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E&E Exam 4 > Clinical Pathology > Flashcards

Clinical Pathology Flashcards

Covers - Urinalysis, Proteinuria, and Azotemia lectures

1
Q

How do polyuria and diuresis differ?

A

(They are both an increase in urine production but polyuria is due to a pathologic process and diuresis is due to a non-pathologic process)

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2
Q

What is pollakiuria?

A

(Increased frequency of urination with a normal urinary volume)

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3
Q

What is the term for decreased urine production and can be due to both pathologic and non-pathologic processes?

A

(Oliguria)

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4
Q

What is the term for minimal to no urine production?

A

(Anuria)

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5
Q

If you delay analyzing a urine specimen, the pH will increase or decrease (choose one).

A

(Increase)

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6
Q

If you delay analyzing a urine specimen, the USG will increase or decrease (choose one).

A

(Increase)

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7
Q

What is the usual USG value range for a euhydrated dog?

A

(1.015-1.045)

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8
Q

What is the usual USG value range for a euhydrated cat?

A

(1.035-1.065)

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9
Q

What is the usual USG range for a euhydrated horse?

A

(1.020-1.050)

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10
Q

What is the usual USG range for a euhydrated cow?

A

(1.025-1.045)

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11
Q

(T/F) USG and urine volume have an inversely proportional relationship i.e. if your urine output is low, your USG will be higher and vice versa.

A

(T)

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12
Q

Leukocytes; nitrite; urobiligen; protein; pH; blood; USG; ketones; bilirubin; glucose

In the list of tests on the human dipstick above, which are unreliable for animal urine?

A

(Leukocyte/WBC, nitrite, urobilinogen, and USG)

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13
Q

What can cause aciduria? Two answers.

A

(Acidosis (metabolic or respiratory) and paradoxical aciduria resulting from hypochloremia metabolic alkalosis (i.e. vomiting a lot that causes alkalosis can result in a paradoxical aciduria))

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14
Q

What is an alkaline tide?

A

(An increase in pH after meals in monogastric animals)

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15
Q

(T/F) Normal urine should not contain any glucose.

A

(T)

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16
Q

What cleaning products can cause a false positive glucosuria?

A

(Bleach and hydrogen peroxide)

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17
Q

(T/F) Ketones should not be present in the urine of healthy animals.

A

(T)

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18
Q

If you have a proteinuria determined via dipstick but the urine was also alkaline as per the dipstick, what test do you need to run to confirm the proteinuria is not a false positive?

A

(SSA test)

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19
Q

What is overflow proteinuria?

A

(Massive excretion of low molecular weight proteins → myoglobin, hemoglobin, Bence-Jones proteins, and colostrum)

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20
Q

What type of proteinuria do tubulointerstitial nephritis, Fanconi syndrome, nephrotoxins, acute kidney insufficiency, and chronic kidney disease cause?

A

(Tubular proteinuria: tubular dysfunction → impaired reabsorption of LMW proteins)

21
Q

What causes post-renal proteinuria?

A

(Inflammation or hemorrhage → pyelonephritis, cystitis, urinary tract neoplasia, urolithiasis, FLUTD/FIC, prostatitis/vaginitis, etc.)

22
Q

What type of proteinuria is characterized by the leakage of high molecular weight proteins primarily albumin?

A

(Glomerular proteinuria: glomerular disease (glomerulonephritis, hypertension, CKD, amyloidosis, membranous nephropathy) → leakage of HMW proteins)

23
Q

What is the use of a urine protein creatinine ratio test?

A

(UPC is used to detect glomerular or tubular disease)

24
Q

When should a UPC not be used?

A

(If there is active urine sediment or if there is hemoglobinuria or myoglobinuria)

25
Q

How can you determine if the proteinuria your patient has is glomerular versus tubular?

A

(Glomerular proteinuria will result in a UPC >3 while tubular will have a UPC between 0.5-3)

26
Q

Does glomerular or tubular proteinuria lead to hypoalbuminemia?

