Podcast
Questions and Answers
Which of the following best describes the initial step in a problem-based approach to veterinary diagnosis?
Which of the following best describes the initial step in a problem-based approach to veterinary diagnosis?
- Immediately performing advanced imaging techniques such as MRI or CT scans.
- Identifying and defining the abnormal finding(s) presented by the animal. (correct)
- Administering broad-spectrum treatment based on common symptoms.
- Consulting with specialists before conducting a physical exam.
An animal presents with elevated albumin and globulin levels on a CBC/chemistry panel. Which of the following is the MOST likely underlying cause?
An animal presents with elevated albumin and globulin levels on a CBC/chemistry panel. Which of the following is the MOST likely underlying cause?
- Failure of passive transfer of antibodies
- Inflammation due to an infectious disease (correct)
- Hemodilution due to congestive heart failure
- Significant blood loss from a parasitic infection
A veterinarian notes differences in gastrointestinal anatomy when treating different species. Why is it so important to understand these anatomical variations for effective clinical practice?
A veterinarian notes differences in gastrointestinal anatomy when treating different species. Why is it so important to understand these anatomical variations for effective clinical practice?
- Anatomical differences only affect surgical procedures; medical treatments are unaffected.
- Anatomical variances across species has little effect on veterinary practice.
- Different species have various digestive processes and susceptibilities due to differences in anatomy. (correct)
- All species respond similarly to treatments, regardless of GI anatomy.
A foal is diagnosed with failure of passive transfer. What change would you MOST expect to see on its CBC/chemistry as a direct result of this condition?
A foal is diagnosed with failure of passive transfer. What change would you MOST expect to see on its CBC/chemistry as a direct result of this condition?
A dog presents with panhypoproteinemia. Which of the following conditions should be considered as a primary differential?
A dog presents with panhypoproteinemia. Which of the following conditions should be considered as a primary differential?
A large animal veterinarian is treating a horse with suspected colic. Why is a detailed understanding of equine gastrointestinal anatomy particularly critical in this situation?
A large animal veterinarian is treating a horse with suspected colic. Why is a detailed understanding of equine gastrointestinal anatomy particularly critical in this situation?
Which of the following conditions is MOST likely to cause hypoproteinemia as a result of decreased protein production?
Which of the following conditions is MOST likely to cause hypoproteinemia as a result of decreased protein production?
Which of the following is the correct sequence of steps in a problem-based approach to cases?
Which of the following is the correct sequence of steps in a problem-based approach to cases?
Sadie, a 10-year-old spayed female Sheltie, presents with vomiting and anorexia of 3 days duration. Which of the following steps would be the MOST appropriate FIRST step in her physical examination?
Sadie, a 10-year-old spayed female Sheltie, presents with vomiting and anorexia of 3 days duration. Which of the following steps would be the MOST appropriate FIRST step in her physical examination?
In a dog experiencing an inflammatory condition, which of the following acute-phase proteins (APPs) would you expect to see increase MOST significantly?
In a dog experiencing an inflammatory condition, which of the following acute-phase proteins (APPs) would you expect to see increase MOST significantly?
Which of the following acute phase proteins is considered a NEGATIVE acute phase protein?
Which of the following acute phase proteins is considered a NEGATIVE acute phase protein?
Which acute phase protein(s) (APP) is considered the major APP in a cat?
Which acute phase protein(s) (APP) is considered the major APP in a cat?
A blood sample from a cow with an active inflammatory process is analyzed. Which of the following acute-phase proteins would be expected to show a significant increase?
A blood sample from a cow with an active inflammatory process is analyzed. Which of the following acute-phase proteins would be expected to show a significant increase?
During protein electrophoresis, an increase in which globulin fraction is MOST indicative of an acute inflammatory response?
During protein electrophoresis, an increase in which globulin fraction is MOST indicative of an acute inflammatory response?
Which of the following statements accurately describes the role of haptoglobin (Hpt) as an acute-phase protein (APP)?
Which of the following statements accurately describes the role of haptoglobin (Hpt) as an acute-phase protein (APP)?
Which of the following would be the MOST likely cause of an increased concentration of positive acute-phase proteins (APPs)?
Which of the following would be the MOST likely cause of an increased concentration of positive acute-phase proteins (APPs)?
Which of the following is a characteristic of a transudate?
Which of the following is a characteristic of a transudate?
Increased vascular permeability leads to which type of fluid accumulation?
Increased vascular permeability leads to which type of fluid accumulation?
What change in serum electrolyte concentrations is expected with upper gastrointestinal obstruction?
