Exam 3 Flashcards
A serum chemistry profile in a horse with colic shows an elevated serum creatinine level. Elevation due to dehydration. What other clinicopathologic finding would confirm this?
High urine specific gravity
Measurement of serum levels of BUN, creatinine, phosphorus and albumin is used to detect
renal glomerular damage
Which clinicopathologic abnormality is least likely to be found in a dog with advanced renal disease>
Increased serum calcium level
Which method is least appropriate for urine collection?
Aspiration of urine form the cage floor or litterbox
In which patient should cystocentesis not be performed?
Adult male cat with disease of the bladder wall
A urine specimen with a fruity odor is most likely to contain
Acetone
Specific gravity reading consistent with isotheruria is
1.008-1.012
Normal Ph of canine and feline urine
7 or less
Squamous epithelial cells found in urine sample usually originate from
Genital tract
Transitional epithelial cells found in urine may originate from all of the following sites EXCEPT
Renal tubules (cuboidal)
White blood cell casts
Disease of the kidney
Cystine crystals in urine of
Male Dachshunds
In a horse with suspected exertional myopathy, , the red brown urine is positive for occult blood and protein using a dipstick test. which additional piece of information supports the diagnosis of myoglobinuria and not hemoglobinuria
There’s an increase in serum creatine kinase activity
Urine of horses is normally thick and cloudy, due to?
Mucus and crystals
Proteinuria found in animals with
A fever
Bilirubin in dogs
Found in large quantities with cholestatic disease
Urine collected by cystocentesis, any of these substance will normally be found EXCEPT
BACTERIA
When present in urine, Bence-Jones protein most easily detected by
Sulfosalicyclic acid test
Which test most useful in detecting renal tubular dysfunction
Fractional sodium excretion
Which type of cast is least significant when found in urine
Hyaline
Prerenal azotemia accompanied by concurrent increase in
Urine specific gravity
What proportion of renal parenchyma must become dysfunctional before renal azotemia is evident
3/4
Which species can resorb most of the urea that passes from the blood, through the bowel mucosa and into the GI tract for protein synthesis?
Cattle
Reduced glomerular filtration can cause
Azotemia
In dogs, the best way to determine significant portein loss from the kidneys is to
Determine the ratio of urine protein concentration to urine creatine concentration in a single urine sample
A female dog was admitted to your clinic with a history of stranguria. the urinary bladder was full of the urine and could not be expressed when gentle pressure was put on the bladder. based on the clinical and physical signs, the radio graphic findings below and your knowledge of kidney function, the expected clinical pathologic picture in the affected dog would be?
increase serum urea nitrogen and potassium levels, with increased urine specific gravity
A water deprivation test to evaluate the ability to concentrate urine is contraindicated in an animals that’s
Azotemic
Which drug is used to test the response to antidiuretic hormone
Vasopressin
When forming A urinalysis with the standard dipstick reagent pads for heme pigments, a positive color test indicates
Intact erythrocytes, free Hb, and free myoglobin
Which of the following substances is used to determine renal plasma flow
Para-amino hippuric acid
A cat has a normal PSP clearance test, elevated blood creatinine and urea nitrogen levels, normal blood glucose levels with no glycosuria, A 3 + protein in the urine, and a normal urine sediment. The most likely interpretation would be
Glomerular problem
Creatine clearance rate problem:
((urine creatine x urine flow rate) / plasma creatine) / body wt = creatine clearance
The typical clinicopathologic picture in a male cat with prolonged urethral obstruction would be?
Increase serum urea nitrogen and potassium levels, metabolic acidosis
Hypercalcemia is a common finding in renal disease of
Horses
A dog has a urine specific gravity of 1.005. The most likely causes of this is
Diabetes insipidus
The type of urolith most frequently associated with bacterial UTI is
Magnesium ammonium phosphate
A cat with anorexia, depression and vomiting has a blood urea nitrogen level of 98 mg/dl, serum phosphorus level of 11 mg/dl, serum calcium level of 7.3 mg/dl, total plasma protein level of 8.2mg/dl, and your specific gravity of 1.066. the most likely mechanism underlying azotemia in this cat is
Dehydration
serum values of which constiuents are most likely to be increased in an azotemic dog
Urea nitrogen and creatinine
The renal threshold for glucose in cats is
290 mg/dl
Urinary crystals most often associated with portosystemic shunts in dogs are
Ammonium biurate
The urinary crystals associated with ethylene glycol toxicity in dogs are
Calcium oxalate
hemorrage in the GI tract is likely to increase the
Blood urea nitrogen level
A urinalysis from a 2 year old neutered male Basenji dog with hypoglycemia shows a specific gravity of 1.025, a trace of protein, 1+ bilirubin, and a 2+ glucose.
