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Renal > diagnostic techniques > Flashcards

diagnostic techniques Flashcards

1
Q

causes of intraurethral obstruction

A
  • calculi
  • tumours
  • inflammatory disease
  • foreign bodies
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2
Q

extraurethral causes of obstruction cause

A

urethral compression

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3
Q

neurogenic causes of urinary obstruction can be (2)

A
  • lover motor neurone (after L5)

- upper motor neurone

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4
Q

lower motor neurone cause of urinary abstruction cause bladder to be (3)

A
  • flaccid
  • overdistended
  • easy to express
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5
Q

upper motor neurone disease cause bladder to be (3)

A
  • firm
  • tense
  • difficult to express
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6
Q

functional urethral obstruction also known as

A

reflex dysynergia

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7
Q

define reflex dysynergia

A
  • rare condition seen mainly in dogs

- dysfunction with urethral relaxation not occurring as not receiving sense to urinate

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8
Q

3 clinical signs reflex dysynergia

A
  • dysuria
  • pass small spurts urine
  • large residual volume
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9
Q

managment reflex dysynergia

A

medical

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10
Q

how obstructive uropathy causes azotemia (4)

A
  • increase pressure in bowman’s space
  • GFR falls
  • decreased renal blood flow
  • protein enters filtrate
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11
Q

bladder enlargment due to overdistension can cause (4)

A
  • ischaemia
  • oedema
  • haemorrhage
  • mucosal sloughing
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12
Q

obstruction and progression times

A
  • 48 hours - CNS depression, vomiting and decreased food and water intake
  • 72 hours - death
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13
Q

treatment obstruction (3)

A
  • IV fluids to dilute potassium
  • calcium gluconate
  • relieve obstruction
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14
Q

cystocentesis dog with obstruction urinary

A
  • avoid as can cause septic peritonitis

- if have to do then empty bladder completly

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15
Q

post unblocking urinary obstruction care

A
  • keep up with ins and outs using IV fluids

- may get hypokalaemia so supplement

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16
Q

define retrograde hydropulsion

A

pushing calculi from urethra back into bladder

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17
Q

how to retrograde hydropulsion (3)

A
  • get a person to block urethra with a finger through the anus
  • fill urethra with saline while blocking distal urethra
  • get person to let go and pressure of fluid should push stones into bladder
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18
Q

define cystotomy tube

A

tube placed across the body wall and into bladder to drain into a bag

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19
Q

define urethrostomy

A

permanent surgical opening into the urethra to divert urine flow

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20
Q

urinary incontinence can be (2)

A
  • neurogenic

- non-neurogenic

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21
Q

common cause of incontinence dogs

A

urethral sphincter mechanism incompetence

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22
Q

urethral sphincter mechanism incompetence can be

A
  • acquired

- congenital

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23
Q

urethral sphincter mechanism incompetence clinical signs

A

usually urinary leaking when recumbent

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24
Q

ureteral ectopica can be (cause)

A
  • congenital

- aquired

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25
Q

ureteral ectopica appearance (3)

A
  • unilateral or bilateral
  • single, double or elongated opening
  • intramural or extramural
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26
Q

define intramural ectopic ureters

A

ureter attaches in normal place then runs through the bladder wall to open elsewhere

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27
Q

define extramural ectopic ureter

A

ureter attaches and opens in same funny place

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28
Q

extramural ectopic ureter seen more in

A

cats

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29
Q

intramural ectopic ureter seen more in

A

dogs

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30
Q

ureteral ectopica 4 clinical signs

A
  • continuous dribbling of urine
  • severe scalding
  • associated with urinary tract infections
  • may have concomitant sphincter mechanism incompetence
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31
Q

genitourinary dysplasia is

A

congenital abnormality affecting vaguba abd urethra

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32
Q

bladder atony is usually secondary to

A

bladder distansion

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33
Q

L1-4 nerves supply

A

sympathetic stimulation along hypogastric nerve to beat and alpha receptors

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34
Q

where beta receptors in bladder

A

in bladder main body cause relaxation

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35
Q

where alpha receptors in bladder

A

in bladder neck cause constriction

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36
Q

S1-3 nerves supply

A
  • somatic stimulation via the pudendal nerve

- parasympathetic stimulation via pelvic nerve

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37
Q

action phenoxylenzamine and diazepam

A

reduce urethral tone

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38
Q

bethanecol actions

A

improves bladder tone and contractility

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39
Q

main clinical signs hypersomatotrophism

A

acromegaly

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40
Q

steps of hypersomatotrophism

A

uncontrolled production of growth hormone results in increased IGF1

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41
Q

IGF1 causes

A

tissue proliferation and hyperplasia

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42
Q

cat main cause hypersomatotrophism

A

pituitary tumour

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43
Q

dogs cause of hypersomatotrophism

A

increased GH secretion from mammary tissue

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44
Q

juvenile hypersomatotrophism clinical signs

A
  • increased length of long bones untill growth plate fuse

- once growth plates have fused changes are restricted to soft tissues and flat bones

