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Year 1/2 > Elimination & Detox 2: Urinary Pathology > Flashcards

Elimination & Detox 2: Urinary Pathology Flashcards

1
Q

SDMA definition?

UREMIA definition?

CREATININE is a MARKER of…

A

SDMA = SENSITIVE & EARLY MARKER of DECREASED GFR in CATS & DOGS

UREMIA = URINE in BLOOD (UREMIC TOXINS)

CREATININE is a MARKER of GFR

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2
Q

what SPECIES is this kidney?

what are 2 TERMS to DESCRIBE THIS ANATOMY?

EACH of their ___ are considered INDIVIDUAL ___ ____, which then all COALESCE & DUMP into ONE ____

A

COW

2 terms?
1. EXTERNAL LOBATION
2. MULTI-PARAMETAL

EACH of their LOBULES are considered INDIVIDUAL RENAL PYRAMIDS, which then all COALESCE & DUMP into ONE URETER

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3
Q

what SPECIES is this kidney?

what is the RED DOT labeling?

A

DOG

RED DOT = RENAL CREST

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4
Q

POLYCYSTIC KIDNEY DISEASE…

etiology? (2)

what BREEDS are most PREDISPOSED? (2)

almost EVERY animal with this disease will END UP WITH ____ ____ ____ via…

A

etiology?
1. CONGENITAL
2. from PKD1 MUTATION

2 BREEDS…
1. PERSIANS
2. BULL TERRIERS

almost EVERY animal with this disease will END UP WITH CHRONIC RENAL FAILURE via CYSTIC STRUCTURES DESTROYING RENAL PARENCHYMA

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5
Q

ID DZ

2 predisposed BREEDS?

A

POLYCYSTIC KIDNEY DZ

2 BREEDS?
1. PERSIANS
2. BULL TERRIERS

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6
Q

ID LESION

A

RENAL CYST

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7
Q

TRUE/FALSE

JUST BECAUSE an animal HAS CYSTS DOES NOT MEAN THAT THEY HAVE POLYCYSTIC KIDNEY DZ.

A

TRUE

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8
Q

RENAL CYSTS…

etiology? (2)

often a(n) ____ FINDING associated with…

A

etiology? –> CAN BE EITHER…
1. ACQUIRED
2. CONGENITAL

often an INCIDENTAL finding associated with CKD

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9
Q

4 PORTALS OF ENTRY for KIDNEY INJURY…

A
  1. ASCENDING (from bladder/urethra to kidney)
  2. HEMATOGENOUS (from sepsis)
  3. DESCENDING (from kidney to UT)
  4. DIRECT (toxins)
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10
Q

ONCE A NEPHRON is DYSFUNCTIONAL, what happens?

what is a COMMON EXAMPLE of this?

A

NEPHRONS CANNOT REGENERATE, so REMAINING NEPHRONS must COMPENSATE

example = GLOMERULAR HYPERTROPHY

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11
Q

what do we usually SEE in response to INJURY to the…

GLOMERULUS?

INTERSTITIUM?

TUBULES?

A

GLOMERULUS = DYSFUNCTION of FILTRATION MEMBRANE

INTERSTITIUM = FIBROSIS

TUBULES = EPITHELIAL CELL NECROSIS or TUBULORRHEXIS

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12
Q

TUBULORRHEXIS definition?

A

RUPTURE of BASEMENT MEMBRANE in TUBULAR CELLS

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13
Q

difference between RENAL DISEASE & RENAL FAILURE?

INCREASED BUN & CREATININE (azotemia) occur SECONDARILY to…

A

RENAL DISEASE = ANY deviation from NORMAL STRUCTURE or FUNCTION with WIDE RANGE OF CLINICAL SIGNS & SEVERITY

RENAL FAILURE = LOSS of >75% RENAL FUNCTION or ~25% REMAINING RENAL FUNCTION that can have ACUTE OR CHRONIC PRESENTATION

AZOTEMIA is SECONDARY to KIDNEY INJURY & DECREASED RENAL FUNCTION

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14
Q

DIFFERENCES in DEFINING…

ACUTE KIDNEY INJURY?

