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

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2
Q

Total Protein is Made up of What Two things?

A

Albumin

Globulins- Alpha, Beta, Gamma

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2
Q

Protein considered a Beta Globulin that is Synthesized by the Liver and Functions in Coagulation and Inflammation

A

Fibrinogen

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2
Q

Panhyperproteinemia, with Increases in both Albumin and Globulin, what is the Differential?

A

Dehyrdation

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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

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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

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2
Q

Red Urine is spun down, The Supernatent is now Clear or Yellow, What is in the Urine?

A

RBC’s

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2
Q

Dipstick Urinalysis measures _____ Bilirubin

A

Conjugated

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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

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2
Q

In What Species is Lipid in the Urine not very Significant?

A

Cats

*Few Lipid Droplets in Urine Sediment is Normal

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3
Q

True/False: During Inflammation, the Liver downregulates Albumin Production

A

True

*During Inflammation Albumin decreases and Globulin Increases

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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

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3
Q

True/False: Decreased Creatinine is NOT clinically significant

A

True

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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

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5
Q

Most prominant Ketone in Animals, that is Not Detected on Dipstick Urinalysis

A

B-Hydroxybuterate

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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

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7
Q

Occassionally in Pre-Renal Azotemia, Creatinine will Increase. In which two Animals this most common?

A

Greyhounds

Neonatal Foals

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7
Q

Increased BUN, Increased Creatinine and Decreased Specific Gravity is characteristic for which Azotemia?

A

Renal Azotemia

*Isosthenuric

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7
Q

When you Get Renal Azotemia, at least ____% of Nephrons are Non-Functioning

A

75

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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

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8
Q

Inability to Concentrate Urine causes _____, where 66% of Nephron is non-Functioning typically with Isosthenuria

A

Polyuria

*Common with Renal Failure

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9
Q

Liquid Portion of Blood that Contains All the Proteins

A

Plasma

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9
Q

In _____ Azotemia you Kidney looses its Concentrating ability leading to Isosthenuria

A

Renal

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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

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10
Q

Epithelial Cells of the Bladder and Proximal Urethra

A

Transitional Cells

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11
Q

What Techinique uses an Instrument that directs a beam of Light through a Solution that Measures the Amount of Light absorbed

A

Spectrophotometry

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11
Q

Measures the Frequency with Which a Test result will be Normal in Animals without the Disease

A

Specificity

*Closer to 100% the Better

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11
Q

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

A

Biomarkers

*Ex. BUN and Creatinine are Biomarkers

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11
Q

Red Urine is spun down, the Supernatent is still Red what is in the Urine?

A

Hemoglobin or Myoglobin

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12
Q

In a patient with Hypoalbuminemia due to _____, Glucose, Cholesterol and Urea will be Decreased while Globulins will be Increased

A

Liver Failure

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12
Q

______ are not Present in the Urine in Normal Healthy Animals, but will develop in animals with a Negative Energy Balance

A

Ketones

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13
Q

Globulins Synthesized by Lymphoid Tissue that Function in Immunity

A

Gamma Globulins

*Ex. IgG, IgM

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15
Q

Small Protein that makes up 30-50% of Total Protein that is Synthesized by the Liver and Catabolized by all Tissues

A

Albumin

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16
Q

Number One Differential for Pre-Renal Azotemia

A

Dehydration

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17
Q

True/False: Small amounts of Bilirubin Crystals are normal in HIghly Concentrated Urine of all Species

A

False

*Only Normal in Dogs. Abnormal in all other Species

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18
Q

Syndrome associated with Glomerular Nephropathy that leads to Hypoalbuminemia, Hypercholesterolemia, Edema, and Hypercoagulability due to Loss of Anti-thrombin

A

Nephrotic Syndrome

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18
Q

Two Differentials for Ketonuria on Dipstick Urinalysis

A

Negative Energy Balance

Diabetic Ketoacidosis

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18
Q

Positive Blood Dipstick Urinalysis due to ____ is commonly caused by Myocyte Damage and the Supernatent will Stay Red after Centrifugation

A

Myoglobinuria

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19
Q

Neoplasia such as Plasma Cell Tumors and B-Cell lymphoma lead to _______

A

Hyperglobulinemia

*Plasma Cell Tumors produce a Lot of One type of Globulin

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19
Q

Pre-Renal Azotemia due to Increased Urea Production is commonly caused by _____

A

Upper GI Bleed

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21
Q

Smallest Protein with the Highest Negative Charge and Biggest Peak on Electrophoresis

