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Clin Path > Urinary > Flashcards

Urinary Flashcards

1
Q

Define concentrating ability:

A

renal capacity to resorb water in excess of solutes in the glomerualr filtrate

concentrate glomerular filtrate

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2
Q

Define diluting ability:

A

capacity to resorb solutes in excess of water in teh gloimerular filtate

dilute glomerular filtrate

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3
Q

Define Isosthenuria:

A

USG= 1.007 to 1.013

urine osmolality = serum osmolality

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4
Q

Define Hyposthenuria:

A

USG

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5
Q

Define Hypersthenuria:

A

concentrated urine >1.013, variable species to species on appropriateness

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6
Q

What produces ADH?

A

pituitary in response to hypovolemia, hyperosmolality

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7
Q

Where does ADH act?

A

collecting tubules

aquaporins/water resorption

needs medullary hypertonicity
urea, Na, Cl

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8
Q

Where is aldosterone produced?

A

Zona Glomerulosa of adrenal gland in response to:

angiotensin 2, ACTH, K+

Acts on Distal/Convoluted Tubules

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9
Q

What does aldosterone do?

A

Leads to resorption of Na/Cl

water follows

K+ is excreted

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10
Q

What 3 things are required by the kidney to concentrate urine?

A

ADH- hyperosmolality, hypovolemia, increased angiotensin

Epithelial cells in CT that are responsive to ADH

Medullary hypertonicity- osmolality of the medullary interstitial fluid must exceed that of the tubular fluid

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11
Q

Define azotemia

A

increased non protein nitrogenous compounds in the blood

increased serum creatinine

increased serum urea nitrogen

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12
Q

Define uremia

A

clinical manifestation of renal failure

Vomiting, wt loss, anemia, oral ulcers, PU/PD

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13
Q

Define GFR:

A

GLomerular filtration rate

rate substance is cleared from plasma

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14
Q

What is GFR depenedent on?

A

blood volume

cardiac output

of functional glomeruli

vessel constriction/dilation

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15
Q

What are the 4 stages of Renal Disease?

A

Diminished renal reserve

Chronic Renal insufficiency

Chronic Renal Failure

End Stage Renal Disease

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16
Q

Define Chronic Renal Failure:

A

Loss of concentrating ability may precede azotemia

> 2/3rds loss of functional renal mass you loose concentrating ability

> 3/4 ths loss of functional mass you develop azotemia

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17
Q

Why do animals loose concentrating ability in CRF?

A

more solute presented to remaining functional nephrons

high solute results in solute diuresis

Medullary hypertonicity not maintained

tissue damage, Na/Cl transport to interstitial fluid is decreased, epithelium in distal nephron tubule less responsive to ADH

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18
Q

Define Acute Renal Failure

A

can be both reversible/non-reversible

abrupt insult that markedly reduced GFR

Toxins, ischemia, infection

19
Q

T/F magnitude of azotemia is used to differentiate between CRF/ARF

A

FALSE

moderate-marked azotemia develops quickly in ARF, takes weeks to months in CRF

20
Q

What common urine volume is observed in ARF?

A

oliguria or anuria is common

21
Q

What makes a solute ideal for measuring GFR?

A

freely filtered

not secreted

not resorbed

inulin, iohexol, mannitol

CREATININE

22
Q

What is Creatinine?

A

small nitrogen based molecule; produced by degredation of creatine, creatine-phosphate

Freely filterd, minimal secretion, species specific

most frequently used to assess renal function, most efficient indirect marker of GFR

BUT it is insensitve

23
Q

What is Urea Nitrogen?

A

BUN, SUN, UN

pdx by liver from ammonia, hepatic urea cycle

main form of nitrogenous waste in mammals

Eliminated by kidney- freely filtered, some tubule resorption, depends on flow etc

24
Q

What non renal factors can affect UN serum levels?

A

RMT/Horses- additional routes of secretion, diet

Carnivores- mild post-prandial increase, high protein diet

GI hemmorrhage

25
Q

Always interpret urine with ______

A

URINE SPECIFIC GRAVITY

26
Q

What causes PRE-RENAL azotemia?

A

Hypovolemia- dehydration, shock, blood loss

decreased cardiac output- cardiac insufficiency, hypoadrenocorticism

Shock- anaphylactic/septic

GI hemorrhage

27
Q

What causes RENAL azotemia?

A

Primary- inflammation, amyloidosis, toxic, congenital, hypoxia, hydronephrosis, neoplasia

28
Q

What causes POST-RENAL azotemia?

A

blockage of excretion, UT obstruction/urine leakage

stones

29
Q

What is the most important thing used to classify type of azotemia?

A

Urine Specific Gravity

other considerations:
multifactorial azotemia
extrarenal factors interferring w/ concentrating ability

30
Q

If a given species of animal has azotemia, what would you expect thier USG be if they have an appropriate response

Dog
Cat
Horse
RMT

A

Dog >1.030

Cat >1.040

Horse >1.025

RMT >1.025

31
Q

IF USG is > than the expected value, what can you conclude?

A

The animal is responding, kidneys are doing their job

32
Q

IF USG is

A

Something is wrong, impaired concentrating ability

33
Q

What are some external renal causes of impaired concentrating ability in face of azotemia?

A

Tubules unresponsive to ADH- hyperCa, hypoK, endotoxemia, corticodteroids

solute overload- osmotic diuresis

decreased medullary hypertonicity- hypoNa/Cl, loop diuretics, decreased urea pdx- liver failure

34
Q

What is FE?

A

fractional excretion

sodim most commonly measured

35
Q

______ damage increases FE

______ decreases FE

A

Tubular damage increases FE

Pre-renal azotemia decreases FE

36
Q

Hyperphosphatemia occurs with decreased GFR in ______

A

Dogs and Cats

37
Q

T/F phosphorus is the single most important electrolyte in RMT classification of azotemia

A

Super false… it doesnt tell you shit

38
Q

Hypophosphatemia is indicative of renal failure in which species?

A

Horses

39
Q

Decreased in GFR results in Hypercalcemia in _____

A

horses

40
Q

Hypocalcemia resulting from renal failure occurs in:

A

Dogs, Cats, RMT

EXCEPT sometimes small animals have the opposite occur in congenital renal dz

41
Q

What is the threshold/formula for determining soft tissue mineralization?

A

multiply phosphorus/calcium

> 70 Watch out

42
Q

What does Magnesium tell you?

A

Nothing you have to read the test results

hypermag occurs with decreased GFR

43
Q

Hyperkalemia occurs with impaired renal function in:

A

dogs, cats, horses

44
Q

What happens to K in RMTs?

A

hypokalemia in azotemia

metabolic acidosis

Clin Path (23 decks)

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