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2nd path test > Urinary (farina) > Flashcards

Urinary (farina) Flashcards

1
Q

nephron

A
  • functional unit of kidney
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2
Q

Renal dz may affect

A
  • glomeruli
  • tubules
  • interstitium
  • blood vessels
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3
Q

GLomeruli

A
  • Selective filter for molecules based on
    • size
    • charge
    • shape
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4
Q

Mesangial cells

A
  • phagocytose macromolecules and immune complexes
  • contract to autoregulate glomerular blood flow
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5
Q

Tubules

A
  • selectively secrete or reabsorb water and organic/inorganic subst
  • can regenerate
    • basement membrane must be intact for scaffolding (regenerating epithelial cells)
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6
Q

Endocrine functions of kidney

A
  • Erytropoietin
    • stimulates erythrocyte production
  • Renin
    • released in response to Na depletion or low blood volume
    • converts angiotensinogen to angiotensin I
  • Vitamin D activation
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7
Q

Renal aplasia

A
  • absense 1 or both
  • congenital
  • can be incidental finding
  • can have compensatory hyperplasia of rem kidney
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8
Q

Renal hypoplasia

A
  • smaller kidney
  • congenital
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9
Q

Horseshoe kidney

A
  • kidneys fused at renal pole
  • congenital
  • these function ok
  • incidental finding
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10
Q

Polycystic kidney disease (PKD)

A
  • primarily cats (persians)
  • aut dom (adult onset)
  • can also have liver cysts
  • renal failure over 7
  • ultrasound at 10 mo
  • bilateral
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11
Q

Acute renal infarct

A
  • red - tan after 2-3 days, then fibrosis
  • most common circulatory abnormality seen
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12
Q

Papillary necrosis

A
  • common in horses
  • common in dehydration wtih lots of NSAID admin
    • inhibit prostaglandin synthase PGE2 which maintains vasodilation in arterioles in juxtamedullary nephrons
    • Loss of vasodilatory effect => ischemia and subsequent ischemic necrosis
      • green gross - loss of tissue if survive
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13
Q

Hydronephrosis/hydroureter

A
  • hydronephrosis - dilation of renal pelvis/calyces
  • hydroureter - dilation of ureters
  • typically secondary to an obstruction

*goat reprocarcinoma pic

*horse pic

*sheep pic

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14
Q

Glomerulonephritis

A
  • immune complexes depositing at/in basement membrane
    • antibodies formed against glomerular basement membrane
  • Complement fixation, leukocytic infiltration and production inflammatory mediators by mesangial cells
  • filtration barrier compromised => Protein loss
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15
Q

Types glomerulonephritis

A
  • Membranous GN
    • thickened glomerular basement membranes => too much pink stuff in glomerulus
  • Proliferative GN
    • inc numbers of mesangial cells
  • Membranoproliferative GN
    • combo of both above
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16
Q

Conditions associated with GN

A
  • Chronic inflammatory stimuli
    • viral dz
    • chronic bact infecitons
    • parasitic and protozoal diseases
    • neoplasms
  • initial inciting cause often not determined
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17
Q

Glomerulosclerosis

A
  • shrunken end stage glomerulus
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18
Q

Dz with same end result as glomerular nephritis

A

Glomerular amyloidosis

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19
Q

Glomerular amyloidosis

A
  • often reactive systemic amyloidosis
    • acute phase protein, chronic inflammation
  • familial condition
    • shar pei
    • abyssinian
  • loss of glomerular function => progressive renal insufficiency, protein loss
  • Lugol’s iodine to fresh tissue: amyloid stains dark brown
  • Congo red: stains for amyloidin histo sections
  • causes proximal tubule damage

*grossly look pale

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20
Q

Embolic nephritis/glomerulitis

A
  • bact lodge in glomerular and peritubular capillaries
  • Horses
    • actinobaccillus equuli
  • Pigs
    • Erysipelothrix rhusiopathiae
  • Cattle
    • trueperella pyogenes (arcanobacterium)
    • from vavularendocarditis

*micro abcesses in cortex (glomeruli), tan colored, blue on histo stain

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21
Q

Acute tubular necrosis - ischemic

A
  • shock or hypotension
  • proximal tubules (higher metabolic rate)
  • disruption of basement membrane
    • no scaffold, therefore no regeneration
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22
Q

Acute tubular necrosis - toxic

A
  • tubules susceptible to toxins
  • proximal tubules
  • histo: ext necrosis prox tubules
  • basement membranes preserved
23
Q

Nephrosis

A
  • pale swollen kidney
24
Q

Tubular degeneration

A
  • vacuolar degeneration tubular epithelium
  • Don’t confuse with normal cat kidney cause they fat
25
Q

Tubular necrosis

Features

A
  • Loss of cellular detail
  • Nuclear Karyorrhexis (nucleus breaking up), karyolysis (nucleus fading out), pyknosis (small and dark)
  • Increased cytoplasmic eosinophilial
  • sloughing epithelial cells (looks vaculed on histo)
26
Q

Tubular regeneration

Features

A
  • increased cytoplasmic basophilia
  • piling/crowding epithel cells
  • nuclei with open chromiatin pattern and prominant nucleoli
  • mitotic figures
27
Q

Interstitial (tubulointerstitial nephritis)

A
  • most common cause chronic renal failure in old cats
  • acute cases
    • edema
    • leukocyte infiltration
    • focal tubular necrosis
  • chronic cases
    • leukocytic (often plasmocytic) infiltrate
    • interstial fibrosis
    • tubular atrophy

