renal disease Flashcards
1
Q
define dysuria
A
difficult urination
2
Q
define oliguria
A
low amounts of wee
3
Q
define anuria
A
no wee
4
Q
define stranguria
A
slow and painful urination
5
Q
define pollakiuria
A
frequent urination
6
Q
define nocturia
A
weeing at night
7
Q
normal urine output for dog and cat
A
15-45ml/kg/day
8
Q
9 signs associated with upper urinary tract disease
A
- polyuria
- polydipsia
- oliguria
- anuria
- depression
- lethargy
- halitosis
- oral ulcerations
- haematuria
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
10
Q
3 methods urine collection
A
- free catch
- catheter
- cystocentesis
11
Q
cons urine catheter sample
A
cant look for haematuria as may be from damage due to catheter
12
Q
urinary catheter cat male
A
- protrude penis
- straighten using forceps on the prepuce
- put catheter in till it goes no further
13
Q
how to urinary catheter large female dog
A
put finger in vagina and slip catheter underneath
14
Q
how retrograde vaginourethro cystographs
A
contrast injected caudal to cranial
15
Q
antegrade urethro cystography how
A
contrast injected cranial to caudal
16
Q
2 indicators of GFR
A
serum levels of
- urea
- creatinine
17
Q
how get rid of urea in small animals
A
in wee
18
Q
how ruminants get rid of urea
A
- in rumen
- in wee
19
Q
2 causes prerenal azotemia
A
- decreased renal perfusion
- increased protein catabolism
20
Q
how many nephrons need to stop working for renal azotemia to start
A
3/4
21
Q
define isothenuria
A
fixed specific gravity. so kidney is not concentrating urine
22
Q
define hyposthenuria
A
low speficic gravity but kidney can still change concentration a bit
23
Q
if serum creatinine is high then urine SG should be
A
high
24
Q
amylase and lipase excretion
A
out through the kidneys
25
anaemia and renal disease why
no erythropoietin production
26
high protein diet and urine pH
low
27
high veg diet and urine pH
high
28
2 causes of ketonuria
- poorly controlled diabetics
| - starvation
29
what will be increased during renal failure (5)
- urea
- creatinine
- potassium
- phosphates
- metabolic acidosis
30
increased potassium causes
cardiac arrhythmias
31
increased phosphate causes
increased bound calcium so muscle tremors and coma
32
7 microscopy chronic renal failure
- thin cortex
- increased interstitial connective tissue
- decreased renal tubules
- thickened basement membrane
- calcification of vessels and basement membrane
- multiple cysts
- glomerulosclerosis
33
define uraemia
toxic syndrome sometimes seen in kidney failure
34
what GFR to make secondary renal hyperparathyroidism occur
uber 25% as phosphate no longer adequately expcreted
35
how does increased phosphate cause hyperparathyroidism
- 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
36
PTH causing calcium to leave bones causes (2)
- fibrous osteodystrophy
| - mineralisation of soft tissue due to increased phosphate
37
where fibrous osteodystrophy seen most commonly (2)
- mandible
| - maxilla
38
3 causes hypercalcaemia
- secondary renal parathyroidism
- primary hyperparathyroidism
- vit D intoxication
39
non renal lesions of kidney failure (7)
- 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
40
ulcerative glossitis and stomatitis appearance
- usually bilaterally symetrical
- foul smelling
- brown mucoid material
41
define glossitis
inflammation of the tongue
42
define stomatitis
inflammation of mucous lining of mouth
43
gastric ulceration causes
black tarry vomit
44
uraemic encephalopathy why in renal failure
occurs due to white matter spongiform degeneration
45
uraemic pneumonitis define
inflammation of lung tissue
46
uraemic pneumonitis causes (4)
- vasculitis of alveolar capillaries
- pulmonary oedema
- fibrin exudation
- mild infiltrate of macrophages and neutrophils
47
uraemic peritonitis causes
patchy diffuse pulmonary calcification
48
fibrous pericarditis characterised by
fine granular depositis of calcium on the endocardium
49
arteritis in renal failure see
fine granular plaques in left atrial endocardium, proximal aorta and pulmonary trunk
50
arteritis causes loss of
anticoagulant antithrombin 3 by glomerular leakage so thrombi form
51
kidney is covered in
retroperitoneum
52
define renal aplasia
failure for kidney to develop
53
define renal hypoplasia
incomplete development of the kidney
54
define ectopic kidneys
kidneys in the wrong place
| - usually normal in structure and function but position can for a problem with the ureters
55
define fused kidneys
- where kidneys are fused at the cranial or caudal pole
| - usually structurally and functionally normal
56
define renal dysplasia
abnormal differentiation of the kidney
57
8 define progressive juvenile nephropathy
- like dysplasia
- severe bilateral renal fibrosis
- shrunken pale kidneys
- pitted surface
- foetal glomeruli
- interstitial inflammation
- fibrosis
- tubular dilation
58
appearance renal cysts
thin walled spherical, clear fluid filled, distension of cortical or medullary tubules
59
cause of renal cysts
- congenital
- secondary to renal dysplasia
- acquired
60
how aquire a renal cyst
intralobular obstruction