CHRONIC KIDNEY DISEASE?

A

ACUTE KIDNEY INJURY = IRIS GRADING I-V

CHRONIC KIDNEY DISEASE = IRIS STAGING 1-4

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15
Q

what DIAGNOSTICS should we perform for EVALUATION of RENAL FUNCTION?

4 total, 2 subs for each!

A
  1. BLOODWORK
    –> CHEM for ELECTROLYTES & KIDNEYS
    –> CBC
  2. URINALYSIS
    –> USG
    –> SEDIMENT
  3. IMAGING
    –> RADS (thoracic)
    –> US (abdominal)
  4. HISOPATH
    –> RENAL BIOPSY
    –> POSTMORTEM EXAM
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16
Q

ACUTE KIDNEY INJURY…

occurs on a ___, meaning…

has ___ ___ of CLINICAL SIGNS, including 3 SPECIFIC findings…

what are 2 COMMON CAUSES of AKI?

prognosis?

A

occurs on CONTINUUM, meaning INJURY can be SUBCLINICAL to SEVERE RENAL FAILURE

has RAPID ONSET of CLINICAL SIGNS, including 3 SPECIFIC findings..
1. DECREASED URINE OUTPUT
2. AZOTEMIA
3. METABOLIC DERANGEMENTS (metabolic acidosis)

2 COMMON CAUSES?
1. NEPHROTOXINS
2. ISCHEMIA

prognosis? = GENERALLY GOOD so long as DAMAGE IS NOT SEVERE ENOUGH to LEAD TO CKD

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17
Q

ID GENERAL DZ

A

AKI (dog kidney)

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18
Q

ID GENERAL DZ

A

CKD

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19
Q

CHRONIC KIDNEY DZ…

causes ___ CHANGE

5 CLINICAL SIGNS?

3 B/W changes?

2 POSTMORTEM changes to kidneys?

A

causes IRREVERSIBLE CHANGE

5 CLINICAL SIGNS?
1. V+
2. D+
3. LETHARGY
4. POOR BCS
5. PU/PD

3 B/W changes?
1. AZOTEMIA
2. NON-REGENERATIVE ANEMIA
3. +/- METABOLIC ACIDOSIS

2 POSTMORTEM changes to kidneys?
1. SMALL/SHRUNKEN
2. IRREGULAR CORTICAL SURFACE from TISSUE LOSS & FIBROSIS

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20
Q

UREMIA/UREMIC SYNDROME…

can be found with ___ or ____ RENAL ____

= definition

what kind of DAMAGE can the body sustain as a result? (2)

A

can be found with ACUTE or CHRONIC RENAL INJURY

= MULTIORGAN MANIFESTATION of CIRCULATING UREMIC TOXINS that BUILD UP (when they should be excreted in urine) due to ACUTE or CHRONIC RENAL FAILURE

DAMAGE to body?
1. toxins can DAMAGE ENDOTHELIAL & EPITHELIAL CELLS
2. cause MALAISE by CROSSING BBB

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21
Q

what 3 CLINICAL SIGNS define MALAISE?

A

V+, ANOREXIA, D+

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22
Q

NON-RENAL LESIONS of UREMIA…

= overall?

what FOUR LOCATIONS can this COMMONLY occur in?

pathogenesis?

