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Pathology I > Session 21,22 - Urinary I + II > Flashcards

Session 21,22 - Urinary I + II Flashcards

1
Q

Clinical manifestation: Flow problems

A

Obstruction
Hydroureter + Hydronephrosis
Tubular cysts

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2
Q

Clinical manifestation: Infarction + Ischemia

A

Focal or regional necrosis

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3
Q

Term: Oliguria

A

Abnormally low amounts of urine

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4
Q

Term: Anuria

A

Failure to produce urine

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5
Q

What are four reasons anatomical flow problems?

A

Stenosis
Neurological dysfunction
Calculi
Mass

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6
Q

What is seen in acute renal failure?

A

Decreased GFR, hydronephrosis

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7
Q

What can happen with prolonged urethral blockage physically?

A

Rupture
Bladder - decreased pain, depression, inappetent
Urethra - Pitting edema +/- fever

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8
Q

Where is pitting edema seen in prolonged urethral blockage?

A

Perineum + inguinal + prepuce + ventral abdomen

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9
Q

What is seen in the blood work with a prolonged urethral blockage?

A

Hyperkalemia
Dehydration
Acidemia
Death

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10
Q

What is seen physically with urethral blockage?

A 
Stranguria 
Dribbling urine 
Abdominal pain 
Vocalization 
Tachycardia
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11
Q

What is seen in blood work with urethral blocks?

A

Hematuria
Crystalluria
Dehydration
+/- Azotemia

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12
Q

What is seen physically with partial urethral blocks?

A

Restless
Teeth grinding
Mild bloat in ruminants

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13
Q

What is seen in the blood work in an animal with a partial urethral block?

A

+/- Hyperglycemia

Stress leukogram

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14
Q

What are the antimicrobial components of urine?

A 
pH 
High osmolarity 
High urea concentration 
Weak organic acids 
sIgA 
Prostatic antibacterial factor
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15
Q

Acute cystitis bacteria: Cattle

A

E. Coli
– and –
Corynebacterium renale

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16
Q

Acute cystitis bacteria: Horse

A

Actinobaculum suis
– and –
Klebsiella sp.

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17
Q

Acute cystitis bacteria: Cat

A

Enterococcus faecalis

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18
Q

What are the gross changes seen in the bladder with cystitis?

A 
Hemorrhage 
Mural thickening 
Ulceration 
Inflammation 
Fibrin + Edema
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19
Q

What is bovine enzoonotic hematuria?

A

Toxic cystitis

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20
Q

What causes bovine enzoonotic hematuria?

A

Black fern

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21
Q

What are the symptoms of boovine enzoonotic hematuria?

A

Fever
Intermittent hematuria + anemia
Coagulopathies

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22
Q

What happens with prolonged ingestion of black fern?

A

Increased risk of neoplasia

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23
Q

What are common bacterial causes for pyelonephritis?

A 
E. Coli 
Staphylococcus aureus 
Proteus mirabilis 
Streptococcous spp. 
Klebsilla pneumonia
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24
Q

What are the presenting signs for pyelonephritis?

A

Arched back
Fever
PU/PD

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25
Q

Term: Renal cysts

A

Fluid filled spaces formed by dilated cortical or medullary tubules

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26
Q

What are possible mechanisms for renal cysts?

A

Obstruction
weakening of tubular wall and saccular dilation
Increased tubular secretion
Abnormal anatomic arrangment of tubular epithelium

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27
Q

Where are cysts found in polycystic disease?

A

Renal + Biliary + Pancreatic

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28
Q

What animals commonly polycystic disease?

A

Persian cats + Bull terriers

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29
Q

What are the two forms of polycystic disease?

A

Sporadic + Inherited

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30
Q

Where does necrosis occur due to NSAID?

A

Renal Papillary Necrosis

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31
Q

Where does necrosis occur due to hypoperfusion?

A

Cortical Necrosis

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32
Q

What can cause infarction in the kidneys?

A

Cardiomyopathy
– and –
Hypertension

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33
Q

What viruses can cause vasculitis that damages the kidneys?

A

FIP
– and –
EVA

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34
Q

What virus can cause emboli/sepsis that leads to kidney damage?

A

Canine herpes virus

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35
Q

What does sepsis tend to progress to in the kidney?

