4 Flashcards
RIS stage 1 chronic renal failure is associated with
1. Azotemia
2. Anaemia, metabolic acidosis
3. Uremia
4. Decreased specific gravity of urine
- Decreased specific gravity of urine
Which one of the following is true in case of tubular proteinuria
- Small sized proteins appear in the urine
- UPC >2
- UPC <0
- Ketonuria
- Small sized proteins appear in the urine
UPC: 0,5-2
The creatinine level of dogs and cats with IRIS stage 1 chronic kidney disease is
- Normal <140
- > 240 umol/L
- > 340 umol/L
- 440 umol/L
- Normal <140
IRIS classification of CKD. Wrong answer
- 4 stages determined by serum creatinine levels
- Stage 1 the creatinine is only mildly elevated
- Substages based on presence of proteinuria
- Substages based on degree of hypertension
- Stage 1 the creatinine is only mildly elevated
Abnormalities that are typical for chronic renal disease… which answer is wrong?
- Hypophosphataemia
The progression of renal disease is caused by… Which is not correct?
- Proteinuria
- Isosthenuria
- Hyperparathyroidism
- Glomerular hypertension
- Isosthenuria
Which statement is true about the progression of CKD?
- Hypertension and proteinuria can increase the hyperfiltration of the nephrons
- Renal fibrosis is primarily caused by the excessive production of parathormone
- The progression of CKD is generally reversible with specific therapy
- The loss of functional nephrosis leads to an increase in the glomerular filtration rate
- Hypertension and proteinuria can increase the hyperfiltration of the nephrons
It prolongs the survival of dogs and cats with chronic kidney disease
- Increased phosphorus intake
- Medical reduction of proteinuria
- Urinary diet
- ABC are all true
- Medical reduction of proteinuria
Which therapy is not recommended for the treatment of dehydration in chronic kidney disease?
- Administration of intravenous infusion
- Administration of subcutaneous infusion
- Increase of water consumption
- Dialysis treatment
- Dialysis treatment
- overhydration
Which is not an indication for dialysis treatment?
- Anuric acute kidney injury
- Polyuric acute kidney injury unresponsive to fluid therapy
- Chronic renal failure, renal fibrosis
- Removal of toxins in case of acute toxicosis
- Chronic renal failure, renal fibrosis
Treatment of chronic kidney disease (CKD) patients include… Which answer is not correct?
- Renal diet, phosphate binders
- ACE-inhibitors, antihypertensive drugs
- Erythropoietin inj., potassium supplementation
- Diuretics per os
- Diuretics per os
In case of elevated blood creatinine concentration
- The animal is uremic azote
- The animal has kidney disease
- The animal has azotemia
- The animal was fed with too much protein
- The animal has azotemia
Which of the following suture materials is not recommended for cystotomy wound closure?
- PDS
- Polyglyconate
- Gltcomer
- Polyglycaprone
- Polyglycaprone
Which of the following suture patterns is not recommended for cystotomy wound closure?
- Double layer continuous lembert
- Double layer (penetrating lembert) suture
- Single layer seromuscular continuous suture
- Double layer interrupted lembert
- Double layer (penetrating lembert) suture
Which of the following findings indicates the diagnosis of the urinary bladder rupture?
- If the cystourethral catheterization cannot harvest urine in a traumatized patient
- If the urine is blood obtained via cystourethral catheterization in a traumatized patient
- If the contrast leakage is confirmed by positive anterograde cystography
- If the contrast leakage is confirmed by positive retrograde cystography
- If the contrast leakage is confirmed by positive retrograde cystography
Which of the following tools/findings is of the lowest diagnostic value in the diagnosis of urinary bladder tumours?
- Double contrast cystography
- Ultrasonography
- Urine sediment analysis/cytology
- Therapy-irresponsive hematuria
- Therapy-irresponsive hematuria
Abnormalities that are typical for chronic renal disease. Which answer is wrong?
- Hypertension
- PU/PD
- Hypophosphatemia
- Hypokalaemia
- Hypophosphatemia
What is not typical for acute kidney failure?
- Azotaemia
- Hypokalaemia
- Oliguria, anuria
- Metabolic acidosis
- Hypokalaemia
Which circumstances may cause nephrosis/acute kidney injury? Which answer is wrong?