A

= overall, INFLAMMATION and MINERALIZATION in DIFFERENT ORGANS

organs?
1. MOUTH
2. STOMACH
3. ALVEOLAR SEPTAL WALLS in LUNGS
4. MYOCARDIUM

PATHOGENESIS is UNKNOWN

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23
Q

ID DZ

this is SEQUELAE of…

A

ULCERATIVE STOMATITIS

SEQUELAE of UREMIC SYNDROME/UREMIA

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24
Q

ID DZ

this is a SEQUELAE of…

A

PLEURAL MINERALIZATION

this is a SEQUELAE of UREMIA/UREMIC SYNDROME

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25
Q

ID DZ

this is a SEQUELAE of…

A

GASTRIC MINERALIZATION

this is a SEQUELAE of UREMIA/UREMIC SYNDROME

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26
Q

2 TYPES of VASCULAR INJURY that can occur in KIDNEY?

list 2 subs for FIRST, 3 for SECOND

A
  1. HEMORRHAGE
    –> manifestation of SYSTEMIC DZ like VASCULITIS or BACTEREMIA
    –> LOCAL TRAUMA (hematoma)
  2. ISCHEMIA
    –> ACUTE or CHRONIC RENAL INFARCTS
    –> RENAL PAPILLARY NECROSIS
    –> ACUTE TUBULAR INJURY
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27
Q

RENAL HEMORRHAGE…

often a MANIFESTATION of ____ ____

on POSTMORTEM, can see…

examples of a DISEASE that can CAUSE THIS in…
–> SWINE?
–> FOALS?
–> PUPPIES?
–> ANY SPECIES?

A

often a MANIFESTATION of SYSTEMIC DZ

on POSTMORTEM, can see SMALL FOCI of HEMORRHAGE & NECROSIS

examples of a DISEASE that can CAUSE THIS in…
–> SWINE = AFRICAN SWINE FEVER
–> FOALS = EQUINE HERPESVIRUS-1
–> PUPPIES = CANINE HERPESVIRUS-1
–> ANY SPECIES = SEPSIS

28
Q

ID LESION

A

RENAL HEMORRHAGE (see PETECHIAE)

29
Q

RENAL INFARCTS

= definition? why does it look like this?

if ACUTE? (3)

if CHRONIC? (3)

what is the OVERALL CAUSE? give 3 subs for this cause

A

= WEDGE-SHAPED area of NECROSIS & HEMORRHAGE; wedge-shaped bc that’s how BLOOD FLOWS IN KIDNEY

if ACUTE…
1. SWOLLEN
2. RED (hemorrhage)
3. or TAN (necrosis)

if CHRONIC
1. DEPRESSED
2. FIRM
3. TAN (fibrosis to REPLACE necrotic tissue)

OVERALL CAUSE = ISCHEMIA
1. THROMBI or THROMBOEMBOLI
2. ENDOTOXEMIA
3. VASCULITIS

30
Q

ID LESION based on THIS PATHOLOGIC DESCRIPTION & PICTURE:

RED RIM of HEMORRHAGE surrounding a WEDGE-SHAPED AREA of TAN NECROSIS.

A

ACUTE RENAL INFARCT

31
Q

ID LESION based on THIS PATHOLOGIC DESCRIPTION & PICTURE:

RED RIM of HEMORRHAGE surrounding a WEDGE-SHAPED AREA of TAN NECROSIS.

A

ACUTE RENAL INFARCT

32
Q

ID LESION & what 3 PATHOLOGIC DESCRIPTORS you’d list?

A

CHRONIC RENAL INFARCT

descriptors?
1. DEPRESSED
2. FIRM
3. TAN (FIBROSIS has REPLACED NECROTIC TISSUE)

33
Q

RENAL PAPILLARY NECROSIS…

commonly associated with… in WHAT species?

pathophysiology? (4)

NSAIDs can also cause LESIONS in WHAT OTHER 2 ORGANS in the HORSE?

