Which of the following is incorrect.

• A Resting stem cells are resistant to the toxic effects of chemotherapy drugs

• B Stem cells give rise to all blood cells

• C Stem cells are capable of self-renewal

• D Stem cells are large multinucleated cells

1

Which of the following is true of neutrophils?

• A They circulate for 8 days

• B They have round nuclei and granular cytoplasm

• C In blood vessels they are equally distributed between the marginal pool and the circulating pool in dogs

• D They synthesise globulins

2

Erythropoiesis is stimulated by

• A GM-CSF

• B Thrombopoietin

• C Erythropoietin

• D Deep sea diving

Which is true of Reticulocytes?

• A They are immature red cells which stain blue-pink on Diff-Quick

• B Released in large numbers following excitement

• C smaller than normal red cells

• D contain small round nuclei

6

Which of the following is incorrect

• A Bilirubin may be found in normal cat urine

• B Urobilinogen may be found in normal cat urine

• C Bilirubin increases in horses following anorexia

• D Bilirubin is found in urine in animals with biliary obstruction

7

Which film comment is correct?A spherocytes ++ B hypochromic cellsC marked polychromasiaD Babesia organisms seen

9

Which film comment is correct?A Spherocytes ++B hypochromic cellsC SchistocytesD Babesia organisms seen

10

These abnormal red cells are seen inA regenerative anaemiaB iron deficiency anaemiaC vascular neoplasia eg haemangiosarcomaD aged samples

11

9 Yr old GSDHistoryDog was normal until previous nightFound collapsed this morning.

P exam T 98 F, P 152/min and irreg. R 12/minvery pale mucus membranescranial/mid abdo mass palpated.

red cells 3.73 x 1012/l 5.5 - 8.5Haemoglobin 8.3 g/dl 12.0 - 18.0PCV 0.24 /l 0.32 - 0.55MCV 67.6 fl 59.0 - 77.0MCH 22.8 pg 20 - 26MCHC 34.2 g/dl 30 - 36

Film commentNormocytic normochromicMany schistocytes and acanthocytes

PP 52 g/l 60 - 80

Which is the most likely differential ?

• A Hypoadrenocorticoid (Addisons)crisis

• B Acute internal haemorrhage from abdominal mass (?tumour)

• C Aplastic anaemia

• D Acute cardiac failure

12

Why is dog so white with PCV of 24%?

• A PCV performed incorrectly

• B Dog has cardiac failure

• C Dog is acutely bleeding/hypovlaemic so reduced peripheral perfusion + PCV does not reflect severity of blood loss in acute haemorrhage

• E Clinician is colourblind

13

What would you do next?

• A Urine analysis

• B Serum iron

• C Xrays + Ultrasound abdo

• D go down the pub

14

Red cells 3.86 x 1012/l 5.5 - 8.5Haemoglobin 8.0 g/dl 12.0 - 18.0PCV 0.24 l/l 0.32 - 0.55MCV 61.2 fl 59.0 - 77.0MCH 20.7 pg 20 - 26MCHC 31.8 g/dl 30 - 36Reticulocytes 13.5 % < 2

9 year old Bull Terrier with maelena9 year old Bull Terrier with maelena

Red cells are hypochromic and microcytic2+ polychromasia

Plasma protein 51 g/l 60 - 80

555

This anaemia is:

• A microcytic hypochromic

• B microcytic hyperchromic

• D normocytic normochronic

• E macrocytic normochromic

15

9 yr old Bull Terrier with maelena

What does the pattern of low PCV and low PP suggest?

• A dehydration

• B haemorrhage

• C non-regenerative anaemia

• D haemolytic anaemia

16

What is the most common cause of low MCV

• A Aged sample

• B regenerative anaemia

• C iron deficiency anaemia

• D beetroot ingestion

17

• A Urine/faecal analysis

• B Abdominal radiography

• C Coombs test

• D Bone marrow aspirate

9 yr old Bull Terrier with maelena Which test would you perform next?

