Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Sea Turtle Quiz 2
| Question | Answer |
|---|---|
| When a new turtle first arrives, what exam should be done first? | Out of water exam |
| When should an in water exam occur | once the turtle is stable and on serial exams |
| How does behavior change from out of the water vs in the water | activity level and behavior improve in water |
| When is manual restraint used on sea turtles | for most non-invasive procedures On healthy sea turtles |
| Why do healthy sea turtles need to be manually restrained | slaps with flippers and bites can cause damage |
| What can happen if a large sea turtle is not placed on a padded surface | pressure sores and trauma |
| What technique can help calm turtles for exams/diagnostics | covering the eyes |
| What are the most important things to remember when documenting a sea turtle whos at a rehab facility | condition, progress at all stages, first encounter to death or success |
| What standard measurements should be taken on intake | maximum and minimum curved and straight carapace length and width |
| In addition to standard measurements, what else should be taken on intake? | body weight |
| Why are weight trends important in rehab | hydration and nutritional status |
| What other body part's length is relatable to sexual maturity | carapace size |
| When should the first physical exam of a turtle occur? | upon entry into the facility |
| How should physical exams be preformed? | head to tail DO IT THE SAME EACH TIME |
| What should be observed with the head in terms of symmetry | symmetry of head, eyes, tympani, nostrils and rhamphotheca |
| What are some typical abnormalities that should be noted in the head | propeller injuries, tympanic swelling from trauma or infection, ocular size differences, asymmetric nostrils |
| What are two signs of a skull fracture that can be heard when palpating the occipital protuberance | crepitus and movement |
| What in the iris of the eye causes no response to atropine | striated muscle in the eye |
| What should be included in the exam of the eyes | pupillary light response in a dark room with a bright light (may be subtle in normal turtles) palpebral, menace response, and corneal reflex |
| Which eye lids are mobile | dorsal and ventral lids |
| Which eyelids are not mobile | secondary eye lid |
| Which eye lids are keratinized | dorsal, ventral and secondary eyelid |
| The ventral lid is ______ with the ______, which forms its inner surface | continuous; conjunctiva |
| What are the nictitating membranes of the eye | anterior and ventral corners of the eye, continuous with the conjunctiva |
| Where are palpebral scales found in the eye | margins of the ventral lid in cheloniids ONLY |
| Do Dermochelys have palpebral scales? | NO |
| What is Blephthospasm in the eye | complete closure of the eyes with challenges opening it |
| What is Horner's syndrome | partial ptosis (dropping of the upper eyelid), small or miotic pupils, and enophthalmos |
| When is severe Horner's syndrome seen? | anterior carapacial and cervical vertebrae injuries |
| What type of eye injury is common in stranded sea turtles | corneal ulceraitons |
| What type of staining is used and where | Fluorescein staining on the cornea |
| Where are common sites of FP around the eye | Eyelid, sclera, conjunctiva and cornea |
| Where are the salt glands located | dorsomedial to the globe |
| What are the salt glands associated with (duct system) | nasolacrimal duct system |
| What do the salt glands do | remove excess salt through clear fluid |
| Do turtles have an inner, middle and outer ear? | No outer ear |
| What is the middle ear used for | sound transduction |
| What is the inner ear used for | sound reception and detection of sound |
| How is the external tympanum covered | tympanic scale that stretches across the auditory canal |
| How is the pharynx connected to the middle ear cavity | Eustachian tube |
| When is tympanic swelling secondary | to head trauma |
| Tympanic swelling aspirations have revealed what | both air and fluid |
| What are not common in sea turtles in relation to tympanic swelling | Aural abscesses |
| What are the anterior tissue of the nares (nostril openings) like | soft, highly vascular and erectile |
| What does the anterior tissue of the nostrils used for | seal nostrils when submerged |
| What should be noted when observing the nares (abnormalities) | asymmetry of the nares, Nasal discharge and traumatic wounds |
