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RUSVM SAM II > Kidney Final Exam > Flashcards

Kidney Final Exam Flashcards

1
Q

Which of the following hormones is produced by the kidneys?

a. Vasopressin
b. PTH
c. EPO
d. Aldosterone

A

c. EPO

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2
Q

What percentage fo the nephron population has to be non-functional in order for renal failure to occur and azotemia to be present?

A

75%

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3
Q

Which of the following is an indirect test that can be used to determine glomerular function?

a. Scintigraphy
b. Inulin test
c. SDMA
d. Creatinine clearance test

A

c. SDMA

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4
Q

Which test is the gold standard test to determine glomerular function?

a. Scintigraphy
b. Inulin test
c. SDMA
d. Creatinine clearance test

A

a. Scintigraphy

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5
Q

A dog with isosthenuric urine (USG 1.008 – 1.012) without azotemia. What percentage of the kidney is damaged?

a. 35%
b. 50%
c. 66%
d. 75%

A

c. 66%

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6
Q

True/False: Urea is a better indicator of GFR than Creatinine.

A

False

**creatinine is better

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7
Q

Which of the following is the best method for urine collection?

a. Free flow
b. Catheterization
c. Cystocentesis
d. None of the above

A

c. Cystocentesis

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8
Q

Which of the following is paired incorrectly?

a. Hyposthenuria: 1.000 -1.007
b. Minimally concentrated: 1.013 - 1.022
c. Isosthenuria: 1.008- 1.012
d. Adequately concentrated: Dogs >1.030, Cats >1.035

A

b. Minimally concentrated: 1.013 - 1.022

**this is inadequately concentrated urine, minimally is 1.013-1.030

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9
Q

Which of the following is not reliable when determining glomerular function?

a. Serum urea levels
b. Serum creatinine levels
c. Cystatin C
d. SDMA

A

a. Serum urea levels

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10
Q

True/False: SDMA will increase when we have lost 75% of the glomerular function and Creatinine will increase when we have lost 40% of glomerular function.

A

False

**Creatinine - 75%
SDMA - 40%

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11
Q

What is the most common bacteria found on microbiology of the kidney?

A

E. coli

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12
Q

True/False: When taking a biopsy from the kidney we take it from the cortex not the medulla.

A

True

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13
Q

What are the clinical signs associated with lower urinary tract disease?

A

Inappropriate urination
Pollakiuria, Dysuria, Stranguria
Hematuria

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14
Q

What is the normal urine output range?

A

1-2 mL/kg/hr

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15
Q

True/False: acute kidney disease may have a normal urine specific gravity.

A

True

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16
Q

What is the most common renal neoplasia in dogs?

a. Renal carcinoma
b. Renal lymphoma
c. Nephroblastoma
d. Renal sarcoma

A

a. Renal carcinoma

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17
Q

What is the most common renal neoplasia in cats?

a. Renal carcinoma
b. Renal lymphoma
c. Nephroblastoma
d. Renal sarcoma

A

b. Renal lymphoma

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18
Q

Which of the following is false regarding renal lymphoma?

a. Cats commonly present with PU/PD, inappetance, weight loss and renomegaly
b. It commonly casues renal azotemia
c. It has a tendency to spread to the CNS
d. Usually affects one kideny and has a low to moderate association with FeLV

A

d. Usually affects one kideny and has a low to moderate association with FeLV

**affects both kidneys

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19
Q

Which of the following causes unilateral renomegaly and hardly causes renal azotemia?

a. Renal carcinoma
b. Renal lymphoma
c. Nephroblastoma
d. Renal sarcoma

A

a. Renal carcinoma

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20
Q

A Persian cat presents with multiple cysts affecting both kidneys which are enlarged. What is the most likely diagnosis?

