Session 21,22 - Urinary I + II Flashcards
1
Q
Clinical manifestation: Flow problems
A
Obstruction
Hydroureter + Hydronephrosis
Tubular cysts
2
Q
Clinical manifestation: Infarction + Ischemia
A
Focal or regional necrosis
3
Q
Term: Oliguria
A
Abnormally low amounts of urine
4
Q
Term: Anuria
A
Failure to produce urine
5
Q
What are four reasons anatomical flow problems?
A
Stenosis
Neurological dysfunction
Calculi
Mass
6
Q
What is seen in acute renal failure?
A
Decreased GFR, hydronephrosis
7
Q
What can happen with prolonged urethral blockage physically?
A
Rupture
Bladder - decreased pain, depression, inappetent
Urethra - Pitting edema +/- fever
8
Q
Where is pitting edema seen in prolonged urethral blockage?
A
Perineum + inguinal + prepuce + ventral abdomen
9
Q
What is seen in the blood work with a prolonged urethral blockage?
A
Hyperkalemia
Dehydration
Acidemia
Death
10
Q
What is seen physically with urethral blockage?
A
Stranguria Dribbling urine Abdominal pain Vocalization Tachycardia
11
Q
What is seen in blood work with urethral blocks?
A
Hematuria
Crystalluria
Dehydration
+/- Azotemia
12
Q
What is seen physically with partial urethral blocks?
A
Restless
Teeth grinding
Mild bloat in ruminants
13
Q
What is seen in the blood work in an animal with a partial urethral block?
A
+/- Hyperglycemia
Stress leukogram
14
Q
What are the antimicrobial components of urine?
A
pH High osmolarity High urea concentration Weak organic acids sIgA Prostatic antibacterial factor
15
Q
Acute cystitis bacteria: Cattle
A
E. Coli
– and –
Corynebacterium renale
16
Q
Acute cystitis bacteria: Horse
A
Actinobaculum suis
– and –
Klebsiella sp.
17
Q
Acute cystitis bacteria: Cat
A
Enterococcus faecalis
18
Q
What are the gross changes seen in the bladder with cystitis?
A
Hemorrhage Mural thickening Ulceration Inflammation Fibrin + Edema
19
Q
What is bovine enzoonotic hematuria?
A
Toxic cystitis
20
Q
What causes bovine enzoonotic hematuria?
A
Black fern
21
Q
What are the symptoms of boovine enzoonotic hematuria?
A
Fever
Intermittent hematuria + anemia
Coagulopathies
22
Q
What happens with prolonged ingestion of black fern?
A
Increased risk of neoplasia
23
Q
What are common bacterial causes for pyelonephritis?
A
E. Coli Staphylococcus aureus Proteus mirabilis Streptococcous spp. Klebsilla pneumonia
24
Q
What are the presenting signs for pyelonephritis?
A
Arched back
Fever
PU/PD
25
Term: Renal cysts
Fluid filled spaces formed by dilated cortical or medullary tubules
26
What are possible mechanisms for renal cysts?
Obstruction
weakening of tubular wall and saccular dilation
Increased tubular secretion
Abnormal anatomic arrangment of tubular epithelium
27
Where are cysts found in polycystic disease?
Renal + Biliary + Pancreatic
28
What animals commonly polycystic disease?
Persian cats + Bull terriers
29
What are the two forms of polycystic disease?
Sporadic + Inherited
30
Where does necrosis occur due to NSAID?
Renal Papillary Necrosis
31
Where does necrosis occur due to hypoperfusion?
Cortical Necrosis
32
What can cause infarction in the kidneys?
Cardiomyopathy
-- and --
Hypertension
33
What viruses can cause vasculitis that damages the kidneys?
FIP
-- and --
EVA
34
What virus can cause emboli/sepsis that leads to kidney damage?
Canine herpes virus
35
What does sepsis tend to progress to in the kidney?
Suppurative Nephritis
36
What does septicemia cause pathologically in the kidney?
Glomerulitis + Suppurative inflammation
37
What does glomerulitis look like histologically?
Tiny areas of hemorrhage
38
What happens when glomerulitis spread when septicemia is involved?
Extends into surrounding tissues
Causes interstitial + tubular inflammation/necrosis
= Suppurative tubulointerstitial nephritis
39
Term: Glomerulopathy
Non-inflammatory glomerular pathology
40
Term: Glomerulonephritis
Inflammation of glomeruli +/- secondary tubulointerstitial changes and inflammation
41
What are specific causes of glomerulonephritis?
Immune complex deposition
Amyloid deposition
Septic emboli
42
What consequences are seen with damage to the glomerular basement membrane?
Proteinuria
-- and --
Reduced perfusion = uremia + hypertension
43
Term: Dense Deposits
Amyloid or antigen/antibody complexes
44
Where can dense deposits occur in the glomeruli?
Podocyte
Basement membrane
Luminal endothelium
Mesangial
45
What viral infections can cause antigen complexes?
CAV + FeLV + FIP + EIA
46
What other things besides viruses that can cause antigen complexes?
Systemic lupus
chronic infection
Neoplasia
47
What factors influence complex deposition?
Slight antigen excess
Antigen size
Complement fixation
Charge/solubility
48
What are the effects on the glomeruli do immune complexes?
Damage endothelial cells
Alter capillary permeability
Limit blood flow
= proliferative glomerulonephritis
49
What areas under go proliferation with immune-complexes present?
Mesangial + Endothelial + Epithelial
50
What pathogens cause proliferative glomerulonephritis?
EIA + Strep
51
What in horses causes proliferative glomerulonephritis?
Antigens
52
Term: Membranous Glomerulonephritis
Subepithelial deposits cause pink thickening of glomerular capillary basement membranes
53
When is membranous glomerulonephritis seen?