18

9 yr old Bull Terrier with maelena

• Urine analysis - no haematuria

• Faecal analysis - no parasites

• Ultrasound exam - solitary mass in intestine

Ultrasound revealed a solitary SI mass. Would you:

• A recommend euthanasia

• B go down the pub

• C dispense iron tablets and go down the pub

• D give a blood transfusion followed by ex-lap and surgically remove the mass

19

3 yr old Irish Setter

• Became unwell over last 7 - 10 days

• Depressed,lethargic, exercise intolerance

• Pale mucus membranes

• Not jaundiced

• T 40.2oC, P 135, R 20

• Splenomegaly

Increased RCDW signifies

• A Variation in haemoglobin concentration

• B numerous nucleated red cells

• C Increased red cell size

• D variation in red cells size due to large and/or small red cells

1

3 year old F Irish Setter

• Polychromasia 3+

• Anisocytosis 2+

• Spherocytes 3+

• Reticulocytes 26%

• Absolute retic count

= 26 x 1.22 x 10 = 317 x 109/l

Likely Diagnosis?

• A IMHA

• B Onion toxicity

• C Babesia canis

• D microangiopathic haemolytic anaemia, likely secondary to a tumour

3

red cells 3.51 x 1012/l 5..00 Š 10.5HB 6.88 g/dl 8.0 - 15.0PCV 0.185 l/l 0.24 Š 0.46MCV 52.8 fl 40 - 60MCH 19.6 pg 11 - 17MCHC 37.1 g/dl 30 - 36

4 yr old local Holstein 3 weeks post-calving Depression, jaundice and haemoglobinuria

Pl pr 80 g/l 60 - 80

Film comment

Anisocytosis 3+Polychromasia 2+Basophilic stipplingHowell-Jolly bodies

What is the most likely cause of the anaemia

• A Babesia bovis

• B Hypophosphataemia

• C Bladder neoplasia / haemorrhage

• D Immune-mediated haemolytic anaemia

4

red cells 1.08 g/dl 7.0 – 11.0Hb 2.80 g/dl 11.5 – 19PCV 0.069 l/l 0.32 – 0.48MCV 64.2 fl 37 - 58MCH 26.0 pg 13 - 19MCHC 40.5 g/dl 31 – 38RDW 36.8 % 11.6 – 14.8

7 yr Welsh Bay Gelding Weight loss, anaemia, jaundice

Pl pr 78 g/l 60 - 80Fibrinogen 3 g/l 2 - 4.5

Red cell morphology

• 2+ Anisocytosis

• No polychromasia

• A few Howell-Jolly bodies

• A few nucleated red cells

Is the anaemia

• A Regenerative

• B Non-regenerative

• C Not possible to say

6

Is the anaemia most likely due to

• A Haemorrhage

• B Haemolysis

• C Primary bone marrow disease

• D renal failure

7

What would you do next?

• A Slide agglutination test and Coombs test

• B Bone marrow aspirate

• C faecal occult blood

• D abdominal radiography

8

4 month old GSD with skin problem• red cells 5.16 x 1012/l 5.5 - 8.5• Hb 12.20 g/dl 12.0 - 18.0• PCV 0.35 l/l 0.37 - 0.55• MCV 68.7 fl 59.0 - 77.0• MCH 23.6pg 20 - 26• MCHC 34.5 g/dl 30 - 36• Pl pr 57 g/l 60 - 80

What is going on?

• Chronic GI haemorrhage due to parasitism

• Acute GI haemorrhage

• Hypothyroid

• All normal for a dog of this age

4 month old GSD

• White cells 17.8 x 109/l 6.0 - 15.0

• neutrophils 10.5 x 109/l 2.5 - 12.5

• bands 0 x 109/l 0.0 - 0.4

• Lymphs 5.8 x 109/l 0.5 - 4.8

• monocytes 0.7 x 109/l < 0.8

• eosinophils 0.7 x 109/l 0.05 - 0.8

4 month old GSD

• Biochemistry• Total protein 57.0 g/l 60 - 80• Urea 6.1 mmol/l 2.5 - 6.7• Creatinine 1.0.0 umol/l 20 - 150• ALT 10 IU/L 5.0 - 60.0• ALP 376 IU/L < 130• Gamma GT 5.0 IU/L 0.1 - 9.0

