Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RUSVM Small Animal Surgery 1 > Surgery Of The Kidney > Flashcards

Surgery Of The Kidney Flashcards

1
Q

What vessels supply the kidney?

A

Arise off aorta —> renal artery and vein —> dorsal and ventral branches at hilus —> interlobular branches do not cross midline

-> left ovarian/testicular vein attaches to left renal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the possible surgical disease of the kidney?

A 
Nephrolithiasis
Pyelonephritis 
Trauma 
Neoplasia 
Hydronephrosis 
Pseudocysts 
Renal parasites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Majority of nephrolithiasis are what type of crystal?

A

Ca oxalate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Clinical signs associated with nephrolithiasis ??

A

Absent or non-specific
Depression, anorexia, hematuria, and pain

Uremia and hydronephrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T/F: Ca oxalate stones can be managed by diet

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How can you diagnose nephrolithiasis?

A

Survey radiographs

  • unilateral/bilateral
  • calculi in other areas

US

Check renal function before surgery

  • excretory urography
  • GFR
  • US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is surgery indicated for nephrolithiasis ?

A

Obstruction

Infection associated with the calculi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would you perform a nephrolithotomy?

A

Ventral midline celiotomy

Retract mesocolon or mesoduodenum

Dissect retroperitoneal fat to isolate vessels -> clap vessels with rumel tourniquet or bulldog vascular clamp

Mobilize kidney and make sagittal insicison

Remove stone and submit, culture renal pelvis
Flush pelvis/ureter with heparinized saline
Catheterize ureter to ensure patency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the closure options for a nephrolithotomy?

A

Sutureless closure

  • > hold 5mins
  • > forms fibrin seal
  • > suture capsule only
  • > release vascular clap

Horizontal mattress

Nephropexy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When calculi are in the renal pelvis, what surgery would you do to remove it?

A

Pyelolithotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F: the renal artery and vein should be occluded with a bulldog clamp for a pyelolithotomy

A

False

  • no occlusion of blood supply needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How would you manage your nephrolithotomy/pyelolithotomy patients post-op?

A

Post op radiographs

Monitor PCV
CVP (hydration status)

Monitor urine output

Monitor renal enzymes/electrolytes

Provide diuresis
-> maintain renal perfusion and minimize clot formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F: In a case of trauma t the kidney, hematuria is an indication for surgery?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is surgery required following renal trauma?

A

Moderate

  • capsular tears
  • extravasated fluids

major trauma
-severe parenchymal damage or vascular damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If you have severe parenchymal damage/ vascular damage to your kidney. What should you do?

A

Parietal nephrectomy

Nephorureterectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hydronephrosis result in what alternations of the kidney

A

progressive dilation of the renal pelvis and atrophy of the renal parenchyma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acquired causes for hydronephrosis ?

A 
Neoplasia 
Abscess 
Cyst 
Stone 
Iatrogenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Congenital causes of hydronephrosis?

A

Torsion, kinking
Stenosis
Atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical signs of hydronephrosis?

A

Unilateral

  • abdominal distention
  • palpable mass

Bilateral
-severe azotemia /death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment of hydronephrosis ??

A

Eliminate cause
Evaluate fxn
- less than a week obstructed => complete resolution

If non functional or severe parenchymal damage => nephroureterectomy

21
Q

When would you do a nephroureterectomy in a case of pyelonephritis ?

A

Advanced cases

- predisposed by damaged parenchyma

22
Q

Treatment for dioctophyma renale?

A

Giant kidney worm - destroy renal parenchyma

Nephrotomy or nephroureterectomy

23
Q

What is the most common benign renal neoplasia?

A

Renal adenoma

24
Q

Primary tumors of the kidney?

A

Renal cell carcinoma
TCC
Nephroblastoma

25
Q

Metastatic renal tumors?

A

Lymphosarcoma
Hemangiosarcoma
SCC

26
Q

What is the most common renal neoplasia in dog?

A

Renal cell carcinoma

  • increased incidence in males and with age
27
Q

Treatment for renal cell carcinoma?

A

Nephroureterectomy and chemo

28
Q

Most common renal neoplasia in cat?

A

Renal lymphoma

29
Q

Treatment for renal lymphoma ?

A

Usually bilateral -> chemo

Surgery not indicated

30
Q

What is a congenital neoplasia that is found i young dogs and cats ?

A

Embryonic nephroblastoma

31
Q

Clinical signs associated with renal neoplasia?

A 
Hematuria 
Abdominal distention 
Anorexia 
Weight loss 
Depression 
Abdominal pain
32
Q

Diagnosis of renal neoplasia ?

A

Abdominal palp
Rads -abdominal or renal masses

US -abdominal and kidney mass

IV urogrpahy, CT, MRI

Exploratory laparotomy - metastatic lesions, preferred method for biopsy

33
Q

Indications for a nephroureterectomy?

A

Severe infection/trauma
Obstructive calculi with persistent hydronephrosis
Neoplasia
Transplant

34
Q

What technique do you use for nephroureterectomy ?

A

Mobilize kidney
Identify vessels and ligate separately
Separate and ligate ureter at vesicoureteral junction

35
Q

When would a partial nephrectomy be indicated?

A

When the contralateral kidney has compromised GFR

Trauma/focal hemorrhage/neoplasia
Preserves renal function

-

36
Q

What is the main complication of a partial nephrectomy?

A

Higher incidence of post op hemorrhage

37
Q

What are the steps of a partial nephrectomy?

A

Occlude blood supply
Incise and peel back capsule
Pass suture through kidney with straight needle —> divide into thirds and tighten suture

Remove distal part of kidney

Loosen tourniquet
Close capsule

38
Q

What are the indications form renal biopsy?

A

Suspected neoplasia
Nephrotic syndrome
Renal cortex dz
Non diagnosed ARF

39
Q

When would renal biopsy be contraindicated?

A

If results dont:

  • > alter therapy
  • > change prognosis (CRF)
  • > owner wont pursue further therapy

Coagulopathies
Hypertension (hemorrhage risk)
Severe chronic hydronephrosis

40
Q

What should be your sample size for a renal biopsy?

A

Obtain > 5-6 glomeruli

41
Q

What are the possible biopsy techniques for the kidney?

A 
Percutaneous 
Ultrasound guided 
Keyhole 
Laparoscopic assisted 
Wedge or incisional
42
Q

How is a percutaneous biopsy done?

A

In small dogs and cats
Secure kidney against abdominal wall
Blind technique that does not visualize target lesions

43
Q

What is the preferred method to take a kidney biopsy?

A

Ultrasound guided

44
Q

What is the keyhole biopsy technique?

A

Modified surgical flank approached

Secure kidney to incision and introduce biopsy needle

45
Q

How is a wedge biopsy performed?

A

Ventral midline celiotomy

Occlude renal vessels

Take a crescent shaped sample

  • 5-10mm long
  • 5mm deep

Close with mattress suture

46
Q

What are possible complications from renal biopsies?

A

Severe hemorrhage

  • hypertension
  • NSAIDS within 5 days
  • coagulopathies
  • poor technique

Hematuria
-usually resolve in 2-3days

Hydronephrosis (ureteral obstrucion from clot)

47
Q

What are indications for renal transplants?

A

Irreversible acute renal failure
Decompensated chronic renal failure
Polycystic disease

48
Q

What screening do you do for renal transplant patients?

A 
CBC, Chem 
UA an culture 
Abd rads 
U/S 
Echo 
FeLV, FIV, toxo 
Rejected if .. 
viral positive 
Cardiac dz 
Neoplasia 
Factious

RUSVM Small Animal Surgery 1 (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions