kidney surgery

Question 1

what is the arterial and venous supply of the kidneys?

Answer 1

renal artery and renal vein

Question 2

what are the most common nephroliths ?

Answer 2

calcium oxalate - most common and struvite

Question 3

what clinical signs are seen with nephroliths?

Answer 3

they may be absent or non-specific like depression, anorexia, hematuria, pain

Question 4

how do you diagnose nephroliths ?

Answer 4

• radiographs

- ultrasound

Question 5

what parameters do you use to determine the best management for nephroliths?

Answer 5

• type of calculi
• location
• clinical effects

Question 6

when is surgery for nephroliths indicated ?

Answer 6

• obstruction
• infection from the calculi
• peristent pain or hematuria

Question 7

what are some treatment options for nephroliths?

Answer 7

• nephrolithotomy
• pyelollithotomy
• lithotripsy (shock waves)

Question 8

what are the advantages and disadvantages of pyelolithotomy ?

Answer 8

• no occlusion of blood supply

- no nephron damage

Question 9

what is pyelolithotomy ?

Answer 9

when calculi is in the renal pelvis and dilated

Question 10

how do you close a nephrolitotomy?

Answer 10

• sutureless closure to form a fibrin seal

- then suture the capsule only

Question 11

what instruments can you use in a nephrolithotomy to occlude the renal vessels?

Answer 11

• bulldog vascular clamp

- rumel torniquet

Question 12

how long can you occlude the renal vessels for during a nephrolitotomy ?

Answer 12

20 minutes

Question 13

what is the post operative management of nephrolithotomy ?

Answer 13

• post op rads to check for calculi
• monitor renal enzymes/electrolytes
• monitor urine output
• provide diuresis

Question 14

how do you diagnose renal trauma?

Answer 14

• contrast excretory urography
• ultrasound
• exploratory

Question 15

how do you treat renal trauma?

Answer 15

• minor cases: conservative treatment
• moderate cases: surgery to repair like omental patching
• major trauma: partial nephrectomy or nephroureterectomy

Question 16

when would you use a nephroureterectomy in cases of renal trauma?

Answer 16

when there is severe parenchymal or vascular damage

Question 17

what is hydronephrosis ?

Answer 17

progessive dilation of the renal pelvis and atrophy of renal parenchyma

Question 18

what are the two ways of acquiring hydronephrosis and examples?

Answer 18

• acquired: neoplasia, cyst, stone

- congenital: torsion, stenosis, atresia

Question 19

what are the clinical signs of hydronephrosis?

Answer 19

unilateral - abdominal distention and palpable mass

bilateral - severe azotemia and death

Question 20

how do you diagnose hydronephrosis?

Answer 20

• abdominal rads
• excretory urogram
• ultrasound

Question 21

how do you treat hydronephrosis?

Answer 21

• eliminate cause

- nephroureterectomy

Question 22

what is the giant kidney worm called?

Answer 22

dioctophyma renale

Question 23

what is the most common kidney neoplasia of dog ?

Answer 23

renal cell carcinoma

Question 24

what is the most common kidney neoplasia of the cat?

Answer 24

lymphoma

Question 25

what is the most common benign kidney tumor?

Answer 25

renal adenoma

Question 26

is xray or ultrasound better at diagnosing kidney neoplasia?

Answer 26

ultrasound

Question 27

what is the treatment for renal cell carcinoma?

Answer 27

nephroureterectomy and chemotherapy

Question 28

what is the treatment for renal lymphoma ?

Answer 28

surgery is often not indicated

Question 29

what is nephroblastoma?

Answer 29

congenital neoplasia in the developing kidney

Question 30

what kind of patient is nephroblastoma more common in?

Answer 30

young dogs and cats

Question 31

what is the treatment for nephroblastoma?

Answer 31

unilateral nephroureterectomy

Question 32

when would you perform a partial nephrectomy over a nephroureterectomy?

Answer 32

when the other kidney isn’t working well

Question 33

what are the disadvantages of a partial nephrectomy ?

Answer 33

• higher incidence of bleeding

- more difficult to perform

Question 34

what are the indications of performing a nephroureterectomy?

Answer 34

• severe infection
• severe trauma
• obstructive calculi with persistent hydronephrosis
• neoplasia

Question 35

when is a renal biopsy indicated?

Answer 35

• suspected neoplasia
• nephrotic syndrome
• renal cortex disease

Question 36

how big should the sample size be for a renal biopsy?

Answer 36

at least 6 glomeruli

Question 37

what techniques can be used for renal biopsy?

Answer 37

• percutaneous
• ultrasound guided
• keyhole
• laparoscopic assisted