Urinary Flashcards
1
Q
The kidney receives approximately –% of renal cardiac output?
A
25%
2
Q
___ % of nephrons are considered juxtaglomerular?
A
20-30%
3
Q
Urinary excretion =
A
filtration - reabsorption + secretion
4
Q
What are the 3 components of the glomerular capillary membrane?
A
endothelium
Basement membrane
podocytes
5
Q
the glomerular capillary membrane keeps molecules with what qualities from filtering ? (2)
A
Large, positive charge
6
Q
Increased glomerular capillary colloidal pressure will (increase/decrease) GFR
A
decrease
7
Q
Increased glomerular capillary hydrostatic pressure will (increase/decrease) GFR
A
increase
8
Q
Increased arterial pressure will (increase/decrease) GFR
A
increase
9
Q
An increase in resistance of afferent arteriole will (increase/decrease) GFR
A
decrease
10
Q
An increase in resistance of efferent arteriole will (increase/decrease) GFR
A
decrease (at first very small initial increase then long term decrease )
11
Q
Decrease renal blood flow will (increase/decrease) GFR
A
decrease
12
Q
Sympathetic stimulation will (increase/decrease) GFR
A
decrease
13
Q
T or F renal blood flow exceeds the metabolic demands of the kidney
A
true
14
Q
NO, prostaglandins, and bradykinin have what effect on vascular resistance and GFR
A
decreased vascular resistance
increased GFR
15
Q
Epinephrine, norepinephrine, and endothelin have what effect on vascular resistance and GFR
A
increased vascular resitance
decreased GFR
16
Q
increased protein and blood glucose have what effect on renal blood flow ?
A
increase renal blood flow
17
Q
How and where is most glucose reabsorbed in the nephron
A
2ndary active transport (w/ Na) at SGL2 in the PCT
18
Q
Most water is reabsorbed in what portion of the nephron
A
PCT
19
Q
Role of principal cells in the late distal tubules
A
reabsorb Na+, secrete K+
20
Q
Role of type A intercalated cells in distal tubules
A
Secrete H+
reabsorb bicarb
21
Q
Role of type B intercalated cells in distal tubules
A
Secrete bicarb reabsorb, H+
22
Q
Name of the Bicarb Cl exchange protein in distal tubules
A
Pendrin
23
Q
Tubular absorbtion (increase/decrease) with increased tubular flow rate
A
increase
24
Q
ANP has what effect on solute reabsorption and at what portion of the nephron
A
Decreased Na Cl reabsorption in the DCT and collecting duct
25
PTH has what effect on solute reabsorption
increased Ca+2 reabsorption, decreased, PO4- reabsobtion
26
Sympathetic nervous stimulation has what effect on solute reabsorption
increased Na and Cl reabsorbtion
27
Aldosterone has what effect on solute reabsorption and at what portion of the nephron
increased Na, Cl reabsorption
increased K+ and H+ secretion
distal tubule nad collecting duct
28
Ang II has what effect on solute reabsorption and at what portion of the nephron
increased Na, Cl reabsorption
increased H+ secretion
PCT, ascending loop of Henle, DCT
29
ADH works on what receptor causes increased aquaporin concentration in distal tubules and collecting duct
V2
30
ADH is synthesized where
the hypothalamus (supraoptic and paraventricular nuclei)
31
ADH is secreted from where
posterior pituitary
32
Stimuli for ADH release (5)
-increased extracellular osmolarity
-decreased arterial pressure
-decreased blood volume
-nausea
-some drugs
33
Stimuli for increased thirst (5)
-dry mouth
-Ang II
-increased extracellular fluid volume
-decreased blood volume
- GI and pharyngeal stimulation
34
effect of insulin on K+
increased cellular uptake of K+
35
effect of aldosterone on K+ (2)
increased cellular uptake of K+
increased K+ secretion
36
effect of beta-adrenergic stimulation on K+
increased cellular uptake of K+
37
effect of metabolic acidosis on K+
increases extracellular K+
38
effect of cell lysis on K+
increases extracellular K+
39
Effect of increased extracellular fluid osmolarity on K+
increases extracellular K+
40
Mechanism of K+ secretion on principal cells of the late distal tubule
Na/K ATPase on basolateral side (active transport)
ROMK and BK channels on the luminal side (passive diffusion)
41
K+ secretion is stimulated by (3)
aldosterone
