Urinary Pathology (1-3) Flashcards

1
Q

name the term

abnormal increase in non-protein nitrogenous substances in blood (urea, creatinine, etc)

A

azotemia

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2
Q

name the term

the group of clinical signs resulting from azotemia

A

uremia

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3
Q

name the term

GFR 20-50% normal, polyuria present, decreased concntrating ability

A

renal insufficiency

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4
Q

name the term

GFR <20% normal, polyuria present, decreased concentrating ability and metabolic effects

A

chronic renal failure

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5
Q

name the term

urine SG is the SAME as plasma (tubules haven’t concentrated or diluted the urine)

A

isothenuria

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6
Q

name the term

urine SG is LOWER than plasma (implies dilution of the filtrate by the tubules)

A

hyposthenuric

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7
Q

name the term

urine SG is HIGHER than plasma (implies concentration of the filtrate by the tubules)

A

hypersthenuric

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8
Q

name the term

reduced urine production

A

oliguria

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9
Q

name the term

no urine production

A

anuria

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10
Q

name 3 reasons why the kidneys are particularly susceptible to toxic injury

A
  1. recieve 20% of the cardiac output
  2. large glomerular capillary surface area
  3. high metabolic rate of PCT and thick ascending Loop of Henle
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11
Q

the occlusion of any branch of the renal artery will lead to this

A

infarction

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12
Q

name 3 pathological features of the kidney in chronic renal failure

A
  1. shrunken and fibroses
  2. pale
  3. firm
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13
Q

name the 4 steps of assessing the kidney at post mortem

A
  1. cut in sagittal plane
  2. remove capsule
  3. assess corticomedullary ratio
  4. assess overall contour of cortex and medulla
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14
Q

what should the corticomedullary ratio be in the kidney?

A

1:2 to 1:3

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15
Q

name the 3 types of azotemia

A
  1. pre-renal
  2. renal
  3. post-renal
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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

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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

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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

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19
Q

name 4 non-renal pathologies associated with renal failure

A
  1. epithelial lesions
  2. CV system
  3. pulmonary lesions
  4. altered calcium-phosphorous metabolism
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20
Q

name 4 cardiovascular pathologies associated with renal failure

A
  1. lesions of uremic origin
  2. lesions of hypertensive origin
  3. fibrinous pericarditis
  4. anemia
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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

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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

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23
Q

name the cardiovascular pathology associated with renal failure

fibrin deposits on visceral pericardial surface

A

fibrinous pericarditis

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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

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25
Q

serum phosphate is (high or low?) in pre-renal, renal and post renal disease due to decreased GFR

A

high (decreased clearance)

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26
Q

name 3 consequences of altered calcium-phosphorous metabolism due to renal failure

A
  1. parathyroid hyperplasia
  2. soft tissue mineralization
  3. osteodystrophy
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27
Q

this is a characteristic lesion seen particularly in dogs;
calcium deposition in the subpleural connective tissue of the intercostal spaces (‘ladder-like’)

A

soft tissue mineralization

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28
Q

name the developmental anomaly of the kidney

rare, familial tendency in Doberman and Beagle

A

renal aplasia

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29
Q

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

A

ectopic kidneys

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30
Q

name the developmental anomaly of the kidney

this is due to abnormal nephrogenesis leading to one large kidney with 2 ureters

A

fused (horseshoe) kidneys

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31
Q

name the developmental anomaly of the kidney

disorganized development of the renal parenchyma;
may resemble hypoplasia (affected kidneys are small)

A

dysplasia

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32
Q

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)

A

congenital cysts

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33
Q

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

A

acquired cysts

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34
Q

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

A

perinephric pseudocysts

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35
Q

name the type of hemorrhage in the kidney

due to trauma; can lead to complete renal failure; subcapsular or intrarenal

A

gross hemorrhage

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36
Q

name the type of hemorrhage in the kidney

common in septicemia disease (streptococcal infections, erysipelas)

