SAM4 Flashcards
Which one of the following is true in case of tubular proteinuria
1. Small sized proteins appear in the urine
2. UPC >2
3. UPC <0
4. Ketonuria
Small sized proteins appear in the urine
IRIS stage 1 chronic renal failure is associated with
1. Azotemia
2. Anaemia, metabolic acidosis
3. Uremia
4. Decreased specific gravity of urine
Decreased specific gravity of urine
The creatinine level of dogs and cats with IRIS stage 1 chronic kidney disease is
1. Normal <140
2. >240 umol/L
3. >340 umol/L
4. 440 umol/L
Normal <140
IRIS classification of CKD. Wrong answer
1. 4 stages determined by serum creatinine levels
2. Stage 1 the creatinine is only mildly elevated
3. Substages based on presence of proteinuria
4. Substages based on degree of hypertension
Stage 1 the creatinine is only mildly elevated
The progression of renal disease is caused by… Which is not correct?
1. Proteinuria
2. Isosthenuria
3. Hyperparathyroidism
4. Glomerular hypertension
Isosthenuria
Which statement is true about the progression of CKD?
1. Hypertension and proteinuria can increase the hyperfiltration of the nephrons
2. Renal fibrosis is primarily caused by the excessive production of parathormone
3. The progression of CKD is generally reversible with specific therapy
4. The loss of functional nephrosis leads to an increase in the glomerular filtration rate
Hypertension and proteinuria can increase the hyperfiltration of the nephrons
It prolongs the survival of dogs and cats with chronic kidney disease
1. Increased phosphorus intake
2. Medical reduction of proteinuria
3. Urinary diet
4. ABC are all true
Medical reduction of proteinuria
Which therapy is not recommended for the treatment of dehydration in chronic kidney
disease?
1. Administration of intravenous infusion
2. Administration of subcutaneous infusion
3. Increase of water consumption
4. Dialysis treatment
Dialysis treatment
Which is not an indication for dialysis treatment?
1. Anuric acute kidney injury
2. Polyuric acute kidney injury unresponsive to fluid therapy
3. Chronic renal failure, renal fibrosis
4. Removal of toxins in case of acute toxicosis
Chronic renal failure, renal fibrosis
Treatment of chronic kidney disease (CKD) patients include… Which answer is not correct?
1. Renal diet, phosphate binders
2. ACE-inhibitors, antihypertensive drugs
3. Erythropoietin inj., potassium supplementation
4. Diuretics per os
Diuretics per os
In case of elevated blood creatinine concentration
1. The animal is uremic azote
2. The animal has kidney disease
3. The animal has azotemia
4. The animal was fed with too much protein
The animal has azotemia
Which of the following suture materials is not recommended for cystotomy wound closure?
1. PDS
2. Polyglyconate
3. Gltcomer
4. Poliglecaprone
Poliglecaprone
Which of the following suture patterns is not recommended for cystotomy wound closure?
1. Double layer continuous lembert
2. Double layer (penetrating lembert) suture
3. Single layer seromuscular continuous suture
4. Double layer interrupted lembert
Double layer (penetrating lembert) suture
Which of the following findings indicates the diagnosis of the urinary bladder rupture?
1. If the cystourethral catheterization cannot harvest urine in a traumatized patient
2. If the urine is blood obtained via cystourethral catheterization in a traumatized patient
3. If the contrast leakage is confirmed by positive anterograde cystography
4. If the contrast leakage is confirmed by positive retrograde cystography
If the contrast leakage is confirmed by positive retrograde cystography
Which of the following tools/findings is of the lowest diagnostic value in the diagnosis of
urinary bladder tumours?
1. Double contrast cystography
2. Ultrasonography
3. Urine sediment analysis/cytology
4. Therapy-irresponsive hematuria
Therapy-irresponsive hematuria
Abnormalities that are typical for chronic renal disease. Which answer is wrong?
1. Hypertension
2. PU/PD
3. Hypophosphatemia
4. Hypokalaemia
Hypophosphatemia
What is not typical for acute kidney failure?
1. Azotaemia
2. Hypokalaemia
3. Oliguria, anuria
4. Metabolic acidosis
Hypokalaemia
Which circumstances may cause nephrosis/acute kidney injury? Which answer is wrong?