A

Albumin

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22
Q

Renal Azotemia leads to Decreased _____, leading to Increased BUN and Increased Creatinine

A

GFR

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23
Q

Larger Proteins that don’t Migrate as Far and have Small Negative Charge

A

Globulins

*Gamma Globulin has Smallest Negative Charge

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23
Q

True/False: Antibiotics such as Sulfa Family Drugs and Anti-convulsants can lead to Drug Associated Cystals in the Urine

A

True

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24
Q

Most Common Urine Crystal in Dogs and Cats

A

Struvites

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25
Q

Yellow- Orange Urine is indicative of ____

A

Bilirubin in Urine

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26
Q

Bloodwork of ____ Renal Disease commonly shows Azotemia, Hyperkalemia and Severe Acidemia

A

Acute

*Metabolic Acidosis

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26
Q

Nonregenerative Anemia, Azotemia, Hyperphosphatemia, Hypokalemia and Polyuria are characteristic of ____ Renal Disease

A

Chronic

*Typically have Normal Potassium or Hypokalemia- Differentiate Between Acute Renal Disease

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27
Q

Paraproteinuria (Bence-Jones) can be seen with _____, where small amounts of Immunoglobulins are being released

A

Multiple Myeloma

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28
Q

Dehydration, Inflammation, and Neoplasia lead to ______

A

Hyperglobulinemia

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28
Q

In ____ Renal Disease, Patients present with Good Body Condition Scores, GI signs, Oliguria, Hyperkalemia and Depression

A

Acute

*Vomiting, Diarrhea. Oliguria leads to Increased Potassium in the Blood

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29
Q

If Peritoneal Creatinine is Greater than 2 times Creatinine in the Blood, that is diagnostic for ____

A

Uroperitoneum

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31
Q

_____ leads to Hyperglobulinemia that Increases Proportionally with Albumin

A

Dehydration

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31
Q

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

A

Renal Cells

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32
Q

In ____Azotemia, You should check if the Patient has been on NSAID therapy or Prednisone

A

Pre-Renal

*NSAID and Prednisone leads to GI Ulceration

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34
Q

Measurement that Gives us an Idea of the Kidneys Ability to Conserve Water and Produce Concentrated Urine

A

Urine Specific Gravity

*Requires 33% Functional Nephrons

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37
Q

Refractometer provides an ____ of the Total Protein

A

Estimate

*Not completely Accurate

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38
Q

Technique where Proteins on Gel are Stained and Quantified with a Densitometer providing a Percentage and Absolute Amount

A

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

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38
Q

Excessive Urea in Blood with Clinical Signs of Renal Failure

A

Uremia

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39
Q

In _____ Renal Disease, patients have a Poor Body condition score, GI signs, Polyuria and Depression

A

Chronic

*Very thin and Tend to be Polyuric

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39
Q

Crystals found in Miniature Schnauzers with Urolithiasis, Patients with Hypercalcemia, and Acute Renal Failure

A

Calcium Oxalate Dihydrate

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40
Q

Orange Granules in Crystal Bundles found in Urine Sediment that is most common in Icteric Patients

A

Bilirubin

*Icterus

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41
Q

Glomerular Nephropathy Renal Disease commonly leads to _____ Syndrome, which is a Protein-Losing Nephropathy leading to Abdominal Transudation with Hypoalbuminemia and Hypercholesterolemia

A

Nephrotic

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42
Q

Yellow Crystals on Urine Sediment that form Aggregates of Granular Material with no Defining Shape and no Clinical Significance

A

Amorphous

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43
Q

Invasive Procedure common for Collecting Urine where Urine is collected with a Needle directly from the Bladder avoiding Bacterial Contamination

A

Cystocentesis

43
Q

Dipstick Urinalysis is Insensitive to Bence Jones Proteins and Globulins and therefore only Detects _____

A

Albumin

43
Q

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

A

Transitional Cells

44
Q

True/False: During Renal Azotemia, Remaining nephrons undergo Hypertrophy

A

True

44
Q

Azotemia plus _____ is Renal Disease until Proven Otherwise

A

Isosthenuria (Renal Azotemia)

*However, not ALWAYS Renal Failure- ex. Diabetes Insipidus

46
Q

Genetic Disorder common in Arabian Horses where they are not able to make Immunoglobulins leading to Hypoglobulinemia

