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Renal > renal disease > Flashcards

renal disease Flashcards

1
Q

define dysuria

A

difficult urination

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2
Q

define oliguria

A

low amounts of wee

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3
Q

define anuria

A

no wee

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4
Q

define stranguria

A

slow and painful urination

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5
Q

define pollakiuria

A

frequent urination

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6
Q

define nocturia

A

weeing at night

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7
Q

normal urine output for dog and cat

A

15-45ml/kg/day

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8
Q

9 signs associated with upper urinary tract disease

A
  • polyuria
  • polydipsia
  • oliguria
  • anuria
  • depression
  • lethargy
  • halitosis
  • oral ulcerations
  • haematuria
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9
Q

8 signs accosiated with lower urinary tract disease

A
  • dysuria
  • pollakiuria
  • oliguria
  • anuria
  • urinary incontinence
  • haematuria
  • abnormal palpation of bladder/urethra
  • external genitalia abnormalities
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10
Q

3 methods urine collection

A
  • free catch
  • catheter
  • cystocentesis
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11
Q

cons urine catheter sample

A

cant look for haematuria as may be from damage due to catheter

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12
Q

urinary catheter cat male

A
  • protrude penis
  • straighten using forceps on the prepuce
  • put catheter in till it goes no further
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13
Q

how to urinary catheter large female dog

A

put finger in vagina and slip catheter underneath

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14
Q

how retrograde vaginourethro cystographs

A

contrast injected caudal to cranial

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15
Q

antegrade urethro cystography how

A

contrast injected cranial to caudal

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16
Q

2 indicators of GFR

A

serum levels of

  • urea
  • creatinine
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17
Q

how get rid of urea in small animals

A

in wee

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18
Q

how ruminants get rid of urea

A
  • in rumen

- in wee

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19
Q

2 causes prerenal azotemia

A
  • decreased renal perfusion

- increased protein catabolism

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20
Q

how many nephrons need to stop working for renal azotemia to start

A

3/4

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21
Q

define isothenuria

A

fixed specific gravity. so kidney is not concentrating urine

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22
Q

define hyposthenuria

A

low speficic gravity but kidney can still change concentration a bit

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23
Q

if serum creatinine is high then urine SG should be

A

high

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24
Q

amylase and lipase excretion

A

out through the kidneys

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25
Q

anaemia and renal disease why

A

no erythropoietin production

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26
Q

high protein diet and urine pH

A

low

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27
Q

high veg diet and urine pH

A

high

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28
Q

2 causes of ketonuria

A
  • poorly controlled diabetics

- starvation

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29
Q

what will be increased during renal failure (5)

A
  • urea
  • creatinine
  • potassium
  • phosphates
  • metabolic acidosis
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30
Q

increased potassium causes

A

cardiac arrhythmias

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31
Q

increased phosphate causes

A

increased bound calcium so muscle tremors and coma

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32
Q

7 microscopy chronic renal failure

A
  • thin cortex
  • increased interstitial connective tissue
  • decreased renal tubules
  • thickened basement membrane
  • calcification of vessels and basement membrane
  • multiple cysts
  • glomerulosclerosis
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33
Q

define uraemia

A

toxic syndrome sometimes seen in kidney failure

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34
Q

what GFR to make secondary renal hyperparathyroidism occur

A

uber 25% as phosphate no longer adequately expcreted

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35
Q

how does increased phosphate cause hyperparathyroidism

A
  • increased phosphate causes incressed ionised calcium
  • kidney stops vit d activation so less calcium absorbed in GIT
  • low calcium causes PTH production and eventually chief cell hyperplasia occurs
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36
Q

PTH causing calcium to leave bones causes (2)

A
  • fibrous osteodystrophy

- mineralisation of soft tissue due to increased phosphate

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37
Q

where fibrous osteodystrophy seen most commonly (2)