A

Polycystic kidney disease

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21
Q

What is the most significant cause of renal disease and acute uremia in cats?

a. Ureteral obstruction from calcium oxalate ureteroliths and non-mineralized debris
b. Uretheral obstruction from calcium oxalate ureteroliths and non-mineralized debris
c. Uroabdomen
d. Polycystic kidney disease

A

a. Ureteral obstruction from calcium oxalate ureteroliths and non-mineralized debris

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22
Q

Which of the following presents with bilaterally enlarged and painful kidneys, azotemia and oliguria or anuria?

a. Acute unilateral ureteral obstruction
b. Acute bilateral ureteral obstruction
c. Big kidney little kidney syndrome
d. Bilateral chronic kidney disease with concomitant ureteral obstruction

A

b. Acute bilateral ureteral obstruction

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23
Q

Which of the following is clinically silent and not associated wtih azotemia but can be seen in cats with acute abdominal pain?

a. Acute unilateral ureteral obstruction
b. Acute bilateral ureteral obstruction
c. Big kidney little kidney syndrome
d. Bilateral chronic kidney disease with concomitant ureteral obstruction

A

a. Acute unilateral ureteral obstruction

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24
Q

Which of the following carries the most guarded prognosis because global renal function is severely compromised?

a. Acute unilateral ureteral obstruction
b. Acute bilateral ureteral obstruction
c. Big kidney little kidney syndrome
d. Bilateral chronic kidney disease with concomitant ureteral obstruction

A

d. Bilateral chronic kidney disease with concomitant ureteral obstruction

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25
Q

Which of the following is false regarding ureteral obstruction?

a. Its prevalent in cats >7 years of age with severe acute uremia, anorexia and intermittent vomiting
b. Hydronephrosis and dilation of the proximal ureter is seen on ultrasound
c. CT is only 70-80% sensitive in diagnosing ureteral obstruction
d. Antegrade pyelography helps to define the indication and location for surgical intervention

A

c. CT is only 70-80% sensitive in diagnosing ureteral obstruction

**true for US, CT is the preferred imaging modality and is the best after antegrade pyelography to diagnose

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26
Q

If surgery is contraindicated for a ureteral obstruction the dog is oliguric which drug can you use on this dog?

a. Furosemide
b. Prazosin
c. Amitryptilline
d. Mannitol

A

d. Mannitol

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27
Q

Which of the following is seen in cats with a past unilateral ureteral obstruction that has casued the kidney to progress to a fibrotic end stage causing contralateral hypertrophy of the kidney that becomes acutely obstructed by a ureterolith?

a. Acute unilateral ureteral obstruction
b. Acute bilateral ureteral obstruction
c. Big kidney little kidney syndrome
d. Bilateral chronic kidney disease with concomitant ureteral obstruction

A

c. Big kidney little kidney syndrome

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28
Q

Which of the following is an excellent choice for dogs but poor choice for cats?

a. Pyelostomy tube
b. Lithiotripsy
c. Ureteral stend
c. Subcutaneous ureteral bypass

A

b. Lithiotripsy

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29
Q

What is the standard of care for both dogs and cats with ureteral obstructions?

A

Ureteral stents:
Cystoscopy - dog (retrograde)
Surgically - cat (antegrade)

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30
Q

Which of the following is not a diagnostic sign of urethral obstruction?

a. Enlarged bladder that is hard to manually express
b. Anorexia, vomiting and weight loss
c. Urinary uregency
d. Resistance when passing a urethral catheter

A

b. Anorexia, vomiting and weight loss

**signs of ureteral obstruction

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31
Q

Which of the following is not commonly seen associated with urethral rupture?

a. Hyperkalemia
b. Hyponatremia
c. Metabolic alkalosis
d. All the above are seen with urethral rupture

A

c. Metabolic alkalosis

**metabolic acidosis

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32
Q

Which of the following can be used to treat hyperkalemia in an obstructed cat?

a. Caclium carbonate and dextrose
b. Shock fluids and Prazosin
c. Calcium gluconate and insulin
d. Potassium bromide and bicarbonate

A

c. Calcium gluconate and insulin

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33
Q

When relieving urethral obstruciton in a cat antegrade is the most common surgical procedure.

A

False

**true for ureteral, urethral is retrograde

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34
Q

What anti-spasmotic drugs can be given to a cat if the owner can’t afford to do an indwelling catheter?

A

Prazosin or Phenoxybenzamine

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35
Q

What are the three most common clinical signs associated with lower urinary tract disease?

A

Dysuria
Pollakiuria
Stranguria

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36
Q

What is the most common microbial seen with urinary tract infections?

a. Proteus
b. Gram positive cocci
c. E. coli
d. Gram negative cocci

A

c. E. coli

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37
Q

True/False: Ascending infections caused my single species are common in lower urinary tract diseases.