- Hypotension, dehydration
- Overhydration with crystalloid infusion
- Hypothermia, NSAID therapy
- Antibiotics, chemotherapy
- Overhydration with crystalloid infusion
trenal azotzemia… Which is the wrong answer?
- May be due to urethral obstruction
- May cause kidney damage without treatment
- May be due to severe dehydration
- May be due to ureter rupture
- May be due to severe dehydration
Which one of the following is not typical in case of acute kidney injury
- Cachexia
- Vomitus
- Metabolic acidosis
- Uraemic ulcer
- Cachexia
Which one of the following is not typical in case of babesiosis?
- Myoglobinuria
- Icterus
- Vomitus
- Acute kidney injury
- Myoglobinuria
Which of the following therapeutic steps is to be taken first after diagnosing urethral obturation in male dogs
- Urethral hydropropulsion
- Prescrotal urethrostomy
- Scrotal urethrostomy
- Perineal urehtrostomy
- Urethral hydropropulsion
Perineal urehtrostomy
True about urohyudropropulsion
- Requires good surgical skills
- No sedation is required
- Renal pelvis is connected to the bladder with special shunt
- This technique may be suitable for removing small stones from the urinary bladder
- This technique may be suitable for removing small stones from the urinary bladder
What is the advantage of scrotal urethrostomy
- Castration can prevent urinary incontinence
- The perineal urethrostomy can be avoided
- Easily dissectable urethrenlargeal section, wide and safe stoma
- The cystotomy can be avoided
- Easily dissectable urethrenlargeal section, wide and safe stoma
Which of the following factors does not affect the success of feline perineal urethrostomy?
- Mucocutaneous approximation of the stoma
- Transection of bulbospongiosus muscle
- Transection of ischiocavernosus muscle
- Type of suture material
- Transection of bulbospongiosus muscle
Which one of the following is indicated in case of unilateral hydronephrosis?
- Partial nephrectomy nephrosis
- Unilateral nephroureteroectomy
- Kidney drainage
- Euthanasia
- Unilateral nephroureteroectomy
Which of the following does not cause hydronephrosis?
- Urethral stricture associated with previous surgery
- Urethral torsion
- Urethral tumor
- Urethrolithiasis
- Urethral torsion
Possible causes of hydronephrosis, which is the wrong answer?
- Ureter stone
- Granuloma formation following neutralization
- Ascending infection
- Transitional cell carcinoma in the bladder
- Granuloma formation following neutralization
Causes of acute nephrosis.. Which is wrong?
- Immune complex deposition
- Renal ischaemia
- Nephrotoxic materials
- Hemoglobin, myoglobin
- Immune complex deposition
What statement is true about immune-complex glomerulonephritis?
- Diagnosis is made based on the typical US image of the kidneys
- Urine protein/creatinine ratio is typically high
- An important element of therapy is broad-spectrum AB treatment
- Serum albumin level is increased
- Urine protein/creatinine ratio is typically high
Oliguria definition dog
- Urine output less than 50 ml/ttkg/day
- Urine output less than 100 ml/ttkg/day
- Urine output less than 30 ml/ttkg/day
- Urine output less than 6-10 ml/ttkg/day
- Urine output less than 6-10 ml/ttkg/day
Oliguria in the dog/etiology
- Chronic renal disease, nephrosis/nephritis, pyometra
- Inadequate water intake, dehydration, acute nephrosis
- Dehydration, renal insufficiency, chronic liver disease
- Endocrine disorders, hepatopathies
- Inadequate water intake, dehydration, acute nephrosis
Which of the following statement is incorrect regarding nephrolithiasis?
- It can occur bilaterally
- It can lead to ureterolithiasis
- It can be caused by congenital disorder
- Dalmatians always form urate uroliths
- Dalmatians always form urate uroliths
Treatment of nephritis
- ACE inhibitors, omega-3 fatty acids
- Puncture and flushing of the renal pelvis
- Systemic antibiotics (?)
- Fluid therapy
- ACE inhibitors, omega-3 fatty acids
Which is the least important to establish the diagnosis of kidney disease:
- Blood urea creatinine measurement
- Measurement of blood phosphorus, calcium and potassium levels
- Urine sediment evaluation and urine specific gravity measurement
- Detection of proteinuria
- Measurement of blood phosphorus, calcium and potassium levels
The suspicion of antifreeze poisoning is supported by… Which answer is wrong from the list below?
