Samples Material Flashcards
1
Q
Increased BUN, Increased Creatinine, and Variable Specific Gravity is characteristic of _____ Azotemia
A
Post-Renal Azotemia
*Usually with Post-Renal you will Know based on Physical Exam. Ex. Tom Cats straining to Urinate
2
Q
Total Protein is Made up of What Two things?
A
Albumin
Globulins- Alpha, Beta, Gamma
2
Q
Protein considered a Beta Globulin that is Synthesized by the Liver and Functions in Coagulation and Inflammation
A
Fibrinogen
2
Q
Panhyperproteinemia, with Increases in both Albumin and Globulin, what is the Differential?
A
Dehyrdation
2
Q
Increased BUN, +/- Increased Creatinine, and Increased Specific Gravity are Hallmark for with Azotemia?
A
Pre-Renal Azotemia
*May or May not have Increased Creatinine
2
Q
During Pre-Renal Azotemia in a Dehydrated animal, Urine Volume will Decrease and Urine Specific Gravity will ____
A
Increase
*Increased USG is due to Increased Water Conservation. USG will range between 1.030-1.060
2
Q
Red Urine is spun down, The Supernatent is now Clear or Yellow, What is in the Urine?
A
RBC’s
2
Q
Dipstick Urinalysis measures _____ Bilirubin
A
Conjugated
2
Q
Larger Cells in Urine Sediment that often have Visible Nucleus and Granular Appearance that when Present on Urine Sediment Indicates Inflammation
A
White Blood Cells
*Most commonly Neutrophils
*2xs Larger than RBCs
2
Q
In What Species is Lipid in the Urine not very Significant?
A
Cats
*Few Lipid Droplets in Urine Sediment is Normal
3
Q
True/False: During Inflammation, the Liver downregulates Albumin Production
A
True
*During Inflammation Albumin decreases and Globulin Increases
3
Q
Kidney is Incapable of Altering the Amount of Water Leaving the Body leading to a USG of 1.007-1.013
A
Isosthenuria
*The kidney is doing Nothing
3
Q
True/False: Decreased Creatinine is NOT clinically significant
A
True
3
Q
Large, Thin often Angular Epithelial Cells that are commonly seen in Urine Sediment of Free Catch Urine that is Rarely Pathogenic
A
Squamous Epithelial Cells
5
Q
Most prominant Ketone in Animals, that is Not Detected on Dipstick Urinalysis
A
B-Hydroxybuterate
6
Q
During Renal Failure, When GFR is Less than 25% of Normal, Phosphorus excretion is Impaired leading to _____
A
Hyperphosphatemia
*Decreased GFR leads to Hyperphosphatemia
7
Q
Occassionally in Pre-Renal Azotemia, Creatinine will Increase. In which two Animals this most common?
A
Greyhounds
Neonatal Foals
7
Q
Increased BUN, Increased Creatinine and Decreased Specific Gravity is characteristic for which Azotemia?
A
Renal Azotemia
*Isosthenuric
7
Q
When you Get Renal Azotemia, at least ____% of Nephrons are Non-Functioning
A
75
7
Q
Biomarker that Begins to Increase with only 40% Loss of Renal Tubular function and is a great test to Rule out Chronic Renal Failure in Cats
A
Symmetric Dimethylarginine (SDMA)
*Helpful to Diagnose Cats that may be Developing Renal Failure- Can pick it up Earlier
8
Q
Inability to Concentrate Urine causes _____, where 66% of Nephron is non-Functioning typically with Isosthenuria
A
Polyuria
*Common with Renal Failure
9
Q
Liquid Portion of Blood that Contains All the Proteins
A
Plasma
9
Q
In _____ Azotemia you Kidney looses its Concentrating ability leading to Isosthenuria
A
Renal
9
Q
In Dipstick Urine Analysis, ____ should not be Present in Healthy Puppies and in Dogs the Renal Threshold is 180mg/dl
A
Glucose
*Cold Urine Fasely Decreases Urine Glucose
10
Epithelial Cells of the Bladder and Proximal Urethra
Transitional Cells
11
What Techinique uses an Instrument that directs a beam of Light through a Solution that Measures the Amount of Light absorbed
Spectrophotometry
11
Measures the Frequency with Which a Test result will be Normal in Animals without the Disease
Specificity
\*Closer to 100% the Better
11
Any Substance, structure, or process that can be measures in the Body or its products and influence or predict the incidence of outcome or disease
Biomarkers
\*Ex. BUN and Creatinine are Biomarkers
11
Red Urine is spun down, the Supernatent is still Red what is in the Urine?
