket fence or spindle shape. They are rarely seen in healthy animals and occur for up to one day after ___________________________________ and also occur in marked __________________________.
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ethylene glycol poisoning
marked hypercalcemia |
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Ammonium biurate are ________________________ spheres with spiky protrusions, it also resembles amorphous ____________________ may occur in healthy ____________________ and ________________________________. Also occur in __________________________________ and some ______________ liver diseases. Urates are common in birds and ________________.
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Ammonium biurate are YELLOW BROWN Spheres with spiky protrusions, it also resembles
amorphous BROWN SAND may occur in healthy DALAMATIONS and ENGLISH BULLDOGS. Also occur in PORTOCAVAL SHUNTS and some CHRONIC liver diseases. Urates are common in birds and REPTILES. |
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Bilirubin crystals seen in species besides dogs or in high numbers in dogs is indicative of __________________ or ______________ disease.
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hemolytic or hepatic dz
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What are the indications for nasal lavage?
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when discharge can not be dx even after rads or rhinoscopy
when discharge is scanty & to harvest more cells |
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What are the causes of persistent nasal discharge?
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viral
bacterial fungal FBs neoplasms |
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What kind of stains are used on a direct smear of nasal discharge?
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blood stains
Gram's stain Papanicolaou's stain |
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Why is nasal discharge not cultured?
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varied bacterial flora is present in normal animals
-OR- m/b result of secondary infection |
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How should a small animal be positioned for nasal lavage?
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anesthesized & placed on table which is at an angle with head lower than body
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What kind of flush is used in nasal lavage?
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sterile saline or phosphate buffered saline (BPS)
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What are the 3 ways a direct aspiration of a nasal lesion can be performed?
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1 - using FNA techniques
2 - by advancing catheter into lesion 3 - rhinoscopy with pediatric endoscope |
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What is the advantage of the rhinoscopy method of obtaining nasal aspirate?
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the lesion can be located visually (as long as discharge/bleeding is not too severe or copious)
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Why is the protein content and cell counts not measured in nasal aspirates/lavages?
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collected fluid is diluted by lavage
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Nasal aspirates/lavages:
When would you make direct smears & air dry? When would you centrifuge 1st? |
direct smears if lavage is turbid
centrifuge 1st if lavage is clear |
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What types of cells m/b found in a normal nasal lavage/aspirate?
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squamous & basal epithelials
ciliated columnar epithelials RBC WBC microorganisms like Simonsiella |
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What do Simonsiella microorganisms look like?
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large
club shaped/stacked rod shaped |
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Which of the following would be considered an abnormal finding in nasal lavage?
a) Simonsiella b) WBC c) columnar epithelial cells d) basal epithelial cells e) pink amorphous material |
E
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What is the primary cell type seen with infectious causes of inflammation/necrosis in nasal lavage/aspirate?
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neutrophils
karyolized neutrophils if bacterial cause |
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Nasal Lavage:
Fungal hyphae & spores m/b difficult to see in routine blood smears so what kind of stains should be used? |
PAS
Fontana GMS |
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What should be suspected when sinusitis is unresponsive to antibacterial therapy?
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fungal infection
FBs neoplasia |
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What are the indications for performing TBL or BAL?
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to ID cause of resp signs as being inflammatory or neoplastic
if inflammatory - to ID as infectious or non-infectious & isolate microorganisms |
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What are the contraindications for performing a BAL or TBL?
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severe respiratory distress
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What are the potential risks/complications with BAL or TBL?
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severe dyspnea
hemorrhage infection SQ emphysema general anesthesia risks |
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What should be avoided when collecting a BAL sample?
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oropharyngeal contamination - it may give misleading results
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Where do you introduce the saline when performing a BAL using an endoscope?
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into trachea at R side
aspirate immediately |
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Where do you introduce the saline when performing a BAL using an endotracheal tube?
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pass sterile catheter thru endotracheal tube to the bifurcation of the bronchi
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How is a dog positioned for transtracheal lavage?
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standing or sitting on table
sedated if necessary |
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Where is the collection site for transtracheal lavage?
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midline at jxn of middle & lower 3rds of neck over inter-tracheal mb
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What should transtracheal lavage fluid be collected in?
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split into EDTA & plain sterile tubes
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When would transtracheal specimens not be sterile?