increased extracellular K+
increased tubular flow rate
42
K+ secretion is inhibited by (1)
acidosis
43
calcium is primarily reabsorbed by what route in the PCT
paracellularly
44
what types of drugs and toxins can be actively secreted (or reabsorbed) by the kidneys
weak acids and weak bases
45
What are the 3 mechanisms or acid-base balance utilized by the kidney
-Secrete H+
-reabsorb HCO3
-Creat new HCO3
46
Chronic acidosis leads to increased excretion of _____
ammonium (NH4+)
47
Stimuli to increase renal H+ secretion (6)
-increased PCO2
-increased H+ in ECF
-decreased ECF volume
-Ang II
-aldosterone
- hypokalemia
48
Stimuli to decrease renal H+ secretion (4)
-decrease PCO2
-decreased H+ in ECF
-increase ECF volume
- hyperkalemia
49
Possible sources of pre-renal proteinuria (3)
-Hemoglobin
-Myoglobin
-Paraproteins
50
Possible causes of transient proteinuria (5)
-strenuous exercise
-fever
-CHF
-seizures
-colostrum ingestion
51
true or false tubular proteinuria can cause hypoalbuminemia
false
52
4 possible broad etiologies of pathologic glomerular proteinuria
-Glomerulonephritis
-amyloidosis
-hypertension
-glomerular capillary membrane damage
53
Reasons for false negative on urine dipstick (3)
-Bence-jones
-dilute urine
-acidic urine
54
Reasons for false positive on urine dipstick (3)
-alkaline urine
-high urine SG
-hematuria/pyuria
55
Urinalysis finding consistent with renal hematuria
RBC cast
56
fatty casts on UA is associated with what 2 pathologies
DM, nephrotic syndrome
57
urine cast associated with fever or extreme exercise, but low levels can also be normal
hyaline casts
58
Urine crystals associated with ethylene glycol toxicity
Calcium oxalate monohydrate
59
Renal threshold for glucose in dogs
180 md/dL
60
Renal threshold for glucose in cats
300 mg/dL
61
differentiate hemoglobinuria from myoglobinuria
both have dark urine that doesn't clear when spun down
-myoglobin clear plasma
-hemoglobin pink plasma
62
Definition of polyuria dog
>50 mL/kg/d urine output
63
possible cause of primary polydipsia (4)
-fever
-pain
-encephalopathy
-behavior
64
Causes for low renal medullary tonicity (2)
hyponatremia - Addisons
Low BUN - PSS, liver failure
65
Which nerve supplies voluntary control to the external urethral sphincter
pudendal
66
Which nerve supplies sympathetic innervation to the bladder
hypogastric
67
Which nerve supplies parasympathetic innervation to the bladder
pelvic
68
Pelvic N act on what receptors in the bladder
M3 on detrusor to cause contraction
69
Pudendal N arises from which spinal cord segments
S1-S3
70
Hypogastric N arises from which spinal cord segments
L1-L4 (dog) L2-L5 (cat)
71
hypogastric N act on what receptors in the bladder
B3 in detrusor to cause relaxation
alpha 1 in internal urethral sphincter to close it
72
voiding is under the control of SNS or PSNS
PSNS
73
urine storagage is under the control of SNS or PSNS
SNS
74
USMI tx
estrogens ( estriol or diethylstilbestrol) or PPA
75
Detrusor instability tx
anti muscarinic (oxybutynin or imipramine)
76
with LMN bladder is (easy/difficult) to express
easy
77
most ectopic ureters are (intra/extra) mural
intramural
78
ectopic ureters more common in M or F
F
79
LMN bladder is caused by damage to what spinal segments
S1-S2
80
Medical tx for detrusor atony
muscarinic agonist - bethanechol
81
Tx for UMN bladder
alpha 1 antagonists (prazosin, tamsulosin) +/- diazepam
82
UMN bladder caused by damage to what area of the spinal cord
cranial to sacrum
83
TX for detrusor/urethral dysynergy
alpha 1 antagonists (prazosin, tamsulosin) +/- diazepam
84
Osmotic diuretic MOA and site of action
increase the osmolarity of tubular fluids to inhibit solute and water reabsorption
mostly PCT
85
loop diuretic MOA and site of action
inhibit Na/K/Cl cotransporter in the luminal membrane of the thick ascending loop of Henle
86
Thiazide diuretic MOA and site of action
Inhibit Na/Cl cotransporter in the luminal membrane of early distal tubule
87
carbonic anhydrase inhibitor MOA and site of action
Inhibit H+ secretion and HCO3- absorption reducing Na resorption in PCT
88
