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Clinical Pathology > UNIT 2 - Lecture 2: Urinary - Lab Evaluation > Flashcards

UNIT 2 - Lecture 2: Urinary - Lab Evaluation Flashcards

1
Q

What is azotemia?

A

Increase in BUN and/or creatinine

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2
Q

What is uremia?

A

Clinical syndrome with azotemic renal failure

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3
Q

What are the clinical signs of uremia?

A

PU/PD, V+, weight loss, depression

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4
Q

What is polyuria?

A

excessive urine production

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5
Q

What is polydipsia?

A

excessive thirst

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6
Q

What is oliguria?

A

little urine production

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7
Q

What is anuria?

A

no urine production

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8
Q

What are the 2 types of kidney injury/disease?

A

Acute kidney injury

Chronic kidney disease

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9
Q

What characteristics do ideal solutes for measuring GFR have? What are some examples?

A
  1. Freely filtered
  2. Not secreted
  3. Not resorbed

EX: inulin, iohexol, mannitol

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10
Q

What is routinely used to clinically assess GFR?

A

creatinine

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11
Q

Where is creatinine produced?

A

From normal muscle metabolism

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12
Q

What is the method of creatinine production?

A

Phosphocreatine –> creatine (+P) –> creatinine

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13
Q

Production and excretion of creatinine is fairly _____ with _____ individual variation.

A

constant, low

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14
Q

_____ is the most efficient, widely available indirect marker of GFR.

A

creatinine

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15
Q

___% of nephrons must be non-functional for renal azotemia to develop (elevated creatinine).

A

70-75%

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16
Q

T/F: Creatinine values are specific for renal disease

A

False; can increase with any cause of decreased GFR

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17
Q

What is the main nitrogenous waste in mammals?

A

BUN (urea)

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18
Q

Where is BUN synthesized and how?

A

By hepatocytes from ammonia generated by catabolism of AAs.

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19
Q

_____ flow rate will lead to _____ absorption of BUN.

A

Reduced, increased

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20
Q

What non-renal factors affect BUN in ruminants and horses?

A

Additional routes of excretion, dietary supplementation

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21
Q

What non-renal factors affect BUN in carnivores?

A

Mild post-prandial increase, high protein diet

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22
Q

What is the main non-renal factor that can affect serum levels of BUN?

A

GI hemorrhage

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23
Q

What is SDMA designed for?

A

Earlier detection of kidney disease in small animals

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24
Q

SDMA is reported to ID CKD _____ earlier in dogs and _____ earlier in cats.

A

9 months, 17 months

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25
When do SDMA levels become elevated?
At 40% loss of renal function
26
SDMA is not affected by \_\_\_\_\_.
muscle mass
27
What is pre-renal azotemia due to?
Decreased GFR from decreased kidney perfusion
28
What is renal azotemia due to?
Decreased GFR from renal dysfunction
29
What is post-renal azotemia due to?
Obstruction or rupture of the urinary tract
30
What is the most common cause for pre-renal azotemia?
dehydration
31
What is the most common site of obstruction/rupture that causes post-renal azotemia?
urethra
32
What are some examples of obstruction of the urinary tract?
Ureterolithiasis, urolithiasis, feline urethral plug, neoplasia, prostatic disease
33
Post-renal azotemia is often associated with marked \_\_\_\_\_kalemia and \_\_\_\_\_magnesemia.
hyperkalemia, hypermagnesemia
34
How can you confirm uroperitoneum?
Compare creatinine [] of peritoneal fluid with creatinine [] of serum/plasma; Perit fluid [] = 2x or more greater than plasma/serum []
35
What is the minimum USG for azotemia in dogs?
\>1.030
36
What is the minimum USG for pre-renal azotemia in cats?
\>1.035-1.040
37
What is the minimum USG for pre-renal azotemia in horses?
\>1.025
38
What is the minimum USG for pre-renal azotemia in ruminants?
\>1.025
39
If USG is \< expected values in the face of azotemia, what does that indicate?
Evidence of impaired renal concentrating ability
40
What is the USG with renal azotemia?
isosthenuric (1.007-1.013)
41
What are 3 causes for AKI?
1. Decreased kidney perfusion from pre-renal causes 2. Intrinsic renal disease (tubular necrosis, inflammation) 3. Post-renal causes
42
T/F: Magnitude of azotemia does **not** determine AKI vs. CKD.
True
43
What urine volumes are common with AKI?
Oliguria or anuria
44
What is the prevalence of CKD in dogs and cats?
Dogs = 0.5-1% Cats = 1-3% (80% geriatric)
45
In CKD, loss of urine concentrating ability occurs at ___ loss of functional renal mass.
~2/3
46
In CKD, _____ may precede \_\_\_\_\_, which develops at ~3/4 loss of functional renal mass.
PU/PD, azotemia
47
What are 2 reasons for the loss of urine concentrating ability in CKD?
1. More solute than usual presenting to remaining nephrons --\> high solute content --\> solute diuresis 2. Medullary hypertonicity is not maintained
48
What are some risk factors for CKD?
1. Breed 2. Age 3. Diet? 4. Prior AKI 5. Comorbidities 6. Drugs
49
What are 3 requirements for a concentrated urine?
1. ADH must be present 2. Distal nephron epithelial cells responsive to ADH 3. Concentration gradient
50
What are 4 **extra-renal** causes of impaired concentrating ability with pre-renal azotemia?
1. ADH deficiency (central DI) 2. Distal nephron epi cells not responsive to ADH (nephrogenic DI) 3. Solute overload 4. Decreased medullary hypertonicity
51
In small animals with kidney disease, phosphorus is _____ due to \_\_\_\_\_.
increased, decreased GFR
52
In ruminants with kidney disease, \_\_\_\_\_phosphatemia may occur, but there are other routes of P excretion such as the _____ and the \_\_\_\_\_.
hyper, saliva, rumen
53
In horses with kidney disease, _____ P is common.
decreased
54
In cattle, \_\_\_\_\_calcemia is common in renal disease.
hypo
55
In horses, \_\_\_\_\_calcemia is common in renal disease and occurs with _____ GFR since kidney is primary route of excretion of Ca in horses.
hyper, decreased
56
When should you calculate Ca x P and how is the product interpreted?
Calculate if hyperCa and/or hyperP are present; If product \> 70, patient is at risk for soft tissue mineralization
57
Decreased GFR will result in \_\_\_\_\_magnesemia because Mg is primarily excreted by the kidneys.
hyper
58
Increased amylase and lipase can mean that the GFR is \_\_\_\_\_.
decreased
59
In dogs, cats, and horses, acute decrease in kidney function can result in \_\_\_\_\_K and _____ due to decreased excretion of K+ and H+.
hyper, acidemia
60
Cattle tend to have \_\_\_\_\_K due to \_\_\_\_\_, _____ intake, or _____ salivary excretion.
hypo, alkalosis, decreased, increased
61
Lactic acid is associated with \_\_\_\_\_.
dehydration
62
What are uremic acids associated with?
azotemia/uremia
63
When are phosophatic acids present?
If hyperP is present

Clinical Pathology (22 decks)

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