| Where is the glottis located and what should it look like on exams | base of tongue, free of discharge |
| where are barnacles commonly found logged and in what species | oral cavity; logger heads |
| What things should be observed during the oral cavity | mucous membrane color, glottis, plaques and ulcerations, abnormal odor, fish hooks and line |
| How do the external and internal nares communicate | choanal slit |
| What should be looked for during a neck exam | necrotic fat, fishing hooks embedded in skin, fishing line wraps |
| When is necrotic neck fat common | cold stunned turtles Kemps are predisposed |
| Four chambers of the heart | sinus venosus 2 atria Ventricle |
| Describe the ventricle | thick walled and internally subdivided |
| How many compartments make up the ventricle | 3 |
| Names the compartments of the ventricle | cavum venosum, cavum arteriosum, cavum pulmonae |
| What type of pulse isnt palpable | Peripheral pulse |
| How is HR assessed | doppler or ultrasound probe place don skin between distal cervical region and proximal front flipper |
| What is the normal HR of a turtle at 75F | 30-60 BPM |
| When is bradycardia common | hypothermia, neurologic loggerhead syndrome, some injectable anesthetics |
| What does respirations consist of | forced exhale followed by rapid inhale |
| What is not possible due to lack of a diaphragm | coughing and gagging |
| Turtle is gurgling, wheezing or repeatedly opening mouth is symbolism of what | tracheal obstruction |
| What do FP often begin as | subtle plaque-like lesions |
| What species is frequently observed to have more severe and frequent FP | Greens |
| Are all masses on turtles FP? | NO |
| What is a unique characteristic of the Loggerhead's shell | carries epibiota (over 80 species) |
| Why should the front and hind legs be palpated | to eval full range of motion, swelling and crepitus note muscle tone and strength |
| What does a failure to use a limb in water constitutes | lameness or paresis |
| When fishing line is wrapped around a limb what isnt uncommon | swelling distal to the line |
| When evaluating the coelomic what should be palpated | inguinal palpation |
| What are abnormalities associated with coelomic evaluation | coelomic fluid, GI tract distention, renomegaly, possibly distention caused by follicles or eggs |
| When does a cloacal prolapse occur | been out of the water for too long or are suffering from intestinal impaction or obstruction |
| How many cranial nerves are there | 12 |
| Which of the cervical vertebrae is fused to carapace | 8th |
| Where are the dorsal vertebrae fused to | carapace |
| Where should neurologic exams be taken | in water, dry docked (ventral recumbency), Dry docked (dorsal recumbency) |
| What should be evaluated in the water (neuro exam) | Menace Response, Posture, tail movement, righting response, compulsive circling, swimming ability, mentation, general activity |
| What are signs of neurologic issues for turtles in water | circling, asymmetric buoyancy, ataxia, weakness/paralysis, inability to hold up |
| What exams should be done while dry docked (ventral recumbency) | activity, mentation, head posture/position, superficial and deep pain, cranial nerve tests |
| What cranial tests should be completed during dry docked ventral recumbency | menace response, pupillary light response, palpebral response, eye position, nystagmus (normal or abnormal), muscle or mastication |
| What should be checked during dry docked dorsal recumbency | withdrawal reflexes, superficial pain, deep pain, cloacal reflex, clasp response, anal and tail sensation |
| What other responses and reflexes checked | spinal palpation (pain and discomfort) and muscle size and tone (muscular atrophy with chronic neural deficits) |
| If the pain is localized to the spinal cord what are the 5 areas to choose from | Cervical, Brachial Plexus, Trunk, Sacral Plexus, Caudal |
| What happens in the cervical vertebrae (c1-c5) if its localized there | increase in spinal reflexes, Horner's syndrome |
| What happens in the Brachial Plexus (C6-C8) if its localized there | Spinal reflexes decrease in front flippers and increase in hind flippers Horner's Syndrome |
| What is Horner's Syndrome | Compression of one side of cervical or thoracic sympathetic chain |
| What are signs of Horner's Syndrome | Signs are ipsilateral (same) side of the body Drooping of eyelids, constriction of pupils, impression eye is sunken) |