- The demonstration of calcium-monohydrate crystals in urine sediment
- The detection of ethylene-glycol in blood
- Detection of ethylene glycol in urine
- The observation of marked halo-signs in the kidneys during ultrasonography
- The demonstration of calcium-monohydrate crystals in urine sediment
Which of the following uroliths appears in case of ethylene-glycol toxicosis?
- Struvite
- Calcium-oxalate dihydrate
- Calcium-oxalate monohydrate
- Purine
- Calcium-oxalate monohydrate
Antidote of ethylene glycol toxicosis:
- Etil alcohol
- Fomepizole
- Both
- Neither
- Both
Which of the following uroliths appears usually in case of dog’s bacterial cystitis?
- Urate
- Calcium oxalate monohydrate
- Cystine
- Struvite
- Struvite
Which treatment is not recommended in feline interstitial cystitis (FIC)?
1.Increased water intake
2. Facial pheromones
3. Urine acidification
4. Adding toys, scratching posts, climbing, hiding places, additional litters
- Urine acidification
What is not true for feline interstitial cystitis ?
- (FIC) Antibiotics (AB) are useless
- Affected cats mostly fed dry food
- Affected cats are mostly outdoor animals
- Affected cats are mostly neutered animals
- Affected cats are mostly outdoor animals
How do you treat a cat with FIC
- Increase water intake
Which of the following means urination not at the proper place?
- Stranguria
- Pollakiuria
- Dysuria
- Periuria
- Periuria
Which is not a contributing factor concerning lower UTI?
- Incontinence
- Corticosteroid therapy
- FIC
- Fanconi syndrome
- Fanconi syndrome
(renal tubule acidosis, renal glucosuria, cystinuria: kidney)
This antibiotic (AB) is not excreted with the urine thus is not a proper treatment for UTI
- Amoxicillin
- Cephalosporins
- Rifampicin
- Trimetoprim-szulfonamid
- Rifampicin
Symptoms of lower urinary tract disease in small animals? Which answer is wrong?
- Hematuria, pollakiuria
- Stranguria, dysuria
- Polyuria, azotemia
- Periuria, incontinence
- Polyuria, azotemia
This feline lower urinary tract disease can be accompanied by crystalluria
- Idiopathic cystitis
- Urolithiasis
- Bacterial cystitis
- All 3
- Allc3
The most common lower urinary tract disease of cats
- Prostate disease
- Idiopathic cysts
- Urolithiasis
- Bacterial cystitis
- Idiopathic cysts
The second most common lower urinary tract disease of dogs
- Prostate disease
- Sterile cystitis
- Urolithiasis
- Bacterial cystitis
- Urolithiasis
Most common causes of lower urinary tract diseases in dogs
- Bladder tumor, prostate alterations
- Anatomical disorders, foreign bodies
- Bacterial infection, urolithiasis
- Interstitial cystitis, mycoplasma
- Bacterial infection, urolithiasis
The most important aspect of struvite urolithiasis treatment in dogs
- Diet
- AB
- Urine acidification
- All 3
- All 3
What is the most common cause of struvite urolithiasis in dogs?
- Neutering in bitches
- Chronic bacterial urinary tract infection
- Dietary anomaly
- Inadequate response to stressors
- Chronic bacterial urinary tract infection
What is the cause of purine urolithiasis?
- Hyperuricosuria
- Portosystemic shunt
- Chronic liver disease
- All 3
- All 3
In dogs, which type of urolithiasis can be affected by housing conditions, lifestyle and body condition?
- Struvite
- Calcium oxalate
- Purine
- Cystine
- Calcium oxalate
Fanconi syndrome symptoms in dogs: which answer is wrong?
- Glucosuria
- Metabolic acidosis
- Aminoaciduria
- Ketonuria
Ketonuria
- Glucosuria –> renal glucosuria
- Metabolic acidosis –> renal tub. acidosis
- Aminoaciduria –> cystenuria
fanconi syndrome is not characterized by
- Central diabetes insipidus
Renal cysts
- Are always congenital
- Are always bilateral
- Are mainly incidental findings
- Generally cause renal failure
- Are mainly incidental findings
Renal amyloidosis typically found in… Which cat breed?