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45
Q

hypersomatotrophism and diabetes

A

growth hormone is an insulin antagonist so you can get insulin intolerance and diabetes mellitus

46
Q

5 clinical signs hypersomatotrophism

A
  • PU/PD
  • weight gain
  • thick set facial features
  • increased intradermal spaces
  • hepatomegaly and cataracts due to poorly controlled diabetes mellitus
47
Q

4 diagnosis hypersomatotrophism

A
  • serum GH estimation - but not widely available
  • serum IGF1 estimation - more useful in dogs
  • serum progesterone levels and abdominal ultrasound in dogs
  • CAT or MRI scan for cats
48
Q

tx hypersomatotrophism dogs

A

remove progesterone influence

49
Q

4 tx hypersomatotrophism cats

A
  • dopamine agonists
  • local irradiation
  • somatostatin analogues
  • hypophysectomy and replacement hormones
50
Q

hyposomatotorophism main signs

A

dwarfism

51
Q

hyposomatotrophism pathogenesis

A

decreased GH secretion anlso possibly decreased TSH and gonadotrophin secretion

52
Q

4 clinical signs hyposomatotrophism

A
  • small stature
  • immature hair coat
  • non chondrodystrophic dwarfism
  • persistent oestrus or infertile males
53
Q

3 diagnosis hyposomatotrophism

A
  • serum GH estimation - relatively unavailable
  • serum IGF1 estimation in dogs
  • delayed growth plate closure
54
Q

3 things that cause primary PD

A
  • hyperadrenocorticism
  • hyperthyroidism
  • hepatic encephalopathy
55
Q

diabetes insipidus can be (2)

A
  • central

- nephrogenic

56
Q

central diabetes insipidus due to

A

decreased ADH secretion

57
Q

3 causes of decreased ADH secretion

A
  • idiopathic (common)
  • secondary to expanding mass lesion in brain
  • secondary to congenital abnormality
58
Q

urine in central diabetes insipidus

A

persistently and unremittingly hyposthenuric

59
Q

define nephrogenic diabetes insipidus

A

nephrons are ADH resistant

60
Q

clinical signs diabetes insipidus

A
  • PD - usually over 200ml/kg/24hrs

- PU

61
Q

6 diagnosis procedures diabetes insipidus

A
  • specific gravity lower than 1.008
  • routine biochemical screen to rule out any other cause
  • hospitalise and observe water intake, if it decreases then it is primary PD
  • water deprivation test shows inability to concentrate urine when dehydrated
  • increase of specific gravity after desmopressin administration
  • low dose dexamethasone suppression test to rule out hyperadrenocorticism
62
Q

tx diabetes insipidus

A

desmopressin

63
Q

parathyroid hormone secreted by

A

chief cells of parathyroid gland

64
Q

why PTH releasd

A

low serum ionised calcium

65
Q

5 PTH actions

A

increases calcium by

  • decreaseing excretion
  • ionising calcitriol production
  • increasing calcium bone reabsorption
  • increaseing calcium absorption in GIT
  • increase phosphate excretion in urine
66
Q

define PTHrP

A
  • parathyroid hormone related peptide

- secreted by some neoplastic cells

67
Q

calcitriol also known as (2)

A
  • vit D

- 1,25 dihydroxychole calciferol

68
Q

3 actions of calcitriol

A
  • increase calcium absorption in GIT
  • renal reabsorption of calcium
  • mobilising calcium and phosphorus from bone
69
Q

calcitonin when secreted

A

response to hypercalcaemia

70
Q

where calcitonin from

A

C cells in thyroid gland

71
Q

significant increases in ionised calcium can cause

A

small changes in total calcium

72
Q

12 clinical signs hypercalcaemia

A
  • PU/PD
  • anorexia
  • dehydration
  • weakness/lethargy
  • vomiting
  • facial pruritis
  • oral discomfort
  • cardiac arrhythmias
  • seizures
  • twitching
  • acute renal failure
  • death
73
Q

what is biologically active form of calcium

A

ionised calcium

74
Q

high calcium and GFR

A

causes vasoconstriction of afferent arterioles so decreasing GFR and predisposing it to azotemia

