Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urogenital system > Kidneys > Flashcards

Kidneys Flashcards

1
Q

Is the renal vein or artery more dorsally located?

A

The renal artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the layers of the kidney?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In what percentage of dogs and cats are multiple renal arteries reported?

A

Dogs: 13%
Cats: 10%

The left kidney is more likely to have multiple renal arteries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the vascular supply of the kidneys?

A

Renal arteries split into dorsal and ventral branches, interlobular then arcuate arteries. The arcuate arteries form the afferent glomerular arterioles. The efferent glomerular arterioles give rise to the vasa recta which are involved in water exchange and maintenance of medullary hypertonicity through counter current exchange. These drain into the venous system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where do the small capsular arteries of the kidney normally arise?

A

Phrenicoabdominal and adrenal arteries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the basic functional unit of the nephron?

A

The nephron. This is composed of the renal corpuscle and renal tubules. The renal corpuscle is composed of the glomerulus (a tuft of afferent arterioles) and glomerular/Bowman’s capsule.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which cells help to maintain autoregulation of the kidney?

A

Macula densa (between the glomerulus and afferent arterioles).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does the glomerular capsule filter blood?

A

Specialized epithelial cells called podocytes prevent passage of particles larger than 60,000 Daltons, while an inherent negative charge repels other molecules such as albumin.

Glomerulitis results in an indiscriminate filtration mechanism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the structure of the nephron.

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What percentage of cardiac output is received by the kidneys?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What determines renal blood flow?

A

Renal perfusion pressure + renal vascular resistance. Renal autoregulation (constriction and vasodilation of the afferent and efferent renal arterioles) is primarily responsible for renal vascular resistance, and allows the kidney to maintain blood flow during times of systemic hypotension or hypertension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is medullary wash-out?

A

Loss of the concentrating ability of the kidney due to increased medullary blood flow which affects the counter-current mechanism of the renal medulla. Typically caused by aggressive or long term fluid administration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the major contributor to medullary interstitial hypertonicity in the kidney?

A

Urea (40-50%). Therefore, malnutrition and other conditions that decrease urea (e.g. PSS), can result in a loss of concentrating ability of the urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is BMBT recommended in patients with uremia?

A

Uremia can impair platelet function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What imaging techniques can be used in the diagnostic work-up of renal disease?

A
  1. Survey radiography.
  2. Intravascular contrast studies (excretory urogram or intravenous pyelogram).
  3. Pyelography.
  4. Ultrasonography
  5. CT
  6. MRT
  7. Scintigraphy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What view is preferred for survey radiography of the kidneys?

A

Right lateral as allows for better separation between the kidneys.

A normal canine kidney should be 2-2.5 times the length of the adjacent vertebra, feline should be 2-3 times.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Does excretory urogram/intravenous pyelogram allow assessment of renal function?

A

No, kidneys with very little function can still opacify.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What dose of contrast should be used for excretory urogram/intravenous pyelogram?

A

400 mg/kg of iodine. Care must be taken in patients with pre-existing renal disease as can exacerbate (ensure adequately hydrated). IV administration can also cause anaphylaxis in some instances.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the phases of excretory urogram/intravenous pyelogram?

A

Renal angiographic phase, renal phase, excretory phase. Excretory phase is the phase during which the ureters can be evaluated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When should pyelography be considered over excretory urogram/intravenous pyelogram?

A

When there are concerns over IV administration of contrast or if the renal artery is obstructed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Using CT angiography were cats more likely to have multiple right or left renal veins?

A

Right renal veins (multiple left renal arteries).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the best modality for determining renal GFR?

A

Dynamic renal scintigraphy. Less accurate than plasma clearance studies but is generally preferred due to its ease and speed. Plasma clearance studies also fail to give information about the contribution of each individual kidney to total GFR.

23
Q

What radiopharmaceutical is most commonly used for dynamic renal scintigraphy for assessment of GFR?

A

Technetium 99 - DTPA.

24
Q

What are some developmental abnormalities of the kidney?

A
  1. Developmental agenesis: failure of the kidneys to develop.
  2. Renal dysplasia: disorganized development of the renal parenchyma.
  3. Renal ectopia: normally found within the pelvic area.
  4. Fused kidney.
  5. Polycystic kidney disease.
25
Q

In which breed of cat is polycystic kidney disease most common?

A

Persian (37-38% incidence).

Drainage and infusion of cysts with iodized oil and cyanoacrylate has been reported.

26
Q

What is the most common composition of feline renal calculi?

A

Calcium oxalates and calcium phosphates.

27
Q

What diagnostic tests might be useful in the diagnosis of renal calculi?

A
  1. CBC/biochem: usually minimal changes unless concurrent obstruction.
  2. Urinalysis: hematuria, pyuria, bacteriuria, crystalluria.
  3. Radiography +/- contrast studies.
  4. Ultrasonography.
28
Q

When should treatment of nephroliths be considered?

A

Causing ureteropelvic junction obstruction, severe hematuria, persistent UTI, increasing size, damaging renal tissue despite medical management.

29
Q

What are the treatment options of nephrolithiasis?

A

Extracorporeal shock wave lithotripsy, nephrotomy, pyelolithotomy, endoscopic nephrolithotomy. Nephrectomy can also be considered if the kidney is severely damaged.