A

commonly associated with NSAID ADMINISTRATION in HORSES

pathophysiology?
1. PROSTAGLANDINS normally PRODUCED by RENAL INTERSTITIAL CELLS to cause KIDNEY VASODILATION

  1. NSAIDs PREVENT prostaglandins from WORKING
  2. loss of VASODILATION from PROSTAGLANDINS causes ISCHEMIA
  3. ISCHEMIA causes COAGULATIVE NECROSIS of RENAL PAPILLA/CREST

NSAIDs can also cause DAMAGE in the horse at these 2 organs…
1. STOMACH (GASTRIC ULCERS)
2. RIGHT DORSAL COLON

34
Q

4 ETIOLOGIES of RENAL PAPILLARY NECROSIS? start with the MOST COMMON

A
  1. NSAID ADMINISTRATION
  2. PYELITIS/PYELONEPHRITIS
  3. UROLITHIASIS
  4. AMYLOID
35
Q

PYELITIS definition?

PYELONEPHRITIS definition?

EMBOLIC NEPHRITIS definition?

A

PYELITIS = INFLAMMATION of RENAL PELVIS

PYELONEPHRITIS = INFLAMMATION of RENAL PELVIS & TUBULOINTERSTITIUM

EMBOLIC NEPHRITIS = HEMATOGENOUS INFLAMMATION of KIDNEY

36
Q

TUBULOINTERSTITIAL NEPHRITIS..

this TERM is NOT a…

= definition?

3 causes?

END RESULT? (1 overall, 2 findings)

A

NOT A SPECIFIC DZ

= ACUTE or CHRONIC INFLAMMATION from INJURY to the INTERSTITIUM that also IMPAIRS TUBULAR FUNCTION, and EVENTUALLY GLOMERULAR

3 causes?
1. ISCHEMIA
2. LEPTOSPIROSIS in ALL SPECIES
3. BORRELIA BURGERFORI (LYME)

END RESULT = CKD
1. INTERSTITIAL FIBROSIS
2. NEPHRON LOSS

37
Q

DESCRIBE this kidney (2)

LIKELY DZ? why?

duration?

A

DESCRIBE?
1. RED/CONGESTED kidney
2. with TAN REGIONS INTERSPERSED throughout CORTEX

likely TUBULOINTERSTITIAL NEPHRITIS
–> NORMALLY you SHOULDN’T be able to see INTERSTITIUM, but in this DZ then SEE FIBROSIS BETWEEN TUBULES

ACUTE

38
Q

ID HISTOPATHOLOGIC DZ & how it USUALLY PRESENTS?

A

HISTOPATHOLOGIC DZ = CHRONIC TUBULOINTERSTITIAL NEPHRITIS

usually PRESENTS as CKD

39
Q

PYELITIS/PYELONEPHRITIS…

USUALLY caused from ____ ____ that ARRIVES TO KIDNEY from ____ via… (2)

FEMALES vs. MALES?

POSSIBLE ETIOLOGIC AGENTS are usually… so, IMPORTANT TO DO WHAT DIAGNOSTIC?

A

USUALLY caused from ASCENDING INFECTION that ARRIVES TO KIDNEY from OUTSIDE via…
1. URINARY BLADDER
2. URETERS

FEMALES more PREDISPOSED than MALES due to SHORTER, WIDER URETHRA

POSSIBLE ETIOLOGIC AGENTS usually BACTERIAL, important to do CULTURE & SENSITIVITY TESTING if we SUSPECT UTI

40
Q

PYELONEPHRITIS vs. RENAL INFARCTS?

A

PYELONEPHRITIS = should affect RENAL PYRAMIDS, RENAL CREST & radiate from RENAL MEDULLA into the CORTEX

RENAL INFARCTS = tend to JUST AFFECT PARTS OF RENAL CORTEX

41
Q

LEFT vs. RIGHT?

what’s the DISEASE?