- Persian
- Siamese
- Abyssinian
- Bengal
- Abyssinian
Renal amyloidosis typically found in… Which dog breed?
- Basenji
- Shar-pei
- Hungarian vizsla
- Poodle
- Shar-pei
Renal amyloidosis is typically not caused by
- Chronic inflammatory processes
- Neoplastic process
- Chronic liver disease
- Genetic (familiar) causes
- Chronic liver disease
What is not true about renal glycosuria? (chronic tubular disease)
- It is caused by glomerular disease
- Plasma glucose levels are normal
- Can have genetic causes
- May be a part of fanconi syndrome
- It is caused by glomerular disease
Cause of glomerular diseases in small animals. Not correct
- Adhesions of immune complexes to the basement membrane
- Ischemia, nephrotoxic materials
- Amyloidosis
- Congenital/acquired basement membrane/podocyte injur
- Ischemia, nephrotoxic materials (AKI)
How would you treat a diagnosed cat with interstitial cystitis?
- Antibiotics
- Urine acidifying diet
- Catheterization, flushing the bladder with isotonic saline
- Increase water
- Increase water
Which statement is true about animals with renal dysplasia?
- Kidneys are typically enlarged on US with a thick cortex
- In such cases, there are usually no changes in the urine, only in the blood
- Common symptoms are polyuria and polydisia
- On a physical examination the kidneys are usually painful
- Common symptoms are polyuria and polydisia
Which therapeutic measure decreases blood potassium level during the treatment of hyperkalaemia? Choose the wrong answer
- IV calcium
- Potassium free infusion and furosemide
- Glucose containing infusions
- Rapid acting insulin applications
- IV calcium
What is the main and initiating cause of the calcium-phosphorus imbalance in chronic renal failure?
- Inadequate vitamin D production
- Poor absorption of calcium from the GI tract
- Retention of phosphorous
- Nephrocalcinosis
- Retention of phosphorous
The following is not true about polycystic kidney disease
- Is often asymptomatic
- Renal abscesses may develop in case of bacterial infection of the cyst
- Ultrasound examination is required to make a diagnosis
- Treatment is often surgical
- Treatment is often surgical
Not true about polycystic kidney disease
- Painful kidney
- Hematuria
- Don not have >1 year to live
- Inherited
- Don not have >1 year to live
The most effective gastric protectant for dogs with chronic kidney disease is:
- Pantoprazole
- Famotidine
- Sucralfate
- Benazepril
- Pantoprazole
The application of this drug is not recommended to improve the appetite of cats with chronic kidney disease
- Pantoprazole
Which urinary stone type can not be dissolved medically?
- Struvite
- Cystine
- Purine
- Calcium oxalate
- Calcium oxalate
it typically causes acute or chronic kidney disease: pre-existing chronic kidney disease, plus:
- Polypoid cystitis
- Hemodynamic disturbance
- Hyperthyroidism
- Hepatopathy
- Hemodynamic disturbance
Until what level is it recommended to increase the hematocrit (Ht) with erythropoietin/darbepoetin therapy in chronic kidney disease?
- Until Ht is 22-25%
- Until Ht is around 30%
- To normal range
- The success of the treatment does not depend on the Ht value
- Until Ht is around 30%
When is it recommended to start erythropoetin/darbepoetin therapy in chronic kidney disease?
- If cyanosis is already occurring due to hypoxia
- When the hematocrit level drops to 18-20%
- Only when clinical signs of hypoxia are already present, not earlier
- If the systolic blood pressure is >180 mmHg
- When the hematocrit level drops to 18-20%
Recommended concomitant with erythropoietin/darbepoetin
- Subcutaneous infusion, because the side effect of treatment is often dehydration
- Gastric protection, because the side effect of treatment is often ulcer formation
- Mirtazapine because the side effects (SE) of treatment is often anorexia
- Iron and B12
- Iron and B12
Hypercholesterolemia is typically associated with the following kidney disease
- Glomerulopathies of dogs
- Chronic kidney disease of cats
- Acute kidney injury of dogs
- Fanconi syndrome
- Glomerulopathies of dogs
Which statement is correct about glomerulopathies?