61
damage to glomerulus causes
protein loosing nephropathy
62
prolonged renal protein loosing nephropathy leads to
decreased antithrombin 3 so causing nephrotic syndrome
63
nephrotic syndrome characterised by (5)
- general oedema
- ascites
- pleural effusion
- hypercoagulability
- hypercholesterolemia
64
define immune mediated glomerulonephritis
- 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
diagnose immune mediated glomerulonephritis
fluorescent deposits indicate presence of immunoglobulins on compliement
66
appearance of immune mediated glomerulonephritis 3
- glomeruli are red/pale dots on cut surface of cortex
- adherent capsule
- granularity to cortical surface
67
7 histology immune mediated glomerulonephritis
- 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
glomerular amyloidosis appearance (5)
- enlarged
- pale
- finely granular capsular surface
- glomeruli visible as fine glistening dots
- iodine stains glomeruli brown
69
staining amyloid deposits
congored will make it have an apple green birefringence with polarised light
70
acute suppurative glomerulitis also known as
bacterial or embolic nephritis
71
how get acute suppurative glomerulitis
bacteria lodge in glomerular and interstitial capillaries and form microabscesses in cortex
72
cause of acute suppurative glomerulitis foals
actinobacillus equi
73
cause of acute suppurative glomerulitis pigs
erysipelothrix rhusiopathiae
74
cause acute suppurative glomerulitis sheep and goats
corynebacterium pseudotuberculosis
75
cause acute suppurative glomerulitis cattle
arcanobacterium pyogenes
76
appearance acute suppurative glomerulitis
multifocal random raised tan pinpoint foci subcapsular and on cut surface of cortex
77
histology acute suppurative glomerulitis (2)
- numerous bacterial colonies with necrotic debris and neutrophils
- glomerular or interstitial haemorrhage
78
what happens in glomerulosclerosis (6)
- 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
nephron repair can occur if
basement membrane is intact
80
primary renal glycosuria is
- an inherited condition
| - affects capactity for reabsorption of glucose from the nephron
81
define fanconic syndrome
- hereditary defect
| - cant reabsorb protein, glucose, phosphate or amino acids in the nephron
82
define cystinuria
- sex linked inherited tubular defect in male dogs
| - predisposes them to calculus formation
83
most important cause of renal faillure
acute tubular necrosis
84
cause of acute tubular necrosis
nephrotoxic or ischaemic injury to renal tubular epithelial cells
85
nephrotic pigment in sheep
chronic copper toxicity
86
babesiosis in cattle causes (kidney)
haemoglobinuric nephrosis
87
define myoglobinuric mephrosis
muscle necrosis as lots of myoglobin excreted by kidney
88
haemoglobin/myoglobin and tubular necrosis
does not cause tubular necrosis but contributes to it
89
lead can caus kidney
mitochondrial damage to cells in PCT
90
mycotoxins, oak poisoning and oxalate containing plants cause what kidney
acute tubular necrosis
91
ethylene glycols is made into what in liver
oxadised by hepatic alcohol dehydrogenase into toxic metabolites like glycolic acid and oxalate
92
what do calcium oxalate crystals from ethylene glycol do in kidney
precipitate in lumen causing obstruction
93
pulpy kidney caused by
bacterial toxins like epsilon toxin from clostridium perfringens causing acute tubular necroisis
94
renal interstitial disease appearance
coalescing grey foci on capsular and cut surface
95
renal interstitium in
fibrovascular stroma that surrounds the nephron
96
E.coli septicaemia kidney causes
white spotted kidney
97
E.coli septicaemia kidney can be (2)
- embolic nephritis
| - non-suppurative interstitial nephritis
98
E.coli septicaemia kidney appearance
microabscesses replaced by lymphocytes, plasma calls and macrophages
99
equine arteritis virus and PRRS causes kidneys (2)
- mulitfocal lymphohitiocytic tubulointerstitial nephritis with interstitial oedema
- vasculitis with fibrinoid necrosis and lymphohistiocytic infiltrates
100
canine adenovirus infection kidneys
sets up viraemia which localises in glomeruli
101
canine adenovirus infection kidney lives
tubular epithelium for weeks-months
102
appearance canine adenovirus infection kidney
- basophilic intranuclear viral inclusions
| - virus cytolysis causing tubular epithelial necrosis
103
leptospirosis kidney
- bacterial tubulointerstitial nephritis
- leptospiraemia
- migrates through vascular endothelium can persist in interstitial spaces and tubular lumen
104
feline infectious peritonitis and kidney
granulomatous necrotising vasculitis with interstitial pyogranulomas
105
infarction kidney appearance (5)
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
primary tumours of the kidney are usually
malignant and metastatic
107
renal carcinoma appearance
large with foci of haemorrhage necrosis and cystic degeneration
- pale kidney
108
define hydronephritis
dilation of renal pelvis due to obstruction of renal outflow
109
hydronephrosis steps (5)
- increased pressure
- atrophy of renal parenchyma
