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Urology > Clin/lab assess SA (Cooke) > Flashcards

Clin/lab assess SA (Cooke) Flashcards

1
Q

Normal kidney function

A
  1. fluid and electrolyte balance
    • conservation
    • excretion
  2. Excretion of nitrogenous wastes
  3. Erythropoietin
  4. Renin
  5. Vitamin D activation
    • calcium reg
    • phosphorus reg
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2
Q

fluid balance effected when

A

2/3 of functional kidney mass is lost

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3
Q

increased BUN and cr when (unable to excrete BUN and cr)

A

3/4 of functional kidney mass lost

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4
Q

Azotemia

A
  • increase in BUN and/or creatinine
  • categories
    • pre-renal
    • renal
    • post-renal
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5
Q

Uremia

A
  • Clinical signs associated with renal failure
  • these patients have to be azotemic
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6
Q

Stranguria

A
  • straining
  • painful urination
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7
Q

Pollakiuria

A
  • increased frequency of urination
  • small volume of urination
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8
Q

Anuria

A
  • lack of urine production
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9
Q

Oliguria

A
  • decreased urine production
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10
Q

Urinary specific signs

A
  1. Stranguria
  2. Pollakiuria
  3. Hematuria
  4. Malodorous urine
  5. Anuria
  6. Oliguria
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11
Q

Polydipsia

A
  • Drinking more than 100 ml/kg/day
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12
Q

polyuria

A
  • increased volume of urine
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13
Q

Non-specific CS of urinary dz

A
  • Polydipsia
  • Polyuria
  • Systemic signs
    • vomiting
    • anorexa
    • weight loss
    • fever
    • pale mucous membranes
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14
Q

Physical exam cat

abdominal palpation

A
  • Bladder
  • left kidney
  • right kidney

*pain, crepitus, size/shape

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15
Q

Physical exam dog

abdominal palpation

A
  • bladder
  • +/- left kidney
  • +/- prostate

*pain, crepitus, size/shape

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16
Q

Physical exam

Rectal exam dogs

A
  • Prostate
  • Urethra
  • lymph nodes, hernias, anal sacs, masses
17
Q

Physical exam

Integument

A
  • wet, stained fur around vulva/prepuce
18
Q

Physical exam

Systemic signs

A
  • fever
  • body condition
  • oral ulcers
  • pale mucus membranes
19
Q

Tests to eval urinary tract

A
  1. Urinalysis
    • upper and lower tract
  2. Serum chemistry
    • tubular function
    • GFR (upper tract)
  3. Renal function tests (upper)
  4. Imaging (upper and/or lower)
20
Q

Creatinine

A
  • estimation of GFR
  • produced by muscle
    • related to muscle mass and GFR
  • excreted by filtration only (no secretion/reabsorption)
  • IRIS staging
  • not sensitive (75% loss of function)
21
Q

Blood urea nitrogen (BUN)

A
  • estimation of GFR
  • produced from liver in protein metabolism
  • excreted by filtration
    • secreted and reabsorbed
  • Related to
    • GFR
    • peritubular capillary blood flow
    • tubular fluid flow
    • dietary protein
    • hepatic function
  • not sensitive (75% loss function)
22
Q

Individual kidney GFR

A
  • nuclear scintigraphy
23
Q

urinalysis eval

A
  • within 1 hour
  • 4-6 hours if refridgerated
    • bring to room temperature
24
Q

Specific gravity

concentration in dehydrated state

A
  • Dog: >/= 1.035
  • Cat: >/= 1.040
25
Q

azotemic dog with USG 1.012

A

pre-renal problem

26
Q

Azotemic dog with USG 1.048

A

renal component

27
Q

Reagent strips

A
  • accurately measure
    • pH
    • glucose
    • ketones
    • hemoglobin
    • protein
    • bilirubin
  • don’t accurately measure
    • leukocytes
    • nitrites
    • urobilinogen
    • SG
  • affected by
    • moisture
    • alkaline urine
    • discolored urine
28
Q

Interpreting protein

A
  • interpret with respect to
    • specific gravity
    • urine sediment
29
Q

Microalbuminuria

A
  • Low levels of albuminuria
    • > 1mg/dL
  • Clinical significance
    • other systemic abnormalities
  • Confirmatory test
30
Q

Glucose in urine

A
  • Without hyperglycemia: tubular damage
  • With hyperglycemia: diabetes
31
Q

Urinalysis:

Blood

Hemoglobin

Myoglobin

A
  • Blood: spins down with urine on top
  • hemoglobin: pigment stays in urine => most common in SA
    • spun blood stays in plasma
  • myoglobin: pigment stays in urine
    • spun blood, doesn’t stay in plasma
32
Q

Urinalysis

Cells

A
  • Squamous cells
    • usually normal
  • Transitional cells
    • traumatic cath
    • inflammation
    • neoplasia
  • Caudate cells
    • rare
    • from renal pelvis
  • Renal tubular cells
    • tubular inflammation (upper tract)
33
Q

Red/white cells

A
  • Red blood cells
    • normally
    • rule out iatrogenic hemorrhage
  • White blood cells
    • normally
    • infection vs inflammation
34
Q

Casts

A
  • Hyaline
    • 1-2/hpf normal
  • Cellular casts
    • suggests ongoing renal disease
  • may be first sign of renal damage animals on aminoglycoside abx
    • absence of casts not indicative of health

*can dissolve with in hours of urine sitting around

35
Q

Sediment

A
  • Fat
  • Crystals
    • crystalluria not always pathologic
    • type may be dependant on pH
  • Sperm
  • Parasite eggs
36
Q

Cystoscopy

A
  • eval of vaginal vault, urethra, bladder
  • +/- tx
    • stones, strictures, ectopic ureters
  • Anesthesia
  • technical skills
  • equiptment

Urology (15 decks)

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