Hemoglobin or Myoglobin
12
In a patient with Hypoalbuminemia due to \_\_\_\_\_, Glucose, Cholesterol and Urea will be Decreased while Globulins will be Increased
Liver Failure
12
\_\_\_\_\_\_ are not Present in the Urine in Normal Healthy Animals, but will develop in animals with a Negative Energy Balance
Ketones
13
Globulins Synthesized by Lymphoid Tissue that Function in Immunity
Gamma Globulins
\*Ex. IgG, IgM
15
Small Protein that makes up 30-50% of Total Protein that is Synthesized by the Liver and Catabolized by all Tissues
Albumin
16
Number One Differential for Pre-Renal Azotemia
Dehydration
17
True/False: Small amounts of Bilirubin Crystals are normal in HIghly Concentrated Urine of all Species
False
\*Only Normal in Dogs. Abnormal in all other Species
18
Syndrome associated with Glomerular Nephropathy that leads to Hypoalbuminemia, Hypercholesterolemia, Edema, and Hypercoagulability due to Loss of Anti-thrombin
Nephrotic Syndrome
18
Two Differentials for Ketonuria on Dipstick Urinalysis
Negative Energy Balance
Diabetic Ketoacidosis
18
Positive Blood Dipstick Urinalysis due to ____ is commonly caused by Myocyte Damage and the Supernatent will Stay Red after Centrifugation
Myoglobinuria
19
Neoplasia such as Plasma Cell Tumors and B-Cell lymphoma lead to \_\_\_\_\_\_\_
Hyperglobulinemia
\*Plasma Cell Tumors produce a Lot of One type of Globulin
19
Pre-Renal Azotemia due to Increased Urea Production is commonly caused by \_\_\_\_\_
Upper GI Bleed
21
Smallest Protein with the Highest Negative Charge and Biggest Peak on Electrophoresis
Albumin
22
Renal Azotemia leads to Decreased \_\_\_\_\_, leading to Increased BUN and Increased Creatinine
GFR
23
Larger Proteins that don't Migrate as Far and have Small Negative Charge
Globulins
\*Gamma Globulin has Smallest Negative Charge
23
True/False: Antibiotics such as Sulfa Family Drugs and Anti-convulsants can lead to Drug Associated Cystals in the Urine
True
24
Most Common Urine Crystal in Dogs and Cats
Struvites
25
Yellow- Orange Urine is indicative of \_\_\_\_
Bilirubin in Urine
26
Bloodwork of ____ Renal Disease commonly shows Azotemia, Hyperkalemia and Severe Acidemia
Acute
\*Metabolic Acidosis
26
Nonregenerative Anemia, Azotemia, Hyperphosphatemia, Hypokalemia and Polyuria are characteristic of ____ Renal Disease
Chronic
\*Typically have Normal Potassium or Hypokalemia- Differentiate Between Acute Renal Disease
27
Paraproteinuria (Bence-Jones) can be seen with \_\_\_\_\_, where small amounts of Immunoglobulins are being released
Multiple Myeloma
28
Dehydration, Inflammation, and Neoplasia lead to \_\_\_\_\_\_
Hyperglobulinemia
28
In ____ Renal Disease, Patients present with Good Body Condition Scores, GI signs, Oliguria, Hyperkalemia and Depression
Acute
\*Vomiting, Diarrhea. Oliguria leads to Increased Potassium in the Blood
29
If Peritoneal Creatinine is Greater than 2 times Creatinine in the Blood, that is diagnostic for \_\_\_\_
Uroperitoneum
31
\_\_\_\_\_ leads to Hyperglobulinemia that Increases Proportionally with Albumin
Dehydration
31
Smallest Epithelial Cells that are Cuboidal To round with Central Nuclei. Typically if you see these on Urinary Sediment you are concerned about Renal Tubular Injury
Renal Cells
32
In \_\_\_\_Azotemia, You should check if the Patient has been on NSAID therapy or Prednisone
Pre-Renal
\*NSAID and Prednisone leads to GI Ulceration
34
Measurement that Gives us an Idea of the Kidneys Ability to Conserve Water and Produce Concentrated Urine
Urine Specific Gravity
