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Clinical pathology > Urinary > Flashcards

Urinary Flashcards

1
Q

What electrolytes are considered intracellular?

A

K+, P

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2
Q

What electrolytes are considered extracellular?

A

Na, Cl, HCO3

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3
Q

How does PTH control P levels in the body?

A

PTH causes P and Ca2+ release from bones. In order to prevent hyperphosphataemia it also results in the excretion of P from the kidney

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4
Q

What five mechanisms lead to hyperphosphataemia?

A

Failure to excrete (renal failure/ obstuction)
Increased release from bone (hyperthyroid)
Increased intake (hyper vitD3)
Increased renal reabsorption (hyperPTH)
Spurious (haemolysis)

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5
Q

What mechanisms can lead to hypophosphataemia?

A

Anorexia
Decreased renal resorption
Primary hyperPTH
Paraneoplastic

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6
Q

What is the reference value for hyponautraemia?

A

<140mmol/L

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7
Q

What mechanisms can lead to hyponautraemia?

A

Increased loss - V+, D+, renal, hypoAC, effusion loss, iatrogenic
Volume overload - CHF, renal failure
Increased plasma osmolality

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8
Q

What is the reference value for hypernautraemia

A

> 160mmol/L

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9
Q

What mechanisms can lead to hypernautraemia?

A

Free water loss - DI, heat stroke, water deprivation, pyrexia
Hypotonic fluid loss - GI, renal, diuresis, DM
Excessive intake
Excessive resorption - hyperaldosteronism
Iatrogenic

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10
Q

What mechanisms control potassium levels in the body?

A

Aldosterone, insulin, SNS

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11
Q

What clinical signs are associated with hyperkalaemia

A

Bradycardia, atrial standstil!

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12
Q

What substance can lead to an artefactual hyperkalaemia of the blood?

A

EDTA

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13
Q

What clinical signs are associated with hypokalaemia?

A

Muscle weakness, PUPD, low USG, ileus, constipation, myopathy (cats)

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14
Q

What mechanisms can lead to hyperkalaemia?

A

Decreased excretion (UT obstruction, hypoAC), extracellular translocation (tumour, trauma, necrosis, KDM), increased intake (iatrogenic)

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15
Q

What mechanisms can lead to hypokalaemia?

A

Decreased intake, intracellular translocation (catecholamines, hypothermia, fluid therapy), increased loss (V+, D+, iatrogenic)

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16
Q

What clinical signs are associated with hypercalcaemia?

A

pupd

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17
Q

What clinical signs are associated with hypocalcaemia?

A

Muscle tremors, seizures, facial pruritis, lethargy, weakness

18
Q

What aetiologies can lead hypercalcaemia?

A

Paraneoplastic, anal-gland carcinoma, Tcell lymphoma, renal dz, primary hyperPTH, hypoadrenocorticism, vitD3 tox

19
Q

What aetiologies can lead hypercalcaemia?

A

ethylene glycol, hypoPTH, renal dz, pancreatitis

20
Q

What chemical markers are used to assess GFR?

A

Creatinine, urea, SMDA

21
Q

What percentage of produced urea is resorbed in the nephron?

A

40%

22
Q

Why can urea NOT be used as a marker of GFR in ruminants?

A

It is degraded in the rumen by microbes!

23
Q

What does an increase in blood urea mean?

A

Reduced GFR

24
Q

What aetiology may lead to increased blood urea?

A

GI haemorrhage - protein breakdown/ hypovolaemia and dehydration - MILD
Renal dysfunction

25
Q

What aetiology may lead to a decrease in blood urea?

A

Aggressive fluid therapy

Decreased urea production - low protein diet, liver disease, PSS

26
Q

Why is creatinine no necessarily the best marker for GFR?

A

It is also increased with increased muscle mass (eg staffy, GH etc)

27
Q

Azotaemia

A

Increased serum BUN and creatinine

28
Q

Uraemia

A

Clinical syndrome characterising kidney disease as azotaemia + clinical signs (PUPD, regenerative anaemia, v+ depression, lethargy and wt loss)

29
Q

What type of azotaemia is characterised by concentrated urine, urea greater than creatinine and clinical signs of dehydration/ hypovolaemia?

A

Pre-renal - dehydration or decreased cardiac output

30
Q

What type of azotaemia is characterised by concentrated urine, urea increased and normal creatinine?

A

Pre-renal - increase in nitrogen (high protein diet, GI haemorrhage

31
Q

What type of azotaemia is characterised by a poor concentrating ability?

A

Renal

32
Q

What type of azotaemia may be characterised by hyperkalaemia, an/ oligouria and a hypercreatinine abdominocentesis fluid?

A

Post-renal - urinary tract rupture

33
Q

Why is SMDA a more sensitive measurement of GFR?

A

It is not affected by muscle mass

34
Q

USG> 1.029

A

Optimal concentration (check for dehydration)

35
Q

USG 1.030 dog/ 1.035 cat

A

Functioning tubules, supporting dehydration

36
Q

USG 1.012-1.030

A

Normal if ell hydrated or partial impairment of the concentrating ability

37
Q

USG 1.008 - 1.012

A

Over hydrated or not concentrating (if dehydrated)

38
Q

USG 1.000-1.007

A

ADH problem (eg DI)

39
Q

What extra renal causes can lead to azotaemia/ dehydration/ poor concentrating abilities?

A

ADH, aldosterone, iatrogenic, washout, infection

40
Q

What may proteinuria + low USG indicate?

A

Glomerular disease, protein overload

41
Q

Describe the interpretation of UP/C ratio.

A

If the ratio is >0,5 (dog) or 0.4 (cat) it indicated proteinuria

42
Q

What may an elevated UP/C without hyperproteinaemia indicate?

A

Glomerular disease

Clinical pathology (7 decks)

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