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ACVIM General Boards > Urinary > Flashcards

Urinary Flashcards

1
Q

Mechanism of action of phenylpropanolamine

A

Alpha-1 agonist

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2
Q

Which nerve innervates the external urethral sphincter?

A

Pudendal

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3
Q

Which antibiotic concentrates in urine?

A

Penicillins (amoxicillin)

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4
Q

Which protein is most likely responsible for persistently high UPC?

A

Albumin

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5
Q

Treatment for calcium oxalate stones

A

Increase water intake
Alkalinize urine (potassium citrate)

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6
Q

Function of the juxtaglomerular apparatus

A

Secretion of renin in response to decreased pressure in the afferent arteriole

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7
Q

When is fractional excretion of sodium increased (>1%)?

A

Tubular renal failure

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8
Q

When is fractional excretion of sodium decreased (<1%)

A

Prerenal azotemia (dehydration, hypovolemia)

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9
Q

Which reaction does carbonic anhydrase catalyze

A

CO2 + H2O<-> H2CO3

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10
Q

What falsely increases urine protein dipstick results?

A

Alkaline urine

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11
Q

Antidote for ethylene glycol toxicity

A

4-MP (fomepizole)

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12
Q

Mechanism of action of PU/PD associated with pyometra

A

Decreased sensitivity of distal tubules/collecting duct to ADH caused by E. coli endotoxin

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13
Q

Canine renal threshold for glucose

A

180mg/dL

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14
Q

Feline renal threshold for glucose

A

280mg/dL

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15
Q

How is uroperitoneum diagnosed?

A

Abdominal creatinine >2:1 serum creatinine

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16
Q

Next step for a dog with PU/PD and hyposthenuria

A

Urine culture (to evaluate for pyelonephritis)

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17
Q

How is calcitriol used for CKD?

A

Increases GI absorption of Ca and PO4 and suppresses PTH

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18
Q

Empiric antibiotic options for UTI (3)

A

Amoxicillin/ampicillin
Cefalexin
TMS

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19
Q

Mechanism of action of PU/PD with hypercalcemia

A

Impaired response to ADH
Impaired Na/Cl reabsorption

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20
Q

When should clopidogrel be initiated with proteinuria?

A

Concurrent hypoalbuminemia

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21
Q

Which nerve delivers sympathetic innervation to the bladder

A

Hypogastric

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22
Q

What is high SDMA representative of?

A

Decreased GFR

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23
Q

Female cat with a ureterolith, 2 small kidneys, bilateral pyelectasia, and dilation proximal to the stone. Cat has been treated with fluids. What is the best treatment option?

A

SUB placement

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24
Q

Which nerve is responsible for providing parasympathetic innervation to the bladder?

A

Pelvic

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25
Q

UPCR cut off for proteinuria in dogs and cats

A

> 0.5 dogs
0.4 cats

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26
Q

Part of nephron primarily affected by aminoglycoside toxicity?

A

Tubules

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27
Q

When does paradoxical aciduria occur?

A

Hypochloremic metabolic alkalosis

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28
Q

Where does the majority of renal bicarbonate reabsorption occur?

A

Proximal tubule

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29
Q

Filtrate at the end of the ascending loop of Henle is ____ relative to plasma

A

Hypotonic

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30
Q
A
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30
Q

Where is the majority of magnesium reabsorbed in the kidney?

A

Ascending loop of Henle

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31
Q

Transporter required for renal glucose reabsorption

A

SGLT (1/2)

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32
Q

How does an increase in glomerular capillary oncotic pressure affect GFR?

A

Decreases GFR

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33
Q

How is angiotensin II broken down

A

Via ACE2, aminopeptidases, chymase in the vasculature and kidneys

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34
Q

Which renal function marker is disproportionately elevated in lily toxicity?

A

Creatinine

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35
Q

Treatment of canine struvite stones

A

Treat UTI
Dissolution diet

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36
Q

What contributes to prevention of protein filtration by the glomeruli

A

Size
Negative charge

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37
Q

How does ANP affect GFR?

A

Increases (afferent vasodilation, efferent vasoconstriction)

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38
Q

How does angiotensin II affect GFR?

A

Constricts efferent arteriole to increase GFR

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39
Q

Function of principal cells in the collecting duct

A

Site of action of aldosterone; function to reabsorb Na/H2O and secrete K+

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40
Q

Stimuli for renin release (3)

A

Decreased afferent arteriole blood pressure
Decreased distal renal tubular Na/Cl/tubular flow
Sympathetic stimulation

41
Q

Cause of PU/PD with CKD (2)

A

Disruption of medullary concentration gradient
Solute diuresis in remaining nephrons

42
Q

Basenji with glucosuria and normoglycemia

A

Fanconi syndrome

43
Q

Pathogenesis of urate uroliths in Dalmatians

A

Mutation in uric acid transporter (SLC2A9) leading to hyperuricosuria

44
Q

Peritubular capillaries which surround the loop of Henle

A

Vasa recta

45
Q

Where is the macula densa located and what does it detect?

A

Distal tubule, filtrate Na/Cl concentrations

46
Q

How does sympathetic stimulation affect GFR?

A

Decreases (constriction of both afferent and efferent)

47
Q

What % of K+ is normally reabsorbed by the kidney?

48
Q

Maximal amount of substance that can be reabsorbed from filtrate

A

Transport maximum

49
Q

Site of majority of Na+ reabsorption

A

Proximal tubule (65%)

50
Q

Where does majority of phosphate reabsorption occur? Which hormone controls this?

A

Proximal tubule, controlled by PTH (via NaP-2a/2c and PiT-2)

51
Q

By what route (paracellular or transcellular) does calcium reabsorption occur in the proximal tubule?

A

Paracellular

52
Q

Which part of the loop of Henle is permeable to water?

A

Descending

53
Q

Site of action of loop diuretics

A

Na/2Cl/K cotransporter in ascending loop of Henle

54
Q

Site of action of thiazide diuretics

A

Na/Cl cotransporter in early distal tubule

55
Q

Function of intercalated cells in the distal tubules

A

Absorb K+/secrete H+

56
Q

Site of action of spironolactone

A

Principal cells (aldosterone receptors)

57
Q

Which protein mediates transcellular Ca2+ reabsorption, and which hormone controls it

A

TRPV5, controlled by PTH

58
Q

The collecting duct is (impermeable/permeable) to urea

A

Highly permeable

59
Q

How does increased arterial pressure affect tubular reabsorption?

A

Decreases it (pressure natriuresis/diuresis)

60
Q

How does constriction of efferent arterioles by angiotensin II affect filtration fraction?

A

Increases it

61
Q

Mechanism for generation of urine concentrating gradient

A

Countercurrent multiplier (generated by loop of Henle)

62
Q

How is HCO3 reabsorbed in the kidney?

A

Combines with H+ to form H2CO3 which dissociates into CO2 and H2O

63
Q

Two major urinary buffer systems

A

Phosphate
Ammonia

64
Q

How are drugs secreted into the renal tubule?

A

Via OCTs and OATs

65
Q

Which nerve conveys sensory signals regarding bladder stretch

66
Q

What type of cholinergic receptor is present on the detrusor muscle?

67
Q

Which species has a low renal threshold for bilirubin

68
Q

Types of pigmenturia

A

Hemoglobinuria
Myogoblinuria

69
Q

Mechanism of action of prazosin

A

Alpha-1 antagonist

70
Q

Mechanism of action of tamsulosin

A

Alpha-1A inhibitor

71
Q

Mechanism of action of bethanechol

A

Muscarinic agonist

72
Q

What % of body weight is comprised of water in adults?

73
Q

What % of total body water is intracellular?

74
Q

What % of total body water is extracellular?

75
Q

What % of extracellular water is comprised of intravascular water?

A

1/4 (5% of total body weight)

76
Q

Type of stones formed with ethylene glycol toxicity

A

Calcium oxalate monohydrate

77
Q

Most common infectious agents associated with pyelonephritis (4)

A

Proteus
Staph
Enterococcus
E coli

78
Q

Elevation in which electrolyte is commonly seen with AKI but not in CKD

79
Q

Stage the following dog based on IRIS CKD guidelines:
Creatinine 3.0mg/dL
SDMA 45ug/dL
UPCR <0.2
BP 150mmHg

A

IRIS stage 3, non-proteinuric, prehypertensive

80
Q

Stage the following cat based on IRIS CKD guidelines:
Creatinine 2.0mg/dL
SDMA 20ug/dL
UPCR 0.5
BP 170mmHg

A

IRIS stage 2, proteinuric, hypertensive

81
Q

Mechanisms of nausea associated with CKD

A

Triggering CRTZ by uremic toxins
Hypergastrinemia/ gastric hyperacidity

82
Q

Manifestation of severe hypokalemia in cats with CKD

A

Cervical ventroflexion, plantigrade stance

83
Q

Consequence of administration of erythrocyte-stimulating agents

A

Development of anti-EPO antibodies

84
Q

Types of immune-complex glomerulonephritis (3)

A

Membranoproliferative
Membranous
Mesangioproliferative

85
Q

Stain used to identify amyloid deposition

86
Q

Dog and cat breed with tendency to deposit amyloid in the renal medulla

A

Shar Pei
Abyssinian

87
Q

Treatment for amyloidosis

A

Colchicine +/- DMSO

88
Q

Nephrotic syndrome

A

Hypoalbuminemia
Proteinuria
Hypercholesterolemia
Edema

89
Q

Major sequelae associated with PLN

A

Thromboembolic disease

90
Q

Antiproteinuric drugs (2)

A

ACE inhibitors
Angiotensin II receptor blockers

91
Q

Type of urolith tiopronin is used for

92
Q

Treatment of USMI in female dogs

A

Phenylpropanolamine +/- estrogen therapy

93
Q

Most common type of ectopic ureter in dogs

A

Intramural

94
Q

Diagnosis of ectopic ureters (2)

A

CT excretory urography
Cystoscopy

95
Q

Treatment of intramural ectopic ureter

A

Transurethral cystoscopic laser ablation

96
Q

Treatment of functional outflow obstruction

A

Prazosin or tamsulosin +/- skeletal muscle relaxant

97
Q

Most common cause of UTI in dogs

A

E coli (45-55% of all positive cultures)
& other Gram negative

98
Q

Common sites that harbour bacterial reservoirs with relapsing UTI (4)

A

Kidneys
Prostate
Uroliths
Vagina

99
Q

Liquid biopsy used to detect urothelial and prostatic carcinoma in dogs

A

BRAF V595E

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