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SAM 2 > Koster Test 2 > Flashcards

Koster Test 2 Flashcards

1
Q

At what % GFR does azotemia develop?

A

25%

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2
Q

What are the causes of pre-renal proteinuria?

A

Fever

CHF

Cushing’s

Sled dog that ran a marathon

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3
Q

What is the most common route of infection for LUTD?

A

Ascending infection

Hematogenous uncommon

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4
Q

What urinary signs are seen within 18 hours of Tiger Lily poisoning?

A

Casts and glucose

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5
Q

T/F: Dogs have a higher risk for prostatic neoplasia if they are castrated

A

True

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6
Q

What is it important to do when investigating an animal for female genital disease?

A

Vaginal speculum exam

Cytology if intact

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7
Q

Tx for cystine calculi?

A

Alkalinize urine

Low protein diet

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8
Q

What is the goal of therapy for stage 1 CKD?

A

Identify primary disease and start specific therapy to eliminate disease if possible

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9
Q

If you see the following on CBC, what do they mean?

Erythron

Leukon

Platelets

A

Erythron = CKD

Leukon = pyelonephritis

Platelets = HUS

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10
Q

What is the specific tx for pyelonephritis (G-)?

A

Floroquinolones or TMS (4-6 weeks)

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11
Q

What drugs are used to treat an uncomplicated UTI?

A

TMS, amoxycillin, cephalosporins

10-14 days

HDSD enrofloxacin for 3 days (dogs only)

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12
Q

What drugs can be used to relax the ureters?

A

Prazosin

Amiptryptalline

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13
Q

What is urge incontinence or detrusor instability?

A

Detrusor contraction during storage of urine or low compliance of the detrusor muscle, which may be confirmed by cystometrography

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14
Q

What is the goal of treatment for stage 4 CKD?

A

Symptomatic therapy

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15
Q

Tx for detrusor instability?

A

Anticholinergic (oxybutynin, imipramine, dicyclomine)

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16
Q

T/F: Dopamine is extremely effective in cats with oliguria

A

False

Not effective

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17
Q

Ammonium urate and xanthine uroliths are associated with what conditions?

A

Hepatic disease

Genetic tubular defects

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18
Q

When treating a UTI, why do you reculture at 2-3 weeks into the tx?

A

Test for resistance

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19
Q

What factors can cause a falsely high urea?

A

GIT bleeding

Intravascular hemolysis

High protein diet

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20
Q

What breeds are associated with ammonium urate and xanthine uroliths and what is the cause in each breed?

A

Dalmatians - hepatic disease, genetic tubular defect

Black Russian - genetic tubular defect

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21
Q

Do you want to increase or decrease the pH when treating urate uroliths?

A

Increase

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22
Q

When is immunosuppressive tx for glomerular disease contraindicated?

A

Pancreatitis

Bone marrow suppression

DM

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23
Q

Common example: Cat with repeated episodes of previous LUTD that develops acute obstruction.

Name the condition

A

ARF

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24
Q

What pathogen causes an encrusting cystitis?

A

Corynebacterium

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25
Q

What are the accurate techniques (direct methods) of measuring glomerular function?

A

Clearance of radioisotopes with renal scintigraphy

Iohexol/creatinine clearance

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26
Q

What is the gold standard for measuring urine concentration?

A

Osmolality (Uosm)

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27
Q

What is the first drug choice for immunosuppressive tx of glomerular disease?

A

Mycophenolate

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28
Q

Which nerve is responsible for bladder voiding? What type of innervation?

A

Pelvic nerve

Parasympathetic

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29
Q

What is the average value for insensible fluid loss?

A

22ml/kg/d

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30
Q

What is the specific tx for TMS toxicity?

A

Urinary alkalinization

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31
Q

What can cause a false negative proteinuria on dipstick?

A

Acidic urine

Bence jones proteinuria

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32
Q

USG in cats and dogs associated with CRF?

A

Cats = 1.008-1.030

Dogs = 1.008-1.022

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33
Q

What is the DOC to treat hypertension in dogs and cats with CRF?

A

Dogs = benazepril

Cats = amlodipine

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34
Q

What drugs are most important when treating LUTD in cats?

A

Analgesics - opioids

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35
Q

What environmental factors are important when treating feline LUTD?

A

Reduce stress

Litter boxes

Water sources

Activity/playing

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36
Q

When you hear reduced fractional excretion of sodium, what do you think of?

A

Pre-renal disease

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37
Q

What drug can you use to treat urate uroliths in dalmatians only?

A

Xanthine oxidase inhibitors

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38
Q

With what form of prostatitis is the patient sick?

A

Acute

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39
Q

What stages of CKD does phosphate levels increase?