30
Q

What are the most common primary renal tumours in dogs and cats?

A

Majority of primary renal tumours are malignant.

Dogs: Renal cell carcinoma.
Cats: Lymphoma.

31
Q

What primary renal tumour tends to occur in young, male dogs?

A

Nephroblastoma

32
Q

What is renal cystadenocarcinoma with nodular dermatofibrosis?

A

Rare, inherited (mutation of the FLCN gene), neoplastic condition in German Shepherds. Metastatic rate is 50%.

33
Q

What are some clinical findings associated with renal neoplasia?

A

Clinical signs generally non-specific.
CBC/biochem: neutrophilia or anemia.
Urinalysis: Hematuria (57%), pyuria (53%), proteinuria (48%), isosthenuria (36%).

Polycythemia +/- thrombocytosis is reported in some patients.

Hypercalcemia, hypoglycemia, leukocytosis, and peripheral neuropathy are rarely reported.

34
Q

What percentage of dogs with primary renal neoplasia have bilateral disease?

A

4-32%

Abdominal metastases are reported in 54% of dogs (ipsilateral adrenal most common).

35
Q

What is the MST in dogs undergoing unilateral nephrectomy for renal neoplasia?

A

Renal carcinoma: 16 months
Sarcoma: 9 months
Nephroblastoma: 6 months

Hemoabdomen was associated with worsened MST.

36
Q

What are some treatment options for acquired renal cysts and perirenal pseudocysts?

A

Acquired renal cysts: percutaneous drainage and instillation of ethanol, nephrectomy.

Perirenal pseudocysts: repeated drainage, repeated surgical resection, nephrectomy.

37
Q

How can renal or renal vascular trauma be diagnosed?

A

Ultrasound +/- FNA, contrast angiography, color flow Doppler ultrasonography, exploratory laparotomy.

38
Q

What repair options are available for renal trauma?

A

Ureteronephrectomy usually performed clinically.

Experimentally wrapping of the kidney in semielastic polyglactin or polyglycolic acid mesh has been described.

39
Q

How is idiopathic renal hematuria treated?

A

Local sclerotherapy with renal pelvic infusions of povidone iodine and silver nitrate, followed by ureteral stent placement.

40
Q

What are contraindications to renal biopsy?

A

Coagulopathy, uncontrolled hypertension, large or multiple renal cysts or abscesses, extensive pylenephritis, ureteral obstruction, severe hydronephrosis.

41
Q

What are options for obtaining a renal biopsy?

A
  1. Percutaneous (blind or ultrasound guided).
  2. Keyhole biopsy.
  3. Laparoscopic biopsy.
  4. Wedge or incisional biopsy.
42
Q

What size biopsy needle is typically used for renal biopsy?

A

14 - 18 gauge.

43
Q

How long can the renal artery be occluded to facilitate renal biopsy?

A

20 minutes. The parenchyma usually starts to soften after 30 - 60 seconds, facilitating biopsy.

44
Q

What factors might increase the risk of complications in patients undergoing renal biopsy?

A

Thrombocytopenia, prolonged clotting times, increased serum creatinine, increased age (>4 years), weight below 5kg.

45
Q

What is the most common major complication associated with renal biopsy?

A

Hemorrhage (more likely in cases of recent NSAID administration or systemic hypertension).

Death is reported in 3% of patients.

Effect on renal function is normally minimal in healthy patients.

Other potential complications include: hematuria, hydronephrosis secondary to renal pelvis or ureteral obstruction by blood clots, renal infarction, damage to renal vasculature, intrarenal arteriovenous fistula formation, infection, cyst or intrarenal hematoma formation, and renal fibrosis

46
Q

In what percentage of dogs and cats is microscopic hematuria observed following renal biopsy?

A

20-70% (resolves within 48-72 hours). Macroscopic hematuria observed in 1-4% and normally resolves within 24-hours.

47
Q

Describe the surgical approach for nephrotomy.

A
48
Q

What are surgical closure options for the kidney following nephrotomy?

A
  1. Pressure can be applied across the incision for 1-5 minutes to allow a fibrin seal to form, followed by closure of the renal capsule.
  2. Horizontal mattress sutures placed through the capsule and partial thickness through the renal cortex. This is associated with a greater reduction in post-operative GFR.
49
Q

Describe the technique for partial nephrectomy.

A

Additional hemostasis can be achieved by tacking omentum over the kidney, wrapping the kidney in absorbable mesh, or use of hemostatic sealants.

50
Q

What important consideration is there when performing left uteronephrectomy in intact patients?

A

Care must be taken to ensure ligation of the renal vein is performed above (upstream of) the level of entry of the ovarian or testicular vein.

51
Q

Describe the surgical approach to nephrectomy.

A
52
Q

What are clinical findings associated with ureteral stump syndrome?

A

Recurrent febrile UTI, lower abdominal pain, hematuria.

Treatment is by resection of the residual ureteral stump.

53
Q

What catheter is ideal for use as a nephrostomy tube?

A

Locking-loop pigtail nephrostomy catheter.

Complications of nephrostomy tube placement include urine leakage and dislodgement. Use of Foley or red rubber catheters associated with higher rates of complications, as well as infection and hemorrhage.

Urogenital system (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions