E1. Of the urinary system Flashcards
1
Q
Look at slides 6 – 12. It is the structure and function of the kidneys
A
Didn’t want to make questions for something that simple.
2
Q
What is renal aplasia? (definition)
A
Absence of development of a kidney, can be unilateral (incidental finding), or bilateral (fatal)
slide 14 and 15 have pictures
3
Q
True or false: renal aplasia is a very common developmental abnormality.
A
False. It is a rare developmental abnormality
4
Q
What animals can you see renal aplasia?
A
Swine, dogs (Doberman pinscher’s and beagles), and cattle.
5
Q
What is renal hypoplasia?
A
It is a quantitative defect caused by reduced mass of metanephric blastema. Hypoplastic kidneys look normal just smaller.
6
Q
In what animals has renal hypoplasia been described?
A
Pigs, foals, dogs (cocker spaniels), and chickens
7
Q
What is the differential diagnosis to renal hypoplasia?
A
Renal dysplasia, and differentiation requires histological examination.
8
Q
What is renal dysplasia?
A
It’s a rare condition very difficult to diagnose grossly. by definition, it’s an abnormal and asynchronous differentiation (disorganized development) of renal tissue.D
9
Q
What may severe bilateral renal dysplasia lead to?
A
Renal failure
10
Q
What are the causes of renal dysplasia?
A
- Congenitalinfections: Feline Panleukopenia, Canine herpesvirus, Bovine virus diarrhea
- Autosomaldominantin Suffolk sheep
- HypovitaminosisAinpigs
- Intrauterineureteral obstruction in pigs and calves
11
Q
Where can you find the renal cysts? (Animals)
what do they look like?
A
- Renalcystsarea common congenital renal malformation found in pigs, calves and to a lesser extent, in other species.
- Cysts of variable size are typically filled with fluid and lined by flat or cuboidal epithelium.
12
Q
Look at slide 23. And some pictures minimal insignificant info
A
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13
Q
What is the gross appearance of a polycystic kidney?
A
Contain numerous variable size cysts, in the cortex and Medulla.
If severe may have “honeycomb” appearance. Cysts are filled with colorless fluid.
Slide 24 has a picture
14
Q
What are the causes of polycystic kidneys?
A
Congenital, may be inherited as an autosomal dominant condition pigs and lambs. It can also be inherited by: – Cairn terrier dogs (in conjunction with cystic biliary disease) – Bull terriers – Collie dogs – Nubian goats – Persian cats
15
Q
What are the two consequences of renal cysts?
A
Cysts may grow slowly or remain static.
Cysts may increase in size and/or number, causing compressive atrophy.
Slide 26 has a picture.
16
Q
Look at slide 27 it has a picture, and some information.
A
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17
Q
What is the definition of ectopic kidneys?
A
Normal kidneys in an abnormal location. Often unilateral.
18
Q
In what animals is ectopic kidneys described?
A
Dogs and pigs
19
Q
What are ectopic kidneys predisposing factor?
A
Urter obstruction and development of hydronephrosis.
20
Q
Look at slides 29 – 36 pictures and info.
A
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21
Q
What are the four types of pigmentary disturbances?D
A
Hemoglobinuria, myoglobinuria, lipofucsin, bile
22
Q
Look at slide 38-43
A
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23
Q
LipofucsinosisIs a incidental finding in ___ _______.
Gross appearance look at slide 44.
A
Old cattle
24
Q
Look at slide 45
A
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25
What causes choluria?
Bile pigment in obstructive jaundice or severe liver disease, kidneys will excrete bilirubin.
26
Look at slide 46-47 picture and information
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27
With three types of circulatory disturbances?
Hyperemia and congestion, hemorrhage, and ischemia
28
What will the kidney look like with hyperemia and congestion
Bright or dark red kidneys.
Hyperemia can be physiologic.
Hypostatic congestion is common as a result of prolonged frustration and circulatory failure.
29
Look at slide 50. Pics and info
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30
List some causes of renal hemorrhage.
| *Look at slide 51, Will Be on the Exam *
Viral infections, septicemia, and toxins
31
Quickly look at slides 52 – 56.
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32
What do renal infarcts look like, and what are they associated with?