• Phosphorus 3.48 mmol/l 0.8 - 1.6

• Calcium 3.35 mmol/l 2.40 - 2.90

• These are all age-related normal findings

3 yr entire male labrador

• Scavenged in dustbin 2 days previously

• Well until yesterday

• Now lethargic / depressed

• Clinical exam pale / ?icteric

• Mild splenomegaly

• Dark urine noted by owner

3 yr old greedy Labrador

• red cells 3.6 x 1012/l 5.5 - 8.5• haemoglobin 6.9 g/dl 12.0 - 18.0• PCV 0.20 l/l 0.37 - 0.55• MCV 67.2 fl 60 - 77• MCH 23.7 pg 19.5 – 24.5• MCHC 32.3 g/dl 32 – 36• Pl pr 78 g/l 60 - 80

Film exam

• Mild anisocytosis

• Mild polychromasia

• Clear areas on one side of cell

• NMB smear made

What is the cause of the anaemia

A Gi haemorrhage

B AIHA

C Zinc toxicity

D Onion toxicity

E Copper toxicity

3 yr Old G. Ret 3 weeks depression and weight loss

and more recently pyrexia• Red cells 3.02 x 1012/l 5.5 - 8.5• Hb 7.3 g/dl 12.0 - 18.0• PCV 0.24 l/l 0.32 - 0.55• MCV 66 fl 60 - 77• MCH 23 pg 19.5 – 24.5• MCHC 36 g/dl 32 - 27• Pl Pr 72 g/l 60 - 80

Red cells normocytic normochromic

Comments so far?

• A Severe regenerative anaemia

• B Moderate non-regenerative anaemia ? Chronic dx or 10 bone marrow dx

• C Suggestive of recent blood loss

9

White cells and platelets

• white cells 7.12 x 109/l 6.0 - 15.0• neutrophils 1.2 x 109/l 0.8 - 4.8• lymphocytes 5.3 x 109/l 1 – 4.8• monocytes 0.1 x 109/l 0.2 – 1.5• eosinophils 0 x 109/l 0.05 - 0.8• platelets 90 x 109/l 150 - 450

Now most likely

• A Anaemia of chronic dx

• B 10 bone marrow dx

• C IMHA with concurrent IMTP

• D acute blood loss

10

Blood film exam

• Atypical lymphocytes

• Irreg nuclei

• Some nucleoli

• Thrombocytopenia

What is at the top of your differential list?

• A Plasma cell myeloma

• B Acute lymphoid leukaemia

• C Aplastic anaemia

• D myelofibrosis

12

Which test would be most useful?

• A Epo assay

• B Ultrasound spleen

• C Bone marrow aspirate

• D Lymph node aspirate

13

8 yr Mn Boxer1 cm cutaneous hairless mass

• A excise and send for histopath

• B advise revisit in 6 weeks

• C dispense Synulox

• D take a fine needle aspirate

1

What would you use to take a fine needle aspirate?

• A 18 ga needle

• B Trucut needle

• C 23 ga needle

• D Jamshidi needle

2

Which is true of sampling thoracic masses

• A Large mediastinal masses can be aspirated if the no aerated lung in penetrated

• B if the needle is long enough, any mass may be sampled safely

• C Needle aspiration of lung/chest masses is highly risky and should not be performed

• D A large bore 14 - 18 ga needle should be used

3

Which statement is incorrect

• A adding a coverslip increased clarity when examining smears

• B The condenser should be positioned low for cytology / haematology film exam

• C Diff-Quick is a suitable stain for cytology

• D Haematology is my favourite subject

4

In normal cows the predominant cell type is

• A lymphocyte

• B neutrophil

• C monocyte

• D eosinophil

5

Which of the following is not a toxic change seen in neutrophils

• A basophilic cytoplasm

• B foamy cytoplasm

• C hypersegmented nuclei

• D Dohle inclusions

6

In early acute inflammation the neutrophilia results from

• A prolonged neutrophil circulation time

• B release of neutrophils form the marginating pool to the circulating pool

• C release of neutrophils from the storage/maturation pool

• D shift of neutrophils from the tissues into the circulation

7

13 y6r old entire female cocker spaniel

6 yr Female JRT

White cells % 85 x 109/l 6.0 - 15.0neutrophils 78 67 x 109/l 0.8 - 4.8bands 20 17 x 109/l < 0.4lymphocytes 0.9 0.8 x 109/l 1 Š 4.8monocytes 0.2 0.2 x 109/l 0.2 Š 1.5eosinophils 0 0 x 109/l 0.05 - 0.8

