Clinical Pathology 1 Final

  1. We want to obtain results quickly, save money on testing, and avoid inaccuracy brought on by delaying sample evaluation. These are alls reasons to...
    Test samples in house
  2. We want to obtain a wider spectrum of test on a sample, save technician time and buy fewer machines to clutter up the counter. These are reasons to...
    Send a sample out of house
  3. If you let a urine sample sit out of the counter for a few hours before testing; which of the following is LEAST likely to happen?
    A. Decreased glucose B.sample may become contaminated C. may show increased bacteria D. Sample may become dilute
    D. If anything the sample in become more concentrated
  4. What is the most common reason we see contamination and precipitates in our stains which screw with results?
    Stains kept around to long!
  5. What method of urine collection is recommended when requesting a culture and sensitivity?
    Cystocentesis
  6. If a client has a fresh stool sample but can not get it to you for a few hours, what should be done with the sample?
    Tell them to refrigerate it
  7. What should you do with every patient regaurdless of the reason they are there?
    Thorough visual exam
  8. how should we treat all biological fluids in the lab?
    Should be treated as infectious and discarded as so!
  9. What is the most common cause of blindness in young children in the U.S.?
    Toxocara canis and cati
  10. What is a normal inhabitant of racoons but devastating larval migrins in the aberrant host?
    Baylisascaris procyonis
  11. What is present in almost all kittens and puppies but easily treated with an oral medication like strongid?
    Toxocara canis and cati
  12. What is bacterial, zoonotic, usually found around water, and we have good vaccines for severals strains?
    Leptospirosis
  13. What is mainly transmitted by ingestion and preperation of raw/ undercooked meat, but due to the fecal contaminates we DO NOT want any PREGNANT women cleaning litter boxes?
    Toxoplasmosis
  14. Who can get rabies?
    All warm blooded animals
  15. What is the most common fungal zoonotic disease?
    Dermatophytes
  16. What is the standard measure under the microscope?
    micrometer
  17. What is the revolving nose peice called on a microscope?
    Turret
  18. When should microscopes be cleaned?
    Both before and after use, every time
  19. What is the invasion of a parasite ON a host
    Infestation
  20. what is an organism that carries pathogens from one host to the next
    Vector
  21. What is an invasion IN the body caused by a foreign living organism?
    Infection
  22. What is the study of disease?
    Pathology
  23. What is a harmful organism that lives Out of the body?
    Ectoparasites
  24. What is a harmful organism that lives inside the body?
    Endoparasites
  25. what is a presumptive list of possibilites based on clinical signs, history, ans lesions?
    Differentail Diagnosis
  26. What is the term that mean, 'the actual cause of disease'?
    Etiology
  27. What is the disturbance in tissue caused by disease- visible grossly and microscopically?
    lesion
  28. Insects have ___ legs and arachnids have ___ legs!
    i=6 and a=8
  29. What are mosquitoes actually classified as?
    flies
  30. Which group of mosquitoes are actually parasitic?
    Only adult females
  31. Biting or chewing lice are called?
    mallophaga
  32. sucking lice are called?
    Anaplura
  33. Which ectoparasites are the most voracious blood suckers, often becoming 3 times their size after their meal?
    Ticks
  34. Which life stage(s) is/are the tick considered parasitic?
    egg, larvae, nymph, adult
    Larvae, nymph, and adult
  35. Fleas, Ticks, Lice, Or Mites
    Which does the female burrow into skin or hair follicles and lay eggs
    Mites
  36. Fleas, Ticks, Lice, Or Mites
    Responsible for mange
    mites
  37. Fleas, Ticks, Lice, Or Mites
    pediculosis
    Lice
  38. What is Pediculosis?
    Infestation of lice
  39. Fleas, Ticks, Lice, Or Mites
    Most common ectoparasitic problems in the dog and cat
    fleas
  40. Fleas, Ticks, Lice, Or Mites
    Have both biting and sucking types
    Lice
  41. Fleas, Ticks, Lice, Or Mites
    Ctenocephalides felis
    flea
  42. Fleas, Ticks, Lice, Or Mites
    Diagnosis is a skin scrape
    Mites
  43. Fleas, Ticks, Lice, Or Mites
    Secondary concerns include transmission of tapeworms, bartonella and the plague; also can cause significant anemia in young animals
    Fleas
  44. Fleas, Ticks, Lice, Or Mites
    Most species specific; much more likely to be clinical in stressed and crowded populations