- 75% of glomerulopathies is amyloidosis
- 50% of glomerulopathies is amyloidosis
- 15% of glomerulopathies is of immune complex origin
- 50% of glomerulopathies is of immune complex origin
- 50% of glomerulopathies is of immune complex origin
Which statement is correct regarding ectopic ureter
- It may cause dysuria
- In acquired form, the incontinence recurring
- The urinary incontinence might be combined with normal micturition episodes
- The urinary incontinence is always constant
- The urinary incontinence might be combined with normal micturition episodes
Ectopic ureters… Which answer is wrong?
- Are usually causing constant urine dripping
- Are occuring only in females
- Can be diagnosed by x-ray or CT-exam
- Can be diagnosed with cystoscopy
- Are occuring only in females
Which of the following breeds is usually not affected by ectopic ureter?
- Labrador
- Husky
- German shepherd
- West highland white terrier
- German shepherd
Which of the following is the most informative one for diagnosing ectopic ureters?
- Cystoscopy
- Double contrast cystography
- Intravenous urography pneumocystography
- Urinary scintigraphy (TcO4-)
- Cystoscopy
Which treatment does not affect the PTH-level in chronic renal cases?
- Feeding renal diet
- Adding phosphorous binders to the diet
- ACE inhibitor therapy
- Vitamin D administration
- ACE inhibitor therapy
What statement is correct? case of renal traumatic bleeding
- The abdominocentesis is always positive (blood)
- The plain abdominal radiography is usually pathogenic
- Retroperitoneal blood loss may even lead to exsanguination
- Retroperitoneal blood loss may occur but usually does not lead to life threatening circulatory changes
- Retroperitoneal blood loss may even lead to exsanguination
Which statement is incorrect concerning prostate ultrasonography?
- It can differentiate cyst from abscess urolithiases
Which of the following procedures is not recommended for surgical resolution of prostatic cysts?
- Marsupialisation
- Omentalisation
- Drainage
- Puncture
- Puncture
If a cat has enlarged kidneys, which diagnosis is not probable?
- PKD
- Hydronephrosis
- Lymphoma of the kidneys
- Renal fibrosis
- Renal fibrosis
Prerenal azotemia… Which is the wrong answer?
- May be due to dehydration
- May cause kidney damage without treatment
- Can be corrected with fluid therapy
- May be caused by urine leakage into the abdomen
- May be caused by urine leakage into the abdomen
Persistent, prerenal proteinuria…
- Is a typical characteristic of urinary tract infections
- Occurs after heavy physical activity
- Bence-jones proteins are typical examples for it
- Is a typical characteristic of leptospirosis
- Bence-jones proteins are typical examples for it
Renal proteinuria can be decreased by
- Renal diet
- Antihypertensive drugs
- ACE-inhibitors
- All 3
- All 3
Which is the most important test for diagnosing glomerulonephropathies?
- Determination of the blood creatinine and urea values
- Determination of the urine specific gravity by a refractometer
- Detection of severe proteinuria
- Examination of the urine sediment
- Detection of severe proteinuria
To determine the urine concentrating ability of the kidneys we use
- Blood urea levels
- Urinary total protein/creatinine ratio (UPC)
- Urine specific gravity with a refractometer
- Blood creatinine and SDMA levels
- Urine specific gravity with a refractometer
Not a typical laboratory alteration in CKD:
Hypolalemia
Anemia
Hyperphosphatemia
Metabolic alkalosis
Metabolic alkalosis
What is your diagnosis if glucosuria appears in case of euglycemia?
- Cushing’s disease
- Addison’s disease
- Addison’s disease
Causes of anemia in chronic kidney patients. Which answer is not correct:
- Lack of erythropoietin
- GI bleeding/ulcers
- Decreased survival of RBC
- Hemolysis
- Hemolysis
Which statement is true for pyelonephritis?
- The bacteria usually reach the renal pelvis from the systemic circulation
- We can get a sample for diagnostic tests by aspirating the renal pelvis
- On US we find shrunken kidneys
- Usually the urinary sediment is unchanged because the inflammation is limited to the renal pelvis
- We can get a sample for diagnostic tests by aspirating the renal pelvis
You can diagnose pyelonephritis by… Which answer is wrong?
- Hemoculture in case of azotaemia
- The histological examination of a renal biopsy specimen
- Visualizing pelvis dilation with imaging methods and performing urine cultures
- The microbiological examination of a renal pelvis puncture
- Hemoculture in case of azotaemia
Which statement is true about the treatment of pyelonephritis?