A

LEFT = ACUTE

RIGHT = CHRONIC

DZ = PYELONEPHRITIS

42
Q

EMBOLIC NEPHRITIS..

caused by ____ ____ to KIDNEY during ____

GROSSLY, called “what?”

usually causes ___ & ____ around ____ ___ & ____

A

HEMATOGENOUS INFECTION to KIDNEY during BACTEREMIA

GROSSLY, “WHITE SPOTTED KIDNEY”

usually causes INFLAMMATION & NECROSIS around BLOOD VESSELS & GLOMERULI

43
Q

ID DZ

what do the FOCI correlate to?

A

EMBOLIC NEPHRITIS, “white spotted kidney”

FOCI = regions of INFLAMMATION & sometimes NECROSIS

44
Q

CYSTITIS…

3 PREDISPOSING factors?

4 etiologies? which is MOST COMMON? include what SPECIES they’re seen in

A

3 PREDISPOSING factors?
1. DAMAGE to BLADDER MUCOSA (from uroliths or trauma)

  1. INCOMPLETE EMPTYING of BLADDER
  2. DIABETES MELLITUS which can cause EMPHYSEMATOUS CYSTITIS

etiologies?
1. BACTERIAL INFECTION of URINARY BLADDER = MOST COMMON

  1. BRACKEN FERN causing ENZOOTIC HEMATURIA –> HEMORRHAGIC CYSTITIS
  2. CANTHARIDIN (blister beetles) to HORSES
  3. CYCLOPHOSPHAMIDE (dogs/cats) for CHEMO
45
Q

EMPHYSEMATOUS CYSTITIS…

often a SEQUELAE of WHAT DZ?

see WHAT on DIAGNOSTICS?

A

SEQUELAE of DIABETES MELLITUS in DOGS/CATS

see GAS IN BLADDER WALL

46
Q

what 2 SPECIES are PREDISPOSED for URETERITIS/URETHRITIS? what DZ do they usually get?

what is often the ETIOLOGIC AGENT/common name of DZ?

A

2 SPECIES? = SHEEP & GOATS with ULCERATIVE URETHREITIS/POSTHITIS

ETIOLOGIC AGENT = C. RENALE (pizzle rot)

47
Q

FELINE INFECTIOUS PERITONITIS can cause ____ & _____ _____ that can then cause damage to the _____

A

FELINE INFECTIOUS PERITONITIS can cause PYOGRANULOMATOUS & NECROTIZING VASCULITIS that can then cause damage to the KIDNEYS

48
Q

WHAT DZ?

describe the OVERALL CONDITION (4 words total) for the KIDNEY?

A

FELINE INFECTIOUS PERITONITIS

KIDNEY undergoes PYOGRANULOMATOUS & NECROTIZING VASCULITIS

49
Q

what 2 UNIQUE things can cause CYSTITIS?

include what SPECIES

A
  1. PARASITES in HORSES, RABBITS, DOGS & CATS
  2. HAIRY VETCH (VICIA VILLOSA) TOXICOSIS in COWS
50
Q

2 main GLOMERULAR DISORDERS?

A
  1. IMMUNE COMPLEX-MEDIATED GLOMERULONEPHRITIS
  2. NON-ICGN GLOMERULOPATHY/GLOMERULONEPHROPATHY
51
Q

ID DZ & DURATION

A

ACUTE GLOMERULONEPHRITIS

52
Q

ID DZ

A

CHRONIC GLOMERULONEPHRITIS

53
Q

4 SEQUELAE of GLOMERULAR DYSFUNCTION causing NON-SELECTIVE FILTRATION?

A
  1. LOSS OF PROTEIN in BLOOD causing PROTEINURIA
  2. LOSS OF ALBUMIN causing EDEMA
  3. LOSS OF ANTITHROMBIN III causing HYPERCOAGULABILITY
  4. eventual LOSS of ENTIRE NEPHRON causing RENAL FAILURE
54
Q

IMMUNE-MEDIATED GLOMERULONEPHRITIS

commonality in WHAT species?

treatability?

