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Clinical Pathology > UNIT 2 - Lecture 4: Urinary -- Specialized Testing > Flashcards

UNIT 2 - Lecture 4: Urinary -- Specialized Testing Flashcards

1
Q

UPC ratio helps quantify _____ loss from loss of selective _____ or _____.

A

urinary protein loss, glomerular filtration, impaired resorption

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2
Q

What type of urine is best to run a UPC ratio on?

A

“quiet” urine without hematuria or pyuria

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3
Q

What are some reasons why it is beneficial to run a UPC ratio?

A
  1. Protein pad on the dipstick is fairly insensitive to globulins and Bence Jones proteins
  2. Protein pad on the dipstick only provides semi-quantitative amount of protein - UPC ratio gives quantified amount
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4
Q

What is the significance of a persistent proteinuria with a “quiet” urine sediment?

A

Can be a marker of CKD in dogs and cats

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5
Q

In dogs and cats, greater proteinuria = greater risk of _____ progression and _____.

A

CKD, mortality

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6
Q

What are the different UPC ratio values for dogs?

A

Non-proteinuric = <0.2

Borderline = 0.2 - 0.5

Proteinuric = >0.5

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7
Q

What are the different UPC ratio values for cats?

A

Non-proteinuric = <0.2

Borderline = 0.2 - 0.4

Proteinuric = >0.4

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8
Q

In tubular proteinuria, the UPC is usually _____.

A

1-2

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9
Q

T/F: Hypoalbuminemia is expected with a UPC of 1-2 (proteinuria).

A

False

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10
Q

What are some DDx for tubular proteinuria (i.e. high UPC)?

A

Fanconi syndrome, renal ischemia, nephrotoxins

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11
Q

Glomerular proteinuria can be _____ and/or _____.

A

functional, pathological

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12
Q

What factors can cause glomerular proteinuria?

A

Stress, exercise, excitement, CHF

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13
Q

What is the UPC expected with pathological glomerular proteinuria?

A

2-5

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14
Q

What is pathological glomerular proteinuria due to?

A

renal disease

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15
Q

Pathological glomerular proteinuria can result in _____ if prolonged.

A

hypoproteinemia

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16
Q

What 3 extra-renal factors can affect the UPC ratio?

A

Hemorrhage, inflammation, infection

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17
Q

One should never perform a UPC on an _____ sediment.

A

active

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18
Q

In PU/PD, which one follows the other?

A

PD follows PU

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19
Q

What 4 organ systems should we consider when there is hx of PU/PD?

A
  1. Neural (cerebral cortex, hypothalamus)
  2. Endocrine (pituitary, adrenals, pancreas, thyroid, paraneoplastic causes)
  3. Renal (1º kidney dz, 2º influences)
  4. Hepatic
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20
Q

What are the most common causes of PU/PD in dogs?

A

CKD, DM, Cushing’s

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21
Q

What are the most common causes of PU/PD in cats?

A

CKD, DM, hyperthyroidism

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22
Q

What are the 2 types of diabetes insipidus?

A

Nephrogenic and central

23
Q

What is nephrogenic DI?

A

ADH is present, but renal tubules not responsive to it

24
Q

What are DDx for nephrogenic DI?

A

HyperCa, pyometra, liver failure, hypoK, endotoxemia, pyelonephritis, hyperaldosteronism, Cushing’s

25
What is central DI?
ADH is decreased; Urine concentrating ability responds to aministration of exogenous ADH
26
What tests may you want to run on a patient with PU/PD?
CBC, chem, UA, thyroid panel (cats), Cushing's test (dogs)
27
How is endogenous creatinine clearance measured?
1. Collect total urine produced over period of time and record volume 2. Measure serum and urine creatinine levels 3. Calculate creatinine clearance
28
Endogenous creatinine clearance is used as a measure of \_\_\_\_\_.
GFR
29
What two things are more accurate than creatinine in measuring exogenous clearance/GFR?
Inulin and iohexol
30
How is exogenous clearance of creatinine, iohexol, etc. measured?
1. Compounds are administered to patient 2. Clearance is measured as outlined for creatinine clearance
31
What does fractional excretion of electrolytes measure?
Proportion of substance excreted in urine compared with that filtered thru glomerulus
32
Tubular damage _____ fractional excretion.
increases
33
Prerenal azotemia _____ fractional excretion.
decreases
34
What is the major nitrogenous waste in birds?
uric acid
35
How much blood uric acid in birds is suggestive of decreased function?
\>13 mg/dL
36
What is gout and when does it occur?
Buildup of uric acid in tissues; Occurs with severely increased uric acid levels (5x greater than normal)
37
Birds with severe kidney dz can _____ K --\> \_\_\_\_\_kalemia
retain, hyper
38
Birds with CKD may lose ability to _____ Na --\> \_\_\_\_\_natremia.
retain, hypo
39
Severe renal dz in birds may cause \_\_\_\_\_phosphatemia.
hyper
40
What component of bird droppings is urine?
clear fluid
41
What color changes in bird urine can indicate liver disease or hemolysis, hematuria, or hemoglobinuria?
Liver disease or hemolysis = green or yellow Hematuria or hemoglobinuria = red or brown
42
What does a normal dipstick of bird urine look like?
pH = 4.7-8.0 No glucose or ketones Negative heme
43
What nitrogenous wastes do reptiles excrete?
uric acid, urea, ammonia
44
Reptile nephrons lack a _____ so they cannot _____ urine.
loop of Henle, concentrate
45
T/F: BUN and creatinine are poor indicators of renal dz in reptiles.
True
46
What is the major end product of N metabolism in fish?
ammonia
47
Where is most ammonia excretion taking place in fish?
Brachial (gill) arches (kidneys \<15%)
48
What are the 2 main functions of fish kidneys?
Ion excretion and osmoregulation
49
Bladder rupture --\> \_\_\_\_\_kalemia.
hyper
50
Bladder rupture --\> \_\_\_\_\_phosphatemia
hyper
51
Bladder rupture --\> \_\_\_\_\_natremia
hypo
52
Bladder rupture --\> \_\_\_\_\_chloridemia
hypo
53
How can we confirm a ruptured bladder?
Imaging and comparison of creatinine levels in abdominal fluid vs. serum (abd \> serum)

Clinical Pathology (22 decks)

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