- 1-2 weeks of AB therapy is required
- Aspiration of pus and rinsing of the renal pelvis accelerated healing
- Treatment if anemia should be started as soon as possible
- Conservative treatment is usually unsuccessful, thus unilateral nephrectomy is the solution
- Aspiration of pus and rinsing of the renal pelvis accelerated healing
Treatment of pyelonephritis: Which answer is wrong?
- ACE-inhibitors, omega 3 fatty acids
- Puncture and flushing of the renal pelvis
- Systemic AB
- Fluid therapy
- ACE-inhibitors, omega 3 fatty acids
True. Subclinical bacteriuria
- Asymptomatic
- Only mild lower UTI symptoms
- Pyelonephritis may be suspected
- Bacteria in urine as usually multidrug resistant
- Asymptomatic
Which statement is false? In case of subclinical bacteriuria
- Usually a predisposing factor for UTI is present
- AB therapy (amoxicillin) will be prescribed
- The urine sediment can be active
- Microbiological examination of urine is positive
- AB therapy (amoxicillin) will be prescribed
Causes of acute interstitial nephritis in small animals
- E. coli / proteus
- Antifreeze
- Leptospirosis
- Ureter stone
- Leptospirosis
When should you think of leptospirosis in a dog?
- Elevated liver enzymes and creatinine values
False:
- In glomerular proteinuria large protein are excreted
- Tubular proteinuria, urinary protein/cret ration is very high
- Borderline proteinuria means UPC is between 0.2 and 0.4 or 5
- Proteinuria of glomerular or tubular origin can be differentiated by renal biopsy
- Tubular proteinuria, urinary protein/cret ration is very high
Most likely diagnosis in cats in case of haematuria
- FIC
- Urolithiasis
- Neoplasia
- Bacterial cystitis
- FIC
Which one of the following is the most likely diagnosis in dogs in case of haematuria?
- Urolithiasis
- Benignus prostate gland hypertrophy
- Bacterial cystitis
- Neoplasma
- Bacterial cystitis
Which statement is incorrect concerning acute abdominal catastrophe (peritonitis)
- The precise diagnosis of particular organ dysfunction is necessary for surgical
indication - The diagnosis of acute abdomen is sufficient for surgical indication
- It definitely requires emergency care
- It is caused by morphological and/or functional disorders of abdominal organs
- The precise diagnosis of particular organ dysfunction is necessary for surgical indication
Monitoring blood pressure is particularly important
- In young animals
- In FIC
- In kidney disease
- In case of heart failure
- In kidney disease
What type of proteins are detected with sulfosalicyclic acid test?
- Albumin and globulin
- Albumin
- Globulin
- None
- Albumin and globulin
Which statement is correct? During nephrotomy…
- The kidney is occluded cia clamping both the renal artery and vein
- Renal vein is to be occluded so that the arterial supply remains intact
- Renal artery is to be occluded so that the venous drainage remains intact
- The ureter is also occluded
- The kidney is occluded cia clamping both the renal artery and vein
Which is not typically a target organ that is damaged by hypertension
- Lungs
- Brain
- Kidneys
- Eyes
- Lungs
Polydipsia definition in dog and cat
- Dog/cat: drink over 50 ml/bwkg/day
- Dog: water intake over 80-100 ml/bwkg/day, cat: water intake over 50
ml/bwkg/day - Dog/cat: water intake over 100 ml/bwkg/day
- Dog: water intake over 50 ml/bwkg/day, cat: water intake over 100 ml/bwkg/day
- Dog: water intake over 80-100 ml/bwkg/day, cat: water intake over 50
ml/bwkg/day
Typical symptoms of renal tubular acidosis
- Metabolic acidosis
- Incontinence
- Polyuria, polydipsia
- Bone development disorders
- Metabolic acidosis
Choose the correct answer! High-dose maintenance fluid therapy (>100 ml/kg/day) for acute kidney injury
- It increases diuresis, thus flushes the kidneys faster
- May cause interstitial edema in the kidneys, that decreases GFR and renal blood flow
- Ensures adequate daily fluid intake in anorexic animals
- In anuria, it ensures that renal function and urine production are restored quickly
- May cause interstitial edema in the kidneys, that decreases GFR and renal blood flow