A

3 and 4

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40
Q

What is the gold standard for quantifying proteinuria?

A

24 hour urine protein measurement

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41
Q

What is a side effect of using piroxicam for TCC?

A

50% of patients develop gastric ulcers so give H2 blockers

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42
Q

Tx for struvite uroliths?

A

Diet to acidify urine (3 months)

Abx during calculolytic diets for infection

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43
Q

Common example: Geriatric dog on chronic NSAID that receives a general anesthetic without fluid support.

Name the condition

A

ARF

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44
Q

What is the preferred imaging modality to diagnose ureteral obstruction?

A

Computed tomography

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45
Q

What can you give to manage anorexia with CRF?

A

Cyproheptidine

Mirtazapine

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46
Q

What is the most common organism found on urine culture?

A

E. coli

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47
Q

What is the goal of therapy for stage 2 and 3 CKD?

A

Renoprotetive therapy to try to slow progression

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48
Q

What is an advantage of nuclear scintigraphy regarding GFR?

A

You can get a GFR for each kidney individually

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49
Q

Supportive care for GI?

A

Control anorexia, nausea, and vomiting

Uremic gastropathy - famotidine, ranitidine, omeprazole

Prokinetics - ondansetron, metoclopramide

Anti-emetics - metoclopramide, maropitant

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50
Q

Tx for prostatitis?

A

Anitmicrobials

Sx

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51
Q

Partial water deprivation test cannot be performed on patients with this condition

A

Cushings

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52
Q

What is the specific tx for aminoglycoside toxicity?

A

Ticarcillin binds with gentamycin

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53
Q

What tier: Glomerular proteinuria w/ azotemia and hypertension but no hypoalbuminemia

A

Tier 3B

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54
Q

Define the initial phase of ARF

A

Decrease in urine output or increase in [creatinine]

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55
Q

If there are clinical signs in a dog with chronic prostatitis, what are they?

A

Recurrent UTIs or preputial discharge

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56
Q

What causes/symptoms of ARF have a poor outcome?

A

Decreased urine production

Hypothermia

Hyperkalemia

Toxic (EG)

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57
Q

Describe a reinfection/superinfection UTI

A

New/different organism

Reinfection - C&S positive >7 days after last treatment course

Superinfection - C&S positive at day 7 after starting abx

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58
Q

Tx for BPH?

A

Surgical (orchidectomy) - decrease size by 50%

Chemical castrations - GnRH, gestagens

DHT inhibitors - finasteride maintain fertility (same response as surgery)

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59
Q

T/F: There is no EBM to support that any therapy will improve outcome of oliguria

A

True

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60
Q

Is renal carcinoma more common in dogs or cats?

A

Dogs

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61
Q

What findings make up nephrotic syndrome?

A

Proteinuria

Hypoalbuminemia

Ascites/edema

Hypercholesterolemia

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62
Q

How much earlier does SDMA increase than creatinine than dogs and cats when there was a 40% decrease in GFR?

A

Dogs = 9 months

Cats = 17 months

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63
Q

Is renal lymphoma more common in dogs or cats?

A

Cats

64
Q

Since mycophenolate is expensive, what other drugs can you use to treat glomerular disease?

A

Cyclosporin

Chlorambucil

Azathioprine

Cyclophosphamide

65
Q

What secondary processes further enhance CKD?

A

Systemic and glomerular hypertension

Mineral imbalance

Proteinuria

Renal fibrosis

66
Q

What drug is used to tx LMN bladder?

A

Bethanecol

Express bladder 3-4/day

67
Q

T/F: Prostatic neoplasia is not related to neuter status

A

True

68
Q

Which is more common, acute or chronic prostatitis?

A

Chronic

69
Q

DDx for glucosuria?

A

DM

Renal tubular disease

Stress hyperglycemia

Effect of glucocorticoid tx

70
Q

What tier: Glomerular proteinuria w/o hypoalbuminemia or azotemia

A

Tier 1

71
Q

Tx for TCC in the bladder?

A

Piroxicam

Sx

Chemo - mitoxantrone

72
Q

Supportive care for hypertension?

A

Keep systolic BP < 180

Avoid ACEi in ARF

Amlodapine and hydralazine

73
Q

How long does the maintenance phase of ARF last?

A

1-3 weeks

74
Q

What drugs are the standard of care when treating lepto?

A

Calcium channel blockers

75
Q

What is reflex dyssynergia and what are two examples of animals that it occurs in?

A

Urethral sphincter spasms with initiation of detrusor contraction

Idiopathic in male GSD

Cats with LUTD

76
Q

What is the gold standard for diagnosing feline iterstitial cystitis?