What change in serum electrolyte concentrations is expected with upper gastrointestinal obstruction?
A patient presents with diarrhea. Which acid-base abnormality is most likely to develop as a result?
A patient presents with diarrhea. Which acid-base abnormality is most likely to develop as a result?
If a fluid sample has a bilirubin concentration greater than twice the serum bilirubin, what is the most likely diagnosis?
If a fluid sample has a bilirubin concentration greater than twice the serum bilirubin, what is the most likely diagnosis?
Which electrolyte is predominantly found in the intracellular fluid (ICF)?
Which electrolyte is predominantly found in the intracellular fluid (ICF)?
Which of the following is a characteristic feature of chylous effusion?
Which of the following is a characteristic feature of chylous effusion?
How do corticosteroids affect calcium absorption in the intestines?
How do corticosteroids affect calcium absorption in the intestines?
Which hormone directly opposes the action of parathyroid hormone (PTH) on calcium levels?
Which hormone directly opposes the action of parathyroid hormone (PTH) on calcium levels?
An alpaca presents with elevated globulin levels and normal albumin levels. Which of the following is the MOST likely underlying cause?
An alpaca presents with elevated globulin levels and normal albumin levels. Which of the following is the MOST likely underlying cause?
A veterinarian is evaluating a blood panel from a puppy and notes panhypoproteinemia. Which of the following differentials is the MOST likely if the puppy has no evidence of external bleeding?
A veterinarian is evaluating a blood panel from a puppy and notes panhypoproteinemia. Which of the following differentials is the MOST likely if the puppy has no evidence of external bleeding?
A dog presents with severe burns covering a large surface area of its body. What specific type of protein change is MOST likely to be observed on a chemistry panel?
A dog presents with severe burns covering a large surface area of its body. What specific type of protein change is MOST likely to be observed on a chemistry panel?
A foal is suspected of failure of passive transfer. What change would you MOST expect to see on its CBC/chemistry as a direct result of this condition?
A foal is suspected of failure of passive transfer. What change would you MOST expect to see on its CBC/chemistry as a direct result of this condition?
A cat presents with cirrhosis. What type of change in protein levels is MOST likely to be noted on a chemistry panel?
A cat presents with cirrhosis. What type of change in protein levels is MOST likely to be noted on a chemistry panel?
A veterinarian is presented with a horse exhibiting signs of colic. Utilizing a problem-based approach, what should be the veterinarian's immediate next step after identifying abdominal pain as a key problem?
A veterinarian is presented with a horse exhibiting signs of colic. Utilizing a problem-based approach, what should be the veterinarian's immediate next step after identifying abdominal pain as a key problem?
During a necropsy of a deceased sheep, a veterinary student is tracing the flow of ingesta through the gastrointestinal tract. Which compartment would ingesta enter immediately after leaving the rumen?
During a necropsy of a deceased sheep, a veterinary student is tracing the flow of ingesta through the gastrointestinal tract. Which compartment would ingesta enter immediately after leaving the rumen?
A veterinary surgeon is preparing to perform a liver biopsy on a dog. A thorough understanding of the regional anatomy is essential to avoid complications. Which anatomical landmark is MOST critical to identify accurately during this procedure to minimize the risk of hemorrhage?
A veterinary surgeon is preparing to perform a liver biopsy on a dog. A thorough understanding of the regional anatomy is essential to avoid complications. Which anatomical landmark is MOST critical to identify accurately during this procedure to minimize the risk of hemorrhage?
A mixed animal practitioner is examining a fecal sample from a horse and a cat. What is the MOST significant anatomical difference in their gastrointestinal tracts that would explain why horses are more prone to fiber fermentation than cats?
A mixed animal practitioner is examining a fecal sample from a horse and a cat. What is the MOST significant anatomical difference in their gastrointestinal tracts that would explain why horses are more prone to fiber fermentation than cats?
A dog presents with elevated levels of Serum Amyloid A (SAA) and C-reactive protein (CRP). Based on this information, which of the following is the MOST likely condition?
A dog presents with elevated levels of Serum Amyloid A (SAA) and C-reactive protein (CRP). Based on this information, which of the following is the MOST likely condition?
In a horse experiencing an inflammatory condition, which acute phase protein would be expected to increase the MOST significantly?
In a horse experiencing an inflammatory condition, which acute phase protein would be expected to increase the MOST significantly?
In which species would haptoglobin (Hpt) be considered a major acute phase protein (APP)?
In which species would haptoglobin (Hpt) be considered a major acute phase protein (APP)?
