Lecture 20: Urinary pathology 1 Flashcards
1
Q
what are the 4 basic components in urinary tract
A
- Kidney
- Ureter
- Bladder
- Urethra
2
Q
male or female: shorter urinary tract
A
females
3
Q
Identify species that match kidney structure 1-7
A
- Dog
- Cat
- Horse
- Pig
- Goat/sheep
- Cow
- Right kidney of horse
4
Q
what species is this a normal urinary bladder in
A
horse
5
Q
what species have a unilobular/unipyramidal kidney
A
cats, dogs, small ruminants horse
6
Q
what species have a multi lobular/ multi pyramidal kidney
A
cattle, pigs
7
Q
what is the functional unit of the kidney
A
nephron
8
Q
what are the 4 main components of the kidney in renal disease
A
- Glomeruli
- Tubules
- Interstitium
- Blood vessels
9
Q
what structures are located in cortex of kidney
A
proximal and distal convoluted tubules, glomeruli
10
Q
what structure is located in medulla of kidney
A
LOH
11
Q
what structure is located in cortex and medulla of kidney
A
collecting duct
12
Q
what part of the kidney is susceptible to hypoxic injury
A
medulla
13
Q
what are some functions of kidney
A
- Remove waste
- Regulates hydration
- Acid-base
- Hormone production- EPO, vitamin D, renin, prostaglandin E2
- Controls systemic blood pressure and volume
- Indirect erythrocyte production
14
Q
what is function of lower urinary tract
A
- Transport waste from kidney to exterior
- Short term storage
15
Q
what is uremia
A
clinical syndrome of renal failure
16
Q
what is azotemia
A
elevated BUN and creatinine
17
Q
what 3 general conditions cause azotemia
A
- Pre-renal- reduced renal blood flow and glomerular filtration
- Renal- insufficient renal function
- Postrenal-obstruction
18
Q
what is GFR
A
rate at which blood passes through glomeruli
19
Q
what is most important parameter of renal function
A
GFR
20
Q
when notice renal failure GFR is ___% normal + uremia
A
20-25%
21
Q
end stage renal disease GRF <__% normal and terminal uremia
A
5%
22
Q
what are some signs of acute renal failure
A
rapid onset of low or no urine production (oliguria/anuria) +azotemia
23
Q
t or f: acute renal disease may be reversible
A
true
24
Q
Acute or chronic renal disease
A
Acute- pale, swollen
25
patients with acute renal failure die from __
hyperkalemia, metabolic acidosis, pulmonary edema
26
___is the most important cause of acute renal failure
acute tubular necrosis
27
answer kahoot
A is acute, B is chronic
28
t or f: chronic renal failure is reversible
false
29
what does kidney grossly look like with chronic renal failure
small, irregularly shaped, firm
30
what are the 3 mechanisms for non-renal lesions of uremia
1. Endothelial damage—> vasculitis—> thrombosis
2. Ammonia production—> caustic injury
3. Calcium- phosphorus imbalance
31
acute or chronic renal failure
chronic- firm, fibrotic
32
what endocrine organ regulates calcium levels
parathyroid
33
what are some common non-renal lesions from renal failure
1. Ulcerative necrotic stomatitis and glossitis
2. Gastric mucosal ulceration and hemorrhage with mineralization
3. Ulcerative and hemorrhagic colitis
4. Fibrinous pericarditis and endomyocardial mineralization
5. Soft tissue mineralization
6. Secondary hyperparathyroidism
7. Fibrous osteodystrophy
8. Nephrocalcinosis
34
what wrong and cause
top image- ulcerative stomatitis and glossitis
Bottom image- gastric ulcers, hemorrhage, mineralization
Cause: chronic renal failure
35
What wrong and what cause
Ulcerative and hemorrhagic colitis
Cause: chronic renal disease
36
What wrong and what cause
Uremic mineralization of heart
Cause: chronic renal failure
37
what Wrong and what cause
top image- uremic pneumonopathy
Bottom left: uremic frosting
Bottom right: mineralization of stomach
Cause: chronic renal failure
38
what wrong, what is result, and what cause