Typically triangular/wedge shape with the apex pointing towards the medulla.
Renal infarcts are associated with thrombosis of renal vessels (usually the intralobular artery).
33
Slide 58-61 are pictures.
| 61 has minimal info
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34
What can prolonged ischemia lead to in a kidney?
Infarction/coagulative necrosis.
| The affected area will heal by fibrosis
35
Slide 63-64 are pictures
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36
What are renal infarcts most commonly seen?
* Cattle and pigs with vegetative valvular endocarditis of the left heart.
* Cats with left atrial thrombos is associated with cardiomyopathy.
* Dogs with renal amyloidosis due to loss (through the urine) of plasma anticoagulants such as antithrombin III.
* Endotoxin‐mediated thrombosis due to Gram‐ negative sepsis or endotoxic shock (example: dogs with suppurative prostatitis).
37
What is amyloidosis?(Definition)
Which organ is one of the most important targets of this condition?
Heterogenous group of diseases due to deposition of amyloid in tissues.
The kidney
*Glomerular amyloidosis is a protein losing nephropathy.
Look at slide 67
38
Which is more common in domestic animals primary amyloidosis or secondary (reactive) amyloidosis?
Secondary. Primary is very rare in domestic animals.
39
What is the cause of primary amyloidosis?
Is due to deposition of amyloid AL, derived from Ig light chains produced by abnormal plasma cells.
40
What is the cause of secondary (reactive) amyloidosis?
Is due to the deposition of amyloid AA that originates from serum alpha globulin.
41
What is secondary amyloidosis associated with?
Is associated with chronic antigenic stimulation (chronic inflammation, infection, neoplasia (these are just examples)).
42
Look at slide 69 good information and pictures. I feel like it's important.
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43
Look at slide 70-72, they are pictures with minimal information. Know the stain that is used.T
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44
What are the stains used to confirm amyloidosis microscopically? (2)
Congo red (polarized light) and Thyoflavin-T (fluorescence).
45
Look at slides 74-76. Pictures
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46
Look at slide 77. Information hard to make a question for. Good chance might be asked.
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47
What is bilateral renal cortical necrosis?
It is an acute and severe ischemia of the renal cortex due to vasospasm of cortical vessels.
Start it is an intriguing (meaning we have no clue how it happened) lesion that has traditionally been associated with endotoxemia.
Slide 79 has a picture h
48
How much of the kidneys cortex is involved in renal cortical necrosis? What does it look like?
– all or part of the cortex may be involved.
| – The renal cortex has a mosaic (Apache) appearance with intermixed areas of red and yellow discoloration.
49
What causes Renal Medullary (Papillary)?
• Caused by a localized ischemia of the renal medulla.
50
What are the causes of medullary necrosis? (5)
* Amyloidosis in cats
* Pyelonephritis
* Diabetes mellitus
* Urinary obstruction
* Use of anti‐ inflammatory and analgesic drugs such as phenylbutazone, phenacetin, aspirin.
51
Slide 83-84 are pictures.
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52
What is acute tubular necrosis (nephrosis)?
Acute necrosis of tubular cells is the primary process of nephrosis.
look at slide 85 has extra info.
53
Give the gross appearance of nephrosis.
The kidneys are swollen, the capsular surface is pale and moist, and bulges on cut surface.
Look @ slide 86
54
What are the differential diagnoses for diffusely pale kidneys? (4)
Amyloidosis, acute nephrosis,glomerulonephritis, lymphosarcoma.
55
Slides 88-89 are pictures, know.
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56
Look at slides 90-93, they are descriptions of the histological appearance of nephrosis and pictures.
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57
Look at the slides 94-97, couldn't make questions and picture.
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58
What are the causes of toxic nephrosis? (4)
Heavy metals, carbon tetrachloride, chlorinated-hydrocarbon, insecticides.
59
Give some examples of heavy metals that can cause toxic nephrosis.
Mercury (in herbicides), lead (old paint, batteries), cadmium, chromium, copper, phosphorus.
60
What are the nephrotoxic plants? P
– Pigweed (Amaranthus retroflexus)
| – Oaks (Quercus sp.).
61
In what animal studies of poisoning occur?
Cattle and horses
* look at slide 100
62
What are the four types of nephritis (classification according to location)?
Glomerulitis
Glomerulonephritis
interstitial nephritis
pyelonephritis
63
What are other names for Glomerulitis? What causes it? What is its pattern?
Embolic nephritis (supported Glomerulitis)
Caused by bacteremia
it is multifocal suppurative Glomerulitis.
64
In Glomerulitis where are bacterial colonies seem?
In glomerular interstitial capillaries
65
What is the main cause of embolic nephritis in foals?
Actinobacillus equuli
66
Skip slide 105
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67
Where do Glomerulonephritis and glomerulopathies take place? (Part of kidney)
glomeruli
68
What is Glomerulonephritis largely but not extensively associated with?
Immune mediated injury
69
What are the two main mechanism related to immune-mediated processes?
- -Deposition of antigen antibody complexes
| - -Autoantibodies directly against glomerular basement membranes (GBM) (anti-basement membrane disease)
70
How does deposition of antigenic antibody complexes work?
* Persistent antigens in the blood result in deposition of Antigen‐ Antibody (Ag‐Ab) complexes in glomerular basement membranes.
* Persistent antigen can be viral, bacterial, parasitic, etc.
71
What is the other name for autoantibodies directed against the glomerular basement membrane?
Anti-basement membrane disease
*look at slide 109 for more information.
72
LOOK AT SLIDE 110
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73
Look at slide 111-115
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74
INTERSTITIAL (TUBULO‐INTERSTITIAL) NEPHRITIS
| What can inflammatory infiltration in the interstitial affect? What is the distribution?
Tubular functions such as reabsorption, concentration and or excretion.
Multifocal or diffuse
75
look at slide 117-119
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76
What is multifocal interstitial nephritis also called? What animal do you find it in? What is it presumed to be a residual lesion of?
– white spotted kidney
– common in young
– presumed to be some residual lesion of E. coli bacteremia in the first few weeks of life.
77
look at slide 121-122
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78
What are the causes of interstitial nephritis in dogs, cattle, sheep, pigs, horses?
• Dogs
– Leptospira interrogans serovars *canicola*,
icterohaemorrhagiae, and others
– Infectious canine hepatitis virus, recovery phase
– Theileria parva
• Cattle:
– *E. coli septicemia (white spotted kidney)*
– Leptospira interrogans serovar canicola
– Malignant catarrhal fever
• Sheep:
– Sheeppox
• Pigs:
– Leptospira interrogans serovar *pomona*
– *Porcine reproductive and respiratory syndrome*
– *PCV‐2 (porcine circovirus 2)*
• Horses:
– Equine viral arteritis
79
What is the gross appearance of chronic interstitial nephritis?
– kidneys shrunken, pale, firm
| – capsule firmly adhered to cortex
80
look at slide 127
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81
# Define pyelonephritis.
What separates this from other forms of nephritis
What animal is this commonly seen in?
Is inflammation of the renal pelvis and renal parenchyma
Lesions of pyelonephritis not necessarily symmetrical
pigs, cattle and dogs. occasionally seen in cats, horses and other domestic animals
82
look at slide 130-131 Pathogenesis & predisposing factors of pyelonephritis.
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83
look at slides 132
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84
What is the gross appearance of pyelonephritis?
* Suppurativeexudatein pelvic cavity, partial destruction of medulla, irregular discoloration of cortex.
* Markedscarringand fibrosis are often seen.
* Evidenceof inflammation in ureter and urinary bladder.
85
pics slide 134
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86
Look at slide135
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87
What characterizes Granulomatous nephritis?
predominance of macrophages in the inflammatory infiltrate. (this is a form of chronic nephritis)
88
What is the etiology/causes of Granulomatous nephritis?(4)
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– Viruses such as corona virus [causing cell‐
mediated immune‐response]
– Fungal organisms
– Bacteria (such as mycobacteria)
– Parasite migration
```
89
LOOK @ SLIDE 137, IS STARED AND INVOLVES FIP
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90
slide 138-140 pics
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91
What parasite is responsible for Granulomatous nephritis in horses? What type of parasite is it?
(KNOW BOTH QUESTIONS slide 141)
Halicephalobus gingivalis (migrates in horses)
Saprophytic nematode
* slide 141 has extra info
92
What is another name for Dioctiophyma renale?
What animals can get this?
What's its size?
Where can it be found?
Giant kidney worm
Occurs in mink, dogs, other fish‐eating mammals.
Large nematode (up to 1 m long x 1 cm in diameter).
Nematode resides in renal pelvis.Can be found free in peritoneal cavity
*slide 143 pic
93
What can Stephanurus dentatus cause in pigs due to migration from intestine to liver?
hepatitis, phlebitis, abscesses
*Cysts often communicate with the renal pelvis
94
Where does Stephanurus dentatus migrate from and to in pigs?
Intestine->liver->peritoneal cavity->peri-renal fat->adjacent tissues
95
slide 145-147 pics
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96
Define hydronephrosis.
Abnormal and permanent dilation of the renal pelvis and calyces with progressive atrophy of renal parenchyma.
97
What causes hydronephrosis?
What is it commonly associated with?
Due to an increased pressure following partial or complete obstruction of the urine outflow.
Commonly associated with
hydroureter (ureteral dilatation).
98
What are the causes of urine outflow obstruction?(6)
* Congenital malformation of ureter, vesicoureteral junction or urethra. (not common)
* Calculi (urethral uroliths in dogs and cats, ureteral or pelvis uroliths in cattle and rams).
* Iatrogenic (ligation of ureter in lieu of, or with the ovarian stump).
* Chronic inflammation.
* Neoplasia such as urinary bladder transitional cell carcinomas or *rhabdomyosarcomas located in the trigone of the urinary bladder.*
* Torsion of ureters or bladder.
99
Hydronephrosis can be:
A. Unilateral
B. Bilateral
C. Either A or B
C. Either A or B
| LOOK AT SLIDE 152 FOR MORE INFO OF PATHOGENESIS
100
What does asis stand for?
process
101
What is Urolithiasis?
The process of formation of solid or semisolid concretions (calculi) anywhere in the urinary collecting system.
102
The calculi found in urolithiasis is known as what? (This is a softball question)
Calculi are known as uroliths.
103
What are uroliths composed of?
Wide variety of minerals, often mixed with protein material. (slide 154 has pic and info)
104
What are the predisposing factors of urolithiasis?(6)
* Increasedurinary concentration of the stones’ constituents (supersaturation).
* Low urine volume (due to dehydration, low water consumption).
* Urine pH (e.g., cystine stones form at low pH ).
* Urinary tract infections (due to the formation of an organic matrix and pH increment).
* Diets high in phosphate in sheep.
* High levels of silica on native pastures grazed by cattle.
105
slides 156-159 are pics
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106
What are Struvites linked to? (involves urolithiasis)
What are they made of?
What is the most common animal to see them in?
- Linked to urinary bladder infection
- Made of magnesium, ammonium, and phosphate.
- Most common in dogs
107
When can you see Struvites in cattle?
When they are on high-grain rations.
108
What can cause Struvite formation?
Bacterial infection of the bladder.
109
Where (sex) are you more likely to see Urethral obstruction?
What are the clinical signs?
Males
- Dysuria, stranguria, pollakiuria and hematuria.
110
What are the possible consequences of urolithiasis? (4)
* None, urolith passed in the urine
* Hydronephrosis if urolith is lodged in ureter
* Chronic cystitis, or bladder distension and rupture if urolith is lodged in urethra
* Acute hemorrhagic urethritis
111
slide 164 is a pic
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112
Where is Familial Renal Diseases most commonly seen?
What is the origin of this disease?
• Most commonly seen in dogs compared to other species.
• May be the result of *abnormal structure or abnormal function.*
Look at slide 165 for examples and info
113
Look at slide 166 has breeds predisposed to Progressive Juvenile Nephropathy.
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114
What are some abnormal functions associated with Familial Renal Disease?(2)
Give examples. (2)
• Biochemical defects in renal tubules.
