Renal Articles 2017

Question 1

What is the somatic nerve involvement of micturition

Answer 1

Peudendal nerve S1-3
Striated muscle nicotinic cholinergic receptors
Contraction forms external sphincter

Question 2

What is the PNS involvement in micturition

Answer 2

S1-3; Contraction of bladder wall, open bladder neck; relaxation of proximal urethral sphincter

Question 3

What is the SNS involvement in micturition

Answer 3

D L1-4, C L2-5 hypogastric
Beta receptors in the body of the bladder wall allow relaxation and stretch
Alpha receptors trigone proximal urethra cause constriction

Question 4

Describe the difference between UMN and LMN bladder

Answer 4

L7 or higher; incomplete detruser contraction spasticity of urethral sphincter; urine retnetion
LMN Bladder sacral detrusor/urethral sphincter areflexia; large easy expressible dribble

Question 5

How are skeletal muscle relaxants used with UMN bladders

Answer 5

Diazepam–modulates Gaba
Baclofen (1-2 mg/kg q 8rs) Activates gaba
Goal to relax external urethral sphincter

Question 6

How has atricarium been used in UO

Answer 6

local infusions of dilute mixture of 0.5 mg/ml instilled into urethra. Reduced first attempt to placed u-cath

Question 7

MOA of phenoxybenazime and use

Answer 7

Alpha antagonist
Decreased SVR & BP
Decreased internal urethral sphincter resistance

Question 8

MOA of Prazosin and use

Answer 8

Selective sympatholytic
competively antagonizes alpha-1 receptors
Relaxes smooth muscle

Question 9

MOA of tamsulosin and use

Answer 9

Selective alpha-1 receptor antagonist preferential for prostrate/urethra
Contains sulfa
accumulates for one day dosing; UMN bladders

Question 10

MOA of bethanechol and use

Answer 10

Parasympathomimetic
Stimulates muscarinic receptors
Bladder contraction

Question 11

MOA of phenylpropinalamine and use

Answer 11

Partial alpha-1 receptor agonist

causes internal urethral sphincter to contract

Question 12

In a JVECC 2017 study what were the risk factors for fluid overload in UO cats. Did this alter outcome?

Answer 12

Fluid bolus on presentation and development of heart murmur or gallop
Did not increase mortality

Question 13

In a JVECC 2017 study how did prazosin affect recurrent urethral obstruction

Answer 13

Did not decreased recurrence. Under powered.
0.25 mg/kg PO q 12 hrs
Used 3.5/5 Fr; Longer ucath place for placebo

Question 14

In a JAVMA 2017 study what was the difference between pigtail stents and ureteral by pass device

Answer 14

SUB devices lower risk of complications and longer survival times

Question 15

In a JAVMA 2017 study what are the limitations to using a POC urine culture system in dogs

Answer 15

Able to detect bacturia but not able to correctly identify bacteria or sensitivity results

Question 16

In a JAVMA 2017 study is there an association between urolithasis and CKD in cats

Answer 16

Positive association between urolithasis and CKD:

Did not seperated out Ureteroliths and pyelo/acute on chronic

Question 17

AJVR 2017 what storage conditions affect UPC

Answer 17

Okay to store for one year at -20C and -80C

Question 18

What are the pitfalls of using creatinine as an indicator of GFR

Answer 18

Creatinine affected by muscle mass
75% kidney damage prior to serum increase
Does not represent severity of renal damage until steady state reached.
Reflects GFR changes but not tubular damage

Question 19

What are useful biomarkers for AKI / CKD in dogs

Answer 19

Dogs: plasma NGAL increases predicts progressive CKD; Heat Shock protein 27/UCr ratio higher in non survivors with AKI; Fibroblast growth factor 23 increased with progressive CKD

Question 20

Vet Journal 2017 What is the seasonality in the northern US for UO in cats

Answer 20

Northeaster US has March-May

Northwestern no seasonality however when combined maintained the March-may timeframe

Question 21

JVIM 2017 UPC measured free catch vs cystocentesis

Answer 21

Comparitive.

Older dogs in study 19% had protienuria

Question 22

JVIM 2017 Darbopotien in dogs for CKD

Answer 22

> 21 day dosing frequency inefffective
effective for treatment of anemia
anemia is normochromic, normocytic, nonregenerative

Question 23

JVIM 2017 6% HES 130/0.4 on creatinine and AKI in critically ill non azotemic cats findings

Answer 23

Did not increase serum creatinine or result in AKI.