Which is the most likely cause of these white cell abnormalities

• A stress leucogram

• B acute inflammatory response

• C physiological / adrenaline induced neutrophilia

• D chronic granulocytic leukaemia

8

6 year F Labrador with depression and fever

White cells % 85 x 109/l 6.0 - 15.0neutrophils 2 2.1 x 109/l 0.8 - 4.8bands 0 0 x 109/l < 0.4lymphocytes 0.6 0.5 x 109/l 1 Š 4.8monocytes 1.6 1.7 x 109/l 0.2 Š 1.5eosinophils 0 0 x 109/l 0.05 - 0.8atypical mononuclear 96 80 x 109/lcellsPlatelets 39 x 109/l 200 Š 500PCV 21 % 36 -55

What is the likely cause of the neutropenia

• A Increased demand due a focus of severe infection

• B Aplastic anaemia eg due to oestrogen toxicity

• C Reduced neutrophil production due to leukaemic infiltrate

• D Blood loss

9

Which describes the stress leucogram

• A neutrophilia, lymphopenia, monocytosis, eosinopenia

• B neutrophilia, lymphocytosis, monocytopenia, lymphopenia

• C neutrophilia, lymphopenia, monocytopenia, eosinophilia

• D neutropenia, lymphocytosis, eosinopenia, monocytosis

10

1 Which is not a potential cause of increased PCV

• A Renal tumour

• B Chronic renal failure

• C Severe pulmonary dx

• D Dehydration

• E Polycythaemia rubra vera

2 Which test would not be useful in establishing the cause of polycythaemia

• A Serum proteins

• B Ultrasound of kidneys

• C Bone marrow aspirate

• D Chest X ray

• E EPO assay

3 Which of the following is true of immunosuppressive therapy?

• A Cyclosporin blocks T cell activation and does not

suppress neutrophil production

• B Hi dose prednisolone can be used with minimal side

effects in dogs

• C Azathioprine is a suitable drug for IMHA in cats

• D Danazol works by reducing anti-body production

• E Human IG is a cheap alternative to cyclophosphamide

4 Which is true of feline blood groups?

• A Most DSH cats are type B• B Most BSH cats are type A• C All type A cats have hi titres of anti-B

antibody• D All type B cats have hi titres of anti-A

antibody• E All type AB cats have low titres of anti-A

antibody

5 Which statement is true of Cross matching

• A always do prior to any transfusion in dogs• B In the major cross match donor cells are mixed with

recipient serum• C No agglutination or haemolysis means the donor

and recipient are the same blood type• D Rouleaux formation in a cross match is regarded a

positive result• E A positive minor cross match is not significant

6 A dog with severe AIHA is deteriorating in spite of therapy. The PCV is now 8% and dog very weak. What would you give this dog?

• A Whole blood

• B Oxyglobin

• C Packed red cells

• D Fresh-frozen plasma

• E Platelet-rich plasma

7 Which is not present in fresh frozen plasma

• A Albumin

• B Vit K dependant factors

• C Factor VIII

• D Von Willebrands factor

• E Platelets

9 Which is true of blood groups in horses

• A Blood typing is not available in the UK• B Most TBs are Qa and Aa -ve• C Naturally occurring isoantibodies to Aa