    Lice
  45. Fleas, Ticks, Lice, Or Mites
    Boophilus annulatus and Ixodes scapularis
    Ticks
  46. Fleas, Ticks, Lice, Or Mites
    Important vector for ehrlichiosis and babesia
    ticks
  47. What is the scientific name for ear mites?
    Otodectes cynotis
  48. What is a Tabandid?
    Horsefly or Deer Fly
  49. Which fly causes 'Fly Worry'?
    horn Fly
  50. Which fly likes to feed inside?
    Stable Fly
  51. Which fly would lap up fluid around the eyes and cause blindness in the herd?
    Face Fly
  52. What mange mite is considered reportable in large animal?
    ALL of them
  53. What fly was successfully eradicated from the US by sterile mating?
    Screwworm Fly
  54. What mite causes leg mange in large animal?
    Chorioptic
  55. Which mite is the most severe and causes deep blistering skin lesions in large animal?
    Psoroptic
  56. Which fly is BIG, has an aggressive bite, and hang out around fresh water?
    Horsefly or Deer fly
  57. Which fly spend most of it's time at the back end of the cows?
    Horn Fly
  58. Insect or Arachnid?
    Ticks, Flies, Mites, Fleas, Lice
    • Insect=ticks and mites
    • Arachnids= Fleas, Flies, Lice
  59. What should ALWAYS be done with a cat that has ear mitres before they leave?
    CLEAN OUT THE EARS!
  60. True or False: Fleas are a big problem in large animal.
    FALSE
  61. What is the proper way to remove a tick?
    Use gloves or tweezers to pull straight out
  62. What words refers to a soft tick?
    Argasid
  63. What word refers to a hard tick?
    Ixodes
  64. What is the most common seen flea?
    Cat flea
  65. What parasite(s) likes to spend all it's life cycles on the host the whole time?
    Lice and mites
  66. Which large animal tick was almost eradicated, causes tick fever, and is reportable?
    Boophilus annulatus
  67. What is the bot fly larva called?
    Warble
  68. Are fleas species specific?
    No
  69. What is the name of the wingless fly and what does it damage?
    Sheep ked; wool and fibers
  70. A definitive host allows the parasite to____ and complete it's ___ ___.
    Reproduce and complete it's life cycle
  71. What zoonotic disease is bacterial, likely to cause sever diarrhea, and commensal in some retile stomachs?
    Salmonella
  72. What is the total magnification you seen things looking through a lens that is 10x, 40x, and 100x? What makes the difference?
    100x, 400x, and 1000x; eye peices are 10x
  73. In the lab things that can cut you are disposed of in the ____ and all biological waste in disposed of in the _____.
    Sharps container; bio-hazard red bags
  74. What is myiasis?
    Any disease that results from the infestation of tissues or cavities of the body by larvae of flies.
  75. What does micturiton mean?
    urination
  76. What is the word for the transient increase in urine output as seen with overzealous hydration or certain drugs like Lasix?
    diuresis
  77. What is the word for the reduction of urine output as seen in dehydration or shock?
    Oliguria
  78. What is the word for lack of urine production
    Anuria
  79. What is the word for increased urine output as seen in diabetes mellitus, diabetes insipidus, and renal disease?
    Polyuria
  80. What species tends to have cloudy urine normally?
    Horse
  81. What does specific gravity tell us and what is it referenced to?
    The concentration; distiled water
  82. What is the most common signalment for urinary incontinence?
    Older spayed female dog
  83. What is the primary hormone responsible for urine volume? What other hormone can effect it?
    Antidiuretic Hormone; Aldosterone
  84. What is one thing that should NOT be seen in normal healthy urine? (think diabetes if it is)
    Glucose
  85. What are 3 normal endocrine functions of the kidney?
    (2 things produced and 2 regulated)