A

Severe Combined Immunodeficiency Syndrome

47
Q

Cone Shaped Epithelial Cells that if seen on Urine Sediment can Indicate Pyelonephritis

A

Caudate Cells

*Rare to See these

48
Q

Rare Casts that are associated with Chronic Renal Disease

A

Waxy Casts

50
Q

True/False: Serum Protein is often Greater than Plasma Protein

A

False

*Plasma Protein is Larger- Contains Fibrinogen

52
Q

Best Indicator of Glomeruli Filtration Rate, that is Not reabsorbed by the Renal Tubules and excreted Unchanged by Kidneys

A

Creatinine

54
Q

Data Interpretation Error involving Transcription of Results and Misinterpretation or Results

A

Post-Analytical Error

54
Q

True/False: When looking at a Patients USG we want to be doing that with Blood Work and Knowledge of the Patients Hydration Status

A

True

56
Q

Hyperglobulinemia due to ______, Leads to an increase in a Single type of Globulin leading to Monoclonal Gammopathy

A

Neoplasia

*Albumin is normal

57
Q

Know this Chart

A
59
Q

Smallest Protein that has the Highest Net Negative Charge with Fastest Migration

A

Albumin

61
Q

Kidney is really Concentrating urine where USG is Greater than 1.030

A

Hypersthenuria

62
Q

True/False: Bilirubinemia will occur Before Bilirubinuria

A

False

*We will see Bilirubinuria BEFORE Bilirubinemia- We will see Bilirubin in the Urine before seeing it in the Blood

63
Q

Two Differentials for Hypofibrinogenemia

A

Liver Failure

DIC

64
Q

Panhypoproteinemia, where there is a Loss in Both Albumin and Globulin, what are the Two Differentials?

A

Blood Loss (Hemorrhage)

Protein-Losing Enteropathy

*Both Hypoalbuminemia and Hypoglobulinemia

65
Q

During Acute Renal Failure, Oliguria and Anuria can lead to _____, which is life threatening leading to Heart Arrythmias

A

Hyperkalemia

67
Q

Species that have the Highest Capacity to Concentrate their Urine

A

Cats

*USG can range up to 1.080- Incredible capacity to Concentrate Urine

67
Q

Recommended Techique for Urine Culture

A

Cystocentesis

69
Q

Quality Control Aspect that Gauges how Repeatable the Result is when Assaying the Same Sample

A

Precision

70
Q

Acetocetic Acid and Acetone are the Only True _____, and therefore the ones detected on Dipstick Urinalysis

A

Ketones

*B-Hydroxybuterate is not Detected on Dipstick

71
Q

Polyuria occurs when ___% of Nephrons are Damaged and Azotemia occurs when ____% of Nephrons are Damaged

A

66%- Polyuria

75%- Azotemia

72
Q

Dehydration and Upper GI Bleed are the most common Differentials for ______ Azotemia

A

Pre-Renal

74
Q

Positive on Blood for Dipstick Urinalysis means Which Three things may be present in the Urine?

A

Hemoglobin

Myoglobin

RBCs

75
Q

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

A

Hemoglobinuria

76
Q

When Performing a Cystocentesis you want to take care not to Go through the Bladder and hit the ____

A

Aorta

78
Q

In _____ Azotemia with Dehydration, Blood work will show Increased PCV, TP and Sodium

A

Pre-Renal

79
Q

True/False: Kidneys have large Functional Reserve Capacity if the Basement Membrane is Intact

A

True

80
Q

Most Common Neoplastic Cells in Urine Sediment

A

Transitional Cell Carcinoma

*Use Traumatic Catheterization to get Sample

81
Q

____ Urine is acceptable for Urinalysis and Sediment Exam but not for Culture

A

Voided (Free Catch)

*Catch Mid-Stream flow

81
Q

Dipstick Urinalysis Positive for Blood that is due to ____, will produce a Clear Supernatent with Centrifugation

A

Hematuria (RBC)

*Trauma, Inflammation, Calculi

83
Q

True/False: The Concentration of a Substance is proportional to its Absorbance

A

True

*Beer’s Law

85
Q

Decreased Renal Blood Flow leading to Decreased GFR and Increased Urea Production are signs of _____ Azotemia

A

Pre-Renal

87
Q

True/False: Hyperglobulinemia is caused by either Inflammation, Dehydration, or Neoplasia

A

True

*Three causes for Hyperglobulinemia

88
Q

Envelope Shaped Crystals that can be a Normal Finding of Stored Urine but are also common causes of Urolithiasis in Miniature Schnauzers