- interstitial vessels collapse
- renal blood flow decreases
- hypoxia and ischaemic necrosis
110
define pyonephrosis
infected pus filled hydrophephritis
111
whats worse uni or bilateral hydronephritis
unilateral as other kidney compensates and it gets worse
112
pyelonephritis is a form of
suppurative tubulointerstitial disease
113
2 causes of primary papillary necrosis
- prolonged use of NSAIDs
| - decreased PG (vasodilator) synthesis
114
cause of secondary papillary necrosis
decreased blood flow
115
appearance papillary necrosis
sharply delineated coagulative necrosis of inner medulla which eventually sloughs causing detachment of renal pelvis
116
how do ureters enter the bladder
obliquely through vesiculoureteral valve
117
5 lower urinary tract defences
- flushing of urine
- peristalsis
- inhospitable environment
- urethral mucous coating
- immune responses
118
define ectopis ureters
empty into werid places
119
define patent urachus
where foetal urachus doesnt close
120
patent urachus associated with
congenital urethral obstruction
121
define urolithiasis
urinary calculi (uroliths) (stones)
122
alkaline pH urine and uroliths (2)
- struvate crystals
| - carbonate crystals
123
acidic pH and uroliths
oxalate crystals
124
clinical signs acute cystitis (3)
- dysuria
- stranguria
- haematuria
125
common cause of cystitis
urease producing bacteria
126
chronic cystitis is (3)
- diffuse
- follicular
- polypoid
127
appearance follicular cystitis
small red nodules on mucosa surface
| hyperplastic lymphoid cells surrounded by hyperaemia and haemorrhage
128
appearance diffuse cystitis (3)
- thickened mucosa due to infiltration with mononuclear inflammatory cells
- submucosal fibrosis
- muscularis hypertrophy
129
appearance polypoid cystitis
multiple peripheral nodules of connective tissue
130
emphysematous cystitis define
glucosuria enhances bacterial growth releasing CO2 into bladder
CO2 absorbed by lymphatics
131
toxic cystitis due to
chronic ingestion of bracken fern causing enzootic haematuria, haemorrhage, chronic cystitis and bladder neoplasia
132
transitional cell papillomas or carcinomas appearance
pedunculated
133
appearance leiomyomas bladder
circumscribed pale firm masses resembling smooth muscle
134
which kidney more cranial
right
135
prostate radiographic appearance (4)
- 2/3 renal pelvis inlet size
- round to oval shape
- soft tissue opacity
- caudal to bladder neck
136
3 indications for excretory/intravenous urography
- visualisation of kidney size, shape, location, integrity of kidney and ureters
- qualitative assessment renal function
- pelvis assessment
137
3 contraindications exceretory/intravenous urography
- dehydration
- hypersensitivity to contrast
- severe heart disease
138
uniform opacity to kidneys indicate 4 (excretory urography)
- compensatory hypertrophy
- acute glomerular or tubulointerstitial disease
- perirenal pseudocysts
- hypoplasia
139
nonuniform focal opacification kidney indicates 6 (excretory urography)
- neoplasia
- haematuria
- cyst
- infarct
- abscess
- hydronephrosis
140
nonuniform multi focal opacification kidney 6 (excretory urography)
- polycystic disease
- infarcts
- acute pyelonephritis
- chronic generalised glomerular or tubulointerstitial disease
- FIP
- neoplasia
141
no opacification of kidneys indicates 5 (excretory urography)
- aplasia/agenesis
- obstruction or avulsion renal artery
- acute or chronic renal failure
- nephrectomy
- diffuse neoplasia
142
prolonged opacification kidney indicates (excretory urography) 3
- renal vein thrombosis
- obstruction of renal pelvis
- acute renal failure
143
prep for contrast study bladder 2
- starve for 24-36 hours
| - cystocentesis
144
pneumocystogram indications (3)
- visualise ureteral arrival
- bladder wall lesions
- bladder location
145
how to pneumocystogram
- 4-11ml/kg of air
| - take left lateral and VD view
146
positive contrast cystogram how to 2
- 4-11ml/kg pure contrast
| - prefil catheter to avoid air bubbles
147
positive contrast cyctogram indications 3
- bladder rupture
- bladder hypoplasia
- abnormal bladder position
148
double contrast cystogram indications
- differentiate between calculi and blood clots
| - visualise bladder wall lesions
149
double contrast cystogram how to (2)
- swirl around small volume of contrast
| - add air
150
retrograde urethrogram used to
diagnose urethral neoplasia, stricture, calculi and ectopic ureter
151
how to retrograde urethrogram
- 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
ventral bladder displacement indicates (2)
- abdominal wall hernia
| - inguinal hernia
153
cranial bladder displacement indicates
prostatomegaly
154
caudal bladder displacement indicates (1)
perineal hernia
155
radiopaque calculi indicate (3)
- calcium oxalate
- silica
- triple phosphate
156
non radiopaque calculi indicate (2)
- cystine
| - urate
157
irregular mucosal surface urethra due to (2)
- neoplasia
| - urethritis
158
urethral displacement due to (3)
- adjacent mass
- hernia with bladder displacement
- asymmetric prostatic disease
159
bladder wall thickness (2)
- 5mm when empty
| - 2mm when full