Major type in cats
| Heartworm in dogs
54
Where does proliferation not occur in membranous glomerulonephritis?
Mesangial or anywhere BUT the basement membrane
55
What is seen in the urine with membranous glomerulonephritis?
Severe protein uria
56
Term: Membranoproliferative GN
Increased cellularity and thickening of the basement membrane
57
What happens in membranoproliferative GN?
Proliferation of endothelial + epithelial + mesangial cells
+/- PMN infiltration
+/- Fibrin deposition
58
What animals is membranoproliferative GN the major type seen?
Dogs
59
What is seen with membranoproliferative GN?
Protein loss + Uremia
60
What is the end stage of any form of GN?
Chronic sclerosing Gn
61
Term: Chronic sclerosing GN
Glomeruli become fibrosed + completely non-function
62
What animals tend to hereditarily get renal amyloidosis?
Abyssinian cats
-- and --
Shar Pei dogs
63
What occurs with renal amyloidosis
Protein in B-pleated sheet conformation will deposit
64
Where does renal amyloid occur in cats?
Medullary
65
Where does renal amyloid occur in dogs?
Glomerular
66
What does renal amyloidosis cause?
Protein-losing nephropathy
67
What does a kidney look like grossly with renal amyloidosis?
Pale + Enlarged
68
What is the histological appearance of a kidney with renal amyloidosis?
Pale pink + Amorphous mesangial + Subendothelial deposits
69
What are causes of protein-losing nephropathies?
Glomerular amyloid deposition
| immune complex GN proteinuria
70
How do protein-losing nephropathies present?
Proteinuria/Polyuria
Hypoproteinaenia/Hypercholesterolaemia
Oedema
Thrombosis
71
Why do you see thrombosis in protein-losing nephropathies?
Loss of antithrombin III
72
Term: Tubulointerstitial disease
Diseases of the tubules + surrounding CT
73
What are two main causes of acute tubular necrosis?
Nephrotoxins + Hypotension ischemia
74
What can cause hypotensive ischemia in the kidney?
Shock
Massive hemolysis
Massive muscle necrosis
75
What are common nephrotoxins that cause acute tubular necrosis?
```
Aminoglycosides
Tetracyclines
Ethylene glycol
Oxalate containing plants
Oak
Grapes
```
76
Where do nephrotoxins tend to damage the kidney?
Proximal tubules
77
What histological features are seen with renal tubular necrosis?
Epithelial cell swelling + degeneration + necrosis
78
How do you know if the tubular epithelium can recover from tubular necrosis?
Basement membrane is intact
79
How does the tubular epithelium recover?
Remaining cells will flatten and stretch across basement membrane
Undergo mitosis and will eventually appear plump again
80
What happens with tubular necrosis if the basement membrane is not intact?
No regeneration = Fibrosis
81
What does acute inflammation get replaced with in the kidney?
Lymphoplasmacytic inflammation
82
What happens once lymphoplasmacytic inflammation occurs in the kidney?
Tissue shrinkage due to loss of tubules + replacement of collagen leading to fibrosis and scarring
83
What are the consequences of tubular damage?
PU/PD = dehydration
Glucose + AA + Uric Acid + Phosphate + Bicarb passed
Hypokalemia + Hypercholermia
Acidosis
84
What are the three forms of renal failure?
pre-renal
renal
post renal
85
What occurs with pre-renal failure?
GFR decreased
| Due to decreased blood flow + perfusion
86
What occurs with renal failure?
Damage to kidney
87
What are the two parts of the kidney that can be damaged in renal failure?
Glomerular + Tubular
88
What are the two opposing forces in the glomerulus?
Glomerular hydrostatic pressure
-- and --
Capsular hydrostatic pressure
89
What does the glomerular hydrostatic pressure do?
Pushes fluid back in to capsular space
90
What does the capsular hydrostatic pressure do?
force fluid to stay in the glomerular capillaries with the help of blood osmotic pressure
91
What does reduced blood pressure cause in the GFr?
Decreased persion = decreased GFR
92
What does the kidney look like grossly with acute renal failure?
Normal to swollen and pale
93
What are the common causes of acute renal failure?
```
Shock
Ischemia
Ethylene glycol toxicity
Aminoglycosides
Lily toxicity
Septicemia
FIP
GN
Lepto
Obstruction
```
94
What is seen with early chronic renal disease?
Diminished renal reserve but no change in urea levels
95
What does the kidney have problems doing in the early stages of chronic renal disease?
Susceptible to fluid + electrolyte stress
96
What causes the renal disease to progress to more severe?
Increase in the loss of functional nephrons + renal insufficency
97
What is seen in the body chemistry with chronic renal failure?
Raised urea
Mild anemia
Impaired concentration
98
Why do you see ulcerative gastritis + stomatitis with renal disease?
Ammonia secretion + vascular necrosis
99
Why do you see atrial + aortic thormbosis with renal disease?
Endothelial + Subendothelial damage
| Nephrotic syndrome
100
Why do you see anemia with renal disease?
Increased erythrocyte fragility
-- and --
Lack of EPO
101
Why do you see soft tissue mineralization with renal disease?
Altered calcium/phosphate metabolism
102
Why do you see parathyroid hyperplasia with renal disease?
Altered calcium/phostphate metabolism
103
Why do you see encephalopathy with renal disease?
Altered calcium + accumulation of toxins
104
Why do you see hypertension with renal disease?
response to reduced renal blood flow = reflex
105
Why do you see PU/PD with renal disease?
Protein losing nephropathies = osmotic
Interstitial fibrosis = chronic renal failure
Nephrocalciniosis