Faconi syndrome
Which of the following is the cause of ARF but not pre-renal azotemia
Thrombi
Which of the following has the best prognosis
Polyuric acute renal failure
Which of the following is false about the phase of functional recovery of acute renal failure
Recovery in all or none
You are presented with a four day old cult that is weak and shocky. The fouls abdomen is distended and the owner has not seen it urinate. You suspect A ruptured bladder. When you obtain the results of serum chemistry analysis, what abnormalities would you expect
Increased serum potassium level, decreased serum sodium and chloride levels
Which of the following is most consistent with massive proteinuria, hypoalbuminemia, edema and hypercholesterolemia
Nephrotic syndrome
After relief of acute urinary obstruction of 24 hours duration, followed by 48 hours of endogenous post obstructive diuresis, which plasma electrolyte change is most likely
Hypokalemia
Postrenal azotemia is usally associated with
Urinary tract obstruction
You are presented with a four year old, 1100 pound, thoroughbred gelding that developed profuse watery diarrhea two days previously. Serum biochemical assay reveals the following results:
Na: 131 (135-140), K: 2.7 (3-4.5), Cl: 101 (105-115), Total CO2: 18
which fluid would be most appropriate to administer first
0.9% sodium chloride solution supplemented with potassium chloride
A horse with intravascular hemolysis, with a PCV of 10% and hemoglobinuria. Most appropriate treament:
IV infusion of blood and lactated Ringer’s solution
A five day old, 44 kilogram calf with diarrhea is comatose and severely 12% dehydrated. The base deficit is estimated at 20 mmol/L with the serum bicarbonate level of 6 mEq/L. the most important and immediate concern and treatment of this calf is to?
Fluid needed?
Total carb deficit?
Correct the dehydration, electrolyte imbalance and acid base imbalance with intravenous fluid therapy
Fluid needed: (44 kg) (0.12) = 5.28 L
Total bicarb deficit wiht 24 mEq as normal: 24-6= 18 →
(18)(44)(0.4)= 317 mEq
Dehydration is characterized by
Increased PCV and increased plasma protein level
13 year old cat is presented because of lethargy and anorexia. You notice that the skin remains tented when you pinch it away from the body. the cat’s mucus membranes feel very dry. In regard to hydration status, the cat is most likely
8% or more dehydrated
Paradoxic aciduria is related to increased excretion of H+ in animals with
metabolic alkalosis
Conditions causing hyponatremia include all of the following except
Dehydration
The major particle compromising normal serum osmolality is
Sodium
The major difference in electrolyte composition between plasma intracellular fluid is intracellular fluid contains a
Higher potassium concentration
When administering IV fluids to a cat or dog, care must be taken to monitor for overhydration. The best initial indicator of overdehydration is
Continued weight gain after the animal has been rehydrated appropriately
The least appropriate treatment for a dog with Vomiting due to GI disease of unknown origin is
IV fluids with sodium bicarb added
pH: 7.1 (7.38-7.42)
HCO3: 8 (18-24
pCO2: 25 (40-45)
Primary metabolic acidosis, secondary respiratory alkalosis
pH: 7.1 (7.38-7.42)
HCO3: 10 (18-24)
pCO2: 25 (30-35)
Partially compensated metabolic acidosis
When using bicarbonate to correct the acid base disturbance in the cat in the preceding question two rapid administration of bicarbonate could result in
Paradoxical acidification of the CSF
Iatrogenically induced metabolic alkalosis
Death
(all of the above) bye
A dog admitted to your clinic in severe hypovolemic shock with a PCV of 12% and a total solids of 3.0 g/ dl. your best course of therapy would be to initiate
Emergency fluid therapy with whole blood
While administering isotonic crystalloid fluids to a severely dehydrated cat, the PCV drops from a pre therapeutic level of 65% to 45% and the plasma total solids dropped from 8 g/dl to 3 g/dl. at this point, the animal has only received approximately 50% of the fluid required for full fluid deficit replacement. The recommended course of action would be to
Stop isotonic crystalloid fluid administration and administer plasma
A 9 year old 30 kilogram dog has been in appetent for 4 days and vomiting for 2 days. He is severely dehydrated and has a PCV of 62% what is the total fluid requirement in liters
(62%-45%) (30 kg) (10 ml/kg) = 5,100 mls
(5,100 ml) (1L/1000 ml)= 5.1 L
A 4 kg cat is severly dehydrated and has a PCV of 57%. Total fluid requirement in L?