Parathyroid gland hyperplasia- secondary hyperparathyrodism due to chronic renal failure
39
what is the pathogenesis of chronic renal failure causing fibrous osteodystrophy
1. Insufficient renal function
2. Phosphorus retention
3. Decrease ca2+
4. Stimulate PTH
5. Parathyroid gland hyperplasia (secondary hyperparathyroidism)
6. Calcium removed from bone
7. Replaced by fibrous tissue
8. Fibrous osteodystrophy
40
what wrong and what 3 main causes
nephrocalcinosis
1. Damaged kidneys of uremic animals
2. Vitamin D toxicosis
3. Primary or nutritional hyperparathyroidism
41
what are some outcomes of renal failure/what normal functions of kidney affected
1. Build up of waste- BUN and creatinine
2. Dehydration
3. Metabolic acidosis
4. Hypertension
5. Non-regenerative anemia
42
what are some clinical signs of renal failure
increase thirst, change in urination, decreased appetite, vomiting, weight loss, dehydration, lethargy
43
which renal hormone plays largest role in reacting to decreased cardiac output in heart failure
renin
44
what is agenesis/aplasia of renal tissue
lack of renal tissue, rare, unilateral
45
what wrong
renal hypoplasia and compensatory hypertrophy of other kidney
46
hypoplasia of kidney usually unilateral but __when bilateral
fatal
47
what wrong in right kidney
Presence of fetal lobulations
48
what wrong
horseshoe kidney
49
are malpositioned kidneys, persistent fetal lobulations and horseshoe kidneys clinically significant
no
50
what is name of disease for inherited cysts
polycystic kidney disease
51
What species/breeds is PKD autosomal dominant
Persian cats, bull terrier dogs
52
what gene is mutated in PKD for autosomal dominant
PKD-1 and PKD-2
53
PKD autosomal dominant patients often have cysts also in __ and __
pancreas and liver
54
what breeds/species have autosomal recessive PKD
west highland white terriers, Cairn terriers, perendale sheep
55
What happens to lambs with PKD
die in utero or days after birth
56
what wrong
Polycystic kidney disease
57
What is the most common type of renal cyst/how get
acquired secondary to obstructions
58
renal dysplasia is genetic in what species
sheep
59
what is renal dysplasia
persistence of primitive/fetal tissue, atypical tubular epithelium, and/or cartilaginous/ osseous tissue
60
what species is progressive juvenile nephropathy familial or hereditary in
dogs
61
what is another ddx for renal dysplasia or progressive juvenile nephropathy that is not developmental
early renal disease related fibrosis
62
Kidneys from sheep what wrong
renal dysplasia
63
kidney histo from sheep- what going on in 1-3 and what dx
1. Small tubule and cells
2. Large cells in glomeruli and clumped
3. Normal glomeruli
Dx: renal dysplasia- small size of tubules suggest fetal tissue
64
What wrong
ectopic ureters
65
ectopic ureters become a problem when attached distal to __, why
urinary bladder sphincter, can’t hold pee
66
ectopic ureters are most common in what species
female dogs
67
what breed are ectopic ureters most common in
Siberian huskies
68
what are clinical signs of ectopic ureters
urinary incontinence
69
what is sequela to ectopic ureters
more susceptible to obstruction or infection—> pyelitis or pyelonephritis
70
what is a patent urachus
urachus should close at birth- medial umbilical ligament of bladder—> doesn’t close and then drips urine
71
what species most commonly gets patent urachus
male foals
72
what does a patent urachus predispose animals to
infection and abscessation
73
what wrong
patent urachus
74
what is a persistent urachal remnant
band of CT that attaches urinary bladder to abdominal wall
75
what is consequence of persistent urachal remnant
incomplete emptying of bladder—> infection—>cystitis
76
what wrong
Persistent urachal remnant