\*Requires 33% Functional Nephrons
37
Refractometer provides an ____ of the Total Protein
Estimate
\*Not completely Accurate
38
Technique where Proteins on Gel are Stained and Quantified with a Densitometer providing a Percentage and Absolute Amount
Electrophoresis
\*Used commonly on Patients with High Total Protein- Determines if we Have a Single Type of Protein like in Neoplasms or Multiple types of Protein like in Inflammation
38
Excessive Urea in Blood with Clinical Signs of Renal Failure
Uremia
39
In _____ Renal Disease, patients have a Poor Body condition score, GI signs, Polyuria and Depression
Chronic
\*Very thin and Tend to be Polyuric
39
Crystals found in Miniature Schnauzers with Urolithiasis, Patients with Hypercalcemia, and Acute Renal Failure
Calcium Oxalate Dihydrate
40
Orange Granules in Crystal Bundles found in Urine Sediment that is most common in Icteric Patients
Bilirubin
\*Icterus
41
Glomerular Nephropathy Renal Disease commonly leads to _____ Syndrome, which is a Protein-Losing Nephropathy leading to Abdominal Transudation with Hypoalbuminemia and Hypercholesterolemia
Nephrotic
42
Yellow Crystals on Urine Sediment that form Aggregates of Granular Material with no Defining Shape and no Clinical Significance
Amorphous
43
Invasive Procedure common for Collecting Urine where Urine is collected with a Needle directly from the Bladder avoiding Bacterial Contamination
Cystocentesis
43
Dipstick Urinalysis is Insensitive to Bence Jones Proteins and Globulins and therefore only Detects \_\_\_\_\_
Albumin
43
Round Epithelial Cells found in the Bladder that if seen in Urine Sediment indicate Hyperplasia with Inflammation in the Bladder as well as Transitional Cell Tumors
Transitional Cells
44
True/False: During Renal Azotemia, Remaining nephrons undergo Hypertrophy
True
44
Azotemia plus _____ is Renal Disease until Proven Otherwise
Isosthenuria (Renal Azotemia)
\*However, not ALWAYS Renal Failure- ex. Diabetes Insipidus
46
Genetic Disorder common in Arabian Horses where they are not able to make Immunoglobulins leading to Hypoglobulinemia
Severe Combined Immunodeficiency Syndrome
47
Cone Shaped Epithelial Cells that if seen on Urine Sediment can Indicate Pyelonephritis
Caudate Cells
\*Rare to See these
48
Rare Casts that are associated with Chronic Renal Disease
Waxy Casts
50
True/False: Serum Protein is often Greater than Plasma Protein
False
\*Plasma Protein is Larger- Contains Fibrinogen
52
Best Indicator of Glomeruli Filtration Rate, that is Not reabsorbed by the Renal Tubules and excreted Unchanged by Kidneys
Creatinine
54
Data Interpretation Error involving Transcription of Results and Misinterpretation or Results
Post-Analytical Error
54
True/False: When looking at a Patients USG we want to be doing that with Blood Work and Knowledge of the Patients Hydration Status
True
56
Hyperglobulinemia due to \_\_\_\_\_\_, Leads to an increase in a Single type of Globulin leading to Monoclonal Gammopathy
Neoplasia
\*Albumin is normal
57
Know this Chart
59
Smallest Protein that has the Highest Net Negative Charge with Fastest Migration
Albumin
61
Kidney is really Concentrating urine where USG is Greater than 1.030
Hypersthenuria
62
True/False: Bilirubinemia will occur Before Bilirubinuria
False
\*We will see Bilirubinuria BEFORE Bilirubinemia- We will see Bilirubin in the Urine before seeing it in the Blood
63
Two Differentials for Hypofibrinogenemia
Liver Failure
DIC
64
Panhypoproteinemia, where there is a Loss in Both Albumin and Globulin, what are the Two Differentials?