(57%-37%) (4 kg) (10 ml/kg) = 800 mls
(800 ml) (1L/1000 ml)= 0.8 L
A 3 year old, 4 kg cat is in severe hypovolemic shock and has a PCV of 65. The total fluid deficit is 1,120 mls. How much should be given immediately in a single bolus
1/12 x 1,120 mls = 94
A 10 kg dog hit by car, in hypovolemic shock. How much fluid should be given over the next hour?
88ml/hr x 10 kg= 880 mls
A 3 kg cat, pale mm, HR 250/ min, tachypnea and cold extremities. How much fluid in the next hour?
44/mlhr x 3 kg =132 mls
10 kg dog is 7% dehydrated. VOlume of fluid deficit should be replaced during the first 24 hours?
(10 kg x 0.07) x 80% = 0,56 L = 560 mls
3 month old 10 kilogram collie puppy has severe, protracted, acute diarrhea. The puppy has been given fluids for shock and is now ready for rehydration phase of the fluid regimen the puppy is assessed to be 7% dehydrated. Within the past few minutes, the puppy had diarrhea with a volume of 400 milliliters. How much fluid should be given during the first 24 hour period of rehydration therapy?
(10 kg x 0.07 x 0.80 x 1000 ml/l) + (400 x2) = 1360 ml
During maintenance phase of fluid therapy, the fluid volume required for maintenance and continuing losses in a cat is
20-40 ml/kg body wt/day
During maintenance phase of fluid therapy, the fluid volume required for maintenance and continuing losses in a dog is
40-60 ml/kg body wt/day
The most common blood type for cats
A
Pressure that holds fluid in the BV lumen is
Oncotic
The best estimate of % of dehydration in a dog with marked loss of skin turgor, dry oral mm, and shock would be
12%
The max rate for safe IV infusion of potassium in cats and dogs is
0.5 mEq/kg/hour
Which drug combats the adverse metabolic effects of hyperkalemia but doesn’t reduce serum potassium levels
Calcium gluconate
What can be used to lower blood potassium
Glucose and insulin
Dog emaciated, dehydrated, 10 kg with PCV of 63%. Acid base panel:
pH: 7.1 (7.38-7.42)
HCO3: 10 (18-24)
pCO2: 25 (30-35)
Primary metabolic acidosis and respiratory compensation
Hyperkalemia is common in neonatal calved with diarrhea because
In acidosis, hydrogen ions diffuse intracellularly and force potassium ions into the extracellular fluid
An important reason for adding glucose to IV replacement fluids for a calf with severe diarrhea is to
Enhance movement of extracellular potassium into cells
Decreased BUN, serum albumin
Normal globulin
Marked increased post prandial serum bile acid levels:
Loss of functional hepatic mass
Reflects liver function?
Serum albumin level
Total serum bilirubin reflects?
Conjugated bilirubin and unconjugated bilirubin
Which clincopatholgic abnormality is most common in horses with acute hepatic failure
Prolonged prothrombin time
Which species will exhibit hypoglycemia most quickly with acute hepatic failure
Ruminant species
Which clincopatholgic finding is not commonly observed in horse with hepatic disease or hepatic failure
Increased serum alanine aminotransferase activity
What proportion of hepatic paranchyma must be affected before clinical signs of hepato-encephalopathy are manifested.
75%
Most common cause of icterus in horses
Hemolysis, liver disease, anorexia
Most suggestive of a congenital protosystemic shunt in a 15 month dog
Microhepatia, hypoalbuminemia, increased postprandial serum bile acid levels
A nine month old mixed breed dog has had episodes of abnormal behavior during the past five months. These episodes principally occur after meals and tend to develop and resolve gradually…
SG: 1.011
Phosphorus: 7.7 (2.5-5.5)
Alkaline phosphatase: 201
Albumin: 2.3
Cause of findings?
hepatic insufficiency
Test most specific for evaluation of liver function in dogs
Fasting and postprandial serum bile acid levels
Post-prandial bile acid concentrations highest when?
Portosystemic shunt
Which is not a liver function test in dogs?
ALT
Resting (pre-prandial) bile acid concentrations highest when?
Cholestasis
Examples of substances used to asses functional hepatic mass would include
Glucose, albumin, urea
Species that develops hypoglycemia more quickly following loss of hepatic function would be?
bovine
Icteric patients usually exibxit increased
Serum bilirubin levels
Which test is most specific for evaluation of liver function animals, and is it safe?
Ammonia tolerance test
NO leads to haptic encephalopathy