Which of the following acute-phase proteins (APPs) is classified as a NEGATIVE acute-phase protein and would therefore decrease during an inflammatory response?
Which of the following acute-phase proteins (APPs) is classified as a NEGATIVE acute-phase protein and would therefore decrease during an inflammatory response?
A protein electrophoresis is performed on a sample from an animal experiencing chronic inflammation. What changes would you expect to see in the protein fractions?
A protein electrophoresis is performed on a sample from an animal experiencing chronic inflammation. What changes would you expect to see in the protein fractions?
In which clinical scenario would monitoring acute phase proteins provide the MOST useful information?
In which clinical scenario would monitoring acute phase proteins provide the MOST useful information?
Why is it important to perform a triage exam on an emergency patient before a complete physical exam?
Why is it important to perform a triage exam on an emergency patient before a complete physical exam?
Which of the following situations would MOST likely result in a pure transudate?
Which of the following situations would MOST likely result in a pure transudate?
In a patient with upper gastrointestinal obstruction, which electrolyte imbalance is MOST likely to occur due to the sequestration of gastric contents?
In a patient with upper gastrointestinal obstruction, which electrolyte imbalance is MOST likely to occur due to the sequestration of gastric contents?
What is the primary compensatory mechanism for metabolic acidosis?
What is the primary compensatory mechanism for metabolic acidosis?
A patient presents with severe, chronic diarrhea. Which acid-base disturbance is MOST likely to develop as a result of this condition?
A patient presents with severe, chronic diarrhea. Which acid-base disturbance is MOST likely to develop as a result of this condition?
Which of the following hormones directly increases calcium absorption in the intestines?
Which of the following hormones directly increases calcium absorption in the intestines?
What effect does hyperventilation typically have on acid-base balance?
What effect does hyperventilation typically have on acid-base balance?
Following a severe burn injury affecting a large surface area of the body, which of the following fluid and electrolyte shifts is MOST likely to occur in the initial acute phase?
Following a severe burn injury affecting a large surface area of the body, which of the following fluid and electrolyte shifts is MOST likely to occur in the initial acute phase?
Flashcards
What is a Problem?
What is a Problem?
An abnormal finding identified through history, physical examination, or diagnostics.
Problem-Based Approach
Problem-Based Approach
A method using abnormal findings to diagnose a condition.
"Nose to tail" Anatomy
"Nose to tail" Anatomy
Examining anatomy from cranial to caudal.
Gastrointestinal Tract & Hepatobiliary System
Gastrointestinal Tract & Hepatobiliary System
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Importance of Anatomy
Importance of Anatomy
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Hyperproteinemia
Hyperproteinemia
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Hypoproteinemia
Hypoproteinemia
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Non-Selective Hypoproteinemia
Non-Selective Hypoproteinemia
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Selective Hypoproteinemia
Selective Hypoproteinemia
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Hypoproteinemia: ↓ Production
Hypoproteinemia: ↓ Production
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Baseline Data
Baseline Data
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Problem List
Problem List
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Ddx List
Ddx List
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Dx Plan
Dx Plan
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Working Dx
Working Dx
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Tx Plan
Tx Plan
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Acute-Phase Proteins (APPs)
Acute-Phase Proteins (APPs)
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Positive APPs
Positive APPs
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Negative APPs
Negative APPs
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Protein Electrophoresis
Protein Electrophoresis
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Malabsorption/Maldigestion
Malabsorption/Maldigestion
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Body Water Distribution
Body Water Distribution
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Starling Forces
Starling Forces
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Abnormal Fluid Distribution Manifestations
Abnormal Fluid Distribution Manifestations
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Abnormal Fluid Distribution Mechanisms
Abnormal Fluid Distribution Mechanisms
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Transudate
Transudate
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Exudate
Exudate
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Electrolyte Abnormalities Causes
Electrolyte Abnormalities Causes
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Serum Sodium
Serum Sodium
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Na-Cl Difference >40
Na-Cl Difference >40
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Metabolic Alkalosis
Metabolic Alkalosis
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Metabolic Acidosis
Metabolic Acidosis
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Respiratory Acidosis
Respiratory Acidosis
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Anion Gap
Anion Gap
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Calcium Absorption/Excretion