A

Suppurative Nephritis

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36
Q

What does septicemia cause pathologically in the kidney?

A

Glomerulitis + Suppurative inflammation

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37
Q

What does glomerulitis look like histologically?

A

Tiny areas of hemorrhage

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38
Q

What happens when glomerulitis spread when septicemia is involved?

A

Extends into surrounding tissues
Causes interstitial + tubular inflammation/necrosis
= Suppurative tubulointerstitial nephritis

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39
Q

Term: Glomerulopathy

A

Non-inflammatory glomerular pathology

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40
Q

Term: Glomerulonephritis

A

Inflammation of glomeruli +/- secondary tubulointerstitial changes and inflammation

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41
Q

What are specific causes of glomerulonephritis?

A

Immune complex deposition
Amyloid deposition
Septic emboli

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42
Q

What consequences are seen with damage to the glomerular basement membrane?

A

Proteinuria
– and –
Reduced perfusion = uremia + hypertension

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43
Q

Term: Dense Deposits

A

Amyloid or antigen/antibody complexes

44
Q

Where can dense deposits occur in the glomeruli?

A

Podocyte
Basement membrane
Luminal endothelium
Mesangial

45
Q

What viral infections can cause antigen complexes?

A

CAV + FeLV + FIP + EIA

46
Q

What other things besides viruses that can cause antigen complexes?

A

Systemic lupus
chronic infection
Neoplasia

47
Q

What factors influence complex deposition?

A

Slight antigen excess
Antigen size
Complement fixation
Charge/solubility

48
Q

What are the effects on the glomeruli do immune complexes?

A

Damage endothelial cells
Alter capillary permeability
Limit blood flow
= proliferative glomerulonephritis

49
Q

What areas under go proliferation with immune-complexes present?

A

Mesangial + Endothelial + Epithelial

50
Q

What pathogens cause proliferative glomerulonephritis?

A

EIA + Strep

51
Q

What in horses causes proliferative glomerulonephritis?

A

Antigens

52
Q

Term: Membranous Glomerulonephritis

A

Subepithelial deposits cause pink thickening of glomerular capillary basement membranes

53
Q

When is membranous glomerulonephritis seen?

A

Major type in cats

Heartworm in dogs

54
Q

Where does proliferation not occur in membranous glomerulonephritis?

A

Mesangial or anywhere BUT the basement membrane

55
Q

What is seen in the urine with membranous glomerulonephritis?

A

Severe protein uria

56
Q

Term: Membranoproliferative GN

A

Increased cellularity and thickening of the basement membrane

57
Q

What happens in membranoproliferative GN?

A

Proliferation of endothelial + epithelial + mesangial cells
+/- PMN infiltration
+/- Fibrin deposition

58
Q

What animals is membranoproliferative GN the major type seen?

A

Dogs

59
Q

What is seen with membranoproliferative GN?

A

Protein loss + Uremia

60
Q

What is the end stage of any form of GN?

A

Chronic sclerosing Gn

61
Q

Term: Chronic sclerosing GN

A

Glomeruli become fibrosed + completely non-function

62
Q

What animals tend to hereditarily get renal amyloidosis?

A

Abyssinian cats
– and –
Shar Pei dogs

63
Q

What occurs with renal amyloidosis

A

Protein in B-pleated sheet conformation will deposit

64
Q

Where does renal amyloid occur in cats?

A

Medullary

65
Q

Where does renal amyloid occur in dogs?

A

Glomerular

66
Q

What does renal amyloidosis cause?

A

Protein-losing nephropathy

67
Q

What does a kidney look like grossly with renal amyloidosis?

A

Pale + Enlarged

68
Q

What is the histological appearance of a kidney with renal amyloidosis?

A

Pale pink + Amorphous mesangial + Subendothelial deposits

69
Q

What are causes of protein-losing nephropathies?

A

Glomerular amyloid deposition

immune complex GN proteinuria

70
Q

How do protein-losing nephropathies present?

A

Proteinuria/Polyuria
Hypoproteinaenia/Hypercholesterolaemia
Oedema
Thrombosis

71
Q

Why do you see thrombosis in protein-losing nephropathies?

A

Loss of antithrombin III

72
Q

Term: Tubulointerstitial disease

A

Diseases of the tubules + surrounding CT

73
Q

What are two main causes of acute tubular necrosis?