A

Calcium Oxalate Dihydrate

90
Q

Castrated Males, Straining to Urinate, Distended Bladder or Abdomen are indications of ____ Azotemia

A

Post-Renal

92
Q

Hemoglobin In Urine will turn the Serum Red, while ____ in Urine doesn’t accumulate in Serum and the Serum will not be discolored

A

Myoglobin

96
Q

Only cause for Hyperalbuminemia

A

Dehydration

98
Q

As the Concentration of your Substance Increases, its Absorbance will ____

A

Increase

*They are Proportional

99
Q

USG in a Dog that Shows the Dog has Adequate Urine Concentrating Ability

A

1.030

*The dog is able to Concentrate the Urine

100
Q

Ratio of Blood Urea Nitrogen Resorption by the Kidney

A

60% Out: 40% Back in

*40% Urea is Reabsorbed

101
Q

Hump on Electrophoresis that Contains Immunoglobulins

A

Gamma

101
Q

Glomerular Proteinuria commonly leads to ______

A

Hypoalbuminemia

*Filtration Barrier is Damaged leading to Albumin being Filtered into Urine

104
Q

Retention of Nitrogenous Waste products with Increased BUN and Creatinine in Blood

A

Azotemia

105
Q

Most Common Method for Measuring Fibrinogen that uses Refractrometry to Provide an Estimate of the Fibrinogen

A

Heat Precipitation

107
Q

True/False: Hypocalcemia is commonly seen with Renal Failure

A

False

*Hypercalcemia

108
Q

Normal Casts that Show up Frequently in Urine Sediment but could indicate Proteinuria or extra-renal Disease

A

Hyaline Casts

*Common and show up on about every urine sample. Typically have no Significance but may be due to Pathology

109
Q

Droplets on Urine Sediment that may Indicate Renal Tubular Injury

A

Lipid Droplets

*Usually an isolated normal Finding, but may be Renal Tubular Injury

110
Q

True/False: An animal with Azotemia and inappropriately Low USG is always in Renal Failure

A

False

*Not always Renal Failure- ex. Diabetes Insipidus and Other Conditions can cause Azotemia and Low USG without Kidney Failure

110
Q

Five Differentials for Hyperglycemic Glucosuria Reading on Dipstick Urinalysis

(High Glucose in Blood and Glucose in Urine)

A

Diabetes Mellitus

Hyperadrenocorticism

Drugs- ex. Dextrose, Glucocorticoids

Postprandial- just Eaten

Acute Pancreatitis

111
Q

Liquid Portion of Blood that Remains after Clotting and does Not Contain Fibrinogen

A

Serum

112
Q

Programs that assure both Accuracy and Precision in Data

A

Quality Control

114
Q

True/False: Biomarkers should be Accurate, Easy to Measure and Noninvasive

A

True

115
Q

If Urine is collected Free catch with Bacteria Present and no Inflammatory Cells, are we More or Less worried about an Infection?

A

Less

*Bacteria in the Environment can Contaminate Samples. If White Cells appear with Bacteria you will be more Concerned of Urinary Tract Infection

116
Q

In Urine Sediment with a USG below 1.008, Red Blood Cells will _____

A

Lyse

117
Q

In Chronic Renal Disease, GFR has dropped Below ______% of Normal GFR

A

20-25

119
Q

In Renal Failure Patient’s, Anemia will be ______

A

Non-Regenerative

*No Erythropoietin Production

120
Q

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

A

Struvite

*Can be Normal Findings in Cats- found in normal patients in small Numbers.

122
Q

Active Process of Dilute Urine with USG less than 1.007

A

Hyposthenuria

*More water is Excreted via the Kidneys

123
Q

Two Differentials for Red Blood Cells in Urine Sediment

A

Hemorrhage

Inflammation

*Anything that causes Bleeding into the Urinary Tract

124
Q

Inflammation, Liver Failure, Hemorrhage, Protein Losing Enteropathy, Protein Losing Nephropathy and 3rd Spacing all lead to ____

A

Hypoalbuminemia

*3rd Spacing common in FIP

125
Q

Data Interpretation Error resulting from Instrument Calibration or Human Error

A

Analytical Error

*Not Common

125
Q

True/False: Healthy Dogs may have a Measurable Protein Level in Urine

A

True

*In most other Healthy Species Protein is not Detectable in Urine. Normal to Find trace amount of Albumin in Dogs Urine

126
Q

Two Differentials for Hyperfibrinogenemia

A

Inflammation

Renal Disease (Cats and Cattle)

*Increased synthesis by the Liver in Inflammation

127
Q

In Renal Disease, what Two Nitrogenous Waste Products Accumulate?

