Urinary Pathology (1-3) Flashcards
1
Q
name the term
abnormal increase in non-protein nitrogenous substances in blood (urea, creatinine, etc)
A
azotemia
2
Q
name the term
the group of clinical signs resulting from azotemia
A
uremia
3
Q
name the term
GFR 20-50% normal, polyuria present, decreased concntrating ability
A
renal insufficiency
4
Q
name the term
GFR <20% normal, polyuria present, decreased concentrating ability and metabolic effects
A
chronic renal failure
5
Q
name the term
urine SG is the SAME as plasma (tubules haven’t concentrated or diluted the urine)
A
isothenuria
6
Q
name the term
urine SG is LOWER than plasma (implies dilution of the filtrate by the tubules)
A
hyposthenuric
7
Q
name the term
urine SG is HIGHER than plasma (implies concentration of the filtrate by the tubules)
A
hypersthenuric
8
Q
name the term
reduced urine production
A
oliguria
9
Q
name the term
no urine production
A
anuria
10
Q
name 3 reasons why the kidneys are particularly susceptible to toxic injury
A
- recieve 20% of the cardiac output
- large glomerular capillary surface area
- high metabolic rate of PCT and thick ascending Loop of Henle
11
Q
the occlusion of any branch of the renal artery will lead to this
A
infarction
12
Q
name 3 pathological features of the kidney in chronic renal failure
A
- shrunken and fibroses
- pale
- firm
13
Q
name the 4 steps of assessing the kidney at post mortem
A
- cut in sagittal plane
- remove capsule
- assess corticomedullary ratio
- assess overall contour of cortex and medulla
14
Q
what should the corticomedullary ratio be in the kidney?
A
1:2 to 1:3
15
Q
name the 3 types of azotemia
A
- pre-renal
- renal
- post-renal
16
Q
name the type of azotemia
occurs due to reduced renal perfusion
(dehydration, cardiac insufficiency, shock);
urine SG will rise as urine output is reduced to increase blood volume
A
pre-renal azotemia
17
Q
name the type of azotemia
develps when there is a decrease in GFR due to acute or chronic renal disease;
decreased renal clearance of both urea and creatinine
A
renal azotemia
18
Q
name the type of azotemia
occurs where there is an obstruction of the urinary tract distal to the kidneys;
GFR will decrease and serum urea and creatinine will increase
A
post-renal azotemia
19
Q
name 4 non-renal pathologies associated with renal failure
A
- epithelial lesions
- CV system
- pulmonary lesions
- altered calcium-phosphorous metabolism
20
Q
name 4 cardiovascular pathologies associated with renal failure
A
- lesions of uremic origin
- lesions of hypertensive origin
- fibrinous pericarditis
- anemia
21
Q
name the cardiovascular pathology associated with renal failure
necrosis of the wall of the left auricle and proximal aorta and pulmonary trunk;
erosion of the wall may be associated with thrombus formation
A
lesions of uremic origin
22
Q
name the cardiovascular pathology associated with renal failure
cardiac hypertrophy (esp. left side), medial hypertrophy of arterioles and fibrinoid degeneration of the muscle coats and small arteries;
esp. important in cats
A
lesions of hypertensive origin
23
Q
name the cardiovascular pathology associated with renal failure
fibrin deposits on visceral pericardial surface
A
fibrinous pericarditis
24
Q
name the cardiovascular pathology associated with renal failure
moderate normochromic, normocytic type;
often present in dog with chronic renal failure;
multifactoral etiology (increased RBC fragility, lack of EPO production)
A
anemia
25
serum phosphate is (high or low?) in pre-renal, renal and post renal disease due to decreased GFR
high (decreased clearance)
26
name 3 consequences of altered calcium-phosphorous metabolism due to renal failure
1. parathyroid hyperplasia
2. soft tissue mineralization
3. osteodystrophy
27
this is a characteristic lesion seen particularly in dogs;
calcium deposition in the subpleural connective tissue of the intercostal spaces ('ladder-like')
soft tissue mineralization
28
# name the developmental anomaly of the kidney
rare, familial tendency in Doberman and Beagle
renal aplasia
29
# name the developmental anomaly of the kidney
most common in pigs and dogs,
kidney usually in a pelvic or inguinal location;
consequences: incotinence, hydronephrosis, pyelonephritis
ectopic kidneys
30
# name the developmental anomaly of the kidney
this is due to abnormal nephrogenesis leading to one large kidney with 2 ureters
fused (horseshoe) kidneys
31
# name the developmental anomaly of the kidney
disorganized development of the renal parenchyma;
may resemble hypoplasia (affected kidneys are small)
dysplasia
32
# name the developmental anomaly of the kidney
common incidental finding in pigs and calves;
usually solitary;
must be differentiated from more significant polycystic kidney disease (PKD)
congenital cysts
33
# name the developmental anomaly of the kidney
small (1-2mm) cysts can occur as a sequel to interstitial fibrosis;
occur because tubukles become obstructed by scar tissue
acquired cysts
34
# name the developmental anomaly of the kidney
develop between the renal capsule and the renal reflection of the peritoneum;