1. Hypotension, dehydration
2. Overhydration with crystalloid infusion
3. Hypothermia, NSAID therapy
4. Antibiotics, chemotherapy
Overhydration with crystalloid infusion
Postrenal azotzemia… Which is the wrong answer?
1. May be due to urethral obstruction
2. May cause kidney damage without treatment
3. May be due to severe dehydration
4. May be due to ureter rupture
May be due to severe dehydration
Which one of the following is not typical in case of acute kidney injury
1. Cachexia
2. Vomitus
3. Metabolic acidosis
4. Uraemic ulcers
Cachexia
Which one of the following is not typical in case of babesiosis?
1. Myoglobinuria
2. Icterus
3. Vomitus
4. Acute kidney injury
Myoglobinuria
Which of the following therapeutic steps is to be taken first after diagnosing urethral
obturation in male dogs
1. Urethral hydropropulsion
2. Prescrotal urethrostomy
3. Scrotal urethrostomy
4. Perineal urehtrostomy
Urethral hydropropulsion
True about urohyudropropulsion
1. Requires good surgical skills
2. No sedation is required
3. Renal pelvis is connected to the bladder with special shunt
4. This technique may be suitable for removing small stones from the urinary
bladder
This technique may be suitable for removing small stones from the urinary
bladder
What is the advantage of scrotal urethrostomy
1. Castration can prevent urinary incontinence
2. The perineal urethrostomy can be avoided
3. Easily dissectable urethrenlargeal section, wide and safe stoma
4. The cystotomy can be avoided
Easily dissectable urethrenlargeal section, wide and safe stoma
Which of the following factors does not affect the success of feline perineal urethrostomy?
1. Mucocutaneous approximation of the stoma
2. Transection of bulbospongiosus muscle
3. Transection of ischiocavernosus muscle
4. Type of suture material
Transection of bulbospongiosus muscle
Which one of the following is indicated in case of unilateral hydronephrosis?
1. Partial nephrectomy nephrosis
2. Unilateral nephroureteroectomy
3. Kidney drainage
4. Euthanasia
Unilateral nephroureteroectomy
Which of the following does not cause hydronephrosis?
1. Urethral stricture associated with previous surgery
2. Urethral torsion
3. Urethral tumor
4. Urethrolithiasis
Urethral torsion
Possible causes of hydronephrosis, which is the wrong answer?
1. Ureter stone
2. Granuloma formation following neutralization
3. Ascending infection
4. Transitional cell carcinoma in the bladder
Ascending infection
Causes of acute nephrosis.. Which is wrong?
1. Immune complex deposition
2. Renal ischaemia
3. Nephrotoxic materials
4. Hemoglobin, myoglobin
Immune complex deposition
What statement is true about immune-complex glomerulonephritis?
1. Diagnosis is made based on the typical US image of the kidneys
2. Urine protein/creatinine ratio is typically high
3. An important element of therapy is broad-spectrum AB treatment
4. Serum albumin level is increased
Urine protein/creatinine ratio is typically high
Oliguria definition dog
1. Urine output less than 50 ml/ttkg/day
2. Urine output less than 100 ml/ttkg/day
3. Urine output less than 30 ml/ttkg/day
4. Urine output less than 6-10 ml/ttkg/day
Urine output less than 6-10 ml/ttkg/day
Oliguria in the dog/etiology
1. Chronic renal disease, nephrosis/nephritis, pyometra
2. Inadequate water intake, dehydration, acute nephrosis
3. Dehydration, renal insufficiency, chronic liver disease
4. Endocrine disorders, hepatopathies
Inadequate water intake, dehydration, acute nephrosis
Which of the following statement is incorrect regarding nephrolithiasis?