aldosterone agonist MOA and site of action
inhibit aldosterone to decrease Na reabsorption and decrease K+ secretion in collecting tubule
89
sodium channel blocker MOA and site of action
Block luminal Na+ channels in collecting tubules
90
CAi example
actetozolomide
91
aldosterone antagonists example
spironolactone, eplerenone
92
MOA of estrogens for USMI
Increase # and sensitivity of alpha receptors in internal urethral sphincter
93
AE administering DES or estriol to male dogs
prostatic metaplasia
94
PPA MOA
alpha-agonist in internal urethral sphincter
95
bethanechol MOA
muscarinic agonist
96
AE bethanechol
SLUDD, vomiting
97
Oxybutynin and imipramine MOA
antimuscarinics
98
Prazosin and tamsulosin both are alpha agonists that work to help contract urethral sphincter which sphincter do each work on
prazosin - int and ext
tamsulosin - int
99
Major AEs of ACEi (2)
hyperkalemia
hypotension
100
ACEi MOA for proteinuria
decrease ANG II --> relaxation of eff arteriole --> decreased glomerular hydrostatic pressure --> decrease protein filtration
101
ARB MOA for protinuria
ANG II blocker at AT 1 receptor --> relaxation of eff arteriole --> decreased glomerular hydrostatic pressure --> decrease protein filtration
102
Clopidogrel MOA
inhibits binding of ADP at P2Y2 to inhibit PLT aggregation
103
Aspirin MOA for thromboprophylaxis
Inhibits COX-1 --> inhibits thromboxane synthesis
104
finasteride MOA
5-alpha reductase inhibitor blocks the conversion of testosterone to active metabolite DHT
105
Which Abx cross blood-prostate barrier (3)
fluoroquinolones, TMS, chloramphenicol
106
Allopurinol MOA
xanthine oxidase inhibitor
107
Allopurinol AE
Xanthine calculi (esp if eating a normal not purine restricted diet)
108
Medical tx for cystinuria (2)
2-mercaptopropionlgycine
D-penicillamine
109
Tx for ethylene glycol toxicity within 8 hours of ingestion
4-methopyrazole
110
4-methopyrazole MOA
competes for alcohol dehydrogenase to prevent the formation of formic acid
111
benefit of SDMA as a renal biomarker over creat
produced by all nucleated cells so not influenced by body composition
112
Definition of persistence proteinuria
> 3 measurements > 2 weeks apart
113
Characteristics of nephrotic syndrome (4)
proteinuria
hypoalbuminemia
hypercholesterolemia
effusion or edema
114
Pathophysiology of cystinuria
defect in non-essential AA reabsorption in PCT
115
pathophysiology of carnituria
defective carnitine reabsorption --> carnitine deficiency --> cardiomyopathy
116
Dog breeds predisposed to urate calculi (2)
Dalmations, English bulldog
117
Causes of acquired Fanconi syndrome
Jerky treats, chlorambucil
118
characteristics of Fanconi syndrome (4)
glucosuria, proteinuria, aminoaciduria, hypophosphatemia
119
diagnosis of RTA
hyperchloremic metabolic acidosis, aciduria
120
Type 1 RTA
Distal, inability to secrete H+
121
Type 2 RTA
proximal, inability to prevent loss of HCO3-
122
one dog and one cat breed amyloidosis
Shar-pei
Abysininan
123
Pathophys of hereditary nephritis
defect in type 4 collagen
124
Breeds predisposed to inherited podocytopathy (2)
soft coated wheaten terriers
airedales
125
cat breed predisposed to polycystic kidney disease
Persians
126
characteristics of cystadenocarcinoma (3)
-bilateral cystic renal tumors
-dermatofibrosis
-uterine leiomyomas
127
Substages for IRIS CKD
proteinuria
hypertension
128
Creat IRIS Stage 1 dog and cat
dog <1.4
cat <1.6
129
Creat IRIS Stage 2 dog and cat
dog 1.4 -2.8
cat 1.6- 2.8
130
Creat IRIS Stage 3 dog and cat
2.9-5
131
Creat IRIS Stage 4 dog and cat
>5
132
hormone that prevents hyperphosphatemia in early CKD
FGF23
133
Cinacalcet MOA
sensitizes parathyroid to Ca to prevent renal secondary hyperparathyroidism
134
four phases of AKI
Induction, extension, maintenance, recovery (or death)
135
Renal biomarkers may take how long after initial insult to start showing signs of AKI
3 d (6 to level out)
136
Predisposition to struvite calculi
urase producing bacteria
137
dog breeds predisposed to CaOx stones
cute little guys
mini schnauzer, yorkie, shih tzu, bichon, Lhasa apso
138
Tx for cystinuria intact male
castrate
139