A

Cystoscopy

77
Q

How long after administration of furosemide shoud urine output increase?

A

2-60 minutes

78
Q

What are some causes of acute on chronic renal disease?

A

Another disease

UTI

Drugs

Ureteral obstruction

Blood loss

79
Q

T/F: There is no inflammatory leukogram or fever associated with LUTD

A

True

80
Q

Supportive care for hyperkalemia?

A

Dextrose infusion

Insulin followed by dextrose infusion (BG monitoring)

Calcium gluconate

Correct met acidosis with bicarb over 15min

81
Q

What are some non-neoplastic causes of renomegaly?

A

Renal inflammation

Amyloidosis

Hydronephrosis

Polycystic kidney disease

Portosystemic shunts

82
Q

What is the average urinary loss?

A

44ml/kg/day

83
Q

What drug do you use to tx UMN bladder?

A

Baclofen (smooth muscle relaxnt)

84
Q

What is considered normal urine output?

A

1-2ml/kg/hr

85
Q

What breed is associated with neoplasia in the bladder or urethra?

A

Scotties

86
Q

Describe a relapse UTI

A

Same organism/strain 7 days after last treatment course

87
Q

What is the most common cause of chronic renal disease?

A

Chronic interstitial nephritis (70%)

88
Q

What USG is considered inadequately concentrated urine?

A

<1.022

89
Q

Why is it better to do sediment in house?

A

Crystals grow in storage

Casts and cells disintegrate in storage

90
Q

What breeds are associated with cystine calculi?

A

Dachshunds

Newfoundland

Bulldogs

91
Q

T/F: UTIs are more common in cats than dogs

A

False

92
Q

Supportive care for hyperphosphatemia?

A

No specific therapies

Reduce in diet

Binders

Aluminum carbonate/hydroxide in food

93
Q

What is the gold standard for measuring glomerular function?

A

Nuclear scintigraphy

94
Q

What is the most common etiology for urinary incontinence?

A

Urinary Sphincter Mechanism Incompetence (SMI)

95
Q

What can cause a false positive proteinuria on dipstick?

A

Alkaline urine

Contaminatino

96
Q

Detrusor atony is associated with what condition?

A

Addison’s

97
Q

What test is done to confirm urinary incontinence?

A

Urethral profilometry

98
Q

What is the USG range for isosthenuria?

A

1.008-1.012

99
Q

What is the best method for urine collection?

A

Cystocentesis

100
Q

What is the specific therapy for ethylene glycol toxicity?

A

4-methylpyrazole within 8hr of ingestion

101
Q

T/F: All intact male dogs with UTI have prostatitis

A

True

102
Q

What urine protein value in cats and dogs is consistent with CKD?

A

Dogs = >0.5

Cats = >0.4

103
Q

What abx would you give to tx prostatitis and how long?

A

Baytril BID for 4-6 weeks

104
Q

Should you feed wet or dry food when treating LUTD in cats?

A

Wet

105
Q

What are the two most common infectious causes of LUTD?

A

E. coli

Gram+ cocci

106
Q

What endocrine diseases can cause LUTD?

A

DM

Cushing’s

107
Q

What infectious diseases can cause glomerular disease?

A

Lyme

Heartworm

Ehrlichia

Leishmania

108
Q

What is the standard of care for an obstructive stone or stricture?

A

Ureteral stent or SUB

109
Q

What tier: Glomerular proteinuria w/ hypoalbuminemia, but no azotemia or hypertension

A

Tier 2A

110
Q

What kind of diet is useful in treating urate uroliths?

A

Low protein (U/D)

111
Q

What does a UA show in a dog with acute prostatitis?

A

UTI

112
Q

What is the urine production rate in an animal with oliguria?

A

<0.5ml/kg/hr

113
Q

What is the normal USG value for dogs and cats?

A

Dogs = >1.030

Cats = >1.035

114
Q

What is the specific treatment for NSAID toxicity?

A

Misoprostol (PGE analogue)

115
Q

What Na-fractional excretion value differentiates pre-renal from post renal?

A

Pre-renal = <1%

Renal = >1%

116
Q

What is the water intake for a normal patient and one with PD?

A

Normal = 60ml/kg/day

PD = 100ml/kg/day

117
Q

Prevention for CaOx stones?

A

Diet

Thiazide diuretics (predispose to UTI)

Potassium citrate

Vitamins

118
Q

What tier: Glomerular proteinuria w/ azotemia but no hypertension or hypoalbuminemia

A

Tier 3A

119
Q

What is the first sign to appear with Tiger Lily poisoning?