pathophysiology? (2)

etiologies? MOST COMMON cause in ANIMALS? (2)

this is a TYPE ____ _____ REACTION

A

COMMON in DOGS

VERY TREATABLE

pathophysiology?
1. due to IMMUNE-COMPLEX DEPOSITION in GLOMERULAR BASEMENT MEMBRANES
2. causes INFLAMMATION & FIBROSIS over time

etiologies?
1. PRIMARY/IDIOPATHIC
2. SECONDARY = from DISEASE with PROLONGED ANTIGENEMIA & IMMUNE COMPLEX FORMATION (MOST COMMON IN ANIMALS)

this is a TYPE III HYPERSENSITIVITY REACTION

55
Q

DIAGNOSIS of GLOMERULAR DZ…

based on…

A

BASED ON EXTENSIVE TESTING! must SEND OFF TO A LAB

56
Q

NONIMMUNE-COMPLEX GLOMERULONEPHROPATHIES…

which is the MOST COMMON?

can be a SEQUELAE of ___ ____

tends to MANIFEST in WHAT part of the kidney? what does it CAUSE?

3 postmortem findings GROSSLY?

A

MOST COMMON = AMYLOIDOSIS

AMYLOIDOSIS can be a SEQUELAE of CHRONIC INFLAMMATION

tends to MANIFEST in GLOMERULUS of kidney; AMYLOID will SQUISH GLOMERULAR CAPILLARIES so that THEY CANNOT FUNCTION

postmortem?
1. FIRM
2. WAXY
3. TAN

57
Q

ACUTE TUBULAR INJURY can be due to ____ or ____

A

TOXINS, ISCHEMIA

58
Q

FANCONI SYNDROME..

what BREED predisposed?

what TYPE of dz is this?

A

BASENJI

SPECIFIC TUBULAR DYSFUNCTION

59
Q

TUBULAR DYSFUNCTION…

what does it cause?

A

causes INABILITY TO CONCENTRATE URINE, so it’s UNMODIFIED

60
Q

ID DZ

A

NEPHROBLASTOMA

61
Q

ID DZ

A

LYMPHOMA

62
Q

6 SEQUELAE to TUBULAR DYSFUNCTION…

A
  1. changes to URINE OUTPUT & USG
  2. METABOLIC ACIDOSIS
  3. UREMIA
  4. ELECTROLYTE IMBALANCES & HYPERKALEMIA
  5. PROTEINURIA
  6. GLUCOSURIA
63
Q

ATI/AKI is a VERY COMMON CAUSE OF ATI/AKI, but they can BOTH look ____

A

ACUTE TUBULAR INJURY is a VERY COMMON CAUSE OF ACUTE KIDNEY INJURY, but they can BOTH look SIMILAR

64
Q

ACUTE TUBULAR INJURY/ACUTE TUBULAR NECROSIS…

= definition? including what this CAUSES

reversibility?

2 causes?

A

= NECROSIS & SLOUGHING of TUBULAR EPITHELIAL CELLS that causes DOWNSTREAM LUMINAL CASTS

REGENERATION IS POSSIBLE

2 causes?
1. ISCHEMIA
2. NEPHROTOXINS

65
Q

LOWER URINARY TRACT DYSFUNCTION…

= definition?

MAJOR CONSEQUENCE?

4 SEQUELAE?

A

= CANNOT EXCRETE URINE

MAJOR CONSEQUENCE = RETAINED URINE

4 SEQUELAE?
1. HYPERKALEIA
2. METABOLIC ACIDOSIS
3. AZOTEMIA
4. UREMIA

66
Q

ID LESION

how do you know?

A

HYDRONEPHROSIS

EXPOSURE of the RENAL CALYCES

67
Q

4 causes of HYDRONEPHROSIS?

A
  1. LOWER UT OBSTRUCTION
  2. NEPHROLITHIASIS
  3. CHRONIC PYELONEPHRITIS
  4. RENAL PAPILLARY NECROSIS

Year 1/2 (139 decks)

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