are common• D Foals of Aa -ve mares are at risk of

developing NI• E Ka and Pa are the most immunogenic

blood types

10 Which would be best for a very anaemic foal with NI

• A sire’s whole blood

• B mare’s whole blood

• C sire’s washed red cells

• D mare’s washed red cells

• E mare’s plasma

1. Which of the following is not involved in primary haemostasis

• A fibrinogen

• B calcium

• C platelets

• D vWF

2. Which factors are Vitamin K dependant

• A II, V, IX, X

• B II, VII, IX, X

• C V, VII, IX, X

• D II, VIII, IX, X

3. Which signs in unlikely in a disorder of 2ndry haemostasis

• A haematoma

• B haemarthrosis

• C petechial haemorrhage

• D haemothorax

4. Which of the following would be unaltered in an animal with a 10

haemostatic disorder

• A Buccal mucosal bleeding time

• B Clot retraction

• C WBCT

• D OSPT

5. You are presented with a dog with epistaxis. To attribute this to

thrombocytopenia what is the maximum number of platelets you would see on a

x100 field

A < 15B < 3C < 6D < 30

6. Which of the following deficiencies would not prolong

OSPT

• A X deficiency

• B VIII deficiency

• C VII deficiency

• D V deficiency

7. Which of the following findings would not be consistent with immune-

mediated thrombocytopenia

• A Marked thrombocytopenia

• B regenerative anaemia

• C neutropenia

• D Large platelets seen in blood film

3 month old G Ret presents with dyspnoea due to pleural effusion and a large haematoma over the elbow. In the previous history there had been bleeding

associated with teething

• Platelet count 110 x 109/l (200 - 500)

• OSPT 10 secs, (control 9 seconds)

• APTT 210 seconds (control 18 seconds)

• FDPs negative

8. What is the most likely cause of this dog’s clinical signs

• A Immune-mediated thrombocytopenia

• B Warfarin poisoning

• C Haemophilia A

• D Von Willebrands disease

Mild thrombocytopenia likely d/t blood loss

10 yr male Lab

• Appeared normal till last night when began bleeding profusely from both nostrils. Bleeding will not stop and dog now collapsed.

• Clin exam - petechiae on gums, hypothermic, tachycardic and vv pale

• Cranial abdominal mass palpable

10 yr male lab

• PCV 24% (36 - 55)

• Platelets 48 x 109/l (200 - 500)

• APTT 72 seconds (15 - 25)

• OSPT 32 seconds (7 - 10)

• FDP +

• Fibrinogen 1 g/l (2 - 4)

9. What is the cause of the epistaxis

• A nasal tumour

• B warfarin poisoning

• C immune-mediated thrombocytopenia

• D DIC

10 yr male Doberman

Severe epistaxis 18 hours duration

No previous spontaneous bleeding, BUT bled ++ at tooth extraction 2 months previously

No history of nasal disease

Dog depressed, weak and tachycardic

10 yr old Doberman

• Platelet count 133 x 109/l (200 - 500)

• WBCT 4 mins (< 6)

• OSPT 9 seconds (control 8 seconds)

• APTT 20 seconds (control 16 secs)

• Clot retraction poor

10 What is the most likely cause of the bleeding

• A nasal tumour

• B Factor VIII deficiency

• C von Willebrands disease

• D DIC

1. Artefacts occur in “old“ urine Which would not occur?

• A crystals form

• B casts break down

• C pH decreases

• D red cell lyse

2. Hyposthenuric urine would not occur in which of these?

• A diabetes insipidus

• B Hypercalcaemia

• C Cushings syndrome

• D Chronic renal failure

9 year old DSH with PD/PU, ascites

• Ascitic fluid - true transudate• Urine analysis Sediment exam

– SG 1.012 hyaline casts– Protein 3+ RBC < 5 / hpf– pH 7 WBC < 5 / hpf

– Blood -ve UPCR = 9– WBC -ve– Glucose -ve

Is this a significant proteinuria?

Biochemistry

• Albumin 12 g/l (25 - 40)

• Globulin 33 g/l (20 - 45)

• Cholesterol 10 mmol/l (2 - 5)

• ALP 30 iu/l (< 60)

• ALT 35 iu/l (< 65)

3. What is the cause of the proteinuria and low serum albumin

• A Glomerular proteinuria

• B Preglomerular proteinuria

• C Post-glomerular proteinuria due to inflammation in LUT

• D Post-glomerular proteinuria due to Fanconi syndrome

4. Which of the following is not a potential cause glucosuria

• A Diabetes melitus

• B Stressed cat

• C Fanconi syndrome

• D IV fluids containing glucose

• E None of the above (I.e. they all could cause glucosuria)

11 year old Labmarked icterus, vomiting

• pH 7 Urine dark orange/yellow

• Protein trace

• Glucose -ve

• Ketones -ve

• Bilirubin +++++

• Urobilinogen -ve

• Blood/Hb -ve

5. What is the most likely cause of the icterus/bilirubinuria

• A IMHA

• B Intra- hepatic disorder

• C Complete post-hepatic biliary obstruction

• D contamination of collection vessel with antiseptic

6. A urine sample has 2+ Blood/Hb, SG 1.005, sediment no red cells seen

Animal’s plasma is clear

• Which can be ruled out?