Blood Loss (Hemorrhage)
Protein-Losing Enteropathy
\*Both Hypoalbuminemia and Hypoglobulinemia
65
During Acute Renal Failure, Oliguria and Anuria can lead to \_\_\_\_\_, which is life threatening leading to Heart Arrythmias
Hyperkalemia
67
Species that have the Highest Capacity to Concentrate their Urine
Cats
\*USG can range up to 1.080- Incredible capacity to Concentrate Urine
67
Recommended Techique for Urine Culture
Cystocentesis
69
Quality Control Aspect that Gauges how Repeatable the Result is when Assaying the Same Sample
Precision
70
Acetocetic Acid and Acetone are the Only True \_\_\_\_\_, and therefore the ones detected on Dipstick Urinalysis
Ketones
\*B-Hydroxybuterate is not Detected on Dipstick
71
Polyuria occurs when \_\_\_% of Nephrons are Damaged and Azotemia occurs when \_\_\_\_% of Nephrons are Damaged
66%- Polyuria
75%- Azotemia
72
Dehydration and Upper GI Bleed are the most common Differentials for ______ Azotemia
Pre-Renal
74
Positive on Blood for Dipstick Urinalysis means Which Three things may be present in the Urine?
Hemoglobin
Myoglobin
RBCs
75
Dipstick Urinalysis Positive for Blood due to \_\_\_\_, will cause Supernatent to Stay Red after Centrifugation and No Red Blood Cells are found in the Sediment
Hemoglobinuria
76
When Performing a Cystocentesis you want to take care not to Go through the Bladder and hit the \_\_\_\_
Aorta
78
In _____ Azotemia with Dehydration, Blood work will show Increased PCV, TP and Sodium
Pre-Renal
79
True/False: Kidneys have large Functional Reserve Capacity if the Basement Membrane is Intact
True
80
Most Common Neoplastic Cells in Urine Sediment
Transitional Cell Carcinoma
\*Use Traumatic Catheterization to get Sample
81
\_\_\_\_ Urine is acceptable for Urinalysis and Sediment Exam but not for Culture
Voided (Free Catch)
\*Catch Mid-Stream flow
81
Dipstick Urinalysis Positive for Blood that is due to \_\_\_\_, will produce a Clear Supernatent with Centrifugation
Hematuria (RBC)
\*Trauma, Inflammation, Calculi
83
True/False: The Concentration of a Substance is proportional to its Absorbance
True
\*Beer's Law
85
Decreased Renal Blood Flow leading to Decreased GFR and Increased Urea Production are signs of _____ Azotemia
Pre-Renal
87
True/False: Hyperglobulinemia is caused by either Inflammation, Dehydration, or Neoplasia
True
\*Three causes for Hyperglobulinemia
88
Envelope Shaped Crystals that can be a Normal Finding of Stored Urine but are also common causes of Urolithiasis in Miniature Schnauzers
Calcium Oxalate Dihydrate
90
Castrated Males, Straining to Urinate, Distended Bladder or Abdomen are indications of ____ Azotemia
Post-Renal
92
Hemoglobin In Urine will turn the Serum Red, while ____ in Urine doesn't accumulate in Serum and the Serum will not be discolored
Myoglobin
96
Only cause for Hyperalbuminemia
Dehydration
98
As the Concentration of your Substance Increases, its Absorbance will \_\_\_\_
Increase
\*They are Proportional
99
USG in a Dog that Shows the Dog has Adequate Urine Concentrating Ability
1.030
\*The dog is able to Concentrate the Urine
100
Ratio of Blood Urea Nitrogen Resorption by the Kidney
60% Out: 40% Back in
\*40% Urea is Reabsorbed
101
Hump on Electrophoresis that Contains Immunoglobulins
Gamma
101
Glomerular Proteinuria commonly leads to \_\_\_\_\_\_
Hypoalbuminemia