| What happens in the Trunk Vertebrae (t1-t9) if its localized there | Spinal reflexes have no change in front flippers and increase in hind flippers |
| What happens in the Sacral Plexus (t10-s3) if its localized there | Spinal reflexes have no change in front flippers and decrease in hind flippers |
| What are the 5 radiopacities for radiography | metal, bone, soft tissue, fat, air |
| How many images does a radiography require | at least 2 orthogonal images |
| What are the 3most common image locations used for radiography | dorsoventral, later, craniocaudal |
| How does the MDCT work | creates x-sectional values to reformate and create 3D images |
| ______ spatial resolution, ______ contrast resolution for radiography | Good; poor |
| ______ spatial resolution, ______ contrast resolution for MDCT | low; increased |
| How are images made by MDCT described | hypo-, iso-, hyper-attenuating |
| for MDCT what does the X, Y and Z axis do | Z is thickness (length of CT table), X is right and left, Y is dorsal to ventral |
| CT images are composed of multiple ____ representing the mean attenuation values of the ______ | pixels; voxels |
| What are FBP (filtered back projection) | mathematic process used to determine the attenuation of each voxel. IR (iterative) methods applied secondarily. |
| What are applied to MDCT images to increase image resolution | filters |
| What increases the noise of the MDCT image | fine detail filters |
| What does the smoothing filter do, and whats it biggest con | decrease noise, decrease resolution |
| in MDCT, the higher the SNR (signal to noise ratio) the _____ noise on image has | less |
| What are attenuation coefficients converted to | Hounsfield unites (HU) or CT numbers |
| HU of water is... | 0 |
| Material with greater X-ray attenuation than water will be.. | + |
| Material with less X-ray attenuation than water will be.. | - |
| Can liquid and soft tissue be differentiated on HU | yes |
| Hyperattenuating HU is.. | bight; + |
| Hypoattenuating HU is.. | dark, - |
| What are the advantages to using MDCT to other modalities | Cross sectional imaging • Increased contrast resolution - linked to x-ray attenuation (0.5% differences) • Reformat in any imaging plane or as 3D • Spatial resolution (0.4 mm CT and 0.08 mm Rad) |
| What is Partial volume averaging | When large differences in absorption in a single voxel. Attenuation average. Bone will appear thinner or thicker |
| What is beam hardening | Occurs near v. dense target, Selective attenuation of the lower energy photons so that only the higher energy contributes to image. Dark streaks. Filters used to pre-harden the beam. |
| Advantages for using an FPCT to a MDCT | Greater coverage with higher spatial resolution. |
| Disadvantages to using FPCT to a MDCT | Poorer contrast resolution, more scatter radiation • HU accuracy very poor and not useable • Limiting motion artifact, slow scintillator limits temporal resolution and scan times. • Beam hardening artifacts due to lower mean kVP energy |
| What does ultrasound utilize in order to work | high frequency sound waves |
| High frequency in ultrasound means... | high resolution, less penetration |
| advantages of using ultrasound | No ionizing radiation Relatively inexpensive, available, portable Evaluate physiology - HR, flow, peristalsis Characterization of tissue architecture |
| disadvantages of using ultrasound | not able to image through structure with high acoustic impedance - bone/ air The examination is operator dependent A unique set of artifacts |
| What are the 4 probe motions | slide, tilt, sweep, rotate |
| When is the slide probe motion used | head to tail and mediolateral |
| When is the tilt probe motion used | heel to toe lift |
| When is the sweep probe motion used | angle |
| What does Anechoic mean | black= fluid |
| Hypoechoic | solid |
| Hyperechoic | capsule, gas, bone |
| How does an MR work | radio wave sends signal and RF receives the signal |
| _____ contrast; _____ spatial res compared to CT (for MR) | Good; less |
| How does NS (nuclear scintigraphy) work | administration of radionuclide and gamma camera detects gamma red |
| What can be seen on a NS | bone scintigraphy, targets osteoblasts, bone activity, perfusion studies, blood supply, inflammation |
| What are the parts of triage | history cursory PE vital signs diagnostics |
| What are the parts of diagnostics for triage | PCV/TS iSTAT BG +/- centesis +/- crossmatch |