• Kidneys may appear grossly and
microscopically normal
• Examples:
– *Fanconi Syndrome in Basenji dogs*
– Primary renal glucosuria in Norwegian Elkhound
115
What are the three possible renal responses to injury?(Slide 168, only partial answer. Question will show up again with different answers)
– tubular regeneration
– healing by fibrosis if the basement membrane is damaged
– Nephrosclerosis fibrosis if fibrosis is severe
116
What are the three urinary system defense mechanisms?
– Barrier system
– Glomerular mesangial cells (part of monocyte macrophages system)
– general immune response
117
What is renal response to injury? (8)
Degeneration, necrosis, hyperplasia, hypertrophy, atrophy, inflammation, regeneration, and fibrosis
118
Slide 71 is a picture
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119
What is the term used to describe kidneys that are severely affected by chronic inflammation and fibrosis?
End-stage kidney
| picture 172
120
What is an end-stage kidney? Is it possible to identify the primary insult that causes this?
It is severe chronic inflammation and fibrosis efface the normal architecture.
It is not possible to identify the primary insult.
Look at slide 173
121
Picture on slide 174
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122
What are the causes of chronic renal failure and dogs? (3)
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– Chronic tubulointerstitial nephritis of unknown cause.
– Chronic pyelonephritis.
– Chronic glomerulonephritis.
– Amyloidosis.
– Familial renal disease.
– Hypercalcemic nephropathy.
– Chronic obstruction (hydronephrosis).
– Sequel to acute renal disease (e.g. leptospirosis)
```
123
Are the causes of chronic renal failure and cats? (9)
– Chronic tubulointerstitial nephritis of unknown cause.
– Chronic pyelonephritis.
– Chronic glomerulonephritis.
– Amyloidosis(familial in Abyssinians).
– Polycystic kidney disease (familial in persians)
– Chronic obstruction (hydronephrosis).
– Sequel to acute renal disease.
– Neoplasia (e.g. Renal lymphoma).
– Granulomatous Interstitial nephritis due to FIP
124
What are the common causes of chronic renal failure in small animals (cats and dogs)? (6)
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– Chronic tubulointerstitial nephritis of unknown cause.
– Chronic pyelonephritis.
– Chronic glomerulonephritis.
– Amyloidosis.
– Chronic obstruction (hydronephrosis).
– Sequel to acute renal disease
```
125
What are the causes of chronic renal failure in horses? (4)(all 4 can be found in cats and dogs. 3 can be found in Cows)
– Chronic interstitial nephritis of unknown cause.
– Chronic pyelonephritis.
– Chronic glomerulonephritis.
– Amyloidosis.
126
What are the causes of chronic renal failure in cows? (7)
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– Chronic interstitial nephritis of unknown cause.
– Chronic pyelonephritis.
– Amyloidosis.
– Renal infarction due to sepsis.
– Renal vein thrombosis.
– Renal lymphoma.
– Leptospirosis
```
127
Slide 178 is a picture
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128
What is the difference between renal disease and renal failure?
Disease is any deviation from normal renal structure or function.
Failure is the inability of the kidney to maintain normal function; renal failure requires loss of at least 70-75% of the renal function.
129
Look at slide 180
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130
What happens to glomerular function during renal failure?
Glomerular function tends to be disrupted by diseases that alter glomerular structural arrangements such as damage to basement membrane, endothelium, epithelium or mesangium.
131
What happens to tubular function during renal failure?
Tubular function tends to be disrupted by metabolic insults to the tubular cells (e.g. hypoxia or toxins).
132
What are two waste products that renal filtration allows elimination of?
Urea and creatinine
133
What is clinical significance of urea and creatinine in urine?
The concentrations are tested in plasma and urine to detect renal malfunction.
134
Look at slide 183-185 talks about urea and creatinine
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135
What are the clinical signs of uremia? (5)
* Vomiting
* Dehydration or anasarca
* Polydypsia, anuria, oliguria, poliuria
* Ammoniacal breath
* Malaisedueto “uremictoxins”
136
What are the non-renal lesions of uremia? (5)
* Uremic stomatitis / glossitis
* Hemorrhagic ulcerative gastritis and colitis
* Endocarditis / mucoarteritis
* Tissue mineralization
* Pulmonary edema
137
In what animal does uremic stomatitis/glossitis occur?
Where will you see?