A

GI signs

vomiting (may subside by 12 hours)

anorexia

depression

120
Q

PE findings of a dog with prostatic neoplasia?

A

Painful gait with pain in sacrum

Prostate palpable in neutered dog

Possible asymmetry

Submandiobular LN may be palpable

121
Q

What is the specific tx for lepto?

A

Penicillins and doxy

122
Q

Supportive care for hypercalcemia?

A

Diuresis

Furosemide

Glucocorticoids

Calcitonin

Bisphosphonates

123
Q

What risk is associated with using diet to dissolve struvite stones?

A

Causing CaOx calculi to form

124
Q

Which urolith is more radiodense, struvite or CaOx?

A

CaOx

125
Q

How are ureteral stents placed in dogs and cats?

A

Dogs = retrograde via cystoscopy

Cats = antegrade via surgery

126
Q

What neoplasias can bee found with female genital disease?

A

Leiomyoma/leiomyosarcoma

TVT

127
Q

What tier: Glomerular proteinuria w/ azotemia, hypertension, and hypoalbuminemia

A

Tier 3C

128
Q

What tier: Glomerular proteinuria w/ hypoalbuminemia and hypertension but no azotemia

A

Tier 2B

129
Q

Tx for PLN?

A

ACE inhibitor or amlodipine for hypertension

ACE inhibitor or ARB and renal diet for proteinuria

Asprin or clopidogral for hypercoagulability

130
Q

Where does prostatic neoplasia metastasize to?

A

LN

Vertebrae

Lungs

131
Q

Tx for prostatic neoplasia?

A

Sx - post-op incontinence

Chemo - mitoxantrone

COX-2 inhibitors

132
Q

What are the causes of dysuria/stranguria/pollakiuria?

A

Irritation of the baldder

Neurological disease

Secondary LUTD

133
Q

What are the only useful tests on a dipstick analysis?

A

Protein

pH

Blood

Glucose

Ketones

Ignore leukocytes, SG, and urobilinogen

134
Q

What nerve is responsible for retaining urine in the bladder? What type of innervation?

A

Hypogastric nerve

Sympathetic

135
Q

Common example: Dog with pancreatitis and hypotension from SIRS.

Name the condition

A

ARF

136
Q

Signalment for dogs with struvite uroliths?

A

Intact, toy breed, female

137
Q
A
138
Q

When is biopsy contraindicated for glomerular disease?

A

Stage 4 IRIS or coagulopathy

139
Q

What urolith is commonly related to UTIs in dogs?

A

Struvite

140
Q

What are the indirect methods for measuring glomerular function?

A

Serum urea

Creatinine

Cystatic C

141
Q

T/F: CaOx stones are more common in females

A

False

Males

142
Q

If you have increased glucose in your urine, how would this affect your specific gravity?

A

Increased

143
Q

When do you run cultures for recurrent UTIs?

A

Pre therapy

During therapy (2-3 weeks)

Post therapy (7 days)

144
Q

What are some renoprotective drugs?

A

Calcium channel blockers (diltiazem)

Selective DA-2 receptor agonists (vasodilation) (dopamine)

Erythropoietin analogues

145
Q

What creatinine concentration identifies a dog and cat as IRIS stage 2?

A

Dog = 125-180

Cat = 140-250

146
Q

What drugs are used in dogs and cats for pain management of ureteral obstrustions?

A

Dogs = fentenyl

Cats = buprenorphine

147
Q

What are the only conditions that dopamine is useful for when treating oliguria?

A

When ARF is secondary to cardiac output failure or severe hypotension

148
Q

What is the prophylactic therapy for recurrent UTIs?

A

Give 30-50% original dose at bed time (nitrofurantoin)

Run microbiology q4w

Discontinue meds if negative for 6 months

Monitor C&S q1m for 3m then q3m for 1y

149
Q

Supportive care for acidosis?

A

Bicarb IV

base deficit x BW x 0.3

Give 1/4 IV and remainder CRI (2-6hrs)

150
Q

What is dysautanomia?

A

UMN bladder associated with toxicity

Autonomic system damaged

151
Q

What drug is used to tx reflex dyssynergia?

A

Phenoxybenzamine

152
Q

What is the treatment of choice for extopic ureter?

A

Cystoscopic laser ablation

153
Q

Supportive care for hypocalcemia?

A

Calcium gluconate 10%

154
Q

Which is more sensitive between creatinine and SDMA? Specific?

A

SDMA more sensitive (100% vs 17%)

Creatinine more specific (100% vs 91%)

155
Q

What % of incontinence is due to SMI?

A

85%

156
Q

Contraindications for mannitol therapy when treating oliguria?

A

Anuria

Dehydration

SAM 2 (6 decks)

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