Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

!Equine Medicine And Surgery > AKI and Hematuria > Flashcards

AKI and Hematuria Flashcards

1
Q

What are the most common causes of AKI in the horse?

A

Hypovolemia
Amikacin, tetracycline
Dehydration
Toxins
Flunixin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

AKI

A

Any clinical or subclinical change to renal blood flow, urine output and GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

AKI is a consequence of …

A

Poor renal perfusion for an extended period → hypoxic injury to the kindeys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you detect AKI?

A

UA and USG
Chem: Creat, protein, electrolytes, SDMA
Urine biochem: GGT, fractional excretion of electrolytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diagnostic imaging of AKI

A

Transabdominal or transrectal U/S:
Transrectal palpation of l. kidney
Endoscopy (urethra, bladder, ureter openings)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to dx AKI

A

Persistence of azotemia with changes of UA ( casts, isosthenuria, protein, hematuria)
Response to tx after 48hr to see if reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Promote/ improve renal blood flow and GFR for AKI

A

IV fluid therapy- polyionic, isotonic crystalloids
Ad libitum water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How to tx AKI

A

COX-2 selective NSAIDs
Dietary management (protein and water)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes hematuria?

A

Urolithiasis
Urethral rents (geldings)
Urinary tract neoplasia
Cantharidin toxicosis
Pyelonephritis
Exercise-induced (empty bladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nematodes causing hematuria

A

Kidney: Halocephalobis gingivalis and strongylus vulgaris
Urethral process: Drashia and habronema sp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What concentration of blood in the urine results in visible changes to urine color?

A

More than 5 RBCs/ HPF or 8 in a voided sample
1/2 mL blood/ liter of urine → gross hematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If you see pigmented urine on shavings or snow, is it always abnormal?

A

No it’s pyrocatechins
Substances in the urine oxidize in low temps producing different colors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which plants can make urine change color?

A

Red clover: Porphyrins (red urine)
Alsike: brown urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What drugs can make urine change color

A

Doxycycline: dark brown or black
Rifampin: red or orange (foals)
Metranidazole: brown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe your diagnostic plan for a horse that presents with hx of hematuria?

A
  1. Get hx: drugs administered, pasture, recent exercise, gait, color change throughout, near the end or at the end
  2. CBC, biochems, urinalysis
  3. Palpation per rectum
  4. Endoscopic exam of urethra and bladder
  5. Vesicular and renal U/S
  6. Renal bx
  7. Coagulation tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What instrument is used to perform a bx?

A

Monopty bx device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What cause of hematuria results in more concentrated blood towards the end of urination?

A

Urolithiasis (cystic calculi)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What cause of hematuria results in more concentrated blood at the end of urination?

A

Urethral rents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is urinary calculi made of?

A

Type 1: CaCO3 (yellow to green and spiculated and friable)
Type 2: CaCO3 and phosphate (smooth hard and white)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should you check each time you find bladder stone?

A

A full diagnostic evaluation of the urinary tract with U/S, endoscopy and urine cx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How would you remove a bladder stone?

A

Perineal urethrostomy (geldings)
Urethral sphincterotomy (mare)
Laparacysttomy*
Endo catch 2, covidien

22
Q

Urethral sphincterotomy

A

For mares
Removed with horse standing or incision cranial to sphincter

23
Q

Laparaocystotomy

A

Specimen retrieval pouch (2 hr sx)***
Direct visualization of calculus, stabilization
No risk of rectal tear, perforation or incomplete removal
Not appropriate for type 2

24
Q

Parainguinal Laparaocystotomy

A

Exteriorizing and suturing the bladder
Facilitated by manipulating the bladder with a hand inserted into the abdomen through a small ventral midline celiotomy

25
Q

What suture patterns are used for parainguinal laparaocystotomy

A

Two layer closure: continuous inverting, cushing and lembert
Avoid mucosa

26
Q

Local Anesthesia + hydro-distension

A

Exteriorizing the bladder
Instilling a local anesthetic solution into the bladder before sx then distending the bladder with fluid

27
Q

What feeds should you avoid if you have a horse prone to bladder stones

A

Legume hay (alfalfa, lucerne)
Beet pulp

28
Q

Which horses get urethral rents?

