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Systemic Path > Urinary 3 > Flashcards

Urinary 3 Flashcards

1
Q

Name the organism that causes leptospirosis.

A

Leptospirosis is caused by the spirochete bacterium Leptospira interrogans.

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2
Q

Which two serovars of Leptospira interrogans most commonly infect dogs?

A

(1) Leptospira interrogans serovar canicola. (2) Leptospira interrogans serovar icterohaemorrhagiae.

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3
Q

What specific type of nephritis is associated with leptospirosis?

A

Tubulointerstitial nephritis / Interstitial nephritis (both terms OK).

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4
Q

Approximately how many serovars of Leptospira interrogans are known?

A

~200.

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5
Q

Which species are affected by leptospirosis?

A

Domestic & wild animals and humans all susceptible to infection.

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6
Q

How is leptospirosis transmitted between animals?

A

Leptospires shed in urine of infected animal –> infect new animal via breaches in mucous membranes.

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7
Q

Where do leptospiral organisms preferentially localize?

A

In renal tubular epithelial cells.

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8
Q

Delayed hypersensitivity to leptospira antigens may be associated with which ocular condition in horses?

A

Equine recurrent uveitis (“moon blindness” or periodic ophthalmia).

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9
Q

Which organism most commonly causes “white spotted kidney” in calves?

A

E. coli.

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10
Q

“White spotted kidney” in calves is most commonly caused by E. coli. How does it reach the kidney, and what is the characteristic gross lesion of this disease?

A

(1) By embolic showering of the kidney. (2) Numerous pale-yellow to white 2 to 5-mm diameter nodules (foci of inflammatory cells) are scattered randomly throughout and over the surface of the kidney.

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11
Q

“White spotted kidney” in calves is most commonly caused by E. coli. What are two other bacterial genera that may cause this disease?

A

Brucella and Salmonella.

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12
Q

Which types of inflammatory cells form renal nodules in “white-spotted kidney” disease of calves?

A

Lymphocytes, plasma cells and macrophages.

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13
Q

What is the most common cause by far of granulomatous nephritis in cats?

A

Mutant feline enteric coronavirus (feline infectious peritonitis is OK as an answer too).

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14
Q

Describe the characteristic appearance of the kidney of a cat that has died of FIP.

A

Numerous randomly scattered to coalescing white to gray plaques (granulomas) cover the renal capsule and extend into the cortex. Often lesions on the capsular surface follow along blood vessels.

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15
Q

What does “FIP” stand for?

A

Feline infectious peritonitis.

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16
Q

What causes FIP?

A

Mutant feline enteric coronavirus.

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17
Q

What is the key histologic lesion caused by FIP?

A

Granulomatous vasculitis.

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18
Q

Which types of cells comprise the inflammatory infiltrates in granulomatous inflammation?

A

Macrophages mainly, although lymphocytes and plasma cells are also present.

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19
Q

Any bacterial species that can produce a bacteremia may shower the kidney causing an embolic nephritis. However, certain bacterial species are typically responsible in different species of animal. I have only asked you to memorize two bacterial species, both of which shower the kidneys to produce hundreds of randomly scattered, predominantly cortical, white nodules. What are these two bacterial species, and which domestic animal species do they affect?

A

(1) E. coli in calves. (2) Actinobacillus equuli in foals.

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20
Q

What is the correct term for inflammation of the renal pelvis and kidney?

A

Pyelonephritis (NOT pyonephritis). PyELo, not Pyo!

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21
Q

How do cases of pyelonephritis typically begin?

A

Pyelonephritis usually begins as an ascending bacterial infection of the urinary tract. Ascending infections typically result from a combination of urinary bladder infection, vesicoureteral reflux, and intrarenal reflux.

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22
Q

What are the two most common bacterial causes of pyelonephritis in cattle?

A

(1) Corynebacterium renale. (2) Arcanobacterium pyogenes*. [Note that Arcanobacterium pyogenes recently changed name to Trueperella pyogenes. Most textbooks still use the old name and you need to know it.]

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23
Q

Why are females more prone than males to development of pyelonephritis?

A

Females’ shorter urethras predispose to bacterial infection of the lower urinary tract.

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24
Q

Describe the characteristic gross lesions of pyelonephritis.

A

The renal pelvis contains suppurative exudate and the inner medulla is damaged. This damage may radiate into the outer medulla and cortex.

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25
Q

What is the term for complete failure of a kidney to develop?

A

Renal aplasia.