A

True

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38
Q

Which of the following is not considered a drug of choice for an uncomplicated UTI?

a. Amoxicillin
b. Amigoglicosides
c. Cephalosporins
d. TMS

A

b. Amigoglicosides

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39
Q

Which of the following terms describes a UTI that comes back 7 days after the last treatment course and is caused by the same organism/ strain?

a. Reinfection
b. Superinfection
c. Relapse
d. None of the above

A

c. Relapse

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40
Q

Which of the following terms describes a new/ different organism that causes CS at day 7 after starting antibiotics?

a. Reinfection
b. Superinfection
c. Relapse
d. None of the above

A

b. Superinfection

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41
Q

True/False: Prophylactic therapy is the last resort for recurrent UTI’s

A

True

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42
Q

True/False: The hypogastric nerve is innervated by the PSNS

A

False

**SNS

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43
Q

Which of the following is false regarding prophylactic therapy for recurrent UTI’s?

a. Given once daily before bedtime at 30-50% of the original dose
b. Can be discontinued if negative CS for 6 months
c. Cephalosporin and penicillin are good drugs to use since they concentrate in urine and have few side effects
d. All the above are true

A

d. All the above are true

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44
Q

Which of the following terms describes a new/ different organism that causes CS >7 days after last treatment course?

a. Reinfection
b. Superinfection
c. Relapse
d. None of the above

A

a. Reinfection

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45
Q

What is the gold standard to diagnosing feline interstitial cystitis?

A

Cystoscopy

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46
Q

Which of hte following is not a risk factor of feline lower urinary tract disease?

a. Two to six years of age
b. Obesity and dry cat food
c. Breed of the cat
d. Stress and not enough litter boxes

A

c. Breed of the cat

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47
Q

True/False: Crystalluria means that urine has been supersaturated

A

True

48
Q

Which of the following is a rectangular crystal seen in alkaline urine and appears radiopaque, big and smooth on radiographs?

a. Calcium oxalate
b. Ammonium urate
c. Cystine
d. Struvite
e. Urate

A

d. Struvite

49
Q

Which of the following is a hexagonal shaped crystal commonly seen in Australian cattle dogs, Dauschund and Newfoundland?

a. Calcium oxalate
b. Ammonium urate
c. Cystine
d. Struvite
e. Urate

A

c. Cystine

50
Q

Which of the following is a round crystal commonly seen in the acidic urine of male dalmations?

a. Calcium oxalate
b. Ammonium urate
c. Cystine
d. Struvite

A

b. Ammonium urate

**also xanthine

51
Q

Calcium monohydrate crystals are ___ shaped and calcium dihydrate crystals are ____ .

A

Monohydrate: dumbell or picket fence crystals
Dihydrate: Square crystals

52
Q

What is the maximum urolith size allowed for voiding urohydropropulsion in female dogs?

a. <1 mm
b. <5 mm
c. <1-3 mm
d. <5-15 mm

A

d. <5-15 mm

53
Q

Allopurinol, a xanthine oxidase inhibitor can only be given to which of the following dogs?

a. English bulldogs
b. Dalmations
c. Dauschunds
d. Miniature schnauzer

A

b. Dalmations

54
Q

Which of the following is false regarding feline idiopathic cystitis?

a. Mast cells release granules within the submucosa
b. There is an increased ion leakage across the urothelium of the mucosa
c. Substance P decreases inflammation and Capsaicin activates C fibers to decrease urination
d. There is an altered urinary glycosaminoglycan excretion within the mucosa

A

c. Substance P decreases inflammation and Capsaicin activates C fibers to decrease urination

**Substance P casues inflammation and Capsaicin activates C fibers to increase urination

55
Q

Which nerve is stimulated by the sympathetic system to store urine by causing the internal sphincter to contract and the bladder wall to relax?

a. Pudendal nerve
b. Pelvic nerve
c. Hypogastric nerve
d. Both A and B

A

c. Hypogastric nerve

56
Q

Which of the following contracts the striated muscles of the external urethra, which are controlled by the somatic nervous system?

a. Pudendal nerve
b. Pelvic nerve
c. Hypogastric nerve
d. Both A and B

A

a. Pudendal nerve

57
Q

Which of the following causes the detrusor muscle to contract allowing you to urinate?

a. Pudendal nerve
b. Pelvic nerve
c. Hypogastric nerve
d. Both A and B

A

b. Pelvic nerve

58
Q

Which of the following is controlled by the PSNS?

a. Pudendal nerve
b. Pelvic nerve
c. Hypogastric nerve
d. Both A and B

A

d. Both A and B

59
Q

What is the treatment of choice for vaginal hyperplasia/ prolapse?