    produce Prostoglandins and Erythropoietin and regulate ADH and Aldosterone
  86. What part is the kidney is responsible for secretion?
    Distal Convoluted Tubules
  87. What part is the kidney is responsible for reabsorption?
    Proximal Convoluted Tubules
  88. What part is the kidney is responsible for filtration?
    Renal Corpuscle
  89. How much blood is circulated throught the kidney every minute?
    25%
  90. Generally speaking, if you see abundant casts in a urine sample what does it mean?
    Renal Failure
  91. Cystitis is usually ________ in cats and _______ in dogs.
    c= idiopathic d= bacterial
  92. What is the most common urolith in cats and dogs?
    Struvite
  93. What is the @nd most common urolith in cats and dogs?
    Calcium oxalate
  94. What urolith is almost always only found in Dalmations or PSS patients?
    Ammonium urate
  95. What urolith looks like a stop signs?
    Cystine
  96. ARF, CRF, or BOTH: Ethylene glycol Toxicity
    ARF
  97. ARF, CRF, or BOTH: Patient is geriatric
    CRF
  98. ARF, CRF, or BOTH:Significant anemia and noticeable weight-loss
    CRF
  99. ARF, CRF, or BOTH: May be reversible
    ARF
  100. ARF, CRF, or BOTH: Kidneys are large and painful
    ACF
  101. ARF, CRF, or BOTH: Kidneys are small, irregualr and not painful
    CRF
  102. ARF, CRF, or BOTH: Azotemia is common on blood work
    Both
  103. What hormone is produced by the kidney and is used in RBC formation?
    Erythropoientin
  104. What method of urine collection is least likly to produce blood contamination?
    Free catch
  105. What method of urine collection is least traumatic to the bladder?
    free catch
  106. What method of urine collection will most likely yeild the most epithelial cells in your microscopic exam?
    Catheterization
  107. What two methods of urine collection is it important to accurately palpate the bladder?
    Manual compression and cystocentesis
  108. Which form of urine collection is potentailly the most dangerous in an overextended bladder?
    Manual Compression
  109. Ketonuria will most likely cause what kind of odor in the urine?
    A sweet, fruity odor
  110. What color urine would you expect if it were decribed as hematuria?
    red or pink
  111. What color would you expect if the urine was described as pyuria?
    cloudy-white
  112. How would you expect urine to look if it were described as polyuria?
    dilute, clear
  113. If What would you expect of a urine sample from a patient with oliguria?
    very concentrated
  114. What hormone is involved with Na re-absorbtion and plays a minor roll in H2 O volume regulation?
    Aldosterone
  115. What animal would logically have a high urine pH; Herbavor, Omnivor, or carnivor?
    Herbavor
  116. What animal is likely to have little bilirubin in the urine normally?
    dog
  117. How is the proximal convoluted tubule modified to best perform it's function of re-absorption?
    It has brush border for increased surface area
  118. What are 3 reasons to perform a urinalysis?
    Sick patient work-up, geriatric work-up, blodd in urine, or PU/PD
  119. What item in urine is most likely to be destroyed by rough handling?
    casts
  120. Reasons you would expect a high urine pH?
    significant bacteria, urine sat out, blocked cat, fever, or metabolic alkalosis
  121. Reasons you would expect low urine pH
    Starvation, metabolic acidosis, extreme activity, hihg protein diet, or fever
  122. What epithelial cell is the largest?
    Squamous
  123. What epithelial cell is the most indicative of serious renal disease?
    Renal
  124. Which epithelial cell has a fried egg appearance and is often plentiful and altered in bladder carcinoma or catheterized patients?
    Transitional
  125. Which epithelial cell is easy to confuse with WBC?
    Renal
  126. When is the best time to collect a urine sample?
    First A. M. urine
  127. What is something that a more intense yellow color may indicate in urine?
    concentrated or excreted vitamin B
  128. What is something that brown urine could indicate in urine?
    myoglobinuria or severe pseudomonas infection
  129. What is the main functioning unit of the kidney?
    Nephon
  130. If you refrigerate a urine sample and do not let it warm to room temp before you examin it what may be falsely evevated?
    Crystals
  131. what bladder stone may be dessolved medically and with diet?
    Struvite
  132. What is one thing in a urinalysis that indicates more systemic illness?
    Hemaglobinuria
  133. If a cat urine sample shows a great deal of bilirubin or bile on the dipstick, what organ are you concered may be damaged?
