Urinary 1-3 Review, Start of Dz of Kidney

Question 1

What are the 2/5 developmental anomalies he mentioned that he stressed about?

Answer 1

Renal dysplasia and Polycystic Kidney

Question 2

Basenji Dog Fanconi Syndrome

Whats happening here?

Answer 2

Abnormal brush border membrane structure of the Proximal tubular epithelium

Question 3

What does Fanconi Syndrome cause clinically?

Answer 3

Glucosuria
proteinuria
metabolic acidosis
endocrine disorder

Question 4

Most important cause of acute renal failure?

Answer 4

acute tubular necrosis

Question 5

CS of Acute Tubule Necrosis?

Answer 5

Oliguria/anuria with

severe azotemia

Question 6

Causes of acute tubule necrosis-main one

Answer 6

Ischemic or nephrotoxic injury

also heavy metal, drugs, toxins, etc

Question 7

Causes of death from Renal Failure

Answer 7

Metabolic acidosis
Pulmonary edema
hypERkalemia

Question 8

Clinical indicators of renal failure

Answer 8

Urine quantity-poly
urine quality-isos
Proteinuria
azotemia
uremic syndrome

Question 9

Why do you have polyuria in renal failure?

Answer 9

failure of resorption of Na and water by the tubules

Question 10

When does isosthenuria occur in renal failure?

Answer 10

Loss of renal fxn, failure to concentrate

Question 11

Uremia can cause systemic lesions, by what 2 mechanisms?

Answer 11

Endothelial injury: vasculitis, thrombosis, infarction

Caustic injury to epithelium of mucosal surfaces due to production of large amounts of NH3 by urea-splitting bacteria

Question 12

Bacteria which might cause tubular necrosis?

Answer 12

LESS-P
Lepto
E. Coli
Staph
Strep
Proteus

Question 13

Tubular necrosis results in further renal injury by what 2 mechanisms?

Answer 13

Leakage of tubular filtrate into renal interstitium

Intratubular obstruction-resulting from sloughed necrotic epithelium (casts)

Question 14

3 major causes for intrarenal falure

Answer 14

Acute tubular necrosis

Acute
Glomerulonephritis

Acute Pyelonephritis

Question 15

What is acute pyelonephritis caused by?

Answer 15

Ascending bacterial infxn from teh urethra, ureters, and renal pelvis

Question 16

What are the 3 main reasons of postrenal failure

Answer 16

Urolithiasis
Tumors
Iatrogenic

Question 17

Post renal obstructions can lead to what 2 conditions?

Answer 17

Hydroureter

Hydronephrosis

Question 18

What is a hematological result of CRF

Answer 18

Non-regenerative anemia

reduced EPO production

Question 19

What is a biochemical result of CRF?

Answer 19

Altered Ca-P metabolism.
↓ GFR → ~HypERphosphatemia~ → Ca precipitation → ~Hypocalcemia~ → ~stim of Parathyroid Hormone secretion~ → ~Ca mobilization by osteoclastic bone resorption~ → reduced bone mineral density ~(Osteopenia)~ known as ~Renal 2° Hyperparathyroidism~ & Chronic Hyperparathyroidism → ~Fibrous Osteodystrophy~

Question 20

Renal 2ndary hyperparathyroidism:
Which ions does it affect

Hows is the gland affected?

Answer 20

Hyperphosphatemia
Hypocalcemia

Bilateral hyperplasia

Question 21

4 portals of entry into the kidney?

Answer 21

Ascending from ureter
Hematogenous
Glomerular filtrate
Direct penetration

Question 22

In an ascending entry from ureter, what usually gets into the kidney via this route?

Answer 22

Infections.

Suppurative pyelonephritis

Question 23

In hematogenous route, what gets into the kidney via this route?

Answer 23

Bacteremia–embolization and nephritis.

Metastesis

Question 24

Glomerular filtrate-what stuff gets into the kidney via this route?

Answer 24

Substances secreted into the filtrate can be bad-toxins, drug metabolits (NSAIDs, chemo, aminos)

Question 25

What is the most important barrier in defense mechanisms of the kidney?

Answer 25

GBM

Question 26

How does the GMB protect the nephron?

Answer 26

Filters out most circulating bacteria and inflammatory cells

Question 27

How does the mesangium protect glomerulus?

Answer 27

They are a component of the monocyte-macrophage system, which can remove macromolecules from teh ciruclation by phagocytosis

Question 28

What is those most harmful thing to the tubular basement membrane?

Answer 28

Ischemia-it usually destroys the TBM.

Question 29

What are the 2 defense mechanisms of the renal interstitium?

Answer 29

Humoral Ab Macrophages, lymphocytes, and plasma cells

Question 30

What are the 2 ways the vasculature can act as a defense mechanism for the kidney?

Answer 30

Intact endothelial lining is a defensive barrier against blood borne paths Also prevents activation of clotting cascade which reduces thrombus formation

Question 31

2 examples glom injury due to hyperfiltration

Answer 31

Prolonged systemic hypertension increase in dietary protein

Question 32

Chronic proteinuria can lead to what?

Answer 32

Glom Injury

Question 33

Glom injury also causes damage in what ways?

Answer 33

Interferes with the peritubular blood supply resulting in hypoxia with tubular atrophy and loss of fxn

Question 34

What is nephrotic syndrome?

Answer 34

Glom damage can cause severe proteinuria leading to hypOproteinemia w/reduced plasma oncotic pressure resulting in ascites, plural effusion and generalized edema

Question 35

Nephrotic syndrom is a result of___?

