Lecture 1 - Renal

Question 1

What is the function of the proximal tubule?

Answer 1

Maintains the volume + balanced composition of extracellular fluid

Question 2

What is the function of the RAAS system in the distal tubule and collecting tubule?

Answer 2

Controls local glomerular harm-dynamics, sodium re-absorption and systemic blood pressure

Question 3

What is the function of ADH within the collecting tubule?

Answer 3

ADH promotes water (and urea) in collecting duct. PTH promotes Ca and Mg reabsorption

Question 4

What stimulates increased ADH secretion?

Answer 4

Changes in certain plasma solutes (sodium, glucose) and changes in blood volume or pressure

Question 5

How does ADH decrease water loss occurring from the kidney?

Answer 5

1. Increases permeability of the distal and collecting tubules from kidney 2. Medullary hypertonicity –> draws water from renal tubules into medullary interstitial and vasculature by osmotic gradient

Question 6

What is polydipsia?

Answer 6

Consumption of larger than normal amount of water per day

Question 7

What is considered to be polydipsia in dogs and cats?

Answer 7

Dog: 100 mL/kg/day Cat: 50 mL/kg/day

Question 8

What is polyuria?

Answer 8

Excretion of a larger than normal volume or urine per day.

Question 9

What volume suggests polyuria in dogs and cats?

Answer 9

Cat and dog - production of greater than 50 mL/kg of urine per day

Question 10

What are the differentials that should be considered with polydipsia?

Answer 10

1. Physchogenic polydipsea 2. Endocrine disorders - hyperadrenocorticism in dogs and hyperthyroidism in cats 3. Hepatic encephalopathy 4. Rare hypothalamic (thirst centre) lesion 5. Drug therapy e.g. phenobarbitone

Question 11

What are the three major pathophysiologic processes causing polyuria?

Answer 11

1. Reduced medullary hypertonicity 2. Absence or interference with ADH function 3. Osmotic diuresis

Question 12

What is a condition that could produce reduced medullary hypertonicity?

Answer 12

Structural renal tubule damage - e.g. chronic kidney disease

Question 13

What could cause absence of interference with ADH function?

Answer 13

Primary ADH deficiency - central diabetes insipidus

Question 14

What could cause osmotic diuresis?

Answer 14

The tubular filtrate contains greater than normal number of osmotic particles - diabetes mellitus - lot’s of glucose in urine

Question 15

What is the definition of dysuria?

Answer 15

Difficult or painful urination

Question 16

What is pollakiuria?

Answer 16

Voiding small quantities of urine with increased frequency

Question 17

What is stranguria?

Answer 17

Straining to urinate

Question 18

What is pigmenturia?

Answer 18

Discoloured urine

Question 19

What is periuria?

Answer 19

Urination in an inappropriate location

Question 20

What does dysuria indicate?

Answer 20

Disease of the lower urinary tract - does not exclude concurrent involvement of URT i.e. pyelonephritis

Question 21

What are the major alternative diagnosis for dysuria in dogs?

Answer 21

1. Bacterial cystitis (lower UTI) 2. Prostatic disease 3. Urolithiasis 4. Bladder or urethral neoplasia 5. Urinary tract obstruction (mechanical - urolith, functional - neurologic disease)

Question 22

What are the major differentials for feline LUTS?

Answer 22

1. Idiopathic urinary tract inflammation (approx. 55%) 2. Urinary tract obstruction 3. Urolithiasis 4. Bacterial cystitis (variable - up to 20%) 5. Anatomic defects - previous urethral injury 6. Neoplasia (rare)

Question 23

What is urinary incontinence?

Answer 23

Disorder of the storage phase of micturition

Question 24

What is urinary retention?

Answer 24

Disorder of the voiding phase - residual urine left in bladder after urination

Question 25

Complete the diagram that is shown below:

Answer 25

Question 26

Name the parts shown in the diagram below:

Answer 26