| What are less immediate diagnostics done in triage | CBC Chemistry Blood culture Coagulation parameters toxin testing |
| What are the ABCs for triage | airway, breathing, circulation |
| What is involved in the Airway portion of triage | clear airway of secretion and debris oral exam including laryngeal exam endotracheal tube if needed |
| What is involved in the breathing portion of triage | observe respiratory pattern (lifting head) Frequent reassessment (serial blood gas, monitor for fatigue) Respiratory failure = PPV |
| What is involved in the circulation portion of triage | fluid therapy hemostasis use doppler for HR, rhythm, and subjective pressure Inotropes |
| Severely debilitated turtles are at risk of life-threatening ______ with handling | hemorrhage |
| What happens after triage | adjust trtmnt based on eval provide fluid therapy correct acid/base and electrolyte imbalances continue to re-eval until stable |
| Cardiopulmonary arrest happens ____ in turtles | slowly |
| 4 types of shock | hypovolemic, cardiogenic, distributive/obstructive, neurogenic |
| How to treat shock | fluid therapy (SQ, IV, IO) |
| What is included in the fluid therapy for shock | turtle maintenance fluids shock does (1 blood volume) |
| What are crystalloids made up of and when are they used | mainstay of treatments water + sodium or glucose base + other electrolytes or buffers |
| Pros of crystalloids | rapid replacement of IV volume Replaces interstitial fluid minimally impairs coagulation No allergic reaction Inexpensive Widely available |
| Cons of crystalloids | Limited duration of IV volume expansion Tissue edema (impaired gas exchange, bacterial translocation, poor wound healing) |
| What are colloids made up of | high molecular weight compounds that do not readily leave the intravascular space |
| Pros of colloids | Long time IV Smaller volume requirement to achieve comparable IV expansion Decrease risk of tissue edema theoretically superior and longer-lasting volume expansion |
| Cons of colloids | Acute kidney injury coagulopathy allergic reactions $ |
| Pros of plasma | same pros as synthetic colloids hemostatic proteins, albumin, and immunoglobulins generally considered safe can be used for coagulopathies in addition to colloidal support |
| Cons of plasma | albumin is superior oncotic support in mammals (may not be true for turtles) +/- large volumes required Immunogenic (minor cross-match) |
| Hypoproteinemia | chronic debilitations Inflammatory response (vasculitis and sepsis) extensive wounds and ulcers GI disease Kidney disease |
| What is the normal PCV | ~>30% |
| When is whole blood used | clinical anemia (tachycardia, weakness, hyperlactemia, etc) |
| Chronically anemic turtles can remain _____ with remarkably low ____ | stable; PCVs |
| What species is most likely to have a transfusion reaction | Greens |
| How much blood can be collected from a donor turtle | 3ml/kg |
| How much blood should a patient receive | 10-20 ml/kg |
| How should a blood transfusion be administered | slowly at first and monitor vitals give over ~20 min |
| What is a normal BG for turtles | ~100 mg/dL |
| What is the treatment threshold for Dextrose | <40-60 mg/dL |
| Is a glucometer good for BG in turtles | No, it overestimates |
| When should dextrose be given through an IV | >2.5% dextrose |
| Why is dextrose given through an IV over a certain amount | prevent cellulitis and increased bacterial risk |
| How much dextrose can be given via IV emergently and at what rate | 5-25%; 0.5-1 ml/kg |
| How can hypernatremia occur | from a net water loss or hypertonic sodium gain |
| What can happen if hypernatremia is corrected too quickly | cerebral edema, seizures, permanent neurologic damage and death |
| How should the sodium be corrected | rate of 0.5-1 mmol/liter per hour |
| What is the free water deficit formula | [(patient's Na/ideal Na)-1] x BW |
| What is the pH for a green sea turtle | 7.44 (7.3-7.6) |
| What is the pH for a loggerhead | 7.56 (7.49-7.63) |
| What is the PCO2 for greens | 49 (32-68) |
| What is the PCO2 for loggerheads | 34 (27-41) |
| What is the PO2 for greens | 53 (36-72) |
| What is the PO2 for loggerheads | 59 (47-72) |
| What is the BE for greens | neg 3 to 3 |
| What is the BE for loggerheads | neg 3 to 3 |
| What is the HCO3 for greens | 41 ( 33-54) |
| What is the HCO3 for loggerheads | 37 (30-44) |
| What is the lactate for greens | 3.73 (0.8-8.7) |
| What is the lactate for loggerheads | 0.3 (0.3-1.01) |
| What does the BE measure | all bases not just bicarb |
| What does HCO3 measure | major alkali present in blood |
| What does lactate measure | end-product of cellular metabolism. Indicator of global perfusion |
| Juvenile green presents to the hospital dull, minimally responsive pH 7.296 PCO2 111.6 PO2 36 BE 28 HCO3 54.4 Lactate 2 What is the diagnosis/ what are you going to do about it | Respiratory acidosis intubate and start PPV while collecting additional diagnostics |
| Subadult loggerhead presents weak with PCV/TS of 4%/1.4 g/dL pH (TC) 7.926 PCO2 17.4 PO2 191 BE 20 HCO3 36.3 lactate 7.0 Whats your diagnosis/What do you do | Respiratory alkalosis and hyperlactatemia (secondary to severe anemia) Cross-match and transfuse |
| Intraoperative patient pH (TC) 7.586 PCO2 13.2 PO2 24 BE -10 HCO3 13.8 lactate >20 What is your diagnosis/ What are you going to do | Mixed/compensated respiratory alkalosis/metabolic acidosis Reduce PPV to increase CO2 and give fluids for the hyperlactatemia |
| Subadult green found floating. Distended, fluid filled GI loops on ultrasound pH (TC) 7.7226 PCO2 34.1 PO2 24 BE 28 HCO3 50.7 What is your diagnosis/What are you going to do | Metabolic alkalosis Exploratory coeliotomy for GI obstruction |
| Juvenile green presents with pneumocoelom pH (TC) 6.911 PCO2 96.5 PO2 65 BE -14 HCO3 19.2 What is your diagnosis/What are you going to do | Respiratory acidosis Coelomocentesis to relieve the tension pneumocoelom |
| How long can a healthy sea turtle go without food | weeks |
| When tube feeding how much should a turtle be given a day | ~1-3% of its body weight a day |
| Orogastric tubing is better for ____ ___ use because its more ____ on the patient | short term; stressful |
| When can Esophageal tubes be used | longer term feedings or damage to head/back |
| What is used when enteral feeding is not possible | TPN |
| For head trauma what saline should be used | hypertonic saline |
| What does the hypertonic saline do | low volume resuscitation supports cerebral perfusion in the face of increase intracranial pressure |
| How do you give the hypertonic saline | give over 10 minutes |
| infusion rates greater 1 mL/kg/min in hypertonic saline can cause... | vagally mediated bradycardia, vasodilation, and bronchoconstriction |
| How can fat soluble toxins be treated | intralipids |
| How are intralipids given | 25 mg ILE/kg body mass at 1mL/min |
| What are some ways the fat soluble toxins can occur | Harmful algal blooms Microcystins |
| What is the first thing that should be done when suspecting dystocia | confirm no structural/anatomic cause prior to medical management |
| What different ways can you confirm no structural/anatomic cause prior to medical management | Ultrasound, CT, rads, scope |
| What are the treatments that should be done for a dystocia patient | Oxytocin Prostaglandin, alpha-2 agonist Collect eggs ASAP and bury on beach |
| What is decompression sickness | gaseous emboli |
| When does gaseous emboli occur | following incidental capture from fisheries interactions |
| How can gaseous emboli be detected | US, rads, ct |
| What are some additional things that can occur in decompression sickness | extreme acidosis, reduced glomerular filtration, stress |
| How to treat decompression sickness | hyperbaric chamber (repurposed autoclave) |
| What can occur the premature hatching prior to the yolk sac being absorbed | predated |
| How long does it take for the yolk sacs to be absorbed | hours to days |
| what is the yolk | source of energy to get to sargassum |
| What should be done for a neonatal turtle immediately | fluids abx needed only in cases of oomphalitis or other diagnosed infection |
| What should be done/monitored for a neonatal turtle | absorb for absorption progression trim/ligate membranes PRN lavage honey monitor for myiasis |
| What are the two pneumocoelom treatments | medical and surgical management |
| What determines if medical or surgical management for pneumocoelom | size of tear |
| what can cause a pneumocoelom | pneumonia, bullae, decompression |
| What is the primary goal for any pneumocoelom case | decompress and stabilize |
| What are the four reasons to take blood | Rescue/rehab at admission and throughout rehab health assessment studies focused research project stranding or mortality events |
| What are the consideration prior to blood collection | permit requirement sample volume for analysis Have the appropriate equipment Stress and other factors |