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26
Q

What is the term for the condition in which fewer nephrons than normal develop in a kidney?

A

Renal hypoplasia.

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27
Q

Ectopic kidneys are typically structurally and functionally normal. Nevertheless, they may be associated with urinary tract disease. Why?

A

They frequently have malpositioned ureters, which can cause urinary tract disease.

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28
Q

What is the lay-term for kidneys in which the left and right cranial poles are fused?

A

“Horseshoe kidneys”.

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29
Q

Explain, in broad histologic terms, the difference between renal hypoplasia and renal dysplasia.

A

(1) Renal hypoplasia: fewer nephrons than normal are present in one or both kidneys. (2) Renal dysplasia: The microscopic architecture of the kidney is not correctly developed.

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30
Q

What is the typical gross appearance of a dysplastic kidney?

A

Dysplastic kidneys are usually small and misshapen.

31
Q

Although dysplastic kidneys may retain some normal function they commonly go on to develop what lesions?

A

(1) Cysts. (2) Fibrosis.

32
Q

What is a simple summary of the disease canine progressive juvenile nephropathy?

A

Severe, progressive, bilateral renal fibrosis in young dogs with an unknown cause but a familial/breed tendency.

33
Q

Name the disease that causes severe, progressive, bilateral renal fibrosis in young dogs.

A

Progressive juvenile nephropathy.

34
Q

You are performing a necropsy on a 6 month old cocker spaniel and note severe, bilateral renal fibrosis. In addition to other renal diseases, which familial disease should be high on your differential list?

A

Progressive juvenile nephropathy.

35
Q

Dogs affected with progressive juvenile nephropathy are typically in what age range?

A

4-24 months old.

36
Q

You are performing a necropsy on a 6 month old dog and note that one kidney is grossly normal and one is shrunken, pale and multinodular. Which of the following potential causes is the LEAST likely? (a) Progressive juvenile nephropathy; (b) renal dysplasia; (c) renal fibrosis resulting from some other renal disease that developed at an early age.

A

(a) Progressive juvenile nephropathy, because this affects both kidneys.

37
Q

Name three (non-renal) organs commonly affected with cysts in polycystic kidney disease.

A

(1) Liver. (2) Biliary system. (3) Pancreas.

38
Q

You are performing a necropsy on a newborn calf and note a 1 cm diameter fluid-filled renal cortical cyst. True or false: this calf likely has polycystic kidney disease. Justify and explain your choice of answer.

A

False. PKD causes multiple cysts. This single cyst is likely just a congenital simple cyst, a common and incidental finding in calves.

39
Q

What is the typical gross appearance of a kidney with polycystic kidney disease?

A

The normal renal parenchyma contains / is replaced by numerous variably-sized, closely-packed, thin-walled fluid-filled cysts. [Just saying “Swiss cheese” isn’t enough.]

40
Q

Name three breeds of small animal commonly affected by polycystic kidney disease.

A

(1) West highland white terriers. (2) Bull terriers. (3) Persian cats.

41
Q

True or false: Severe polycystic kidney disease, although dramatic-looking, is rarely associated with clinical signs.

A

False. It can lead to renal failure.

42
Q

How do acquired renal cysts form?

A

Scarring occurs for some reason in the kidney –> Multifocal nephron blockage, with tubules “choked off” by fibrosis –> Fluid accumulation –> Tubular or urinary space dilation –> cysts.

43
Q

Describe the pathogenesis of hydronephrosis.

A

Obstruction of urinary outflow from kidney (ureteral or urethral blockage caused by calculi, chronic inflammation, neoplasia or neurogenic functional disorders) –> Accumulation of urine in renal pelvis (due to persistence of glomerular filtration in face of obstruction) –> (1) Papillary necrosis and (2) cortical atrophy [–>] Eventual reduction of the kidney to a fluid-filled, thin-walled shell.

44
Q

What kind of conditions can result in hydronephrosis?

A

[Ureteral or urethral blockage caused by …] (1) Calculi. (2) Chronic inflammation and fibrosis. (3) Neoplasia. (4) Neurogenic functional disorders.

45
Q

True or false: primary renal neoplasms, although rare, are typically benign

A

False. They are often highly malignant, quick to metastasize and associated with poor survival time.

46
Q

True or false: the most common secondary (metastatic) renal neoplasm is lymphosarcoma.

A

True.

47
Q

Name the most common malignant primary renal neoplasm.

A

Renal (adeno)carcinoma.