A

Geldings (hematuria)
Stallions (hemospermia)- American QH and frequently bred stallions

29
Q

What is the mechanism of urethral rent formation and where do they occur?

A

Idiopathic @ ischiatic arch
Bulbospongiosus muscle contracts to expel urine from the urethrae at the end of urination → ↑ P within CSP

30
Q

Presenting signs in the stallion

A

Infertility: RBCs affect motility and cell membrane of sperm
Hemospermia @ the end of ejaculation
Pain during ejaculation or erection

31
Q

How do you confirm the dx of urethral rents?

A

Endoscopic exam of the urethra

32
Q

How do you tx urethral rents?

A

Stallions: Extender added to semen to dilute conc., long sexual abstinence
Spontaneous healing in both
Temporary perineal urethrostomy and corpus spongiotomy

33
Q

Temporary perineal urethrostomy

A

↓ pressure gradient between urethral lumen and CSP @ the end of urination
Transect the BS muscle to prevent ↑ pressures at the end of urination

34
Q

Corpus spongiotomy

A

Ischial incision that extends to CSP but doesn’t enter the lumen
Avoids urethral fistula and stricture (urethrotomy)
TX OF CHOICE

35
Q

Habronemiasis

A

Skin disease of Equidae caused by the larvae of the spirurid stomach worms in the genera Draschia and Habronema

36
Q

Habronemiasis of the urethral process and lifecycle

A

Transmitted by house flies, face flies, and stable flies, that lay eggs in a horse’s manure →the larvae hatch in the manure and are ingested by the flies → the flies deposit the larvae around the horse’s lips, →swallowed and develop into adults in the stomach.

37
Q

How do you tx Habronemiasis?

A

Prednisone, cydectin, ComBot, Spotton (fenthon), eqvalan

38
Q

Which horses are predisposed to idiopathic hematuria

A

Arabians

39
Q

CS of idiopathic hematuria

A

Sudden bleeding (hematuria + hematochezia)
Acute nephritis → chr. nephritis and tissue fibrosis → renal hypertension → severe hematuria

40
Q

Tx of idiopathic hematuria

A

Antimicrobial drugs (3w min)
Repeated blood transfusions

41
Q

Most common tumors in the kidney

A

Adenocarcinoma (renal cell carcinoma)* and lymphosarcoma

42
Q

Most common tumors of the urinary bladder

A

Squamous cell carcinoma and transitional cell carcinoma
similar CS of those with calculi

43
Q

Piroxicam (Feldene)

A

COX-2 inhibition (overexpressed in epithelial cancers)
COX-2 derived PGs responsible for tumor growth and metastasis and tumor angiogenesis

44
Q

CS for blister beetle toxicosis

A

Vesicant/ mucosal irritant
Death + shock
Sweating profusely
↑ Hr, resp, temp, CRT
Bright red mm, hematuria

45
Q

In which type of forage do blister beetles swarm?

A

Alfalfa fields during blooms

46
Q

What is hemolytic uremic syndrome?

A

Verotoxins produced by E. coli
Endothelial damage in glomerular capillary loops and small arterioles → renal failure and hemorrhage

47
Q

Most common cause of ulcerative cystitis

A

Inhibition of protective PGs by long term use of phenylbutazone (NSAIDs)

48
Q

When a horse gets post-exercise hematuria with no underlying bladder dz, is the bladder normally full or empty pre-exercise?

A

Concussion of bladder during exercise
The bladder is empty (urinates right before exercise)

49
Q

How does an osteochondroma of the os pubis result in hematuria?

A

Osteochondroma (benign bone tumor that outgrows at the end of the bone) protrudes and causes compression of the bladder

50
Q

How do you detect osteochondroma?

A

U/S?

51
Q

What causes the presence of a hematoma in the bladder of neonatal foals?

A

Associated with excessive umbilical ablation and trauma to the umbilicus

!Equine Medicine And Surgery (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions