Renal and urinary - session 12/13 Flashcards
The three main receptor pathways that stimulate gastric acid secretion in parietal cells are the muscarinic cholinergic receptor, the histamine H2 receptor, and the gastrin receptor (named the CCK-B receptor). The prework pointed out one pathway in particular that is altered in CKD patients and can lead to an increased gastric acid production and an increased risk of gastrointestinal ulcer disease. Which statement accurately describes key events in that pathway?
gastrin degradation is reduced
Hypergastrinemia occurs in CKD and is suspected to be an important factor in CKD-related GI ulcer formation
Darbopoetin is associated with severe adverse effects. Name some
hypertension
seizures
pure red cell aplasia
Which category of drugs discussed in the treatment of sporadic bacterial cystitis, was it mentioned that in human medicine, this category of drugs may be as effective as antibiotics in uncomplicated, sporadic bacterial cystitis?
NSAIDs
Which drugs are considered first-tier treatment for sporadic bacterial cystitis according to the prework, specifically the ISCAID consensus guidelines?
Amoxicillin
Amoxicillin-clavulanic acid
TMS
Which drug can be used in obstructive feline idiopathic cystitis to decrease urethral tone and reduce urethral spasms that hinder urine flow and increase the likelihood of re-obstruction?
Prazosin
Prazosin is indicated for what
FIC
α1-adrenergic antagonist that may be useful to reduce sympathetic tone to treat functional urethral obstruction in dogs and cats
blocks smooth muscle constriction
Cats are prone to become inappetent with disinterest in drinking water when they are in pain or general discomfort. Relative to kidney function, that is a particular problem with which category of drugs that can be used to manage pain in non-obstructive feline idiopathic cystitis?
NSAIDs
Tricyclic antidepressants (TCAs) have adverse effects related to their ability to act as anticholinergics and antihistaminics, leading to the potential for xerostomia, tachycardia, urine retention and sedation. Which drugs are TCAs?
Amitryptaline
Buspirone
serotonin agonist
anti anxiety behavior drug
Based on its high lipid solubility, low protein binding, and broad spectrum of activity against many uropathogens, which drug is considered the drug of choice for canine bacterial prostatitis?
Enrofloxacin
Choose the drug used to treat USMI with an effect that could potentially be reversed by using prazosin
phenylpropanolamine = alpha 1 agonist = sympathomimetic
prazosin = alpha 1 antagonist = dec smooth muscle tone
phenylpropanolamine: class
alpha 1 agonist
sympathomimetic
Phenoxybenzamine: class
alpha adrenergic antagonist
Prazosin: class
alpha 1 antagonist
Clomipramine
TCA
Clomicalm
drug used to treat renal secondary hyperparathyroidism.
calcitriol (vit D3)
inc Ca absorption = dec PTH release
The likelihood of hypercalcemia, as an adverse effect of Calcium-based phosphate binding drugs, can be increased by concurrent use of:
Hydrochlorothiazide
blocks secretion of Ca++, promoting elevated blood levels
Hydrochlorothiazide
thiazide diuretic
What is the signalment most likely to get bacterial cystitis?
dogs - bacterial (cats tend to have FIC)
female
Bacterial cystitis in cats suggests which underlying conditions?
diabetes mellitus, hyperthyroidism, CKD
In cases of sporadic bacterial cystitis, what medication should you consider starting to ameliorate clinical signs while waiting for the culture results?
NSAID
Key nutritional modifications in therapeutic diets for dogs with CKD include __________ protein, __________ potassium, and __________ phosphorous.
modified protein
added potassium
reduced phosphorus
What are goals for nutritional management for cats with CKD?
to maintain adequate nutrition; mitigate clinical consequences of CKD, including signs of uremia; address the changes in homeostasis that result from inadequate kidney function; slow disease progression and prolong lifespan.
True or False: Both overweight cats and underweight cats are at increased risk of developing a urinary tract infection (UTI) and feeding cats to maintain ideal body condition may help reduce the risk of a UTI.
TRUE
What medication is FDA approved to treat hypertension in cats?
Telmisartan
ARB - angiotensin receptor blocker
Telmisartan
ARB
hypertension in cats
What is the main treatment for patients with AKI?
fluids
What is the main treatment for patients with CKD?
Diet
Which uroliths are radiodense?
Calcium oxalate & Struvite
Which breed has a genetic predisposition to forming urate uroliths?
Dalmatians
According to the readings, what is the cornerstone of urolith prevention strategies for MOST stone types?
high moisture diet
Which urolith has been found to be androgen dependent?
cystine - castration recommended
Which uroliths can be medically dissolved?
Struvite, urate, cystine
Which urolith cannot be medically dissolved?
Calcium oxalate
The radiographic finding in cats of “big kidney, little kidney syndrome” indicates what condition?
bilateral ureteral obstruction
Do struvite uroliths prefer acidic or alkaline environements?
Alkaline
feed acidifying diet
Administration of hydrochlorothiazide (a thiazide diuretic) is recommended in prevention of what urolith type?
Calcium oxalate
thiazide diuretics cause inc reabsorption of Ca therefore dec calcium in the bladder
When is it contraindicated to use hydrochlorothiazide?
- patients who are hypercalcemic
- patients taking calcium based phosphate binders