A

OHE

60
Q

What is the most common neoplasia of the female genital tract?

A

Transmissible venereal tumor

61
Q

Which two prostatic diseases are commonly seen in intact males making the treatment of choice castration in these dogs?

A

Prostatitis

Benign Prostatic Hyperplasia

62
Q

True/False: All intact male dogs with UTI’s will have benign prostatic hyperplasia associated with it.

A

False

**they have prostatitis

63
Q

What is the common signalment of benign prostatic hyperplasia?

a. Intact older male
b. Intact younger male
c. Neutered older male
d. Neutered younger male

A

a. Intact older male

64
Q

Which of the following is not going to be seen in intact male dogs?

a. Prostatitis
b. Benign prostatic hyperplasia
c. Prostatic cyst
d. Prostatic neoplasia

A

d. Prostatic neoplasia

65
Q

Which of the following is false regarding acute prostatitis?

a. All dogs will have concurrent UTI’s
b. They’re usually asymptomatic and non-painful
c. We will normally start them on fluoroquinolones to treat the UTI but TMS, doxy, erythromycin and rifampin can also be used
d. Antimicrobials and surgery is the recommended therapy

A

b. They’re usually asymptomatic and non-painful

**this is seen with chronic prostatitis. Acute is painful and sick

66
Q

Which of the following is false regarding prostaic neoplasia?

a. Carcinoma is more common than adenocarcinoma
b. SIgnalment is not related to their neuter status
c. They present with lameness and mass effect signs
d. The tumor can metastasize the the lumbar spine

A

a. Carcinoma is more common than adenocarcinoma

**adenocarcinoma > carcinoma

67
Q

True/False: Surgery is the treatment of choice for prostatic neoplasia.

A

False

**It can casue post- operative incontinence

68
Q

What is the most common neoplasia of the bladder or urethra?

A

Transitional cell carcinoma

69
Q

Which of the following is an example of pre-renal acute kidney injury?

a. Hypoadrenocorticsm
b. Leptospirosis
c. Lymphoma
d. Hyperadrenocorticism

A

a. Hypoadrenocorticism

70
Q

A cat comes in with proteinuria of glomerular origin and biopsy confirms ICGN. What is the first choice treatment to give to this cat because of its rapid onset and decreased side effects?

A

Mycophenolate mofetil

71
Q

Which of the following drugs should be used to treat hypertension in a cat?

a. Omeprazole
b. Amlodipine
c. Benazepril
d. Meropitant

A

b. Amlodipine

72
Q

A dog come into the clinic isosthenuric with a specific gravity of 1.008 and protein +1. What is the next test you want to perform on this dog?

A

UPC ratio

73
Q

A urine specific gravity of 1.018 indicates the animal is:

a. Hyposenthuric
b. Inadequately concentrated urine
c. Adequately concentrated urine
d. Isosthenuria

A

b. Inadequately concentrated urine

74
Q

What is the mechanism of action of ACE inhibitors?

a. Increase glomerular pressure
b. Decrease K+ and HCO3
c. Decrease proteinuria and glomerular pressure
d. Increase sodium and water retention

A

c. Decrease proteinuria and glomerular pressure

75
Q

What is the first treatment of choice in a dog with hypertension?

a. Amlodipine
b. Benazepril
c. Omeprazole
d. Sucralfate

A

b. Benazepril

76
Q

A cat comes in and its in IRIS stage III with hyperphsophatemia, non-regenerative anemia, and hypertensive. What is the treatment of choice for this cat?

a. Benazepril, Darbopoietin, Renal diet, and Calcium hydroxide
b. Amlodipine, Renal diet, Darbopoietin and Aluminum hydroxide
c. Benazepril, Cyproheptadine and Darbopoietin
d, Amlodipine, Mirtazapine, Cyproheptadine and Renal diet