| How much blood can be collected in a healthy sea turtle | 3 ml/kg |
| In terms of body weight, how much blood can be safely collected from a turtle | 0.5% to 0.8% of body weight |
| What is needed, equipment wise, to draw blood | needles, syringes, skin prep solution, blood tubes, blood storage container, biohazard disposal, waste container |
| Steps to collecting blood | clean with disinfectant use largest gauge needle appropriate for the turtle use gentle negative pressure on the plunger collect minimal amount of blood needed for labs (3 ml/kg) place pressure on site until clotted |
| using the negative pressure on the plunger prevents what | hemolysis |
| What tube is recommended for sea turtles | Lithium Heparin (GTT) |
| What are the two choices of the anticoagulant | Heparin and EDTA |
| Advantages of using heparin | 1 sample for CBC and chem small sample volume |
| Disadvantages of using heparin | blue tinge on blood film clumping of thrombocytes and sometimes leukocytes |
| When is EDTA most likely to be used | non-mammalian species ok to use on birds, snakes, some lizards and fish |
| What can cause artificial hemolysis | transfer of whole blood through needle more than once difficult blood withdrawl excessive negative pressure contact of sample tube with ice exposure to warm temperatures |
| How does BILIVERDINEMIA present in a sample | green |
| What can BILIVERDINEMIA be an indication of | starvation, extravascular hemolysis, or liver disease |
| What are some potential sources of contamination in sea turtles (in association with blood draws) | lymph, extravascular fluids |
| What are some potential effects on hematology analytes if blood in contaminated | decrease in PCV, ,hemoglobin, RBC+WBC count Increase lymphocyte counts |
| What are some potential effects on chemistry analytes if blood in contaminated | Most chemistry analytes comparable to plasma Significant difference of lymph (decreased TP,K) |
| When is the best time to process the blood sample | within1 hour of collection |
| Delay in processing time of the blood sample can cause | hemolysis, degradation of blood cells, cell clumping, falsely decrease glucose and increased potassium |
| ______ _____ values start to change _____ after venipuncture | Blood gas values; rapidly |
| How long should a blood sample be on the rocker for max | no more than 5 minutes |
| Where should blood be placed in a long delay | refrigerator or in a cooler with wet ice |
| What is assessed in the erythrocytes portion of the CBC | PCV RBC count Hemoglobin Morphology, hemoparasites/other infectious agents |
| What is assessed in the Leukocytes portion of the CBC | WBC count WBC estimate WBC differential Morphology |
| What is assessed in the Thrombocytes portion of the CBC | Subjective quantitative assessment Morphology |
| WBC estimate/microL | [average WBC per HPF] x objective power^2 |
| 20 WBC observed in 10 HPF, the average is 2 WBC/HPF. If using the 40X objective | 2 x 40^2 = 3200 WBC/microL |
| What are the two ways to do a WBC count | Eosinophil Unopettes Natt Herricks |
| Describe the Eosinophil Unopette method for WBC counting | Indirect method Total count is based on chamber count and WBC differential |
| Describe the Natt-Herricks method for WBC counting | All cells are clearly visible Can be used to do a RBC count Difficult to differentiate the lymphocytes and thrombocytes |
| What are the goals for blood film eval | Eval all 3 cell lines Quantitative assessment Morphologic assessment |
| What are the three cell lines | • Erythrocytes • Leukocytes • Thrombocytes |
| What is part of the quantitative assessment of the blood film evaluation | • Red blood cell density • WBC estimate • WBC differential • Thrombocytes |
| What should be looked at under 10x/20x magnification (blood film eval) | • Quality of smear and cell distribution, feathered edge • Predominant leukocyte type and concentration • Red cell density and arrangements (e.g., rouleaux) • Thrombocyte clumps • Abnormal cells (reactive, left-shifted) |
| What should be looked at under 50/100x magnification (blood film eval) | Get familiar with leukocyte morphology +perform WBC estimate WBC differential: 200 cells |
| What should be looked at under 100x magnification (blood film eval) | morphology erythrocyte morphology thrombocyte clumps, number, morphology |
| Describe Erythrocytes | nucleated ellipsoid Basophilic inclusions/clear vacuoles: degenerate organelles Anisocytosis and polychromasia and/or rare mitotic figures: |