48
Q

Name the renal neoplasm that is sometimes seen as an incidental finding at slaughter in pigs and chickens.

A

Nephroblastoma.

49
Q

In which two species of domestic animal is renal lymphosarcoma most common?

A

(1) Cattle. (2) Cats.

50
Q

Do you need another reminder that lymphoma and lymphosarcoma are the same disease?

A

No.

51
Q

You are performing a necropsy on a cat and note numerous variably-sized (up to 8 mm diameter) discrete to confluent white renal cortical nodules. What are your top two likely diagnoses?

A

(1) Feline infections peritonitis. (2) Lymphoma.

52
Q

What type of epithelium lines the bulk of the lower urinary tract?

A

Transitional epithelium / Urothelium

53
Q

Which species of domestic animal has mucoid urine?

A

Horse.

54
Q

What is the most common developmental disorder of the ureters?

A

Ectopic ureters.

55
Q

What is the primary presenting clinical complaint in an animal with ectopic ureters?

A

Dribbling urine.

56
Q

True or false: females are more predisposed than males to ectopic ureters.

A

True.

57
Q

Which breed of dog is predisposed to ectopic ureters?

A

Siberian husky.

58
Q

The primary complaint by the owner of a dog with an ectopic ureter is “leaking.” What other, more serious conditions do ectopic ureters lead to?

A

(1) Urinary tract obstruction. (2) Urinary tract infection.

59
Q

You are presented with a 3 day old foal who has urine dribbling from his umbilicus and severe urine scalding on the ventral abdomen. What is the most likely diagnosis?

A

Patent (persistent) urachus.

60
Q

What is the most common developmental disorder of the urinary bladder?

A

Patent (persistent) urachus.

61
Q

True or false: the most common site for development of calculi is the urethra.

A

False. The urethra is the most common site for lodging of calculi, but not formation. The ureter is the most common site for development of calculi, followed by the bladder.

62
Q

True or false: the term calculus refers to crystals within urine while the term urolith is reserved for grossly visible concretions in the urinary passages.

A

False. The terms calculus and urolith are synonyms.

63
Q

True or false: crystalluria inevitably leads to urolithiasis.

A

False. Horses, for example, frequently have calcium carbonate crystalluria but calculi are relatively rare in this species.

64
Q

Urolithiasis may lead to obstruction of the urinary tract. Is this more common in males or females? Justify and explain your answer.

A

More common in males due to (1) a longer urethra and (2) certain species-dependent “bottlenecks”: the sigmoid flexure in cattle, the os penis in dogs and cats and the urethral process in small ruminants.

65
Q

Name two common causes (i.e., chemical composition) of urolithiasis in dogs and cats.

A

(1) Struvite (magnesium ammonium phosphate hexahydrate, AKA triple phosphate). (2) Oxalate.

66
Q

What is the chemical that comprises “struvite”?

A

Magnesium ammonium phosphate hexahydrate, AKA triple phosphate

67
Q

What type of calculus is common in pastured ruminants?

A

Silica.

68
Q

Describe the typical gross appearance of the mucosa of a bladder with chronic cystitis.

A

The mucosal surface of the bladder may be hyperemic, hemorrhagic or ulcerated. Often numerous small raised red mucosal nodules are present (these are hyperplastic lymphoid nodules surrounded by hyperemia and hemorrhage). The bladder wall may be thickened.

69
Q

What do these three have in common: (a) bracken fern; (b) cyclophosphamide; (c) cantharidin toxin in blister beetles?

A

All three are causes of toxic cystitis. [Bracken fern in cattle; Cyclophosphamide in dogs; Blister beetles in horses].

70
Q

What is enzootic hematuria, in which species is this condition seen, and what is the cause?

A

Enzootic hematuria is a disease of cattle in which chronic bracken fern ingestion leads to hematuria, cystitis and (sometimes) bladder neoplasia.

71
Q

What urinary tract lesion may be induced by cyclophosphamide use in dogs?

A

Sterile hemorrhagic cystitis.

72
Q

What plant may cause urinary bladder neoplasia in cattle?

A

Bracken fern.

73
Q

What is the connection between a horse eating hay that contains dead beetles and the horse developing severe hemorrhagic cystitis?

A

If the beetles are blister beetles, which contain the toxin cantharidin, the toxin can lead to hemorrhage and necrosis of multiple epithelial surfaces, including that of the bladder.

74
Q

What is the most common neoplasm of the canine bladder?

A

Transitional cell carcinoma.

Systemic Path (12 decks)

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