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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
Q

What is central DI?

A

ADH is decreased;

Urine concentrating ability responds to aministration of exogenous ADH

26
Q

What tests may you want to run on a patient with PU/PD?

A

CBC, chem, UA, thyroid panel (cats), Cushing’s test (dogs)

27
Q

How is endogenous creatinine clearance measured?

A
  1. Collect total urine produced over period of time and record volume
  2. Measure serum and urine creatinine levels
  3. Calculate creatinine clearance
28
Q

Endogenous creatinine clearance is used as a measure of _____.

A

GFR

29
Q

What two things are more accurate than creatinine in measuring exogenous clearance/GFR?

A

Inulin and iohexol

30
Q

How is exogenous clearance of creatinine, iohexol, etc. measured?

A
  1. Compounds are administered to patient
  2. Clearance is measured as outlined for creatinine clearance
31
Q

What does fractional excretion of electrolytes measure?

A

Proportion of substance excreted in urine compared with that filtered thru glomerulus

32
Q

Tubular damage _____ fractional excretion.

A

increases

33
Q

Prerenal azotemia _____ fractional excretion.

A

decreases

34
Q

What is the major nitrogenous waste in birds?

A

uric acid

35
Q

How much blood uric acid in birds is suggestive of decreased function?

A

>13 mg/dL

36
Q

What is gout and when does it occur?

A

Buildup of uric acid in tissues;

Occurs with severely increased uric acid levels (5x greater than normal)

37
Q

Birds with severe kidney dz can _____ K –> _____kalemia

A

retain, hyper

38
Q

Birds with CKD may lose ability to _____ Na –> _____natremia.

A

retain, hypo

39
Q

Severe renal dz in birds may cause _____phosphatemia.

A

hyper

40
Q

What component of bird droppings is urine?

A

clear fluid

41
Q

What color changes in bird urine can indicate liver disease or hemolysis, hematuria, or hemoglobinuria?

A

Liver disease or hemolysis = green or yellow

Hematuria or hemoglobinuria = red or brown

42
Q

What does a normal dipstick of bird urine look like?

A

pH = 4.7-8.0

No glucose or ketones

Negative heme

43
Q

What nitrogenous wastes do reptiles excrete?

A

uric acid, urea, ammonia

44
Q

Reptile nephrons lack a _____ so they cannot _____ urine.

A

loop of Henle, concentrate

45
Q

T/F: BUN and creatinine are poor indicators of renal dz in reptiles.

A

True

46
Q

What is the major end product of N metabolism in fish?

A

ammonia

47
Q

Where is most ammonia excretion taking place in fish?

A

Brachial (gill) arches (kidneys <15%)

48
Q

What are the 2 main functions of fish kidneys?

A

Ion excretion and osmoregulation

49
Q

Bladder rupture –> _____kalemia.

A

hyper

50
Q

Bladder rupture –> _____phosphatemia

A

hyper

51
Q

Bladder rupture –> _____natremia

A

hypo

52
Q

Bladder rupture –> _____chloridemia

A

hypo

53
Q

How can we confirm a ruptured bladder?

A

Imaging and comparison of creatinine levels in abdominal fluid vs. serum (abd > serum)

Clinical Pathology (22 decks)

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