A

Nephrotoxins + Hypotension ischemia

74
Q

What can cause hypotensive ischemia in the kidney?

A

Shock
Massive hemolysis
Massive muscle necrosis

75
Q

What are common nephrotoxins that cause acute tubular necrosis?

A 
Aminoglycosides 
Tetracyclines 
Ethylene glycol 
Oxalate containing plants 
Oak 
Grapes
76
Q

Where do nephrotoxins tend to damage the kidney?

A

Proximal tubules

77
Q

What histological features are seen with renal tubular necrosis?

A

Epithelial cell swelling + degeneration + necrosis

78
Q

How do you know if the tubular epithelium can recover from tubular necrosis?

A

Basement membrane is intact

79
Q

How does the tubular epithelium recover?

A

Remaining cells will flatten and stretch across basement membrane
Undergo mitosis and will eventually appear plump again

80
Q

What happens with tubular necrosis if the basement membrane is not intact?

A

No regeneration = Fibrosis

81
Q

What does acute inflammation get replaced with in the kidney?

A

Lymphoplasmacytic inflammation

82
Q

What happens once lymphoplasmacytic inflammation occurs in the kidney?

A

Tissue shrinkage due to loss of tubules + replacement of collagen leading to fibrosis and scarring

83
Q

What are the consequences of tubular damage?

A

PU/PD = dehydration
Glucose + AA + Uric Acid + Phosphate + Bicarb passed
Hypokalemia + Hypercholermia
Acidosis

84
Q

What are the three forms of renal failure?

A

pre-renal
renal
post renal

85
Q

What occurs with pre-renal failure?

A

GFR decreased

Due to decreased blood flow + perfusion

86
Q

What occurs with renal failure?

A

Damage to kidney

87
Q

What are the two parts of the kidney that can be damaged in renal failure?

A

Glomerular + Tubular

88
Q

What are the two opposing forces in the glomerulus?

A

Glomerular hydrostatic pressure
– and –
Capsular hydrostatic pressure

89
Q

What does the glomerular hydrostatic pressure do?

A

Pushes fluid back in to capsular space

90
Q

What does the capsular hydrostatic pressure do?

A

force fluid to stay in the glomerular capillaries with the help of blood osmotic pressure

91
Q

What does reduced blood pressure cause in the GFr?

A

Decreased persion = decreased GFR

92
Q

What does the kidney look like grossly with acute renal failure?

A

Normal to swollen and pale

93
Q

What are the common causes of acute renal failure?

A 
Shock 
Ischemia 
Ethylene glycol toxicity 
Aminoglycosides 
Lily toxicity 
Septicemia 
FIP 
GN 
Lepto 
Obstruction
94
Q

What is seen with early chronic renal disease?

A

Diminished renal reserve but no change in urea levels

95
Q

What does the kidney have problems doing in the early stages of chronic renal disease?

A

Susceptible to fluid + electrolyte stress

96
Q

What causes the renal disease to progress to more severe?

A

Increase in the loss of functional nephrons + renal insufficency

97
Q

What is seen in the body chemistry with chronic renal failure?

A

Raised urea
Mild anemia
Impaired concentration

98
Q

Why do you see ulcerative gastritis + stomatitis with renal disease?

A

Ammonia secretion + vascular necrosis

99
Q

Why do you see atrial + aortic thormbosis with renal disease?

A

Endothelial + Subendothelial damage

Nephrotic syndrome

100
Q

Why do you see anemia with renal disease?

A

Increased erythrocyte fragility
– and –
Lack of EPO

101
Q

Why do you see soft tissue mineralization with renal disease?

A

Altered calcium/phosphate metabolism

102
Q

Why do you see parathyroid hyperplasia with renal disease?

A

Altered calcium/phostphate metabolism

103
Q

Why do you see encephalopathy with renal disease?

A

Altered calcium + accumulation of toxins

104
Q

Why do you see hypertension with renal disease?

A

response to reduced renal blood flow = reflex

105
Q

Why do you see PU/PD with renal disease?

A

Protein losing nephropathies = osmotic
Interstitial fibrosis = chronic renal failure
Nephrocalciniosis

Pathology I (19 decks)

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