*lumpy bumpy irregular ligth pink kidney grossly

*lepto pig pic

28
Q

Pyelonephritis

A
  • inflammation of renal pelvis and parenchyma
  • Usually results from ascending infection from LUT
    • concurrent ureteritis and cystitis
  • Vesicoureteral reflux: retrograde flow up ureters during micturation
  • infections agents similar to those causing UTIs
  • radiating pattern grossly

*Edge of pelvis irregular, discoloration

*chronic cow case lighter pink

29
Q

Stephanurus dentatus

A
  • parasitic renal dz swine
  • eggs passed in urine
30
Q

Dioctophyma renale

A
  • giant kidney worm in mammals
  • adults live in renal pelvis
    • progressive destruction of renal parenchyma
  • fish eaters

*disgusting big worm

31
Q

Renal neoplasia

A
  • Adenoma
    • small, benign, incidental (looks like fat glob)
  • Adenocarcinoma
    • sheep, cattle dogs (looks like a white alien)
    • well-demarcated, compress renal parenchyma, located at one pole of kidney
  • Nephroblastoma
    • pigs, chicken, fish
    • younger animals, kidney looks primitive
  • metastises
    • lymphoma most common (multiple nodular masses thruout)
32
Q

Non-urinary lesions assoc with renal failure

A
  • gastric ulcers/uremic gastritis
  • ulcerative glossitis/tomatitis
  • mineralization intercostal pleura (uremic frosting)
  • uremic pneumonitis
  • parathyroid hyperplasia
    • phosphate retention from dec GFR - dec plasma ionized Ca++ - stimulates PTH rel
    • bilat dz indicates metabolic dz, not cancer
  • Anemia
    • dec erythropoietin, hemolysis from factors in uremic plasma
    • GI hemorrhage
33
Q

Ectopic ureter

A
  • ureters can empty into weird places
  • congenital
  • unilateral or bilateral
  • certain breeds predisposed
34
Q

Patent urachus

A
  • failures of closure of urachal lumen
    • results in driblling urine from urachus
  • most common in foals
35
Q

Urolithiasis

A
  • calculi in urinary passages
  • predisposing factors
    • urine pH (precipitation)
    • Hereditary (dalmations)
    • Dietary factors
    • UTIs
36
Q

Cystitis

A
  • ascending infection from rectal flora
  • predisposing factors
    • loss normal voiding
    • loss acidic urine pH (carnivores)
    • Glucosuria
    • Proteinuria
    • Mucosal trauma
  • Degress inflammation doesn’t correlate to histological inflammation
  • Females predisposed
37
Q

Emphysematous cystitis

A
  • gas in bladder
    • bacterial fermentation of urinary glucose to CO2
  • diabetics
38
Q

Enzootic hematuria

A
  • ruminants
  • bracken fern ingestion
    • toxic substances and carcinogens, alkylates DNA
  • Neoplasms
    • TCC
    • SCC
    • Papilloma
    • fibroma/sarcoma
    • hemangioma/sarcoma
    • leiomyosarcoma
39
Q

Neoplasia of lower urinary tract

A
  • Papilloma (look for features of malignancy)
    • covered by well-differentiated transitional epithelium
    • may undergo malignant transformation to TCC in dogs
  • TCC
    • most often in bladder neck/trigone
    • 50% met
  • Botryoid rhabdomyosarcoma (stem cells)
    • young (<18 mo) large/giant breed dogs
40
Q

UTI abx

A
  • clavamox for 14 days
41
Q

Relapse

A

same infection coming back

42
Q

recurrent infections

A

new infections

43
Q

Causes of recurrent UTIs

A
  • tumor
  • diabetes
  • Cushings (immunosuppression)
  • pyelonephritis (if org changed probs not)
  • ectopic ureters
  • neuro
  • bladder stones
44
Q

Piroxicam

A

COX 2 inhibitor

45
Q

Oral ulcers from

A

azotemia (uremia)

46
Q

Synechiae

A
  • adhesion of glomerulus to side of nephron
47
Q

Distiguishing acute from chronic renal failure

Acute

A
  • Acute
    • good body cond
    • smooth, enlarged kidneys (+/- pain)
    • Severe clnical signs related to BW
    • PCV N-inc
    • K+ N-inc
    • more severe metabolic acidosis
48
Q

Distiguishing acute from chronic renal failure

Chronic

A
  • Poor body condition
  • Small irregular kidneys on palpation
  • relatively mild CS related to BW (HIGH BUN)
  • nonregenerative anemia
  • K+ N-dec
  • less severe metabolic acidosis
  • Longstanding PU/PD
49
Q

Oxalates

A

Ethylene glycol poisoning

50
Q

Ethylene glycol toxicosis

A
  • Histopath
    • tubular necrosis
    • intratubular birefringent crystals
51
Q

Gout

A
  • Deposition of urates in tissues
    • visceral gout: depostion on serosal surfaces of organs
    • synovial gout: deposition in joints
52
Q

High levels uric acid predispose to

A
  • Tissue deposition
    • Renal dysfunction
    • dehydration
    • high protein diet
53
Q

Birds with renal tumors can present with

A
  • lameness
    • disrupt sciatic nerves
54
Q

Renal pelvic inflammation

A

Pyelitis

2nd path test (10 decks)

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