    Liver
  134. What would be the first though if you saw high nitrites in urine?
    Bacterial infection
  135. What is a good example of pre-renal azotemia? Post-renal azotemia?
    ARF; Dehydration
  136. What is the intermediate host/ vector of heartworm?
    Mosquitoes
  137. What is the definitive host of heartworm?
    The canine
  138. Who are some secondary/ aberrant hosts of heartworm?
    Fox, wolf, cats, ferrets, wolvarines, sealions
  139. How do we currently test for heartworm, what does it actually test for, and is it an accurate test?
    We used ELISA tests, they look for antigens, and they are cheap, quick, easy, and specific so yes they are good
  140. What are some standard preventative drugs used for heartworm?
    Advantage-muti, Tri-heart, revolution, Ivermectin, Heartguard, Interceptor
  141. Microfilaricides and adulticides; what are they, what do they do, and how are they different?
    Heartworm drugs, one for adults and other for microfilaria, for treatment and prevention.
  142. What is the scientific name for heartworm? The name for the look alike?
    Dirofilaria immitis; Dipetalonema reconditum
  143. What are the stages of treatment for heartworm?
    1 injection given IM in lumbar area with rest to follow. 4 weeks later 2 injections 24 hours apart also in lumbar area in stict rest to follow! The animal will also need a microfilaricidal aggent. But REST REST REST
  144. Why is rest sooo important in the treatment of heartworm?
    The treatment is literally poisons injected into the muscle. They kills the adult worm that are in the heart and blood stream. Rest is to help prevent a clot in the blood stream and the treatment is very painful!
  145. How is heartworm tested in cats and is it any good?
    Tested same as in dogs; ELISA test and it is good when there are circulating microfilaria. Most the time, since they can't reproduce in an aberrent host, there are nothing that will trigger the test.
  146. What is the difference in heartworm burden between cats and dogs?
    Dogs have been known to have 10's but uncommon to have more than 30. Cats usually 1-2 uncommon for more than 6
  147. What is the difference between heartworm treatment in cats and dogs?
    There is no treatment for cats
  148. What is the average life span of the heartworm in dogs? Cats?
    5-7yrs and 2-3 yrs
  149. What are some clinical signs of heartworm in dogs?
    • Signs vary from nonexistent to sudden death! Mild disease – generally see a cough, Moderate – cough, abnormal lung sounds on ausculation,
    • Severe– all above + dyspnea+ ascites, syncope, possible collapse and death
  150. What are some clinical signs of heartworm disease in cats?
    can be similar to dog~ dyspnea, cough, caval syndrome, heart disease or subclinical. Or can be very different~ chronic vomiting, weightloss, blindness, and anorexia
  151. What are common drug chooses/treaments for most blood parasites?
    Tetracycline and Doxycycline
  152. How do we try and prevent blood parasites?
    Try to prevent ectoparasites; no fleas, ticks, or flies. Try and maintain good husbandry
  153. What are some common signs of blood parasites?
    fever, anorexia, pallor, icterus, weakness, anemia, weight-loss, dyspnea, splenomegaly, vomiting
  154. In refference to the cell, where will you find hemobartonella?
    It is an epicelluar bacteria (sits on the edge of the cell)
  155. Who usually gets hemobartonella, how is it treated, and what else would you suspect with this?
    young free-roaming male cats w/ flea infestation, treated with tetri/doxycycline+steroids+supportive care, also suspect FeLV/FIV
  156. In reference to the cell, where would you find Babesia?
    It is an coccoid, intraerythrocytic protozoan(in the red blood cell)
  157. Who can get babesia?
    Cats, dogs, ruminats, horses, pigs, and humans
  158. Who is most likely to get ehrilichia & what are the common signs?
    Acute Phase: fever, lethargy, splenomegaly, lymphadenopathy, anorexia, peripheral edema, dyspnea. Chronic Phase: weight-loss, bleeding tendencies, anterior uveitis, paresis
  159. What geographic area is the most prevalent with Lyme's disease?
    Northern East Coast (Around Lyme's Connetticut)
  160. Who is most likely to get Lyme's and how is it transmitted?
    Dogs and humans; Ixodes scapularis (Deer Tick/ Blacklegged Tick) must attach for 24-36 hours and be carrying the bacteria Borrelia burgdorferi
  161. Signs of Lymes?
    Bulls eye lesion in humans. Actual signs can take months to show;fever, lethargy, anorexia, swollen or painful joints, cardiac, neurological and renal abnormalities
  162. Where in the body will you most likely find Rocky Mountain Spotted Fever (Rickettsia rickettsii)?
    Lives in the vascular endothelial cells
  163. With anaplasmosis how will gae change what happens?
    <1 almost no signs, 1-2 moderate to severe, adults it could be fatal.