A
  • mandible

- maxilla

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38
Q

3 causes hypercalcaemia

A
  • secondary renal parathyroidism
  • primary hyperparathyroidism
  • vit D intoxication
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39
Q

non renal lesions of kidney failure (7)

A
  • endothelial degeneration and necrosis due to toxins causes a vasculitis, thrombosis and infarction
  • uraemia also damage stomach and oral cavity epithelium
  • uraemic encephalopathy
  • uraemic pneumonitis
  • intercostal mineralisation
  • fibrinous pericarditis
  • arteritis
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40
Q

ulcerative glossitis and stomatitis appearance

A
  • usually bilaterally symetrical
  • foul smelling
  • brown mucoid material
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41
Q

define glossitis

A

inflammation of the tongue

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42
Q

define stomatitis

A

inflammation of mucous lining of mouth

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43
Q

gastric ulceration causes

A

black tarry vomit

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44
Q

uraemic encephalopathy why in renal failure

A

occurs due to white matter spongiform degeneration

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45
Q

uraemic pneumonitis define

A

inflammation of lung tissue

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46
Q

uraemic pneumonitis causes (4)

A
  • vasculitis of alveolar capillaries
  • pulmonary oedema
  • fibrin exudation
  • mild infiltrate of macrophages and neutrophils
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47
Q

uraemic peritonitis causes

A

patchy diffuse pulmonary calcification

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48
Q

fibrous pericarditis characterised by

A

fine granular depositis of calcium on the endocardium

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49
Q

arteritis in renal failure see

A

fine granular plaques in left atrial endocardium, proximal aorta and pulmonary trunk

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50
Q

arteritis causes loss of

A

anticoagulant antithrombin 3 by glomerular leakage so thrombi form

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51
Q

kidney is covered in

A

retroperitoneum

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52
Q

define renal aplasia

A

failure for kidney to develop

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53
Q

define renal hypoplasia

A

incomplete development of the kidney

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54
Q

define ectopic kidneys

A

kidneys in the wrong place

- usually normal in structure and function but position can for a problem with the ureters

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55
Q

define fused kidneys

A
  • where kidneys are fused at the cranial or caudal pole

- usually structurally and functionally normal

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56
Q

define renal dysplasia

A

abnormal differentiation of the kidney

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57
Q

8 define progressive juvenile nephropathy

A
  • like dysplasia
  • severe bilateral renal fibrosis
  • shrunken pale kidneys
  • pitted surface
  • foetal glomeruli
  • interstitial inflammation
  • fibrosis
  • tubular dilation
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58
Q

appearance renal cysts

A

thin walled spherical, clear fluid filled, distension of cortical or medullary tubules

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59
Q

cause of renal cysts

A
  • congenital
  • secondary to renal dysplasia
  • acquired
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60
Q

how aquire a renal cyst

A

intralobular obstruction

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61
Q

damage to glomerulus causes

A

protein loosing nephropathy

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62
Q

prolonged renal protein loosing nephropathy leads to

A

decreased antithrombin 3 so causing nephrotic syndrome

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63
Q

nephrotic syndrome characterised by (5)

A
  • general oedema
  • ascites
  • pleural effusion
  • hypercoagulability
  • hypercholesterolemia
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64
Q

define immune mediated glomerulonephritis

A
  • immune complexes get depoisted in subepithelial, subendothelial or mesangial locations
  • antibodies form against them leading to compliment fixation
  • proteinases and O2 derived free radicals are released and damage basement membrane
65
Q

diagnose immune mediated glomerulonephritis

A

fluorescent deposits indicate presence of immunoglobulins on compliement

66
Q

appearance of immune mediated glomerulonephritis 3

A
  • glomeruli are red/pale dots on cut surface of cortex
  • adherent capsule
  • granularity to cortical surface
67
Q

7 histology immune mediated glomerulonephritis

A
  • high cellularity and proliferation in glomerular cells
  • thickened basement membrane
  • thickened bowman’s capsule
  • fibrinous thrombi
  • renal tubules filled with homogenous proteinaceous fluid
  • interstitial and periglomerular fibrosis
  • glomerulosclerosis
68
Q

glomerular amyloidosis appearance (5)

A
  • enlarged
  • pale
  • finely granular capsular surface
  • glomeruli visible as fine glistening dots
  • iodine stains glomeruli brown
69
Q

staining amyloid deposits

A

congored will make it have an apple green birefringence with polarised light

70
Q

acute suppurative glomerulitis also known as

A

bacterial or embolic nephritis

71
Q

how get acute suppurative glomerulitis

A

bacteria lodge in glomerular and interstitial capillaries and form microabscesses in cortex

72
Q

cause of acute suppurative glomerulitis foals

A

actinobacillus equi

73
Q

cause of acute suppurative glomerulitis pigs

A

erysipelothrix rhusiopathiae

74
Q

cause acute suppurative glomerulitis sheep and goats

A

corynebacterium pseudotuberculosis

75
Q

cause acute suppurative glomerulitis cattle

A

arcanobacterium pyogenes

76
Q

appearance acute suppurative glomerulitis

A

multifocal random raised tan pinpoint foci subcapsular and on cut surface of cortex

77
Q

histology acute suppurative glomerulitis (2)

A
  • numerous bacterial colonies with necrotic debris and neutrophils
  • glomerular or interstitial haemorrhage
78
Q

what happens in glomerulosclerosis (6)

A
  • decrease in functioning glomeruli
  • glomerular capillaries lost
  • mesangial matrix and bowman’s space replaced with fibrous connective tissue
  • reduced blood flow through vasa recta causing hypoxia
  • hypoxia causes epithelial degeneration and loss
  • chronic proteinuria
79
Q

nephron repair can occur if

A

basement membrane is intact

80
Q

primary renal glycosuria is

A
  • an inherited condition

- affects capactity for reabsorption of glucose from the nephron

81
Q

define fanconic syndrome

A
  • hereditary defect

- cant reabsorb protein, glucose, phosphate or amino acids in the nephron

82
Q

define cystinuria

A
  • sex linked inherited tubular defect in male dogs

- predisposes them to calculus formation

83
Q

most important cause of renal faillure

A

acute tubular necrosis

84
Q

cause of acute tubular necrosis

A

nephrotoxic or ischaemic injury to renal tubular epithelial cells

85
Q

nephrotic pigment in sheep

A

chronic copper toxicity

86
Q

babesiosis in cattle causes (kidney)

A

haemoglobinuric nephrosis

87
Q

define myoglobinuric mephrosis

A

muscle necrosis as lots of myoglobin excreted by kidney

88
Q

haemoglobin/myoglobin and tubular necrosis

A

does not cause tubular necrosis but contributes to it

89
Q

lead can caus kidney

A

mitochondrial damage to cells in PCT

90
Q

mycotoxins, oak poisoning and oxalate containing plants cause what kidney

A

acute tubular necrosis

91
Q

ethylene glycols is made into what in liver

A

oxadised by hepatic alcohol dehydrogenase into toxic metabolites like glycolic acid and oxalate

92
Q

what do calcium oxalate crystals from ethylene glycol do in kidney

A

precipitate in lumen causing obstruction

93
Q

pulpy kidney caused by

A

bacterial toxins like epsilon toxin from clostridium perfringens causing acute tubular necroisis

94
Q

renal interstitial disease appearance

A

coalescing grey foci on capsular and cut surface

95
Q

renal interstitium in

A

fibrovascular stroma that surrounds the nephron

96
Q

E.coli septicaemia kidney causes

A

white spotted kidney

97
Q

E.coli septicaemia kidney can be (2)

A
  • embolic nephritis

- non-suppurative interstitial nephritis

98
Q

E.coli septicaemia kidney appearance

A

microabscesses replaced by lymphocytes, plasma calls and macrophages

99
Q

equine arteritis virus and PRRS causes kidneys (2)

