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CVNT2 > Diseases of the Urinary System and Therapeutics > Flashcards

Diseases of the Urinary System and Therapeutics Flashcards

1
Q

Are the kidneys in the intra- or retroperitoneal space?

A

Retroperitoneal

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2
Q

Which kidney is more cranial?

A

Right slightly more cranial than left

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3
Q

What is azotemia?

A

Elevation of urea and/or creatinine in the bloodstream

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4
Q

What is uraemia?

A

The clinical signs associated with azotaemia

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5
Q

What is polyuria?

A

Excessive urine production

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6
Q

What is oliguria?

A

Production of a very small amount of urine (inadequate)

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7
Q

What is anuria?

A

Absence of urine

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8
Q

What is polydipsia?

A

Excessive water intake

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9
Q

What is pyelonephritis?

A

Bacteria kidney infection (may be unilateral or bilateral)

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10
Q

What is glomerunephritis?

A

Inflammation of the glomeruli

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11
Q

What is renal insufficiency?

A

A measurable reduction in kidney function

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12
Q

How long must pass before kidney disease is considered chronic?

A

> 3 months

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13
Q

What is usually the first readily measurable sign of kidney disease?

A

Inability to concentrate urine

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14
Q

What is hypersthenuria?

A

Excretion of urine with an unusually high specific gravity

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15
Q

What is hyposthenuria?

A

Excretion of urine with an unusually low specific gravity

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16
Q

What USG is considered normal for cats and dogs?

A

Dogs >1.030

Cats >1.035

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17
Q

What USG is considered hyposthenuria?

A

<1.008

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18
Q

What main types of urinalysis are there?

A 
USG testing 
Dipstix analysis 
Microscopy 
Cytology 
Bacterial culture and sensitivity
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19
Q

Why do we test specifically for urea and creatinine?

A

They are both endogenous waste products excreted by the kidneys (= good measure of kidney function)

20
Q

Why should you take a fasted blood sample?

A

A recent protein meal will falsely raise urea

21
Q

What does azotaemia indicate in terms of kidney function?

A

Indicates reduced glomerular filtration of blood

22
Q

What causes pre-renal azotaemia?

A

Inadequate renal perfusion

23
Q

What causes renal azotaemia?

A

Reduced functional mass of the kidneys due to underlying kidney disease

24
Q

What causes post-renal azotaemia?

A

Obstruction of the ureters or urethra

Rupture of the urinary tract (= uroabdomen)

25
Q

What is the body’s response to a pre-renal azotemia?

A

To preserve as much water as possible = production of concentrated urine

26
Q

What is the result (urine-wise) of a renal azotemia?

A

Poorly concentrated urine (less than hypersthenuria)

27
Q

What effect can kidney disease have on phosphates in the blood?

A

Hyperphosphataemia common - reflects reduced renal function

28
Q

What effect can kidney disease have on potassium levels?

A

Hypokalaemia common as a direct consequence of kidney disease - contributes to weakness and inappetence

29
Q

What effect can kidney disease have on red blood cells?

A

Anaemia = erythropoietin is synthesised by the kidney

RBCs in uraemic px have a reduced lifespan

30
Q

With what type of kidney damage will patients present more unwell?

A

Acute kidney injury

31
Q

What level of urine excretion do acute kidney injury patients commonly present with?

A

Anuria or oliguria

32
Q

What common toxins can cause acute kidney injury?

A 
Cholecalciferol (vit D) 
Ethylene glycol (antifreeze) 
Grapes/raisins 
Lilies (cats only) 
Ibuprofen/NSAIDs
33
Q

What are the clinical findings you expect with acute kidney dysfunction?

A

Lethargic, depressed
Inappetent and nauseous
Cardiac arrhythmias/arrest
Volume overload (an/oliguria)

34
Q

What specific clinical sign do you see with ethylene glycol toxicity?

A

Tremors (hypocalcaemia)

35
Q

What specific clinical sign do you see with leptospirosis?

A

Icterus

36
Q

What blood findings are used to diagnose acute azotemia?

A

Increased urea/creatinine/phosphate
Increased K+ if anuric/oliguric
Decreased K+ if polyuric

37
Q

How should AKI be managed?

A

Remove underlying cause (nephrotoxic drugs/toxins/gastric decontamination)

Manage fluid balance/electrolytes/uraemic toxins

Supplementary management of nutrition/nausea/pain

38
Q

Which crystalloids are most appropriate for managing AKI?

A

Hartmanns

39
Q

What are the main objectives for initial fluid therapy of AKI?

A

Correct any hypovolaemia (pre-renal component)

Once euvolaemic, correct any dehydration (0ver 6 hours)

40
Q

What are the effects of hyperkalaemia on the heart?

A

Reduced pacemaker activity
May be bradycardic
Ventricular fibrillation
Cardiac arrest if severe

41
Q

How can hyperkalaemia be identified on an ECG trace?

A

Wide QRS
Flattened P
Spiked T

42
Q

What is the purpose of giving calcium gluconate for hyperkalaemia?

A

Helps stabilise the myocardium

43
Q

What is the purpose of giving glucose and/or insulin for hyperkalaemia?

A

Glucose stimulates release of insulin

Insulin stimulates uptake of potassium into cells

44
Q

What specific therapy should be used for ethylene glycol toxicity?

A

Medical-grade ethanol

45
Q

What type of therapy should be used to treat leptospirosis/pyelonephritis?

A

Antibiotics

46
Q

What are the indications for dialysis or euthanasia?

A

Persistent anuria +/- volume overload

persistent unmanageable hyperkalaemia

47
Q

What treatment should be considered if px fails to respond to treatments for anuria?

A

Consider trial diuretic - 2mg/kg frusemide ONCE

CVNT2 (47 decks)

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