Answer 35

PLN

Question 36

What is a clinical sign of prolonged proteinuria?

Answer 36

weight loss

Question 37

What are some acute responses to injury of the glom? 4

Answer 37

Mesangial hypertrophy and hyperplasia Increased vascular permeability Infiltration of leukocytes necrosis

Question 38

What are some chronic responses to injury of the glom? 3

Answer 38

Atrophy Fibrosis (glomsclerosis) Renal tubules will become secondarily atrophic due to loss of blood supply from efferent glom arteriole

Question 39

Glomerulosclerosis is what? Resulting from what?

Answer 39

Fibrosis which results from Chronic Glom Dmg

Question 40

What are some abnormal glom filtrates that can cause tubular dmg? 2

Answer 40

Inc protein | Inc crystalline salts/organic acids

Question 41

4 ways tubular responds to damage

Answer 41

Atrophy Degeneration regeneration necrosis

Question 42

What is nephrotoxin associate ischemia?

Answer 42

Nephrotoxins indirectly stimulate vasoconstriction of the intertubular capillaries causing ischemia

Question 43

Nephrotoxins cause dmg by what 3 mechanisms?

Answer 43

1. Direct damage to epithelium 2 produce reactive metabolites that dmg the epithelium via oxidative injury 3. indirectly stimulate vasoconstriction of the intertubular capillaries causing ischemia

Question 44

What is nephrosis?

Answer 44

A form of acute tubular necrosis that is NOOOOTTT caused by inflammation

Question 45

What causes nephrosis?

Answer 45

Hypoxic injury combined with nephrotoxic injury

Question 46

What can exacerbate the hypoxic injury in nephrosis?

Answer 46

Hemoglobinuria during a hemolytic crisis

Question 47

What part of the nephron is more sensitive to hypoxia due to higher metabolism demands?

Answer 47

PT

Question 48

What part of the nephron is resistant to ischemia and often remains morphologically normal in necrosis?

Answer 48

Glom

Question 49

Multinodular lymphocytic rx to chronic or recurrent inflammation is called? What is this a common rxn to?

Answer 49

Lymphofollicular inflammation Lepto

Question 50

What are some infectious causes in interstitial nephritis?

Answer 50

Ehrlichiosis Lepto EIA

Question 51

How does hypercoag happen w/dz of the urinary tract?

Answer 51

Glom damage--PLN---loss of antithrombin III--hypercoag

Question 52

What is the specific form or renal dysplasia called? It occurs with variable severity and degrees of renal failure.

Answer 52

Juvenile Progressive Nephropathy

Question 53

What dog breeds is Juvenile Progressive Nephropathy common in?

Answer 53

Lhasa Apsos, Shih tzu, and Golden Retriever

Question 54

What species is an ectopic kidney common in?

Answer 54

Pigs and Dogs

Question 55

Fused kidney is also called? is it functional?

Answer 55

Horseshoe Kidney Yes, 1 large kidney and 2 ureters

Question 56

How does a renal cyst look?

Answer 56

Spherical, thin-walled, distended tubules filled with clear watery fluid

Question 57

How do renal cysts occur?

Answer 57

Result from tubular obstruction or dysplasia

Question 58

Renal cysts are common in what spp?

Answer 58

Pigs and Cattle

Question 59

Define Polycysitc kidneys

Answer 59

many renal cysts affecting NUMEROUS nephrons

Question 60

Who is prone to polycystic kidney Dz? | How do they get it

Answer 60

Persian cats Bull Terriers Autosomal dominant trait

Question 61

Pathogenesis of polycystic kidney dz, is it dangerous?

Answer 61

Mutations in 1 or more genes, resulting in abnormal tubulogenesis. Can be dangerous depending on the severity

Question 62

How is Proliferative Glomerulonephritis characterized?

Answer 62

Increased cellularity of the glom tufts caused by proliferation of glom endothelial, epithelial, and mesangial cells and an influx of leukocytes.

Question 63

What spp is Proliferative Glomnephritis common in?

Answer 63

Horses

Question 64

What is glomerulosclerosis associated with?

Answer 64

High blood pressure | Unrestricted protein in diet

Question 65

How does the glom look in result of glomerulosclerosis?

Answer 65

Shrunken, hyalinized and sclerotic with fibrous CT. This reduces tubular blood flow causing secondary tubular degeneration and atrophy

Question 66

What are the most common site of renal deposition of amyloid? I

Answer 66

Glom Abyssinians predominantly have medullary interstitial deposition

Question 67

What breeds are predisposed to reactive amyloidosis

Answer 67

Abyssinian cats Chinese shar-pei

Question 68

What is a common cause of PLN

Answer 68

amyloidosis

Question 69

What does glom amyloidosis look like grossly?

Answer 69

Kidneys are enlarged, pale and have a WAXY smooth to fine granular capsular surface

Question 70

What does glom amyloidosis look like microscopically?

Answer 70

Deposition of amyloid protein w/in the glom tufts

Question 71

What stain do you use to see amyloidosis microscopically?

Answer 71

Congo Red Stain

Question 72

What dz causes multiple, RANDOMLY DISTRIBUTED FOCI of suppurtative inflammation

Answer 72

Acute Suppurative Glonerulitis

Question 73

Whats another name for acute suppurative glomerulitis?

Answer 73

Bacterial embolic nephritis