1. It can occur bilaterally
2. It can lead to ureterolithiasis
3. It can be caused by congenital disorder
4. Dalmatians always form urate uroliths
Treatment of nephritis
1. ACE inhibitors, omega-3 fatty acids
2. Puncture and flushing of the renal pelvis
3. Systemic antibiotics (?)
4. Fluid therapy
FALSE: Puncture and flushing of the renal pelvis
Which is the least important to establish the diagnosis of kidney disease
1. Blood urea creatinine measurement
2. Measurement of blood phosphorus, calcium and potassium levels
3. Urine sediment evaluation and urine specific gravity measurement
4. Detection of proteinuria
Measurement of blood phosphorus, calcium and potassium levels
The suspicion of antifreeze poisoning is supported by… Which answer is wrong from the list
below?
1. The demonstration of calcium-dihydrate crystals in urine sediment
2. The detection of ethylene-glycol in blood
3. Detection of ethylene glycol in urine
4. The observation of marked halo-signs in the kidneys during ultrasonography
The demonstration of calcium-dihydrate crystals in urine sediment
Which of the following uroliths appears in case of ethylene-glycol toxicosis?
1. Struvite
2. Calcium-oxalate dihydrate
3. Calcium-oxalate monohydrate
4. Purine
Calcium-oxalate monohydrate
Antidote of ethylene glycol toxicosis
1. Etil alcohol
2. Fomepizole
3. Both
4. Neither
Both
Which of the following uroliths appears usually in case of dog’s bacterial cystitis?
1. Urate
2. Calcium oxalate monohydrate
3. Cystine
4. Struvite
Struvite
Which treatment is not recommended in feline interstitial cystitis (FIC)?
1. Increased water intake
2. Facial pheromones
3. Urine acidification
4. Adding toys, scratching posts, climbing, hiding places, additional litters
Urine acidification
What is not true for feline interstitial cystitis (FIC)
1. Antibiotics (AB) are useless
2. Affected cats mostly fed dry food
3. Affected cats are mostly outdoor animals
4. Affected cats are mostly neutered animals
Affected cats are mostly outdoor animals
How do you treat a cat with FIC
- Increase water intake
Which of the following means urination not at the proper place?
1. Stranguria
2. Pollakiuria
3. Dysuria
4. Periuria
Periuria
The most common lower urinary tract disease of cats
1. Prostate disease
2. Idiopathic cysts
3. Urolithiasis
4. Bacterial cystitis
Urolithiasis
The second most common lower urinary tract disease of dogs
1. Prostate disease
2. Sterile cystitis
3. Urolithiasis
4. Bacterial cystitis
Urolithiasis
Bacterial cystitis = most common
Most common causes of lower urinary tract diseases in dogs
1. Bladder tumor, prostate alterations
2. Anatomical disorders, foreign bodies
3. Bacterial infection, urolithiasis
4. Interstitial cystitis, mycoplasma
Bacterial infection, urolithiasis
The most important aspect of struvite urolithiasis treatment in dogs
1. Diet
2. AB
3. Urine acidification
4. All 3
All 3
What is the most common cause of struvite urolithiasis in dogs?
1. Neutering in bitches
2. Chronic bacterial urinary tract infection
3. Dietary anomaly
4. Inadequate response to stressors
Chronic bacterial urinary tract infection
What is the cause of purine urolithiasis?
1. Hyperuricosuria
2. Portosystemic shunt
3. Chronic liver disease
4. All 3
All 3
In dogs, which type of urolithiasis can be affected by housing conditions, lifestyle and body
condition?
1. Struvite
2. Calcium oxalate
3. Purine
4. Cystine
Calcium oxalate
Fanconi syndrome symptoms in dogs: which answer is wrong?
1. Glucosuria
2. Metabolic acidosis
3. Aminoaciduria
4. Ketonuria
Ketonuria
Renal cysts
1. Are always congenital
2. Are always bilateral
3. Are mainly incidental findings
4. Generally cause renal failure
Are mainly incidental findings
Renal amyloidosis typically found in… Which cat breed?
1. Persian
2. Siamese
3. Abyssinian
4. Bengal
Abyssinian
Renal amyloidosis typically found in… Which dog breed?
1. Basenji
2. Shar-pei
3. Hungarian vizsla
4. Poodle
Shar-pei
Renal amyloidosis is typically not caused by
1. Chronic inflammatory processes
2. Neoplastic process
3. Chronic liver disease
4. Genetic (familiar) causes
Chronic liver disease
What is not true about renal glycosuria?