75
Q

dogs most common cause of hypocalcaemia

A

neoplasia

76
Q

hypocalcaemia commonly associated with

A

low serum albumin

77
Q

9 clinical signs hypocalcaemia

A
  • tremors
  • cramps
  • stiff gait
  • behavioural change
  • panting
  • hyperthermia
  • tachycardia
  • hypotension
  • death
78
Q

who most likely to develop urolith obstruction LA

A

early castrated males

79
Q

what diet predisposes to urolith formation LA (4)

A
  • high concentrate low rouphage as increases phosphate in blodd (by not recycling through git slaiva)
  • high phosphate low calcium diest
  • high Mg diest
  • alkaline urine
80
Q

most common urolith LA

A

struvite

81
Q

where urolith obstruction occur in ruminants (2)

A
  • urethral process small ruminents

- distal to sigmoid flexure of cattle

82
Q

6 early clinical signs obstruction LA

A
  • haematuria
  • dysuria
  • crystals on prepuce
  • urine dribbling
  • tail flagging
  • colic signs
83
Q

7 later clinical signs LA obstruction

A
  • annorexia
  • depresion
  • preputial swelling
  • abdominal distension
  • recumbent
  • seizures
  • death
84
Q

6 diagnosis urolith obsruction

A
  • history
  • azotemia
  • hyperkalaemia
  • hyponatraemia
  • acidosis
  • imaging
85
Q

3 complications obstruction

A
  • bladder rupture
  • urethral rupture
  • hydronephrosis
86
Q

amyloidosis cattle accosiated with

A
  • metritis
  • mastitis
  • pneumonia
87
Q

enzootic haematuria define

A

chronic toxicity with ptaquiloside carcinogens found in bracken

88
Q

3 clinical signs enzootic haematuria

A
  • haematuria
  • haemorrhagic cystitis
  • anaemia
89
Q

7 clinical signs umbilical infection

A
  • fever
  • malaise
  • lethargy
  • heat
  • pain
  • swelling
  • discharge from umbilicus
90
Q

umbilical arteries should be (size)

A

less than 1cm diameter

91
Q

tx small (under 2cm) umbilical hernia

A

usually resolve around 2 months

92
Q

difference bewteen umbilical infection and hernia

A

hernias arent painful

93
Q

tx large umbilical hernias (over 2cm)

A

surgery

94
Q

umbilical hernia bad if

A

strangulating

95
Q

define patent urachus

A

where its been closed and then opened again

96
Q

define persistne urachs

A

open from birth

97
Q

LA specifica gravity in renal failure

A

1.008-1.014 as cant concentrate urine

98
Q

8 clinical signs of bladder rupture

A
  • azotemia
  • hyperkalaemia
  • hyponatraemia
  • metabolic acidosis
  • respiratory acidosis due to pressure on diaphragm
  • straining to urinate
  • abdominal distension
  • ventral and preputial oedema
99
Q

proteinuria is considered a

A

hallmark of glomerular disease

100
Q

how much protein in urine is considered normal

A

trace or 1+

101
Q

4 causes of proteinuria

A
  • infection
  • inflammation
  • neoplasia
  • haemorrhage
102
Q

common quantification of proteinuria

A
  • protein:creatinine ratio

- protein measurement divided by creatinine in urine

103
Q

how detect bence jones proteins in urine

A

electrophoresis

104
Q

what are bence-jones proteins

A

immunoglobulin light chains

105
Q

4 categories of proteinuria

A
  • pre-glomerular
  • glomerular
  • tubular
  • post-glomerular
106
Q

how pre-glomerular proteinuria

A

excess proteins getting through glomerulus so cant reabsorb

107
Q

how glomerular proteinuria

A

increased glomerular capillary pressure causes more proteins shoved through
- relatively mild proteinuria

108
Q

how tubular proteinuria

A
  • mild proteinuria

- tubules do not reabsorb protein filtered by glomeruli

109
Q

how post-glomerular proteinuria

A
  • caused by inflammatory conditions of lower urinary tract or repro system
  • most common cause is infection and urolithiasis
110
Q

nephrotic syndrome presents with (4)

A
  • significant proteinuria
  • hypoalbuminaemia
  • hypercholesterolemia
  • oedema, ascites or pleural effusion
111
Q

6 tx protein losing nephropathy

A
  • identify and treat underlying disease process
  • diet modification
  • immunosuppressive drug therapy
  • tx amyloidosis
  • ACE inhibitors
  • antithrombotic drugs
  • antihypertensive drugs to decrease blood pressure
112
Q

dietary modifications tx protein losing nephropathy (3)

A
  • high quality but low quantity protein
  • low sodium
  • omega 3 fatty acid supplements

Renal (3 decks)

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