usually found in conjunction with concomitant chronic renal disease
perinephric pseudocysts
35
# name the type of hemorrhage in the kidney
due to trauma; can lead to complete renal failure; subcapsular or intrarenal
gross hemorrhage
36
# name the type of hemorrhage in the kidney
common in septicemia disease (streptococcal infections, erysipelas)
petechial hemorrhage
37
# name the type of hemorrhage in the kidney
significant lesion in neonatal herpes virus infection of pups
renal cortical ecchymotic hemorrhages
38
name the 5 steps of infarction in the kidney
1. vascular occlusion
2. stasis and congestion
3. swelling of parenchyma
4. necrosis
5. eventual repair by fibrosis
39
what is the consequence if the renal artery is occluded
total/sub-total renal necrosis
40
what is the consequence if the arcurate artery is occluded
| (kidney)
necrosis of a wedge of the cortex and medulla
41
what is the consequence if the interlobular vessel is occluded
| (kidney)
cortical necrosis only
42
what are the features of an acute infarct of the kidney
swelling and hemorrhage
43
what is the features of a chronic infarct of the kidney
shrunken and fibrotic
44
what is the features of a renal infarct after 2-3 days
becomes pale with surrounding zone of hyperemia
45
the function of this is to act as a filter for the ultrafiltration of plasma;
damage often results in leakage of protein into the urine
glomerulus
46
# name the term
leakage of protein into the urine
proteinuria
47
what 4 things is the nephrotic syndrome characterized by
1. proteinuria
2. hypoalbuminemia
3. hypercholesterolemia
4. oedema
48
this is caused by increased hepatic production and defective metabolism of the VLDL fraction of lipoproteins
hypercholesterolemia
49
this ratio is used to quantify urinary protein loss in dogs and cats;
the higher the value, the more likely it is that glomerulonephropathy is present
urine protein:creatinine ratio
50
# name the familial renal disease (FRD)
characterized by splitting of components of the glomerular basement membrane thus compromising its function
Samoyed hereditary glomerulopathy
51
name two immune-mediated mechanisms that can caus glomerulonephritis
1. immune complex glomerulonephritis
2. antibodies produced against the glomerular basement membrane
52
# name the type of glomerulonephritis
characterized by the deposition of circulating antigen-antibody complexes in the glomeruli followed by complement fixation and neutrophil chemotaxis
immune complex glomerulonephritis
53
this refers to hypocellular and non-functional glomeruli which result from severe prolonged glomerular damage ;
lesion is characterized by fibrosis within the glomeruli whoich can result in rupture of Bowman's capsule
glomerulosclerosis
54
# name the kidney condition
accumulation of an insoluble fibrillar protein;
kidneys are enlarged and pale with a smooth finely granular capsular surface;
results in substantial protein loss in the urine with resultant hypoproteinemia and nephrotic syndrome
amyloidosis
55
which breeds have a hereditary predisposition to reactive amyloidosis
Shar Pei's and Abysinian cats
56
what to use to visualize amyloid macroscopically in a kidney with amyloidosis
iodine
57
what stain can be used microscopically to confirm the presence of amyloid
Congo Red
58
name the 2 types of glomerulitis
1. suppurative
2. viral
59
what is the most important cause of acute renal failure
acute tubular necrosis (ATN)
60
name the sequence of events for acute tubular necrosis in the kidney
1. degeneration
2. necrosis
3. desquamation
61
what are the two subtypes of acute tubular necrosis
1. ischemic/tubulorrhectic
2. Nephrotoxic
62
name 4 causes of nephrotoxic ATN (acute tubular necrosis)
1. heavy metals
2. oxalates
3. antibacterials
4. oak/acorns
63
why is the proximal convoluting tubule the most susceptible to injury, esp. from toxins
high metabolic rate
64
what are the two possible consequences/outcomes of acute tubular necrosis
1. regeneration (basement membrane in tact)
2. fibrosis (basement membrane lost)
65
which form of acute tubular necrosis is more likely to cause basement membrane damage/disruption
ischemic/tubulorrhectic ATn
66
name an example of tubulointerstitial disease in the dog
Leptospira canicola
67
name an example of tubulointerstitial disease in the cow
E. coli septicemia ('white spotted kidney')
68
name an example of tubulointerstitial disease in the horse
equine viral arteritis
69
name 3 renal parasites
1. Toxocara
2. Dioctophyma renale: giant kidney worm
3. Stephanurus dentatus: kidney worm
70
this is inflammation of both the renal pelvis and renal parenchyma;
often associated with suppurative tubulointerstitial inflammation
pyelonephritis
71
this is inflammation of the renal pelvis alone
pyelitis
72
name 3 reasons why the inner medulla of the kidney is highly susceptible to infection if it reaches the renal pelvis
1. poor blood supply
2. high osmolarity inhibiting neutrophil function
3. high ammonia concentration inhibiting comlement activation
73
what is a classic example of an organism causing pyelonephritis in cattle?