  164. With both anaplasmosis and babesia in large animal, why is transport across states lines risky?
    They are pretty easy on the young and they build immunity. Older animals that have never been exposed could get VETRY sick
  165. What disease is has the tick as a vector and is often called Tick fever?
    Anaplasmosis
  166. How is babesia transmitted in small animal?
    Rhipicephalus sanguineus (brown dog tick) and Dermacentor variabilis(American Dog Tick); can also be from mouth of dog with open lesions.
  167. What is the vector for Cytauxzoonosis?
    The tick
  168. How is Hemobartonella transmitted?
    Usually fleas but also ticks, lice, bites, intrauterin, blood transfusions
  169. What is the vector for Ehrlichia canis transmittion?
    Rhipicephalus sanguineus (Brown Dog Tick)
  170. What is the vector for Rocky Mountain Spotted Fever and what is the actual endoparasite scientific name?
    Dermacentor variabilis (American Dog Tick);Rickettsia rickettsii
  171. What is the vector for Lyme's Disease and what is the actual endoparasite scientific name?
    Ixodes scapularis(Deer Tick or Black Legged Tick);Borrelia burgdorferi
  172. What is the vector for American Canine Hepatozoonosis and what is the actual endoparasite scientific name? How is this one different?
    Amblyomma maculatum; Hepatozoon americanum; The tick is ingested not ingesting
  173. How is Eperythrozoonosis transmitted and what family does it belong to?
    Flea, tick, lice, iatrogenic, flies; Rickettsia
  174. Ticks have 2 classes, hard and soft; what are the proper names for these and what is the life cycle?
    Ixodid and argasid; egg, larva, nymph, adult
  175. Lice have 2 classes, Bitting and sucking; what are the proper names for these and what is the life cycle?
    Mallophaga, anoplura; nit, nymph, adult
  176. What is the life cycle of fleas and flies?
    egg, larva, pupa, adult
  177. What is the proper name for the stable fly? aka? Causes?
    Stomoxys calcitrans, Biting House fly, Fly Strike
  178. myiasis is also called? Warbles are also called?
    Maggot Wounds; Cuterebra, Bot Fly larva
  179. What is the proper name of the most common flea?
    Ctenocephalides felis
  180. Scientific name for the Brown dog tick? Vector for what?
    Rhipicephalus sanguineus; babesia and ehrlichia
  181. Scientific name for the Deer tick/ Blacklegged tick? Vector for what?
    Ixodes scapularis; Lyme's Disease
  182. Scientific name for the American dog tick? Vector for what?
    Dermacentor variabilis: Babesia and Rocky Mountain Spotted Fever
  183. What are the 3 types of small animal mange?
    Demodex canis, Sarcoptes scabei, and noteodres cati
  184. What is the proper name for ear mites?
    Otodectes cynotis
  185. Proper name for the deer fly? AKA? Vector for?
    Tabanids; houseflies, green-headed flies; anthrax and EIA
  186. Proper name for the Horn Fly and what do we worry about with them?
    Haematobia irritans; Fly Worry
  187. Proper name for Face Fly and what is usually causes?
    Musca autumnalis; Bovine Pink eye and leading cause to blindness in cattle
  188. Proper name for the Srewworm Fly and what we usually saw with them?
    Cochliomyia hominivorax; myiasis
  189. What family and species does Cattle Crub belong to and what is the parasitic larve called?
    Bot Fly; Hypoderma; Warble
  190. What is the proper name for the Sheep ked? What's special about it and what does it damage?
    Melophagus ovinus; Wingless Fly; wool and fiber
  191. What is the only soft tick we deal with?
    Spinose Ear tick (argasid)
  192. What is the proper name for the cattle tick and what is special about it?
    Boophilus annulatus; almost eraticated; reportable
  193. What is the proper name for the Rocky Mountain Wood Tick and what can it's toxin cause?
    Dermacentor andersoni; tick paralysis
  194. What is the proper name for the lonestar tick?
    Amblyomma americanum
  195. 2 types of mange found in large animal and not small; one is the cause of leg mange and the other is the most severe causeing pruritic blisters.