• A haemoglobinuria due to intravascular haemolysis

• B haematuria

• C myoglobinuria

7. Chronic haematuria in aged bitch. Diagnosis?

• A cystitis

• B urolithiasis

• C Neoplasia

• D Idiopathic renal H++

8. What are these crystals from a bitch’s urine?

pH 8.5

Sediment – WBC 15 / hpf

– Bacteria seen

– RBC 30 / hpf

• A oxalate• B struvite• C cystine• D urate

9. Which of the following crystals are not seen in normal

urine

• A triple phosphate / struvite

• B oxalate

• C CaCO3

• D Cystine

10. Which is incorrect of casts

• A Formed in kidney tubules but not always seen in renal disease

• B Hyaline casts may be seen in normal urine

• C White cell casts may be seen in normal urine

• D Red cells casts are fragile and break up rapidly

7 yr old BSH cat, tachycardia dyspnoea, muffled heart sounds,

pleural effusion

• Creamy pink fluid

• Protein 32 g/l

• Cell count 6500 / ul

• Triglyceride 8 mmol/l (< 1.2)

3 Which statement is correct

• A The fluid is a exudate and likely due to bacterial infection

• B the fluid is a transudate and likely due to congestive heart failure

• C the fluid is chyle and most likely due to congestive heart failure

• D the fluid is chyle and most likely due to traumatic rupture of the thoracic duct

3 yr DSH cat pyrexia, V+ depression ascites

• Fluid is turbid and yellow

• Cell count 120,000/ul

• Protein 45 g/l

4. What would you do next?

• A Inject amoxycillin and send home on oral antibiotics

• B ultrasound heart

• C administer antibiotic and fluids to stabilise then perform ex lap

• D perform urine analysis

8 yr G Ret with pericardial effusion

• PCV 28%

• Nucleated cell count 5600/ul

• Protein 48 g/l

5 Which is not a possible cause

• A Coagulopathy

• B Intra-pericardial neoplasia

• C idiopathic benign haemorrhage

• D congestive heart failure

6 Which of the following is not a potential cause of modified

transudate• A protein loosing nephropathy

• B congestive heart failure

• C non-exfoliating neoplasia

• D Liver disease

. 1 yr DSH rescue catascities, pleura effusion, wt loss

• Protein 70 g/l

• Albumin 22 g/l

• Globulin 48 g/l

• Cell count 6800 / ul

• Mostly neutrophils

• Some macrophages

7. What is the likely diagnosis?

• A Lymphocytic cholangitis

• B Neoplasia

• C FIP

• D Congestive heart failure

5 yr GSD with pyrexia, weight loss and generalised stiffness

• X rays show ST swelling

• Joint taps from both carpii and hocks were similar

• Viscosity reduced• Fluid turbid• Cell count 20,000 / ul

8 What is the likely diagnosis

• A septic arthritis seeding from septic focus elsewhere

• B rheumatoid arthritis

• C degenerative joint disease

• D non-erosive IMPA

9.Which is true of CSF

• A Normal CSF is clear amber fluid

• B ideally samples should be taken cranial to the site of the lesion

• C Cell counts should be performed using a haematology analyser

• D analysis should be performed quickly because cells degenerate fast

2 yr old BMD marked pyrexia, neck pain. CSF analysis:

• Slightly turbid

• Cell count 1200 /ul

• Protein 0.6 g/l

• Cytology 85% neutrophils, 15% monocytes

• No bacteria seen

10. What is the most likely diagnosis

• A cervical disc protrusion

• B bacterial meningitis

• C spinal cord neoplasia

• D steroid-responsive meningitis