\*Filtration Barrier is Damaged leading to Albumin being Filtered into Urine
104
Retention of Nitrogenous Waste products with Increased BUN and Creatinine in Blood
Azotemia
105
Most Common Method for Measuring Fibrinogen that uses Refractrometry to Provide an Estimate of the Fibrinogen
Heat Precipitation
107
True/False: Hypocalcemia is commonly seen with Renal Failure
False
\*Hypercalcemia
108
Normal Casts that Show up Frequently in Urine Sediment but could indicate Proteinuria or extra-renal Disease
Hyaline Casts
\*Common and show up on about every urine sample. Typically have no Significance but may be due to Pathology
109
Droplets on Urine Sediment that may Indicate Renal Tubular Injury
Lipid Droplets
\*Usually an isolated normal Finding, but may be Renal Tubular Injury
110
True/False: An animal with Azotemia and inappropriately Low USG is always in Renal Failure
False
\*Not always Renal Failure- ex. Diabetes Insipidus and Other Conditions can cause Azotemia and Low USG without Kidney Failure
110
Five Differentials for Hyperglycemic Glucosuria Reading on Dipstick Urinalysis
(High Glucose in Blood and Glucose in Urine)
Diabetes Mellitus
Hyperadrenocorticism
Drugs- ex. Dextrose, Glucocorticoids
Postprandial- just Eaten
Acute Pancreatitis
111
Liquid Portion of Blood that Remains after Clotting and does Not Contain Fibrinogen
Serum
112
Programs that assure both Accuracy and Precision in Data
Quality Control
114
True/False: Biomarkers should be Accurate, Easy to Measure and Noninvasive
True
115
If Urine is collected Free catch with Bacteria Present and no Inflammatory Cells, are we More or Less worried about an Infection?
Less
\*Bacteria in the Environment can Contaminate Samples. If White Cells appear with Bacteria you will be more Concerned of Urinary Tract Infection
116
In Urine Sediment with a USG below 1.008, Red Blood Cells will \_\_\_\_\_
Lyse
117
In Chronic Renal Disease, GFR has dropped Below \_\_\_\_\_\_% of Normal GFR
20-25
119
In Renal Failure Patient's, Anemia will be \_\_\_\_\_\_
Non-Regenerative
\*No Erythropoietin Production
120
Large, Colorless Prism like Crystals that are very common in Dogs and Cats
which in Large Numbers indicate a Crystal Urea that is promoted by Urease-Positive bacteria during a Urinary Tract Infection
Struvite
\*Can be Normal Findings in Cats- found in normal patients in small Numbers.
122
Active Process of Dilute Urine with USG less than 1.007
Hyposthenuria
\*More water is Excreted via the Kidneys
123
Two Differentials for Red Blood Cells in Urine Sediment
Hemorrhage
Inflammation
\*Anything that causes Bleeding into the Urinary Tract
124
Inflammation, Liver Failure, Hemorrhage, Protein Losing Enteropathy, Protein Losing Nephropathy and 3rd Spacing all lead to \_\_\_\_
Hypoalbuminemia
\*3rd Spacing common in FIP
125
Data Interpretation Error resulting from Instrument Calibration or Human Error
Analytical Error
\*Not Common
125
True/False: Healthy Dogs may have a Measurable Protein Level in Urine
True
\*In most other Healthy Species Protein is not Detectable in Urine. Normal to Find trace amount of Albumin in Dogs Urine
126
Two Differentials for Hyperfibrinogenemia
Inflammation
Renal Disease (Cats and Cattle)
\*Increased synthesis by the Liver in Inflammation
127
In Renal Disease, what Two Nitrogenous Waste Products Accumulate?