organism adheres to the urinary epithelium via pili
Corynebacterium renale
74
name the 3 components of the glomerular filter
1. vascular endothelium
2. glomerular basement membrane
3. podocyte foot processes
75
name 3 types of primary renal tumors that may occur
1. renal adenocarcinoma
2. renal adenoma
3. nephroblastoma
76
what is the most common primary renal neoplasm in dogs, cattle and sheep
renal adenocarcinoma
77
this is the most important uteral anomaly;
most common in females with opening to the bladder neck, urethra or vagina;
more prone to obstuction/infection
ectopic ureter
78
this is failure of seal between bladder and umbilicus at birth resulting in a direct channel between the bladder apex and umbilicus;
increased susception to infection;
commonest in foals
patent urachus
79
these are congenitally weak areas of the bladder wall, usually at the vertex;
can progress to cystitis
diverticuli
80
# name the bladder displacement
sequel of vaginal prolapse or perineal hernia;
can result in hydronephrosis or bladder rupture
retroflexion
81
# name the bladder displacement
reflex dyssynergia;
failure of spincter relaxation during micturition
neuromuscular dysfunction
82
name the major predisposing factor of urinary tract inflammation
urine stasis
83
# name the term
inflammation of the bladder
cystitis
84
what is the usual cause of cystitis
bacterial infection from the urethra
85
name 3 bacterial pathogens involved with cystitis
1. E. coli
2. staphs
3. streps
86
name an important bacterial pathogen involved with cystitis in cattle
C. renale
87
name an important bacterial pathogen involved with cystitis in pigs
E. suis
88
# name the type of cystitis
hemorrhagic, fibrinopurulent, necrotising, or ulcerative;
acute inflammation, oedema of lamina propria and superficial hyperemia/hemorrhage;
urine thick, foul smelling and hemorrhagic
acute cystitis
89
# name the type of cystitis
thickened mucosa and submucosa +/- hypertrophy of muscularis;
mononuclear cell inflammatory reaction
diffuse chronic cystitis
90
# name the type of cystitis
multifocular nodular proliferation of mononuclear cells (usually lymphocytes);
often in association with chronic uritholiasis
follicular chronic cystitis
91
# name the type of cystitis
most common in the bitch;
single or multiple discrete masses resulting from chronic infection or chronic urolithiasis;
often associated with heamturia
polypoid chronic cystitis
92
# name the type of cystitis
in dogs and cats with diabetes mellitus; relates to fermentation of sugar by glucose-fermenting bacteria
emphysematous cystitis
93
# name the type of cystitis
colonization of bladder by opportunistic fungi;
can cause extensive inflammation and ulceration
mycotic cystitis
94
name the common site of obstruction for dogs with urolithiasis
base of os penis
95
name the common site of obstruction for bulls with urolithiasis
ischial arch
proximal end of sigmoid flexure
96
name the common site of obstruction for rams with urolithiasis
vermiform appendage
97
name the common site of obstruction for cats with urolithiasis
urethra generally
98
obstruction caused by calculi (urolithiasis) is more common in this sex due to the anatomy of the lower urinary tract
males
99
# name the type of bladder neoplasia
caused by chronic ingestion of bracken fern;
ectasia and engorgement of capillaries (prone to hemorrhage);
tumors chiefly in bladder but can also occur in renal pelvis, ureter and liver
enzootic hematuria
100
# name the type of bladder neoplasia
spreads through and along the bladder wall destroying epithelium and invading muscle layers;
metastases to regional lymph nodes and lungs in 50% of cases
transitional cell carcinoma (TCC)
101
# name the type of bladder neoplasia
common;
occurs in smooth muscle of the bladder wall forming well defined white nodular projections
leiomyoma
102
# name the type of bladder neoplasia
young large breed dogs (<18mo, St. Bernards);
occurs as large fungating mass which is infiltrative and can metastasize
botyroid rhabdomyosarcoma
103
# name the prostatic disease
prostate gland grows slowly under influence of testosterone;
diffuse +/- cysts;
+/- constipation;
cells in sheets of varying size, mild increase in N:C ratio, nuclei may be eccentric
benign prostatic hyperplasia (BPH)
104
# name the prostatic disease
occurs in dog following estrogen administration or concurrently with testicular neoplasia;
conversion of prostatic epithelium to squamous epithelium;
moderate cellularity, large cells with 'floppy' appearance, occassional inflammatory cells
squamous metaplasia
105
# name the prostatic disease
in conjunction with benign prostatic hyperplasia (BPH) or as primary entity;
diffuse or focal;
neutrophils dominant (also macrophages), bacteria often present
suppurative prostatitis / prostatic abscess
106
# name the prostatic disease
may be congenital or arise secondary to hyperplasia, inflammation or neoplasia;
variable findings: few cells to moderate normal/slightly hyperplastic epithelial cells
prostatic cysts
107
what is the commonest form of prostatic neoplasia
prostatic adenocarcinoma
108
# name the prostatic disease
highly aggressive tumors, often metastasize to regional nodes and parenchymatous organs;
moderate/marked cellularity, anisokaryosis, large irredular nuclei, increased N:C ratio, nucleoli may be prominent
prostatic adenocarcinoma (prostatic neoplasia)
