Lecture 20: Urinary pathology 1 Flashcards
what are the 4 basic components in urinary tract
- Kidney
- Ureter
- Bladder
- Urethra
male or female: shorter urinary tract
females
Identify species that match kidney structure 1-7
- Dog
- Cat
- Horse
- Pig
- Goat/sheep
- Cow
- Right kidney of horse
what species is this a normal urinary bladder in
horse
what species have a unilobular/unipyramidal kidney
cats, dogs, small ruminants horse
what species have a multi lobular/ multi pyramidal kidney
cattle, pigs
what is the functional unit of the kidney
nephron
what are the 4 main components of the kidney in renal disease
- Glomeruli
- Tubules
- Interstitium
- Blood vessels
what structures are located in cortex of kidney
proximal and distal convoluted tubules, glomeruli
what structure is located in medulla of kidney
LOH
what structure is located in cortex and medulla of kidney
collecting duct
what part of the kidney is susceptible to hypoxic injury
medulla
what are some functions of kidney
- Remove waste
- Regulates hydration
- Acid-base
- Hormone production- EPO, vitamin D, renin, prostaglandin E2
- Controls systemic blood pressure and volume
- Indirect erythrocyte production
what is function of lower urinary tract
- Transport waste from kidney to exterior
- Short term storage
what is uremia
clinical syndrome of renal failure
what is azotemia
elevated BUN and creatinine
what 3 general conditions cause azotemia
- Pre-renal- reduced renal blood flow and glomerular filtration
- Renal- insufficient renal function
- Postrenal-obstruction
what is GFR
rate at which blood passes through glomeruli
what is most important parameter of renal function
GFR
when notice renal failure GFR is ___% normal + uremia
20-25%
end stage renal disease GRF <__% normal and terminal uremia
5%
what are some signs of acute renal failure
rapid onset of low or no urine production (oliguria/anuria) +azotemia
t or f: acute renal disease may be reversible
true
Acute or chronic renal disease
Acute- pale, swollen
patients with acute renal failure die from __
hyperkalemia, metabolic acidosis, pulmonary edema
___is the most important cause of acute renal failure
acute tubular necrosis
answer kahoot
A is acute, B is chronic
t or f: chronic renal failure is reversible
false
what does kidney grossly look like with chronic renal failure
small, irregularly shaped, firm
what are the 3 mechanisms for non-renal lesions of uremia
- Endothelial damage—> vasculitis—> thrombosis
- Ammonia production—> caustic injury
- Calcium- phosphorus imbalance
acute or chronic renal failure
chronic- firm, fibrotic
what endocrine organ regulates calcium levels
parathyroid
what are some common non-renal lesions from renal failure
- Ulcerative necrotic stomatitis and glossitis
- Gastric mucosal ulceration and hemorrhage with mineralization
- Ulcerative and hemorrhagic colitis
- Fibrinous pericarditis and endomyocardial mineralization
- Soft tissue mineralization
- Secondary hyperparathyroidism
- Fibrous osteodystrophy
- Nephrocalcinosis
what wrong and cause
top image- ulcerative stomatitis and glossitis
Bottom image- gastric ulcers, hemorrhage, mineralization
Cause: chronic renal failure
What wrong and what cause
Ulcerative and hemorrhagic colitis
Cause: chronic renal disease
What wrong and what cause
Uremic mineralization of heart
Cause: chronic renal failure
what Wrong and what cause
top image- uremic pneumonopathy
Bottom left: uremic frosting
Bottom right: mineralization of stomach
Cause: chronic renal failure
what wrong, what is result, and what cause
Parathyroid gland hyperplasia- secondary hyperparathyrodism due to chronic renal failure
what is the pathogenesis of chronic renal failure causing fibrous osteodystrophy
- Insufficient renal function
- Phosphorus retention
- Decrease ca2+
- Stimulate PTH
- Parathyroid gland hyperplasia (secondary hyperparathyroidism)
- Calcium removed from bone
- Replaced by fibrous tissue
- Fibrous osteodystrophy
what wrong and what 3 main causes
nephrocalcinosis
1. Damaged kidneys of uremic animals
2. Vitamin D toxicosis
3. Primary or nutritional hyperparathyroidism
what are some outcomes of renal failure/what normal functions of kidney affected
- Build up of waste- BUN and creatinine
- Dehydration
- Metabolic acidosis
- Hypertension
- Non-regenerative anemia
what are some clinical signs of renal failure
increase thirst, change in urination, decreased appetite, vomiting, weight loss, dehydration, lethargy
which renal hormone plays largest role in reacting to decreased cardiac output in heart failure
renin
what is agenesis/aplasia of renal tissue
lack of renal tissue, rare, unilateral
what wrong
renal hypoplasia and compensatory hypertrophy of other kidney
hypoplasia of kidney usually unilateral but __when bilateral
fatal
what wrong in right kidney
Presence of fetal lobulations
what wrong
horseshoe kidney
are malpositioned kidneys, persistent fetal lobulations and horseshoe kidneys clinically significant
no
what is name of disease for inherited cysts
polycystic kidney disease
What species/breeds is PKD autosomal dominant
Persian cats, bull terrier dogs
what gene is mutated in PKD for autosomal dominant
PKD-1 and PKD-2
PKD autosomal dominant patients often have cysts also in __ and __
pancreas and liver
what breeds/species have autosomal recessive PKD
west highland white terriers, Cairn terriers, perendale sheep
What happens to lambs with PKD
die in utero or days after birth
what wrong
Polycystic kidney disease
What is the most common type of renal cyst/how get
acquired secondary to obstructions
renal dysplasia is genetic in what species
sheep
what is renal dysplasia
persistence of primitive/fetal tissue, atypical tubular epithelium, and/or cartilaginous/ osseous tissue
what species is progressive juvenile nephropathy familial or hereditary in
dogs
what is another ddx for renal dysplasia or progressive juvenile nephropathy that is not developmental
early renal disease related fibrosis
Kidneys from sheep what wrong
renal dysplasia
kidney histo from sheep- what going on in 1-3 and what dx
- Small tubule and cells
- Large cells in glomeruli and clumped
- Normal glomeruli
Dx: renal dysplasia- small size of tubules suggest fetal tissue
What wrong
ectopic ureters
ectopic ureters become a problem when attached distal to __, why
urinary bladder sphincter, can’t hold pee
ectopic ureters are most common in what species
female dogs
what breed are ectopic ureters most common in
Siberian huskies
what are clinical signs of ectopic ureters
urinary incontinence
what is sequela to ectopic ureters
more susceptible to obstruction or infection—> pyelitis or pyelonephritis
what is a patent urachus
urachus should close at birth- medial umbilical ligament of bladder—> doesn’t close and then drips urine
what species most commonly gets patent urachus
male foals
what does a patent urachus predispose animals to
infection and abscessation
what wrong
patent urachus
what is a persistent urachal remnant
band of CT that attaches urinary bladder to abdominal wall
what is consequence of persistent urachal remnant
incomplete emptying of bladder—> infection—>cystitis
what wrong
Persistent urachal remnant