Urea
Creatinine
129
\_\_\_\_\_ Renal Disease, allows Filtration of Larger and more Negatively charged Proteins where patients are commonly Hypoalbuminemic
Glomerular Nephropathy
\*Proteinuria and Hypoproteinemia
130
Major cause of Hemoglobinuria
Intravascular Hemolysis
\*Serum will be Pink or Red Tinged
131
Conventional Biomarkers in Renal Disease
BUN and Creatinine
132
In Stored Urine Sediments with USG above 1.025, Red Blood cells appear \_\_\_\_\_
Crenated
\*Spikes
133
Decreased _____ is commonly due to Decreased Urea Production from Liver Failure
BUN
\*Liver Failure is Big for Decreased BUN
135
What Type of Tube is used for Serum Collection?
Red Top or Marble Top
\*No Fibrinogen
136
Measures the Frequency with which a test Result will be Abnormal in Animals with the Disease
Sensitivity
\*How many of the Abnormals are Actually Abnormal- Sensitivity above 90% is Ideal
137
\_\_\_% of Nephrons have ceased Function when the Kidney is unable to Concentrate Urine
66%
138
SCIDs and Failure of Passive Transfer both cause \_\_\_\_\_
Hypoglobulinemia
139
Top Differential Diagnosis for Polyuria
Renal Failure
140
Obstruction of Urinary Outflow due to Urolithiasis in Castrated Males or Uroabdomen are examples of _____ Azotemia
Post-Renal
\*Anything that Happens Distal to the Nephron
142
Number One Differential for Alkaline pH on Dipstick Urinalysis
Urinary Tract Infection
143
Urinary Test used to Detect Globulins and Bence-Jones Proteins
Sulphosalicylic Acid Test (SSA)
144
Patient with Hypoproteinemia due to Decrease in Both Albumin and Globulin, what two Conditions cause this?
Hemorrhage
Protein Losing Enteropathy
145
Protein Loosing Nephropathys can develop into Nephrotic Syndromes characterized by what Four Things:
Proteinuria
Hypoalbuminemia
Hypercholesterlemia
Ascites
146
GFR has decresed to 5% of Normal Function, with Marked Dehydration, Marked Azotemia, Hyperkalemia, and Oliguria to Anuria is known as \_\_\_\_\_
End-Stage Renal Disease
\*Develop Hyperkalemia due to Oliguria
147
Ratio used to Estimate the Quantity of Urinary Protein Excreted per day, where normal is below 0.5
Urinary Protein : Creatinine Ratio
\*Ratio \> 1 means Glomerular Proteinuria
148
Hump on Electrophoresis that contains Fibrinogen
Beta
149
True/False: Both Glomerular and Tubular Proteinuria lead to Hypoalbuminemia
False
\*Glomerular Proteinuria leads to Hypoalbuminemia. In Tubular Proteinuria, Albumin will either be Normal or Increased
150
Hyperglobulinemia due to an ______ process, many Different Proteins are produced leading to Polyclonal Gammopathy
Inflammation
152
Total Protein - Albumin =
Globulin
153
Error in Data Interpretation that May result if the Patient is on Medication (ex. NSAID), Time of Day, Recent Patient Exercise, and Whether you used Physical or Chemical Restraint for the Patient
Pre-Analytical Factors
154
Normal Crystals in Horses, Rabbits, Guinea pigs and Goats that are Colorless or Yellow with no Clinical Significance
Calcium Carbonate
\*Not found in Canine or Feline urine
156
Movement of Charged Particles through a Solution under the Influence of an Electrical Field. Particles will Separate based on Net Charge, Size, Shape, Strength of Electrical Field, Medium and Temperature
Electrophoresis
\* Passed through Gel Field. Allows us to Separate out Proteins and Figure out what Type of Proteins are Present
157
Substance produced by Muscle Catabolism that is continually Made that is Filtered by the Glomeruli and Excreted with No Reabsorption
Creatinine
\*NOT REABSORBED
158
Bilirubinuria is Abnormal in every Species except \_\_\_\_\_
Canines
\*More than 20% Normal Dogs have 1+ Bilirubinuria
159
Patients with Glomerular Nephropathy Renal Disease commonly have _____ due to Loss of Albumin
Hypoproteinemia
160
Liver Failure, Severe Malnutrition, Protein Losing Nephropathy, Effusions and Burns all cause \_\_\_\_\_
Hypoalbuminemia
