Unit 2: 7 - Urogenital 2

Question 1

What is the most serious driving force behind renal necrosis, fibrosis, scarring, and atrophy?

Answer 1

Vascular damage

Question 2

What is important about the left renal vein and what drains into it?

Answer 2

Receives blood from left ovarian/testicular v.;

This is especially important in intact animals

Question 3

What ligament are the ureters associated with?

Answer 3

Broad ligament

Question 4

The ureters enter the bladder on the _____ surface at the _____.

Answer 4

dorsolateral, urinary trigone

Question 5

What is the median ligament?

Answer 5

Holds bladder in place;

Ventral midline of bladder to ventral abdominal midline

Question 6

Where are the lateral ligaments and what do they contain?

Answer 6

Lateral surfaces of bladder to lateral pelvic wall, blend with broad ligament and contain the ureters

Question 7

What is the blood supply to the bladder?

Answer 7

Cranial and caudal vesicular aa.

Question 8

What are the 3 sources of innervation to the bladder?

Answer 8

1. Sympathetic = hypogastric n. –> urinary retention
2. Parasympathetic = pelvic n. –> urinary release
3. Somatic = pudendal n. –> external urethral sphincter

Question 9

What are the 3 parts of the male urethra?

Answer 9

Prostatic, membranous, penile

Question 10

What are urethral tears and partial ruptures usually related to?

Answer 10

trauma

Question 11

What is the treatment for urethral tears?

Answer 11

Primary surgical repair, healing by second intention

Question 12

What should be the first thing attempted with urethral calculi?

Answer 12

Moved back to the bladder by retrohydropropulsion or urohydropropulsion

Question 13

What is the indication for a urethrotomy?

Answer 13

Removal of calculi that cannot be moved

Question 14

What is the biggest concern with a urethrotomy?

Answer 14

stricture

Question 15

What is a urethrostomy?

Answer 15

Permanent stoma is created and urethral mucosa is sutured to skin

Question 16

What are indications for a urethrostomy?

Answer 16

Recurrent obstruction with stone or mucus plugs, neoplasia

Question 17

What type of urethrostomy is done in cats?

Answer 17

perineal

Question 18

What type of urethrostomy is done in dogs?

Answer 18

scrotal

Question 19

Dogs must be _____ for a scrotal urethrostomy to work.

Answer 19

castrated

Question 20

What is the most common indication for a cystotomy?

Answer 20

Urinary calculi removal

Question 21

What 3 areas should always be sampled with a cystotomy?

Answer 21

1. Stone analysis
2. Bladder wall histopath
3. Culture of bladder wall/urine/stone

Question 22

What is the preferred incision site for a cystotomy?

Answer 22

ventral

Question 23

What urinary calculi are radiopaque?

Answer 23

Calcium oxalate, struvite, silicate

Question 24

What urinary calculi are radiolucent?

Answer 24

Cysteine, urate

Question 25

What stones can be dissolved?

Answer 25

Struvite, urate, cystine

Question 26

What is the treatment for a urolith?

Answer 26

Cystotomy

Question 27

What 3 things should always be done when doing a cystotomy for urolithiasis?

Answer 27

1. Calculi analysis 2. Bacterial culture of bladder mucosa 3. Abdominal rads post-op

Question 28

What is the prevalence of recurrence of urolithiasis?

Answer 28

12-25%

Question 29

What is the most common bladder/urethral neoplasia?

Answer 29

TCC of the trigone

Question 30

What are differentials for a bladder mass?

Answer 30

Polypoid cystitis, stones, prostatic dz

Question 31

What type of urinary tumors can be resected?

Answer 31

apical

Question 32

What is the prognosis for most malignant urinary neoplasias?

Answer 32

guarded

Question 33

What is the most common source for a uroabdomen?

Answer 33

bladder

Question 34

What acid-base and electrolyte abnormalities can be seen with a uroabdomen?

Answer 34

Hyperkalemia, hyponatremia, metabolic acidosis, azotemia

Question 35

Immediate surgery for a uroabdomen is contraindicated in patients that are significantly _____ or \_\_\_\_\_.

Answer 35

hyperkalemic, uremic

Question 36

What are 2 ways in which a uroabdomen can be diagnosed?

Answer 36

1. Fluid CREA \> Serum CREA (\>2:1) 2. Fluid K \> Serum K (\>1.4 : 1)

Question 37

When is surgery indicated for ureteroliths?

Answer 37

If there is obstruction

Question 38

If a ureterolith is non-obstructive, what can be done?

Answer 38

Stone dissolution and/or prevention of future stone formation

Question 39

What is an extramural ectopic ureter?

Answer 39

Bypasses bladder entirely and enters urethra

Question 40

What is an intramural ectopic ureter?

Answer 40

Enters bladder at normal location, courses submucosally, and opens into urethral lumen

Question 41

What is the CS associated with an ectopic ureter?

Answer 41

Continuous urinary incontinence

Question 42

What breed, age, and sex are ectopic ureters more common in?

Answer 42

Dogs, \<1 year, female

Question 43

What is cystoscopy good for when there is an ectopic ureter?

Answer 43

To determine intra- vs. extramural

Question 44

What procedure is done for an intramural EU?

Answer 44

Neoureterostomy

Question 45

What procedure is done for an extramural EU?

Answer 45

Ureteroneocystotomy

Question 46

What is a neoureterostomy?

Answer 46

Creation of a new stoma in the bladder

Question 47

What is an ureteroneocystotomy?

Answer 47

Ligation of the distal ureter and re-implantation into the bladder

Question 48

Why might adjunct treatment be needed after EU correction?

Answer 48

30-55% of dogs continue to show some degree of urinary incontinence

Question 49

Renal biopsies should be avoided unless ..... ?

Answer 49

Unless the results will alter the course of therapy or prognosis

Question 50

What type of biopsy is preferred for the kidney?

Answer 50

Tru-cut

Question 51

What part of the kidney is ideal for a biopsy and why?

Answer 51

Cortex/peripheral tissue; Hemorrhage can occur if the arcuate vessels are entered

Question 52

What is a nephrostomy tube?

Answer 52

Temporary ureteral bypass

Question 53

What MUST be known before performing a nephrectomy?

Answer 53

Function of the contralateral kidney

Question 54

What is the limiting factor for renal transplantation?

Answer 54

Immunosuppression

Question 55

What spp is the only one that can have a renal transplant?

Answer 55

cats