| How much do Erythrocytes make up of normal total RBC | <1% |
| ASSESSING THE ERYTHROID REGENERATIVE RESPONSE | Capillary tube: PCV, TP, plasma color Blood film eval (RBC density, RBC morphologic features) |
| What are morphologic features of erythroid regeneration | increased Anisocytosis increased Polychromasia Basophilic stippling Binucleation increased Mitotic figures increased RBC precursors |
| What should be evaluated of erythrocytes | RBC density RBC regeneration RBC size and color RBC inclusions RBC shape Hemoparasites |
| What is reduced in anemic patients that can be observed when evaluating sea turtle erythrocytes | RBC density |
| What are RBC inclusions | degenerate organelles |
| What are factors to consider in anemic patients | Cause of anemia (often multifactorial in standard sea turtles) Long life span of RBC Length of RBC regeneration History: acute/chronic presentation, antimicrobial admin Blood film evaluation: RBC regeneration |
| What are some of the different factors that can cause anemia | bone marrow depression, hemolysis, hemorrhage |
| When evaluating leukocytes what should be examined | WBC concentration and differential WBC morphology |
| What is part of the WBC morphology with leukocyte eval | • Heterophil toxic change • Heterophil left-shift • Reactive lymphocytes • Reactive monocytes |
| Describe sea turtle heterophils | Colorless cytoplasm with spindle-shaped granules eccentric nucleus with clumped chromatin |
| What is the functionality equivalent of heterophils in mammals | neutrophils |
| What is heterophilia caused by | inflammation, tissue injury, stress |
| What is heteropenia | overwhelming infection |
| Describe the morphology of left shift heterophils | larger nucleus and/or "immature" granules |
| When are left shift heterophils | acute inflammation |
| What are heterophils with left shift concurrently with | toxic change |
| How are heterophils differentiated | "mature" and "immature" |
| What are the criteria for non-mammalian toxic change | Vacuolation/Foaminess Basophilia Abnormal granulation Nuclear pleomorphism |
| What can heterophil toxic change observed with | • release of immature/developing cells (left-shift) into circulation inflammation • infection (e.g., bacterial, viral) • tissue necrosis • metabolic disorders • drugs |
| Describe basophils | Round dark purple metachromatic cytoplasmic granules that often obscure the round nucleus |
| Describe monocytes | Round, oval, or reniform nucleus, abundant pale blue to grey cytoplasm |
| What can be contained inside a monocyte | phagocytized material or fine eosinophilic granules |
| What doe sea turtles not have (in monocytes) | azurophils |
| What is the function of monocytes | phagocytosis, essential in granuloma formation with microbial infections |
| Monocytes are ____ affected by ____ changes | minimally; seasonal |
| What are azurophilic monocytes | unique cell type in reptiles |
| Describe lymphocytes | round central to slightly eccentric nucleus with clumped chromatin, high N:C ratio w/ scant amount of homogeneous light blue cytoplasm |
| Presence of reactive lymphocytes and/or plasma cells in peripheral blood suggests: | immune stimulation |
| What is the function of lymphocytes | production of immunoglobulins and affecting cell-mediated responses |
| increased lymphocytes is called... | lymphocytosis |
| Lymphocytosis suggests | inflammation, wound healing, viral/parasitic infections |
| decreased lymphocytes is called | lymphopenia |
| Lymphopenia suggests | immunosuppressive conditions, chronic stress, malnutrition |
| What should be evaluated about the thrombocytes in a blood film | Morphology Subjective quantitative evaluation |
| What intrinsic factors should be considered during blood data interpretations | species life stage class (reproductive status, nutritional status) |
| What extrinsic factors should be considered during blood data interpretations | Captive/rehab vs wild/stranding Season Geographical location Clinical history: medications Preanalytical factors Lab methods |
| When discussing preanalytical extrinsic factors what are some examples | Venipuncture site Sampling artifacts |
| When discussing lab methods extrinsic factors what are some examples | • Reference intervals • WBC count method • Chemistry analyzer |
| What factors are increased in Lipemia | Hemoglobin, liver enzymes, bile acids, glucose, calcium, phosphorus, triglycerides |
| What factors are decreased in Lipemia | Albumin, sodium, chloride |
| 2 ways to analyze total protein | Refractometer Biuret method |
| Cons of using a refractometer | affected by glucose, urea, electrolytes, lipoproteins Hemolysis, bilirubin/biliverdin may interfere with reading |
| 2 ways to analyze albumin | Bromocresol green method Protein electrophoresis |
| Is the refractometer or biuret method the gold standard | biuret method |
| Cons of using bromocresol green method | various interferences inaccurate results in non-mammalian species |
| Is the bromocresol green method or protein electrophoresis the gold standard | Protein electrophoresis |
| What happens with the hyperproteinemia | dehydration chronic inflammatory disease Active folliculogenesis |
| What happens with the Hypoproteinemia | Consider potential contamination of blood by other fluid chronic malnutrition debilitation/malabsorption/malnutrition hypothermia severe hepatic disease severe blood loss |
| BUN and CREA are _____ for diagnosis of renal failure in reptiles | insensitive |
| BUN in aquatic reptiles _____ with prerenal azotemia, but is not reliable | increase |
| URIC acid is or is not an indicator of renal disease | is not |
| What could mildly increase the uric acid in reptiles | dehydration, post-prandial, high protein diet |
| Urea nitrogen in sea turtles is a possible indicator of ____ | feeding status |
| albumin may be low with significant _____ | neuropathy |
| Calcium/phosphorus is affected by | nitrogen, UV light, Vit, D and Albumin |
| Calcium/phosphorus increase can cause.... | renal disease |
| Potassium is possibly elevated with | renal disease |
| magnesium is possibly elevated with | renal disease |
| increase in sodium can symbolize | dehydration, excessive dietary sodium intake, possibly salt gland disorder |
| decrease in sodium can symbolize | iatrogenic overhydration, disorders of GI, kidneys, possibly salt gland disorder |
| increase in Cl can symbolize | dehydration, possibly renal tubular disease, possibly salt gland disorder |
| decrease in Cl can symbolize | Cl loss, overhydration with low-Cl fluids |
| Is a decrease in Cl rare or common | rare |
| Increase in K can symbolize | consider hemolysis if present (false increase), diet, acidosis, disorders of kidney/GI tract, muscle injury |
| Decrease in K can symbolize | diet, loss (GI), alkalosis |
| Tissue enzymes across taxa | ALT GLDH ALP GGT AST |
| What is ALT | nonspecific but sensitive marker of liver disease in most mammals lower activity in reptiles, horses, cows, pigs, guinea pigs, birds |
| What is GLDH | strong and specific markers for hepatocellular injury in birds |
| What is ALP | Various isoenzymes vary by species ALP in birds mainly from bone ALP |
| What is GGT | More sensitive for cholestasis and biliary disease in birds and larger mammals |
| What is AST | Wide tissue distribution Increases without CK may suggest liver injury in sea turtles |
| What is CK (creatine kinase) | specific for muscle damage |
| increase in CK | Manual restraint, exertion, muscle wasting, seizures, trauma, intramuscular injections, systemic infections, hypothermia |
| What analysts may be concurrently elevated with CK | AST, LDH, K, P |
| in mammals: biliverdin reductase converts biliverdin to ____ | bilirubin |
| biliverdin: major product of _______ ______ in birds, reptiles, amphibians | heme degradation |
| What does normal biliverdin look like in herbivorous reptiles | clear to yellow |
| In cases of hemolysis, liver disease or starvation the reptile is experiencing | biliverdinemia |
| What does biliverdinemia look like | medium to dark green |
| increased glucose in sea turtles could mean | latrogenic administration stress, pain exertion septicemia coelomitis |
| decreased glucose in sea turtles could mean | consider delay in processing hypothermia malnutrition/maldigestion, debilitation/starvation severe hepatobiliary septicemia exertion in nesting females |
| What is the minimum needed to be done in plasma biochemistry during rehab | BUN, uric acid total protein glucose sodium, chloride potassium magnesium creatine kinase |
| What is the optimal for hematology in rehab | manual WBC ct |
| What is the optimal for plasma biochemistry in rehab | Protein electrophoresis Calcium, phosphorus, iCaAST cholesterol, triglycerides osmolarity (measured) |
| What is the optimal for blood gas in rehab | pCO2, HCO3, lactate |
Created by:
Kayla_K