A

b. Amlodipine, Renal diet, Darbopoietin and Aluminum hydroxide

77
Q

Which drug can be used ina cat with mild proteinuria?

a. Mirtazapine
b. Cyproheptadine
c. Telmisartan
d. Omeprazole

A

c. Telmisartan

**can also use benazepril

78
Q

Which of the following is not associated with chronic renal failure?

a. Hyperphsophatemia
b. Hypokalemia
c. Hypertension
d. Metabolic alkalosis

A

d. Metabolic alkalosis

**Metabolic acidosis

79
Q

Which of the following is a renal etiology of acute renal injury?

a. Hypoxia and ischemia
b. Aminoglycosides
c. Uroabdomen
d. Addisons

A

b. Aminoglycosides

80
Q

Which phase of acute renal failure lasts 1-3 weeks where urine is ultrafiltrated?

a. Initial
b. Extension
c. Maintenance
d. Recovery

A

c. Maintenance

81
Q

Which phase of acute renal failure is present without any clinical signs and defined by a decrease in urine output or increase in creatinine?

a. Initial
b. Extension
c. Maintenance
d. Recovery

A

a. Initial

82
Q

Which phase of acute renal failure do we see polyuria with extreme sodium loss?

a. Initial
b. Extension
c. Maintenance
d. Recovery

A

d. Recovery

83
Q

Which phase of acute renal failure do we have continued hypoxia and inflammation and compormised Na:K pumps?

a. Initial
b. Extension
c. Maintenance
d. Recovery

A

b. Extension

84
Q

Which of the following is not a risk factor for acute renal failure?

a. Dehydration
b. Hypertension
c. Anesthesia
d. Hypoxia

A

b. Hypertension

**hypovolemia

85
Q

What is the mechanism of action of amlodipine?

a. DA-1 receptor agonist
b. DA-2 receptor agonist
c. Calcium channel blocker
d. Beta adrenergic

A

c. Calcium channel blocker

86
Q

Which of the following is the main treatment for leptospirosis?

a. Furosemide
b. Mannitol
c. Amlodipine
d. Dopamine

A

c. Amlodipine

87
Q

True/False: Mannitol cannot be used in a patient that is dehydrated or anuric

A

True

88
Q

Which of the following is not effective in cats?

a. Furosemide
b. Mannitol
c. Amlodipine
d. Dopamine

A

d. Dopamine

89
Q

Which of the following is the treatment of choice for ethylene glycol toxicity?

a. Misoprostal
b. Fomepizole
c. Doxycycline
d. Amlodipine

A

b. Fomepizole

90
Q

How can you treat hyperkalemia?

A

Insulin
Dextrose
Calcium gluconate
HCO3

91
Q

Which of the following does not act on the kidneys?

a. Vasopressin
b. Calcitriol
c. PTH
d. Aldosterone

A

b. Calcitriol

92
Q

What drug can you use to treat hyperphosphatemia?

A

ALuminum hydroxide/ carbonate

93
Q

True/False. ACE inhibitors can be used in patients with acute renal failure.

A

False

**avoid because they inhibit arterial vasoconstriction

94
Q

Which of the followig is false regarding chronic renal failure?

a. Urine specific gravity in a dog = 1.008-1.022 and for the cat = 1.008 - 1.030
b. Azotemia is seen becuase of a decrased GFR, increased catabolism and GI hemorrhage
c. Vomiting, diarrhea and weight loss are rarely seen in these patients
d. Azotemia is seen when 75% of the nephrons are lost and inability to concentrate urine is seen with 66% loss

A

c. Vomiting, diarrhea and weight loss are rarely seen in these patients

95
Q

Which of the following is not associated with chronic renal failure?

a. Hypophosphatemia
b. Hypokalemia
c. Hypercalcemia
d. Metabolic acidosis

A

a. Hypophosphatemia

**hyperphosphatemia

96
Q

What are the three factors that are used to stage chronic renal failure?