    Chorioptic Mange; Psoroptic Mange
  196. Roundworms: Classification, Scientific name, host, and transmission?
    Nematode, Toxocara, canis= dog/ cati= cat/ leonine=both, prenatal/ transmammary/ eating birds or rodents
  197. Hookworm: Classification, Scientific name, and transmission?
    Nematodes, Ancylostoma(Southern)/Uncinaria(Northern), passed in feces
  198. Whipworms: Classification, Scientific name, host, and transmission?
    Nematode, Trichuris vulpis, usually dogs, ingestions of oocytes
  199. Threadworm: Classification, Scientific name, host, and transmission?
    Nematode, Strongyloids stercoralis, dog/cat/fox/human/primate, autoinfection, transmammary
  200. Flucks; What is the proper name and what must be the intermediate host?
    Trematodes; snail and crayfish
  201. Tapeworms are in what classification? What are the heads called? The bodies?
    Cestodes; scolex; proglotides
  202. What is the most common tapeworm, common name and scientific? What is the vector?
    Dipylidium caninum; Double-pore tapeworm; FLEAs and lice
  203. Which tapeworm uses rodents, birds, and rabbit as the intermediate host?
    Taenia
  204. Which tapeworm has a zoonotic concern? Intermediate host is cattle and rodents; has 2 names.
    Hydatid and Echinococcus
  205. Coccidia: What is it classified as? What is it called in small animal? Large animal? What is the drug of choose?
    Protazoan; Isospora (canis and felis); Eimeria; Albon
  206. What disease are we worried about pregnant women being arond? What is it classified as? Definitive host? Transmitted?
    Toxoplasmosis; protazoan; cats; feces (litter boxes/gardening) and meat (prepairing/ eating raw/ undercooked)
  207. What is the long name of Giardia? What is it classified as? Drug of choose?
    Giardia lamblia; protazoan; Flagyl(metronidazole) or Panacur
  208. What are the 3 abomasal worms? What are they classified as?
    Haemonchus, Trichostringylus, and Ostertagia; Nematodes
  209. Which of the abomasal worms is potentially the most serious (proper and common name)? How many types and what are they labeled as?
    Ostertagia/ Brown stomach worm; Type 1 is un-arrested and Type 2 is arrested
  210. Which of the abomasal worms affect the young worse? Proper and common name
    Barber's pole worm/Haemonchus
  211. What is the proper name for the Hair worm? Where is it found?
    Trichostrongylus; abomasal worm
  212. What are the 2 intestinal strongyles called?
    Cooperia and Nematodrirus
  213. What are the proper and common names of the 2 large animal tapeworm? Who are the host?
    Hydatid (echinococcus)= dog is definitive ruminant is intermediate. Ruminant Tape.(Moniezia)= ruminant is definitive, free living mite is intermediate
  214. Liver Flukes: Proper name? Classified as? Found?
    Fasciola hepatica; Trematode; bile ducts of the ruminants
  215. What protazoa is described as watery diarrhea?
    Crytocyptosporidium
  216. What is the sexually transmitted protazoan? Who is asymtomatic?
    Tritrichomonas foetus; bull
  217. What protazoan has the dog as definitive host and ruminant as intermediate? Also has zoonotic potential.
    Sarcocystis
  218. Pig Ascarid: classification, proper name, and why isn't this uaually a problem
    Nematode, Ascaris suum, most raised on concrete
  219. What swine parasite is transmitted by canabalism and had zoonotic potenia?
    Trichinella spiralis
  220. Proper name for the pig whipworm?
    Trichuris suis
  221. What is the proper name for the equine pinworm and where will you find them?
    Oxyuris equi; around the anus
  222. What is the one equine strongyles that can cause a problem and what does it cause?
    S. vulgaris; Verminous/ Mesenteric Arteritis
  223. What is Panacur good for?
    Whipworm because of inflammatory effects as well as rounds, hooks, and Taenia sp of tapes
  224. # 1 choose for Giardia? #1 choose for coccidia?
    Flagil (metronidazole); Aldon
  225. Wormer for tapes alone? Wormer for tapes, rounds, and hook
    Droncit/ cestex; Drontal Plus
Author
duncables
ID
22674
Card Set
Clinical Pathology 1 Final
Description
Cards for Final in Clinical Pathology
Updated