1. It is caused by glomerular disease
2. Plasma glucose levels are normal
3. Can have genetic causes
4. May be a part of fanconi syndrome
It is caused by glomerular disease
Cause of glomerular diseases in small animals. Not correct
1. Adhesions of immune complexes to the basement membrane
2. Ischemia, nephrotoxic materials
3. Amyloidosis
4. Congenital/acquired basement membrane/podocyte injury
. Ischemia, nephrotoxic materials
How would you treat a diagnosed cat with interstitial cystitis?
1. Antibiotics
2. Urine acidifying diet
3. Catheterization, flushing the bladder with isotonic saline
4. Increase water
Increase water
Which statement is true about animals with renal dysplasia?
1. Kidneys are typically enlarged on US with a thick cortex
2. In such cases, there are usually no changes in the urine, only in the blood
3. Common symptoms are polyuria and polydisia
4. On a physical examination the kidneys are usually painful
Common symptoms are polyuria and polydisia
Which therapeutic measure decreases blood potassium level during the treatment of
hyperkalaemia? Choose the wrong answer
1. IV calcium
2. Potassium free infusion and furosemide
3. Glucose containing infusions
4. Rapid acting insulin applications
Iv calcium
What is the main and initiating cause of the calcium-phosphorus imbalance in chronic renal
failure?
1. Inadequate vitamin D production
2. Poor absorption of calcium from the GI tract
3. Retention of phosphorous
4. Nephrocalcinosis
Retention of phosphorous
The following is not true about polycystic kidney disease
1. Is often asymptomatic
2. Renal abscesses may develop in case of bacterial infection of the cyst
3. Ultrasound examination is required to make a diagnosis
4. Treatment is often surgical
Treatment is often surgical
Not true about polycystic kidney disease
1. Painful kidney
2. Hematuria
3. Don not have >1 year to live
4. Inherited
Don not have >1 year to live
The most effective gastric protectant for dogs with chronic kidney disease is
1. Pantoprazole
2. Famotidine
3. Sucralfate
4. Benazepril
Pantoprazole
Which urinary stone type can not be dissolved medically?
1. Struvite
2. Cystine
3. Purine
4. Calcium oxalate
Calcium oxalate
It typically causes acute or chronic kidney disease: pre-existing chronic kidney disease, plus
1. Polypoid cystitis
2. Hemodynamic disturbance
3. Hyperthyroidism
4. Hepatopathy
Hemodynamic disturbance
Until what level is it recommended to increase the hematocrit (Ht) with
erythropoietin/darbepoetin therapy in chronic kidney disease?
1. Until Ht is 22-25%
2. Until Ht is around 30%
3. To normal range
4. The success of the treatment does not depend on the Ht value
Until Ht is around 30%
When is it recommended to start erythropoetin/darbepoetin therapy in chronic kidney
disease?
1. If cyanosis is already occurring due to hypoxia
2. When the hematocrit level drops to 18-20%
3. Only when clinical signs of hypoxia are already present, not earlier
4. If the systolic blood pressure is >180 mmHg
When the hematocrit level drops to 18-20%
Recommended concomitant with erythropoietin/darbepoetin
1. Subcutaneous infusion, because the side effect of treatment is often dehydration
2. Gastric protection, because the side effect of treatment is often ulcer formation
3. Mirtazapine because the side effects (SE) of treatment is often anorexia
4. Iron and B12
Iron and B12
Hypercholesterolemia is typically associated with the following kidney disease
1. Glomerulopathies of dogs
2. Chronic kidney disease of cats
3. Acute kidney injury of dogs
4. Fanconi syndrome
Glomerulopathies of dogs
Which statement is correct about glomerulopathies?
1. 75% of glomerulopathies is amyloidosis
2. 50% of glomerulopathies is amyloidosis
3. 15% of glomerulopathies is of immune complex origin
4. 50% of glomerulopathies is of immune complex origin
50% of glomerulopathies is of immune complex origin
Which statement is correct regarding ectopic ureter
1. It may cause dysuria
2. In acquired form, the incontinence recurring
3. The urinary incontinence might be combined with normal micturition episodes
4. The urinary incontinence is always constant
The urinary incontinence might be combined with normal micturition episodes
Ectopic ureters… Which answer is wrong?