What causes it? A
It can be found on the bottom of the tongue in cats and dogs. It is caused by bacterial production of ammonia.(Look at the slide 188) i
138
Describe grossly uremic stomatitis/glossitis.
Ulcerative and necrotizing stomatitis is characterized by a brown, foul‐smelling mucoid material adhered to the eroded and ulcerated lingual and oral mucosa.
139
What is the "doctor word" for urine breath?
Halitosis.
140
Why does Hemorrhagic ulcerative gastritis happen?
Occurs as a result of arteriolar necrosis with:
(a) mucosal infarction and
(b) mineralization of the gastric glands and submucosal blood vessels.
141
What might happen to the ulcerated mucosa of hemorrhagic ulcerative gastritis?
May get secondary bacterial invasion
142
What animals can you see uremic gastritis/ colitis in?
Uremicgastritisisseen in dogs and cats, whereas the colon is affected in horses and cattle.
143
Looking at slide number 192.
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144
Where is mucoarteritis most commonly found in the heart? What is its gross appearance?
Most common in the left atria and proximal aorta.
| Grossly it consists of opaque, light yellow roughened endocardial plaques.
145
With Dystrophic and Metastatic Calcification, where will you see deposition of mineral?
```
Walls of the:
– alveolar septa,
– pulmonary arterioles
– Pericardium
– soft tissues
– parietal pleura in the cranial intercostal spaces (“pleural frosting” )
```
146
What may Dystrophic and Metastatic Calcification be associated with?
It may be associated to deposition of calcium secondary to cell injury or hypercalcemia, or hyperphosphatemia.
147
What is most often the cause of death in uremic animals?
Pulmonary edema
148
What is pulmonary edema the results of?
Results from damage to their air blood barrier and plasma fluid leaks into the alveoli.
149
Look at slide 195, it has a picture, gross appearance, and histologic appearance.
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150
Look at slide 197.
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151
What can abnormal renal function results in excessive retention?
Phosphorus (hyperphosphotemia)
152
How does the body trying to maintain homeostasis after retention of phosphorus?What is the problem with this response?
It increases calcium.
The issue is to increase calcium the parathyroid glands are activated and promote reabsorption of calcium from bone (calcium goes from bone into blood).
153
Slide 199 is a picture
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154
What is the natural antibacterial activity of normal animal urine? (3)
–Normal voiding of urine.
– Low pH.
– High osmolality.
155
What can cause cystitis?(3)
– It is due to formation and accumulation of uroliths, that is caused by
– Bacterial infections (bacteria involved are similar to those causing pyelonephritis)(picture on slide 201)
– Exposure to toxic compounds (less common)
156
List three examples of toxic compounds that can cause cystitis.
–ingestion of blister beetle in alfalfa (cantharidin toxicity in horses)
*–Ingestion of bracken fern (enzootic hematuria in cattle)*
–treatment with cyclophosphamide (dog, cat)
157
Look at slide 203
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158
What is acute cystitis usually associated with?
Mucosal hemorrhage and ulceration.
159
What can acute cystitis produce?
Produces exudate (hemorrhagic, fribrinopurulent)
160
Look at slide 205 it has chronic cystitis.
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161
Look at slide 206-210.
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162
How common are the primary tumors of the urinary tract?
They are rare
| LOOK AT SLIDE 211
163
Which is more common/seen more often, bladder tumors or renal tumors?
Bladder tumors are seen more often than renal tumors.
164
What are the three primary epithelial tumors?
Renal adenoma, renal adenocarcinoma, renal cystadenocarcinoma
165
True or false: renal cystadenocarcinoma is cancerous.
True. It is a cancer of the has a lot of cyst like lesions.
166
Slides 213- 215 are pictures.
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167
What animals are nephroblastomas common to see in?
Pigs, rats and chickens.
can also be diagnosed in cattle and dogs.
(Look at slide 216)
168
Slides 217- 218 are pictures
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169
Look at slide 219, I could not think of any question.
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170
Slide 220 is a picture
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171
What are the three primary mesenchymal tumors?
* leiomyoma/ leiomyosarcoma
* fibroma/fibrosarcoma
* hemangioma/ hemangiosarcoma
look at slide 221
172
Slides 222- 225 are pictures.
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