A

(Glomerular)

27
Q

What are the four criteria for nephrotic syndrome?

A

(Proteinuria, hypoalbuminemia, hypercholesterolemia, and edema)

28
Q

What type of pre-renal proteinuria is seen with multiple myeloma?

A

(Bence-Jones proteinuria → overflow proteinuria)

29
Q

What test can be performed to detect Bence-Jones proteinuria?

A

(Urine protein electrophoresis and immunofixation)

30
Q

(T/F) It is normal to see squamous epithelial cells in free-catch and catheterized urine specimens.

A

(T but should be 0/lpf in a cystocentesis sample)

31
Q

Why does the presence of bacteria in the urine increase urine pH?

A

(Bacterial urease breaks urea down into ammonia which will increase urine pH)

32
Q

What does increased cyllindruria indicate?

A

(Renal tubular damage)

33
Q

What are the three types of crystals that are normally present in the urine of dogs and cats?

A

(Amorphous, small amounts of calcium oxalate mono/dihydrate, triple phosphate/struvite crystals)

34
Q

What diseases/disorders are indicated by the presence of ammonium urate crystals in urine?

A

(Portosystemic shunt and/or liver insufficiency)

35
Q

High numbers of calcium oxalate monohydrate crystals are associated with what toxicity?

A

(Ethylene glycol intoxication)

36
Q

(T/F) Crystals in urine typically means there is a urolith.

A

(F, crystals in urine do not mean there are uroliths)

37
Q

How can you determine the composition of the uroliths your patient has?

A

(Send it out for evaluation, this is the only way!)

38
Q

What is the term for increased non-protein nitrogenous compounds in the blood?

A

(Azotemia, specifically urea nitrogen and creatinine)

39
Q

What is uremia?

A

(Clinicals signs associated with renal failure → vomiting, diarrhea, coma, convulsions, ammonia odor to breath)

40
Q

What non-renal causes can increase a patient’s BUN?

A

(GI hemorrhage or a high-protein diet)

41
Q

How does liver insufficiency impact BUN values?

A

(It will decrease them because the liver converts ammonia to urea so if it is insufficient, that occurs at a lower rate and will decrease BUN)

42
Q

What are two cases in which an increased urine creatinine is expected?

A

(Healthy greyhounds (high muscle mass) and neonatal foals born to dams with a dysfunctional placenta (this should diminish rapidly after birth, if it doesn’t then that indicates a renal issue))

43
Q

Prerenal azotemia is characterized by increased BUN and/or creatinine, hyper or hyposthenuria (choose one), and a quiet urine sediment.

A

(Hypersthenuria)

44
Q

What are the three causes of prerenal azotemia?

A

(Decreased renal perfusion → dehydration, hypovolemia, cardiac insufficiency, shock, and blood loss; increased protein metabolism/catabolism → fever, starvation, necrosis, GI bleeding, hyperadrenocorticism; and decreased plasma oncotic pressure → severe hypoalbuminemia)

45
Q

Renal azotemia is characterized by increased BUN and/or creatinine, a quiet urine sediment, and what kind of urine concentration? Two answers.

A

(Isosthenuria or minimally concentrated urine)

46
Q

Post-renal azotemia is characterized by increased BUN and/or creatinine, a variable USG, and what on sediment?

A

(Depends on lesions location and duration → hematuria, casts, renal cells)

47
Q

What electrolyte abnormalities are associated with post-renal azotemia?

A

(Hyponatremia, hypochloremia, hyperkalemia, and hyperphosphatemia)

48
Q

What are water deprivation and ADH response tests used for?

A

(Non-azotemia patients with PU/PD and hyposthenuria → differentiates psychogenic polydipsia, central diabetes insipidus, nephrogenic diabetes insipidus and medullary washout)

49
Q

What are three causes for nephrogenic diabetes insipidus (a non-renal disease which decreases the kidneys response to ADH)?

A

(Hypercalcemia, canine pyometra, and hypokalemia)

E&E Exam 4 (10 decks)

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