1. Are usually causing constant urine dripping
2. Are occuring only in females
3. Can be diagnosed by x-ray or CT-exam
4. Can be diagnosed with cystoscopy
Are occuring only in females
Which of the following breeds is usually not affected by ectopic ureter?
1. Labrador
2. Husky
3. German shepherd
4. West highland white terrier
German shepherd
Which of the following is the most informative one for diagnosing ectopic ureters?
1. Cystoscopy
2. Double contrast cystography
3. Intravenous urography pneumocystography
4. Urinary scintigraphy (TcO4-)
Cystoscopy
Which treatment does not affect the PTH-level in chronic renal cases?
1. Feeding renal diet
2. Adding phosphorous binders to the diet
3. ACE inhibitor therapy
4. Vitamin D administration
ACE inhibitor therapy
What statement is correct? In case of renal traumatic bleeding
1. The abdominocentesis is always positive (blood)
2. The plain abdominal radiography is usually pathogenic
3. Retroperitoneal blood loss may even lead to exsanguination
4. Retroperitoneal blood loss may occur but usually does not lead to life threatening
circulatory changes
Retroperitoneal blood loss may even lead to exsanguination
Which of the following procedures is not recommended for surgical resolution of prostatic
cysts?
1. Marsupialisation
2. Omentalisation
3. Drainage
4. Puncture
Puncture
If a cat has enlarged kidneys, which diagnosis is not probable?
1. PKD
2. Hydronephrosis
3. Lymphoma of the kidneys
4. Renal fibrosis
Renal fibrosis
Prerenal azotemia… Which is the wrong answer?
1. May be due to dehydration
2. May cause kidney damage without treatment
3. Can be corrected with fluid therapy
4. May be caused by urine leakage into the abdomen
May be caused by urine leakage into the abdomen
Persistent, prerenal proteinuria…
1. Is a typical characteristic of urinary tract infections
2. Occurs after heavy physical activity
3. Bence-jones proteins are typical examples for it
4. Is a typical characteristic of leptospirosis
Bence-jones proteins are typical examples for it
Renal proteinuria can be decreased by
1. Renal diet
2. Antihypertensive drugs
3. ACE-inhibitors
4. All 3
All 3
Which is the most important test for diagnosing glomerulonephropathies?
1. Determination of the blood creatinine and urea values
2. Determination of the urine specific gravity by a refractometer
3. Detection of severe proteinuria
4. Examination of the urine sediment
Detection of severe proteinuria
To determine the urine concentrating ability of the kidneys we use
1. Blood urea levels
2. Urinary total protein/creatinine ratio (UPC)
3. Urine specific gravity with a refractometer
4. Blood creatinine and SDMA levels
Urine specific gravity with a refractometer
Not a typical laboratory alteration in CKD
1. Hypolalemia
2. Anemia
3. Hyperphosphatemia
4. Metabolic alkalosis
Metabolic alkalosis
What is your diagnosis if glucosuria appears in case of euglycemia?
1. Cushing’s disease
2. Addison’s disease
Addison’s disease
Causes of anemia in chronic kidney patients. Which answer is not correct
1. Lack of erythropoietin
2. GI bleeding/ulcers
3. Decreased survival of RBC
4. Hemolysis
Hemolysis
Which statement is true for pyelonephritis?
1. The bacteria usually reach the renal pelvis from the systemic circulation
2. We can get a sample for diagnostic tests by aspirating the renal pelvis
3. On US we find shrunken kidneys
4. Usually the urinary sediment is unchanged because the inflammation is limited to the
renal pelvis
We can get a sample for diagnostic tests by aspirating the renal pelvis
You can diagnose pyelonephritis by… Which answer is wrong?
1. Hemoculture in case of azotaemia
2. The histological examination of a renal biopsy specimen
3. Visualizing pelvis dilation with imaging methods and performing urine cultures
4. The microbiological examination of a renal pelvis puncture
Hemoculture in case of azotaemia
Which statement is true about the treatment of pyelonephritis?