A

Creatinine
Proteinuria
Blood pressure

97
Q

Which of the following is not an indication to use renal diet?

a. Metabolic acidosis and hyperphosphatemia animals
b. Hypotensive dogs with IRIS stage III
c. Cats in IRIS stage II
d. Cats and dogs that are in IRIS stage 4

A

b. Hypotensive dogs with IRIS stage III

**hypertensive animals

98
Q

What affect do ACE inhibitors have on efferent arterioles?

A

Vasodilation, Increase efferent arteriole size to decrease pressure + resistance

99
Q

True/False: Benazepril is the drug of choice to treat proteinuria associated with CKD in cats.

A

False

**Telmisartan

100
Q

A dog comes into the clinic and he is in IRIS stage III renal failure with non regenerative anemia, severe hypertension, proteniemia and hyperphosphatemia. Which of the following is the most appropriate treatment for this dog?

a. Renal diet, Amlodipine, Telmisartan, Insulin
b. Dextrose and Aluminum hydroxide
c. Benazepril, renal diet, Darbopoietin, Aluminum hydroxide
d. Darbopoietin, Aluminum hydroxide, insulin

A

c. Benazepril, renal diet, Darbopoietin, Aluminum hydroxide

101
Q

True/False: Dipstick is a screening test for proteinuria that can give false positives with alkaline urine.

A

True

102
Q

True/False: If the UPC ratio is >8 we must consider amyloidosis which is a glomerular disease and if itsa UPC <2 then we want to consider tubular diseases

A

True

103
Q

What glomerular disease causes the most significant protein loss?

A

Protein losing nephropathy (PLN)

104
Q

Which of the following breeds is familial for amylid deposits within the glomeruli?

a. Boxers
b. Shar-pei
c. Laboradors
d. German shepherd

A

b. Shar-pei

105
Q

Which of the following is not commonly seen with glomerulonephritis?

a. Proteinuria
b. Hypertension
c. Nephrotic or uremic syndrome
d. Hypocoagulability

A

d. Hypocoagulability

**hypercoagulability

106
Q

Which of the following is seen on thromboelastography when measureing hypercoagulability of glomerulonephritis?

a. Increased antithrombin
b. Decreased Fibrin
c. Increased D-dimers
d. All the above

A

c. Increased D-dimers

107
Q

Which of the following is not an early clinical sign associated with glomerulonephritis?

a. Decreased body condition
b. Lethargy
c. Anorexia
d. SQ edema

A

d. SQ edema

**nephrotic syndrome which is later

108
Q

What is the only very late clinical sign that is seen with glomerulonephritis?

A

Uremic syndrome

109
Q

True/False: Renal biopsies should be done when the animal is in IRIS stage IV or if he has any coagulopathies.

A

False!

110
Q

What are the three tests that need to be done to make a diganosis for glomerulonephritis?

A

Light microscopy
TEM
Immunofluorescent antibody assessment (IFA)

111
Q

All of the following are contraindication for immunosuppressive therapy except:

a. Pancreatitis
b. Glomerulonephritis
c. Bone marrow suppression
d. Diabetes mellitus

A

b. Glomerulonephritis

112
Q

What is the first choice of drug used to treat glomerulonephritis?

A

Mycophenolate mofetil

113
Q

Which drugs can be used to treat hypercoagulability associated with PLN?

A

Aspirin (low dose)

Clopidogrel

114
Q

Which of the following is matched incorrectly?

a. Pelvic nerve - PSNS
b. Pudental nerve - Somatic, stimulates striated muscles
c. Hypogastric nerve: SNS, voiding of urine
d. Pelvic nerve- Sensory, stimualtes the bladder

A

c. Hypogastric nerve: SNS, voiding of urine

**stores urine, PSNS voids urine

115
Q

Which of the following is false regarding neurologic disease?

a. UMN bladder is going to be hard to express and have a small amount of urine
b. Bethancol a PSNS mimetic can be used to treat a LNM bladder
c. Baclofen can be used to treat a lesio above the sacral segment
d. LMN bladder causes detrusor areflexia and sphincter hyperreflexia

A

d. LMN bladder causes detrusor areflexia and sphincter hyperreflexia

**sphincter areflexia, hyperreflexia is UMN

116
Q

True/False: Dysautanomia is when the ANS is damaged and its mainly seen in cats.

A

True

RUSVM SAM II (4 decks)

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