A
  • mulitfocal lymphohitiocytic tubulointerstitial nephritis with interstitial oedema
  • vasculitis with fibrinoid necrosis and lymphohistiocytic infiltrates
100
Q

canine adenovirus infection kidneys

A

sets up viraemia which localises in glomeruli

101
Q

canine adenovirus infection kidney lives

A

tubular epithelium for weeks-months

102
Q

appearance canine adenovirus infection kidney

A
  • basophilic intranuclear viral inclusions

- virus cytolysis causing tubular epithelial necrosis

103
Q

leptospirosis kidney

A
  • bacterial tubulointerstitial nephritis
  • leptospiraemia
  • migrates through vascular endothelium can persist in interstitial spaces and tubular lumen
104
Q

feline infectious peritonitis and kidney

A

granulomatous necrotising vasculitis with interstitial pyogranulomas

105
Q

infarction kidney appearance (5)

A

usually interlobar artery so only cortex

  • if arcuate artery then both cortex and medulla
  • affected areas are dark red and wedge shaped to start due to haemorrhage
  • become pale with rim of congestion
  • necrosis of cells pushes blood out then they undergo lysis and phagocytosis
106
Q

primary tumours of the kidney are usually

A

malignant and metastatic

107
Q

renal carcinoma appearance

A

large with foci of haemorrhage necrosis and cystic degeneration
- pale kidney

108
Q

define hydronephritis

A

dilation of renal pelvis due to obstruction of renal outflow

109
Q

hydronephrosis steps (5)

A
  • increased pressure
  • atrophy of renal parenchyma
  • interstitial vessels collapse
  • renal blood flow decreases
  • hypoxia and ischaemic necrosis
110
Q

define pyonephrosis

A

infected pus filled hydrophephritis

111
Q

whats worse uni or bilateral hydronephritis

A

unilateral as other kidney compensates and it gets worse

112
Q

pyelonephritis is a form of

A

suppurative tubulointerstitial disease

113
Q

2 causes of primary papillary necrosis

A
  • prolonged use of NSAIDs

- decreased PG (vasodilator) synthesis

114
Q

cause of secondary papillary necrosis

A

decreased blood flow

115
Q

appearance papillary necrosis

A

sharply delineated coagulative necrosis of inner medulla which eventually sloughs causing detachment of renal pelvis

116
Q

how do ureters enter the bladder

A

obliquely through vesiculoureteral valve

117
Q

5 lower urinary tract defences

A
  • flushing of urine
  • peristalsis
  • inhospitable environment
  • urethral mucous coating
  • immune responses
118
Q

define ectopis ureters

A

empty into werid places

119
Q

define patent urachus

A

where foetal urachus doesnt close

120
Q

patent urachus associated with

A

congenital urethral obstruction

121
Q

define urolithiasis

A

urinary calculi (uroliths) (stones)

122
Q

alkaline pH urine and uroliths (2)

A
  • struvate crystals

- carbonate crystals

123
Q

acidic pH and uroliths

A

oxalate crystals

124
Q

clinical signs acute cystitis (3)

A
  • dysuria
  • stranguria
  • haematuria
125
Q

common cause of cystitis

A

urease producing bacteria

126
Q

chronic cystitis is (3)

A
  • diffuse
  • follicular
  • polypoid
127
Q

appearance follicular cystitis

A

small red nodules on mucosa surface

hyperplastic lymphoid cells surrounded by hyperaemia and haemorrhage

128
Q

appearance diffuse cystitis (3)

A
  • thickened mucosa due to infiltration with mononuclear inflammatory cells
  • submucosal fibrosis
  • muscularis hypertrophy
129
Q

appearance polypoid cystitis

A

multiple peripheral nodules of connective tissue

130
Q

emphysematous cystitis define

A

glucosuria enhances bacterial growth releasing CO2 into bladder
CO2 absorbed by lymphatics

131
Q

toxic cystitis due to

A

chronic ingestion of bracken fern causing enzootic haematuria, haemorrhage, chronic cystitis and bladder neoplasia

132
Q

transitional cell papillomas or carcinomas appearance

A

pedunculated

133
Q

appearance leiomyomas bladder

A

circumscribed pale firm masses resembling smooth muscle

134
Q

which kidney more cranial

A

right

135
Q

prostate radiographic appearance (4)

A
  • 2/3 renal pelvis inlet size
  • round to oval shape
  • soft tissue opacity
  • caudal to bladder neck
136
Q

3 indications for excretory/intravenous urography

A
  • visualisation of kidney size, shape, location, integrity of kidney and ureters
  • qualitative assessment renal function
  • pelvis assessment
137
Q

3 contraindications exceretory/intravenous urography

A
  • dehydration
  • hypersensitivity to contrast
  • severe heart disease
138
Q

uniform opacity to kidneys indicate 4 (excretory urography)

A
  • compensatory hypertrophy
  • acute glomerular or tubulointerstitial disease
  • perirenal pseudocysts
  • hypoplasia
139
Q

nonuniform focal opacification kidney indicates 6 (excretory urography)

A
  • neoplasia
  • haematuria
  • cyst
  • infarct
  • abscess
  • hydronephrosis
140
Q

nonuniform multi focal opacification kidney 6 (excretory urography)

A
  • polycystic disease
  • infarcts
  • acute pyelonephritis
  • chronic generalised glomerular or tubulointerstitial disease
  • FIP
  • neoplasia
141
Q

no opacification of kidneys indicates 5 (excretory urography)

A
  • aplasia/agenesis
  • obstruction or avulsion renal artery
  • acute or chronic renal failure
  • nephrectomy
  • diffuse neoplasia
142
Q

prolonged opacification kidney indicates (excretory urography) 3

A
  • renal vein thrombosis
  • obstruction of renal pelvis
  • acute renal failure
143
Q

prep for contrast study bladder 2

A
  • starve for 24-36 hours

- cystocentesis

144
Q

pneumocystogram indications (3)

A
  • visualise ureteral arrival
  • bladder wall lesions
  • bladder location
145
Q

how to pneumocystogram

A
  • 4-11ml/kg of air

- take left lateral and VD view

146
Q

positive contrast cystogram how to 2

A
  • 4-11ml/kg pure contrast

- prefil catheter to avoid air bubbles

147
Q

positive contrast cyctogram indications 3

A
  • bladder rupture
  • bladder hypoplasia
  • abnormal bladder position
148
Q

double contrast cystogram indications

A
  • differentiate between calculi and blood clots

- visualise bladder wall lesions

149
Q

double contrast cystogram how to (2)

A
  • swirl around small volume of contrast

- add air

150
Q

retrograde urethrogram used to

A

diagnose urethral neoplasia, stricture, calculi and ectopic ureter

151
Q

how to retrograde urethrogram

A
  • use 10-15ml in dogs
  • use 5-10ml in cats
  • positive contrast
  • take a couple of lateral view immediately
  • for male keep bladder partially full and dilute contrast with saline 1:1
152
Q

ventral bladder displacement indicates (2)

A
  • abdominal wall hernia

- inguinal hernia

153
Q

cranial bladder displacement indicates

A

prostatomegaly

154
Q

caudal bladder displacement indicates (1)

A

perineal hernia

155
Q

radiopaque calculi indicate (3)

A
  • calcium oxalate
  • silica
  • triple phosphate
156
Q

non radiopaque calculi indicate (2)

A
  • cystine

- urate

157
Q

irregular mucosal surface urethra due to (2)

A
  • neoplasia

- urethritis

158
Q

urethral displacement due to (3)

A
  • adjacent mass
  • hernia with bladder displacement
  • asymmetric prostatic disease
159
Q

bladder wall thickness (2)

A
  • 5mm when empty

- 2mm when full

Renal (3 decks)

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