1. 1-2 weeks of AB therapy is required
2. Aspiration of pus and rinsing of the renal pelvis accelerated healing
3. Treatment if anemia should be started as soon as possible
4. Conservative treatment is usually unsuccessful, thus unilateral nephrectomy is the
solution
Aspiration of pus and rinsing of the renal pelvis accelerated healing
Treatment of pyelonephritis: Which answer is wrong?
1. ACE-inhibitors, omega 3 fatty acids
2. Puncture and flushing of the renal pelvis
3. Systemic AB
4. Fluid therapy
ACE-inhibitors, omega 3 fatty acid
True. Subclinical bacteriuria
1. Asymptomatic
2. Only mild lower UTI symptoms
3. Pyelonephritis may be suspected
4. Bacteria in urine as usually multidrug resistant
Asymptomatic
Which statement is false? In case of subclinical bacteriuria
1. Usually a predisposing factor for UTI is present
2. AB therapy (amoxicillin) will be prescribed
3. The urine sediment can be active
4. Microbiological examination of urine is positive
AB therapy (amoxicillin) will be prescribed
Causes of acute interstitial nephritis in small animals
1. E. coli / proteus
2. Antifreeze
3. Leptospirosis
4. Ureter stone
Leptospirosis
False
1. In glomerular proteinuria large protein are excreted
2. Tubular proteinuria, urinary protein/cret ration is very high
3. Borderline proteinuria means UPC is between 0.2 and 0.4 or 5
4. Proteinuria of glomerular or tubular origin can be differentiated by renal biopsy
Tubular proteinuria, urinary protein/cret ration is very high
Most likely diagnosis in cats in case of haematuria
1. FIC
2. Urolithiasis
3. Neoplasia
4. Bacterial cystitis
FIC
Which one of the following is the most likely diagnosis in dogs in case of haematuria?
1. Urolithiasis
2. Benignus prostate gland hypertrophy
3. Bacterial cystitis
4. Neoplasma
Bacterial cystitis
Monitoring blood pressure is particularly important
1. In young animals
2. In FIC
3. In kidney disease
4. In case of heart failure
In kidney disease
Which statement is incorrect concerning acute abdominal catastrophe (peritonitis)
1. The precise diagnosis of particular organ dysfunction is necessary for surgical
indication
2. The diagnosis of acute abdomen is sufficient for surgical indication
3. It definitely requires emergency care
4. It is caused by morphological and/or functional disorders of abdominal organs
The precise diagnosis of particular organ dysfunction is necessary for surgical
indication
What type of proteins are detected with sulfosalicyclic acid test?
1. Albumin and globulin
2. Albumin
3. Globulin
4. None
Albumin and globulin
Which statement is correct? During nephrotomy…
1. The kidney is occluded cia clamping both the renal artery and vein
2. Renal vein is to be occluded so that the arterial supply remains intact
3. Renal artery is to be occluded so that the venous drainage remains intact
4. The ureter is also occluded
The kidney is occluded cia clamping both the renal artery and vein
Which is not typically a target organ that is damaged by hypertension
1. Lungs
2. Brain
3. Kidneys
4. Eyes
Lungs
Polydipsia definition in dog and cat
1. Dog/cat: drink over 50 ml/bwkg/day
2. Dog: water intake over 80-100 ml/bwkg/day, cat: water intake over 50
ml/bwkg/day
3. Dog/cat: water intake over 100 ml/bwkg/day
4. Dog: water intake over 50 ml/bwkg/day, cat: water intake over 100 ml/bwkg/day
Dog: water intake over 80-100 ml/bwkg/day, cat: water intake over 50
ml/bwkg/day
Typical symptoms of renal tubular acidosis
1. Metabolic acidosis
2. Incontinence
3. Polyuria, polydipsia
4. Bone development disorders
Metabolic acidosis
Choose the correct answer! High-dose maintenance fluid therapy (>100 ml/kg/day) for acute
kidney injury
1. It increases diuresis, thus flushes the kidneys faster
2. May cause interstitial edema in the kidneys, that decreases GFR and renal
blood flow
3. Ensures adequate daily fluid intake in anorexic animals
4. In anuria, it ensures that renal function and urine production are restored quickly
May cause interstitial edema in the kidneys, that decreases GFR and renal
blood flow