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pneumonia or bronchopneumonia
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Ideally, how soon should you make smears from lavages?
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within 15-30 minutes
air dried then stained with Diff Quick |
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What is not a normal finding in trans-tracheal or BAL?
a) neutrophils b) Simonsiella bacteria c) ciliated columnar epi d) macrophages e) all of the above are normal findings in BOTH |
E
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WOULD THE CAUSE BE EIPH OR COPD WITH A HORSE WHOSE BAL CONTAINED THE FOLLOWING (EVERYTHING ELSE NORMAL)?
MUCIN MACROPHAGES HEMOSIDERAPHAGES RBC'S NEUTROPHILS |
EIPH b/c all other findings were normal
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Simonsiella bacteria are normal bacteria seen in transtracheal lavages or BAL. What do they look like and where are the often seen?
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bullet shaped
often attached to epi cells |
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Name 4 potential causes of eosinophilic inflammation.
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parasitic pneumonia:
D. immitis - dogs Aelurostrongylus abstrusus - cats Dictyocaulus filarail - cattle allergic pneumonitic or bronchitis in cats (asthema) |
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What kind of cells would you expect to find in the lavage of a horse with COPD?
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mix of chronic & inflammatory cells
pink amorphous material - mucin marked neutrophil infiltration if recurrent infection neutrophils |
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What types of cells would you see in a case of EIPH if it were acute? Chronic?
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acute - RBC, MO containing phagocytosed RBCs
chronic - hemosiderophages, mucin, inflammatory cells |
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Tumors in lung parenchyma are not detected by _____ unless they are exfoliative & penetrate into airways.
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BAL
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What are the indications for performing vaginal cytology?
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to monitor progression/stage of estrus cycle (esp dogs/cats)
determine optimum breeding time in dogs detection of inflammation & neoplasia in female repro tract |
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Where is the sterile, saline moistened swab directed when obtaining vaginal cytology?
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directed craniodorsal when entering vaginal vault
once cranial to urethral orifice, rub swab against vaginal wall |
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What stains are used for vaginal cytology?
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blood stains or Schorr's stain
or fixed in absolute alcohol if using H.E. staining |
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What stage of the estrus cycle would you find the following cells:
RBCs-increased then decreased increase cornified epi cells increased mucus decrease in smaller parabasal cells bacteria on or around epi cells |
proestrus
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What stage of the estrus cycle would you find the following cells:
mostly basal & parabasal cells, few cornified supf epi cells, RBCs & WBCs |
anestrus
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What stage of the estrus cycle would you find the following cells:
>90% large flattened cornified epi cells |
estrus
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What do cornified supf epi cells look like?
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large
flattened degenerated deeply basophilic cytoplasm angular margins pyknotic nuclei or anucleate |
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How does the feline estrus cycle differ from that in dogs?
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RBCs not seen in proestrus,
neutrophils - inconsistent finding during diestrus |
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What kind of cells are found in vaginal cytology with acute inflammation/metritis?
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neutrophils
karyolyzed neutrophils cell debris bacteria |
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What are the indications for obtaining prostate gland cytology?
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enlarged prostate gland
prostate abnormalities detected by palpation/rads along with clinical symptoms |
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When would you find increasing numbers of prostate cells in fresh urine?
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inflammation, neoplasia
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What are the 4 methods of obtaining prostate cytology?
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1) fresh urine sample - sediment
2) directly thru urethra 3) prostatic wash 4) FNA |
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Why are urine & fluids obtained a/f urine collection, cystic lavage or prostate massage centrifuged asap?
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to prevent cell degeneration
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What type of stains are used on prostate smears?
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Romanowsky
H&E Papanicolaou |
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Which of the following is not a normal finding in examination of normal prostate massage material?
a) transitional epi cells b) blood cells c) prostatic epi cells d) neutrophils e) sperm |
D
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Describe normal transitional epithelial bladder cells.
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single or large sheets
variable size little variation in N:C basophilic cytoplasm central nucleus w/fine chromatin |
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Describe normal prostatic epithelial cells.
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small uniform cells
small clusters round eccentric nucleus coarse chromatin pale cytoplasm |
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How is the cytoplasm different in prostate epi cells with hyperplasia?
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darker/deeper basophilic cytoplasm
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What are the main causes of squamous metaplasia of the prostate?