A

Urea

Creatinine

129
Q

_____ Renal Disease, allows Filtration of Larger and more Negatively charged Proteins where patients are commonly Hypoalbuminemic

A

Glomerular Nephropathy

*Proteinuria and Hypoproteinemia

130
Q

Major cause of Hemoglobinuria

A

Intravascular Hemolysis

*Serum will be Pink or Red Tinged

131
Q

Conventional Biomarkers in Renal Disease

A

BUN and Creatinine

132
Q

In Stored Urine Sediments with USG above 1.025, Red Blood cells appear _____

A

Crenated

*Spikes

133
Q

Decreased _____ is commonly due to Decreased Urea Production from Liver Failure

A

BUN

*Liver Failure is Big for Decreased BUN

135
Q

What Type of Tube is used for Serum Collection?

A

Red Top or Marble Top

*No Fibrinogen

136
Q

Measures the Frequency with which a test Result will be Abnormal in Animals with the Disease

A

Sensitivity

*How many of the Abnormals are Actually Abnormal- Sensitivity above 90% is Ideal

137
Q

___% of Nephrons have ceased Function when the Kidney is unable to Concentrate Urine

A

66%

138
Q

SCIDs and Failure of Passive Transfer both cause _____

A

Hypoglobulinemia

139
Q

Top Differential Diagnosis for Polyuria

A

Renal Failure

140
Q

Obstruction of Urinary Outflow due to Urolithiasis in Castrated Males or Uroabdomen are examples of _____ Azotemia

A

Post-Renal

*Anything that Happens Distal to the Nephron

142
Q

Number One Differential for Alkaline pH on Dipstick Urinalysis

A

Urinary Tract Infection

143
Q

Urinary Test used to Detect Globulins and Bence-Jones Proteins

A

Sulphosalicylic Acid Test (SSA)

144
Q

Patient with Hypoproteinemia due to Decrease in Both Albumin and Globulin, what two Conditions cause this?

A

Hemorrhage

Protein Losing Enteropathy

145
Q

Protein Loosing Nephropathys can develop into Nephrotic Syndromes characterized by what Four Things:

A

Proteinuria

Hypoalbuminemia

Hypercholesterlemia

Ascites

146
Q

GFR has decresed to 5% of Normal Function, with Marked Dehydration, Marked Azotemia, Hyperkalemia, and Oliguria to Anuria is known as _____

A

End-Stage Renal Disease

*Develop Hyperkalemia due to Oliguria

147
Q

Ratio used to Estimate the Quantity of Urinary Protein Excreted per day, where normal is below 0.5

A

Urinary Protein : Creatinine Ratio

*Ratio > 1 means Glomerular Proteinuria

148
Q

Hump on Electrophoresis that contains Fibrinogen

A

Beta

149
Q

True/False: Both Glomerular and Tubular Proteinuria lead to Hypoalbuminemia

A

False

*Glomerular Proteinuria leads to Hypoalbuminemia. In Tubular Proteinuria, Albumin will either be Normal or Increased

150
Q

Hyperglobulinemia due to an ______ process, many Different Proteins are produced leading to Polyclonal Gammopathy

A

Inflammation

152
Q

Total Protein - Albumin =

A

Globulin

153
Q

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

A

Pre-Analytical Factors

154
Q

Normal Crystals in Horses, Rabbits, Guinea pigs and Goats that are Colorless or Yellow with no Clinical Significance

A

Calcium Carbonate

*Not found in Canine or Feline urine

156
Q

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

A

Electrophoresis

* Passed through Gel Field. Allows us to Separate out Proteins and Figure out what Type of Proteins are Present

157
Q

Substance produced by Muscle Catabolism that is continually Made that is Filtered by the Glomeruli and Excreted with No Reabsorption

A

Creatinine

*NOT REABSORBED

158
Q

Bilirubinuria is Abnormal in every Species except _____

A

Canines

*More than 20% Normal Dogs have 1+ Bilirubinuria

159
Q

Patients with Glomerular Nephropathy Renal Disease commonly have _____ due to Loss of Albumin

A

Hypoproteinemia

160
Q

Liver Failure, Severe Malnutrition, Protein Losing Nephropathy, Effusions and Burns all cause _____

A

Hypoalbuminemia