Calcium Absorption/Excretion
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Gastrointestinal & Hepatobiliary System
Gastrointestinal & Hepatobiliary System
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Hemoconcentration
Hemoconcentration
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↑ Protein Loss
↑ Protein Loss
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↓ Protein Synthesis
↓ Protein Synthesis
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↑ Protein Catabolism
↑ Protein Catabolism
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Failure of Passive Transfer
Failure of Passive Transfer
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Collect Baseline Information
Collect Baseline Information
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Signalment
Signalment
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History (Medical)
History (Medical)
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Triage
Triage
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Physical Examination (PE)
Physical Examination (PE)
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Positive Acute Phase Proteins (inflammation)
Positive Acute Phase Proteins (inflammation)
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Cause of Malabsorption
Cause of Malabsorption
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Inflammation's Effect on Albumin
Inflammation's Effect on Albumin
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Causes of Lymphoid Hypoplasia
Causes of Lymphoid Hypoplasia
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Causes of Cachexia
Causes of Cachexia
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Role of Albumin
Role of Albumin
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Causative factors of Transudate
Causative factors of Transudate
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Causative factors of Exudate
Causative factors of Exudate
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Causes of Hemorrhagic Effusion
Causes of Hemorrhagic Effusion
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Causes of Lymphorrhagic Effusion
Causes of Lymphorrhagic Effusion
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Causes of Uroperitoneum
Causes of Uroperitoneum
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Causes of Bile Peritonitis
Causes of Bile Peritonitis
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Causes of Septic Effusion
Causes of Septic Effusion
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Metabolic Component in Cursory Acid-Base Review
Metabolic Component in Cursory Acid-Base Review
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Respiratory Component in Cursory Acid-Base Review
Respiratory Component in Cursory Acid-Base Review
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The hormones that balance caclcium
The hormones that balance caclcium
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Study Notes
Test Yourself - Routine Clinical Pathology
- Routine clinical pathology can reveal information about postprandial status, hemoconcentration/dehydration, and inflammation.
- Also vomiting, diarrhea, hepatocellular injury, cholestasis, and liver dysfunction/failure.
- Helpful tests include:
- Albumin, ALP, ALT, AST, Bicarbonate, Bilirubin, and BUN. They are part of basic chemistry.
- Calcium, Chloride, Cholesterol, Creatine Kinase, Creatinine, GGT, Globulin, Glucose, Potassium, Phosphorus, SDH and Triglyceride.
Test Yourself - Ancillary Clinical Pathology
- Can aid in diagnosis of pancreatitis, exocrine pancreatic insufficiency (EPI), or protein-losing enteropathy.
- Useful tests include α-1 protease inhibitor, cobalamin, folate, PLI, and TLI.
- Can also indicate small intestinal bacterial overgrowth (SIBO), small intestinal dysbiosis, antibiotic-responsive diarrhea, or tylosin-responsive diarrhea.
- Aids in localizing small intestinal disease (proximal vs. distal vs. diffuse).
Important Proteins
- Albumin.
- Globulins (= Total Protein – Albumin).
- Acute-phase proteins.
- Coagulation proteins/factors (hemostasis!).
- Many coagulation proteins/factors (pro- and anti-) are made by the liver.
- Several require Vitamin K.
- Calcium.
Importance of Vitamin K
- Vitamin K is a fat-soluble vitamin from diet that is related to intestinal bacteria.
Role of Globulins
- Globulins are all proteins in serum other than albumin.
- There are 3 fractions:
- α and β are mostly synthesized by the liver and include lipoproteins, acute phase proteins, and some immunoglobulins.
- γ = immunoglobulins are made by B lymphocytes and plasma cells.
Positive vs. Negative Acute-Phase Proteins for Clinical Evaluation
- Positive APPs (increase during inflammation) include:
- Fibrinogen.
- C-reactive protein (CRP).
- Serum amyloid A (SAA).
- Haptoglobin (Hpt).
- Ceruloplasmin (Cp).
- α2-macroglobulin (A2MG).
- α1-acid glycoprotein (AGP).
- Complement (C3, C4).
- Negative APPs (decrease during inflammation) include albumin and transferrin.
Albumin vs Globulins
- Albumin Bands or fractions do not include Alpha and beta groups.
Electrolyte Review With Sodium
- Has a relationship in blood volume and plasma osmolality balance levels.
- Electrolyte is influenced by water, while water influences serum and volume.
Acid Base Balance
- Can be achieved by balancing out by Carbon dioxide and levels.
- Inversely, higher CO2 mean lesser electrolytes.
Mineral G/I Levels
- Dependent on Vitamin D, liver, kidney, and digestive health.
- Has multiple factors which influence the digestive health.
Bone Disorders
- Is influenced by many factors in digestive level.
Changes In Kidney Readings
- Kidneys are disrupted by imbalance of Magnesium to other level.
BUN balance
- BUN dependent on creatine influences through GFR, with many proteins related.
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