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chronic irritation or inflammation
d/t increased levels of circuting estrogen - Sertoli cell tumor |
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Which of the following is NOT a feature of a prostate carcinoma?
a) cell cohesion b) pleomorphism c) anisokaryosis d) reactive lymphocytes e) multinucleation |
D - reactive lymphocytes are seen with prostitis
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What is different about the nucleus in prostate epi cells from bladder epi cells?
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prostate - eccentric nucleus
bladder - central nucleus |
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If there is dysuria or hematuria w/out dysuria or there is increased epi cell numbers in an unstained urine sediment what should be suspected?
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cystitis or neoplasia
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How many times do you "touch" the slide with touch imprints?
What kind of stain is used? |
15-20x on 4-6 slides
Diff-Quik or any blood stain |
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Why is FNA aspirate of solid mass or internal organ better than biopsy?
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simple, quick, inexpensive, less invasive, risks from general anesthesia, hemorrhage or infection are reduced or avoided
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FNA - when is negative pressure released?
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before needle is withdrawn
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If fluid is aspirated from internal organ or solid mass what should be done with it?
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placed in EDTA & sterile tubes
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What is the best method for collection of fragile cells (eg. lymphoid)?
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FNA - nonsuction method
also causes less blood contamination |
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Squash or smear method for FNA of solid or cheesy material?
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squash - gross!!!
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What 3 general processes cause enlargement of LNs?
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hyperplasia
inflammation neoplasia |
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In a normal LN how many of the cells are mature lymphocytes?
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>90% of all cells
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Describe the 2 types of mature lymphocytes.
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1) small, dark cells with scanty pale blue cytoplasm, round nuclei, densely aggregated chromatin - cells usually smaller than neutrophils
2) slightly larger paler cells with more abundant pale-staining cytoplasm (less mature than other type - prolymphoctes) |
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Which of the following is not a common finding in a normal LN:
a) basophils b) lymphoglandular bodies c) neutrophils d) mature lymphocytes e) mast cells |
A
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What cells are increased in a reactive/hyperplastic LN? What other cells are found?
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increased prolymphocytes & lymphoblasts
plasma cells macrophages neutophils eosinophils |
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Which of the following would you expect to find generalized lymphadenopathy with hyperplastic cytologic picture?
a) FLV b) FIP c) Ehrlichiosis d) all of the above e) none of the above |
D
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The following cells are found in acute or granulomatous lymphadenitis?
macrophages epitheliod type macrophages multinuclear giant cells plasma cells neutrophils |
granulomatous
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Name 2 types of protozoal infections that would cause lymphadenitis.
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toxoplasmosis
leishmaniasis |
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Is nuclear moulding a common feature of lymphoma/lymphosarcoma?
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yes
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Why should the submaxillary LN not be aspirated?
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cells there are highly reactive which could lead to false positive results
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What is the major difference in neutrophils & bacteria found in acute septic inflammation versus acute sterile inflammation?
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acute septic: karyolyzed neutrophils + bacteria
acute sterile: >70% intact neutrophils & no bacteria |
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What is the main difference b/w cells found in chronic inflammation versus chronic granulomatous?
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multinucleated giant cells are found in chronic granulomatous inflammation
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Which benign lesion contains the following cells?
adipocytes clumps of benign CT squames RBCs |
lipoma
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What kind of benign lesion contains many RBCs, some WBCs, no platelets & mostly hemosiderophages?
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hematoma
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What kind of benign lesion grossly - fluid is black, viscous, micro - it contains many RBC, MO, mucin?
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sialocele
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How is an epithelioma different if infected versus uninfected?
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uninfected:
aspirate contains alot of amorphous debris, some squames & ch-ol crystals infected: aspirate contains lots of karyolyzed neutrophils & bacteria |
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WHAT WOULD THE NUCLEUS OF A NEOPLASTIC CELL LOOK LIKE?
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multinucleated
fragmentation clumped chromatin large/irregular sharp corners aniskaryosis |
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What kind of tests should you perform prior to aspiring internal masses?
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coagulation profile
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Describe a normal hepatocyte.
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large
round or oval abundant lightly basophilic granular cytoplasm nuclei - round, central, m/b binucleate, coarse chromatin single nucleolus |
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Decribe normal biliary cells.
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small cells
round nuclei scant cytoplasm usually exfoliate in sheets |
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For which of the following would this description be accurate - presence of inflammatory cells, esp neuts & degenerate/vacuolated/poorly stained hepatocytes:
a) cholestasis b) glucocorticoid effect c) hepatic lipidosis d) hepatitis/degeneration e) hepatic neoplasms |
D
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Cytology does not replace histopath but offers a valuable tool for _____ of a lesion and establishing the ____.
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assessment
next course of action |
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Which of the following is NOT an advantage of cytology:
a) noninvasive,safe, inexpensive b) quick assessment c) requires no sophistaicated equipment d) timely determination of a plan of action e) always gives you a diagnosis |
E
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Which of the following is NOT a limitation of cytology:
a) m/b difficult to obtain cells esp if fibrous lesion b) often may only provide general classifiation of dz and not specific dx c) only small differences b/w hyperplastic cells, adenoma cells, well-differentiated malignant cells so histopath must be used d) in comparison with histopath, sensitivity/specificity may be 90% e)they are all limitations of cytology |
E
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______ is indicated by the presence of many dark green-black granules or clumps within the cytoplasm or extracellular accumulation of green-black "casts" b/w hepatocytes.
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bile pigment (cholestasis)
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What are the benefits of a CBC?
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deydration vs anemia
cause of anemia & response inflammation/necrosis or stress toxemia definitive Dx: parasites & leukemia |
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What is ESR a measure of?
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inflammation
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What is the stain of choice for RBCs?
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NMB
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With Romanowsky stains - acidic groups appear _____
basic groups appear _____ |
blue-purple
red-orange |
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Increased numbers of HJ bodies are seen when?
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regenerative anemias
splenectomized animals animals tx with glucocorticoids |
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What is the most sens indicator of regeneration?
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reticulocytes
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Name 4 types of poikilocytes?
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acanthocytes
dacrocytes stomatocytes schistocytes |
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____ are assoc with IMHA. blood transfusions, Zn tox, bee stings & snake bites.
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spherocytes
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_____ hemolysis is the removal & destruction of RBCs by spleen & liver. It is stimulated by a change in RBC mb & is seen in IMHA. Increased phagocytic activity in spleen leads to splenomegaly.
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extravascular hemolysis
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What lab findings are seen in EV hemolysis?
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hx of chronic onset
regenerative response NO Hbemia (clear plasma) No Hburia hyperbilirubinemia |
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What are the lab findings with IV hemolysis?
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hx of acute onset
regenerative response Hbemia Hburia hyperbilirubinemia |
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______ is an intracellular blood parasite causing hemolysis that becomes regenerative anemia with fever, icterus &Hbemia/Hburia.
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Babesiosis
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______ causes acute or chronic dz. It is gram neg nonacid fast mycoplasma causing regen anemia, icteric plasma, fever, splenomegaly and leukocytosi.
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FIA/Hemobartonella felis
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______ are round red protrusions from RBc mb - denatured precipitated Hb d/t oxidation.
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Heinz bodies
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Total WBC - multiply mean number of WBC in 10 fields @ high/dry mag by ____.
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1.5
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Absolute blood count if calculated for each cell type by multiplying it's _____ value by total WBC count.
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differential value (%)
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To manually count WBu:
hemocytometer lower light, condensor down, diaphragm adjusted count all cells in 4 large corner squares & divide sum by ___ |
20
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Leukocytosis:
____, ____ - common, increase & decrease rapidly, less significant ____ - less common, more significant ____ - uncommon (w/out severe inflammation), very significant |
dog, pig
cat horse |
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Name 4 causes of hypersegmentation of neutrophils.
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normal aging process
prolonged transit time in blood resolving chronic inflammation MPD |
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M/E ratio:
____ ratio is assoc with leukopenia or regen anemia. ____ ratio m/b d/t leukocytosis (inflammation) or decreased RBC prod (dyshemopoiesis) or both conditions |
high
low |
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Low M/E ratio = ____ RBC precursors OR ____ WBC precursors
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increased RBC precursors
decreased WBC precursors |
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High M/E ratio = ____RBC precursors OR ____ WBC precursors
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decreased RBC precursors
increased WBC precursors |
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What is the most important fxn of platelets?
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formation of platelet plug
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Name the causes of low SG.
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physiological
diuretics DI liver dz pyometra CRF Cushing's psychogenic PD |
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Name the causes of high SG.
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physiological
dehydration DM |
