Kidney Sx

Question 1

T/F: Interlobar branches to the kidney do not cross midline

Answer 1

True

Question 2

What are some surgical diseases of the kidneys?

Answer 2

Neprholithiasis
Pyelonephritis
Trauma
Neoplasia
Hydronephrosis
Pseudocysts
Renal parasites

Question 3

What is nephrolithiasis?

Answer 3

Kidney stones

Question 4

What is the common crystal that leads to nephrolithiasis?

Answer 4

Ca oxalate- no medical management therapy

Question 5

What are CS associated with nephrolithiasis?

Answer 5

Depression, anorexia, hematuria, pain

Question 6

What are dx tests ran for nephrolithiasis?

Answer 6

Survey rads and U/S

Question 7

When is sx indicated with nephrolithiasis?

Answer 7

Obstruction or infection is associated with calculi

Question 8

What is the sx approach for a nephrolithotomy?

Answer 8

Ventral midline celiotomy

Question 9

What is the most common technique used for closure of a nephrolithotomy?

Answer 9

Close the nephrotomy by apposing the cut tissues and
applying digital pressure for approximately 5 minutes while restoring blood flow through the renal vessels. Then oppose the capsule with a continuous suture pattern

Question 10

What is the max time a vascular clamp can be used on the kidneys?

Answer 10

20 minutes-any longer would cause damage to the parenchyma

Question 11

When is pyelolithotomy performed?

Answer 11

Calculi in renal pelvis and dilated

Question 12

T/F: There is no risk for thromboemboli with pyelolithotomy?

Answer 12

True- no occlusion of blood supply

Question 13

What are the dx tests ran for renal trauma?

Answer 13

Contrast excretory, ultragraphy or exploratory

Question 14

Progressive dilatation of renal pelvis and atrophy of renal parenchyma

Answer 14

Hydronephrosis

Question 15

What are the CS with unilateral vs. bilateral hydronephrosis?

Answer 15

Unilateral: abdominal distension & palpable mass
Bilateral: severe azotemia & death

Question 16

T/F: Less than 1 week obstruction of the kidney will result in complete resolution

Answer 16

TRUE

Question 17

What sx is indicated for a non-functional kidney?

Answer 17

Nephroureterectomy

Question 18

What is a complication of obstructive uropathy?

Answer 18

Pyelonephritis- ascending infection

Question 19

What is the name of the giant kidney worm?

Answer 19

Dioctophyma renale

Question 20

What type of patients do you commonly see giant kidney worm in?

Answer 20

Hunting dogs

Question 21

What is the most common renal neoplasia?

Answer 21

Renal adenoma

Question 22

Which dx test can you confirm the kidney being origin of neoplasia?

Answer 22

Rads- cannot confirm

U/S- can confirm

Question 23

What is the preferred method for renal biopsy?

Answer 23

Exploratory laparotomy

Question 24

What is the most common neoplasia in dogs?

Answer 24

Renal cell carcinoma

Tx- nephroureterectomy and chemotherapy

Question 25

What is the most common renal neoplasia in cats?

Answer 25

Renal lymphoma

Question 26

When is a nephroureterectomy indicated?

Answer 26

severe infection/trauma | Obstructive calculi with persistent hydronephrosis, neoplasia, or transplant

Question 27

Why is a partial nephrectomy rarely performed?

Answer 27

infrequently performed due to compromised GFR in contralateral kidney

Question 28

What is the sample size for a renal biopsy?

Answer 28

5-6 glomeruli- cortex! | Collect at least two samples

Question 29

What are contraindications for renal biopsy?

Answer 29

Coagulopathies, hypertension, chronic hydronephrosis

Question 30

What are the renal biopsy approaches?

Answer 30

Percutaneous, ultrasound guided, keyhole, laproscopic and wedge/incisional

Question 31

What is the most common method of renal biopsy?

Answer 31

U/S guided

Question 32

When is a renal transplant indicated?

Answer 32

irreversible acute renal failure decompensated chronic renal failure polysystic dz

Question 33

WHat does the minimum PCV have to be for a renal transplant-if under minimum what must be done?

Answer 33

30% | Blood transfusion or EPO injection

Question 34

What is the number one complication of renal transplants?

Answer 34

Acute rejection

Question 35

What is the closing procedure of a nephrolithotomy if the sutureless technique fails?

Answer 35

If adequate hemostasis is not achieved, or if urine leakage is a concern, place absorbable sutures through the cortex in a horizontal mattress fashion. Then close the capsule with a continuous suture pattern.