Hematuria Flashcards

1
Q

How many RBCs per ml is associated with macroscopic hematuria?

A

(> 2.5 million/ml, anywhere from 10k-2.5mil is microscopic, anything under 10k is normal)

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2
Q

You cannot see microscopic hematuria by gross inspection, what can you do to diagnose it?

A

(See > 10 RBC/hpf when you examine the sediment and/or get a trace to 3+ reaction on dipstick analysis)

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3
Q

What portion of the urinary system would be the site of the lesion in the following scenarios:

  • There is blood at the beginning of urination
  • There is blood at the end of the urination
  • There is blood throughout urination
A
  • There is blood at the beginning of urination (Distal urethra)
  • There is blood at the end of the urination (Proximal urethra or bladder)
  • There is blood throughout urination (Kidneys, ureters, or bladder)
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4
Q

What are some of the types of neoplasia that affect the distal urethra?

A

(SCC, fibrosarcoma, sarcoid, and papillomas)

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5
Q

When will hematuria be noted (beginning, throughout, or end) when there is a urethral rent and why?

A

(Will be at the end because that is when the muscles contract and forces blood through the rent; tx is PU or corpus spongiotomy both with the goal to minimize pressure on the rent site)

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6
Q

Where do urethral calculi tend to get lodged?

A

(The ischial arch)

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7
Q

Where are you most likely to find stones in the equine urinary tract?

A

(The bladder)

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8
Q

What are some of the types of neoplasia that affect the bladder in horses?

A

(SCC, TCC, lymphosarcoma, and leiomyosarcoma)

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9
Q

What is the goal of treatment for bladder neoplasms?

A

(Prolonging survival time by improving patient comfort; can attempt surgical resection, intravesicular instillation of 5-FU, or using COX-2 selective NSAIDs but successful long term outcomes have not been reported)

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10
Q

Bacterial cystitis occurs infrequently in horses and is most often associated with certain neurological syndromes, why is that?

A

(Bc with those neuro syndromes (such as EHV-1, lesions of S3-caudal) there is an inability to completely evacuate the bladder which results in sabulous cystitis)

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11
Q

What is the typical treatment for bacterial cystitis?

A

(TMS)

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12
Q

How is traumatic hematuria diagnosed?

A

(By not diagnosing anything else → diagnosis of exclusion)

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13
Q

What do you expect to see on ultrasound of a horse with idiopathic hemorrhagic cystitis?

A

(A thickened bladder wall)

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14
Q

What do you expect to see on a biopsy of the bladder wall in a case of idiopathic hemorrhagic cystitis?

A

(Suppurative, proliferative cystitis; if send to histopath may suggest a neoplastic process but not in every case and no bacteria present)

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15
Q

Why might a horse with bilateral ureteroliths be dull, inappetant, and lose weight?

A

(Because they will be azotemic, I specify both because affected horses typically remain asymptomatic until both ureters are obstructed; this is the same for nephroliths)

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16
Q

What might you expect to feel on rectal palpation of a horse with a ureterolith?

A

(Calculi in the ureter, ureteral dilation, and nephromegaly (of the left kidney if it is affected))

17
Q

What are some of the primary neoplasms of the kidneys?

A

(Adenocarcinoma, nephroblastoma, TCC, and SCC; secondary are lymphosarcoma, hemangiosarcoma, melanoma, and adenocarcinoma)

18
Q

What is the treatment of choice for renal neoplasms?

A

(Nephrectomy but they are usually very large and adherent to surrounding organs at the time of diagnosis so surgical removal is very difficult or impossible, also removing the kidney of a horse is just not as reasonable of a choice as removing the kidney of a small animal)

19
Q

What type of kidney necrosis is caused by aminoglycosides or NSAIDs respectively?

A

(Aminoglycosides = tubular, NSAIDs = papillary)

20
Q

(T/F) You can usually diagnose tubular or papillary kidney necrosis with gross examination of urine.

A

(F, tubular or papillary necrosis usually causes microscopic hematuria so you’ll need to examine the sediment or use a dipstick to diagnose the hematuria)