A

petechial hemorrhage

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37
Q

name the type of hemorrhage in the kidney

significant lesion in neonatal herpes virus infection of pups

A

renal cortical ecchymotic hemorrhages

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38
Q

name the 5 steps of infarction in the kidney

A
  1. vascular occlusion
  2. stasis and congestion
  3. swelling of parenchyma
  4. necrosis
  5. eventual repair by fibrosis
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39
Q

what is the consequence if the renal artery is occluded

A

total/sub-total renal necrosis

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40
Q

what is the consequence if the arcurate artery is occluded

(kidney)

A

necrosis of a wedge of the cortex and medulla

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41
Q

what is the consequence if the interlobular vessel is occluded

(kidney)

A

cortical necrosis only

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42
Q

what are the features of an acute infarct of the kidney

A

swelling and hemorrhage

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43
Q

what is the features of a chronic infarct of the kidney

A

shrunken and fibrotic

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44
Q

what is the features of a renal infarct after 2-3 days

A

becomes pale with surrounding zone of hyperemia

45
Q

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

A

glomerulus

46
Q

name the term

leakage of protein into the urine

A

proteinuria

47
Q

what 4 things is the nephrotic syndrome characterized by

A
  1. proteinuria
  2. hypoalbuminemia
  3. hypercholesterolemia
  4. oedema
48
Q

this is caused by increased hepatic production and defective metabolism of the VLDL fraction of lipoproteins

A

hypercholesterolemia

49
Q

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

A

urine protein:creatinine ratio

50
Q

name the familial renal disease (FRD)

characterized by splitting of components of the glomerular basement membrane thus compromising its function

A

Samoyed hereditary glomerulopathy

51
Q

name two immune-mediated mechanisms that can caus glomerulonephritis

A
  1. immune complex glomerulonephritis
  2. antibodies produced against the glomerular basement membrane
52
Q

name the type of glomerulonephritis

characterized by the deposition of circulating antigen-antibody complexes in the glomeruli followed by complement fixation and neutrophil chemotaxis

A

immune complex glomerulonephritis

53
Q

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

A

glomerulosclerosis

54
Q

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

A

amyloidosis

55
Q

which breeds have a hereditary predisposition to reactive amyloidosis

A

Shar Pei’s and Abysinian cats

56
Q

what to use to visualize amyloid macroscopically in a kidney with amyloidosis

A

iodine

57
Q

what stain can be used microscopically to confirm the presence of amyloid

A

Congo Red

58
Q

name the 2 types of glomerulitis

A
  1. suppurative
  2. viral
59
Q

what is the most important cause of acute renal failure

A

acute tubular necrosis (ATN)

60
Q

name the sequence of events for acute tubular necrosis in the kidney

A
  1. degeneration
  2. necrosis
  3. desquamation
61
Q

what are the two subtypes of acute tubular necrosis

A
  1. ischemic/tubulorrhectic
  2. Nephrotoxic
62
Q

name 4 causes of nephrotoxic ATN (acute tubular necrosis)

A
  1. heavy metals
  2. oxalates
  3. antibacterials
  4. oak/acorns
63
Q

why is the proximal convoluting tubule the most susceptible to injury, esp. from toxins

A

high metabolic rate

64
Q

what are the two possible consequences/outcomes of acute tubular necrosis

A
  1. regeneration (basement membrane in tact)
  2. fibrosis (basement membrane lost)
65
Q

which form of acute tubular necrosis is more likely to cause basement membrane damage/disruption

A

ischemic/tubulorrhectic ATn

66
Q

name an example of tubulointerstitial disease in the dog

A

Leptospira canicola

67
Q

name an example of tubulointerstitial disease in the cow

A

E. coli septicemia (‘white spotted kidney’)

68
Q

name an example of tubulointerstitial disease in the horse

A

equine viral arteritis

69
Q

name 3 renal parasites

A
  1. Toxocara
  2. Dioctophyma renale: giant kidney worm
  3. Stephanurus dentatus: kidney worm
70
Q

this is inflammation of both the renal pelvis and renal parenchyma;
often associated with suppurative tubulointerstitial inflammation

A

pyelonephritis

71
Q

this is inflammation of the renal pelvis alone

A

pyelitis

72
Q

name 3 reasons why the inner medulla of the kidney is highly susceptible to infection if it reaches the renal pelvis

A
  1. poor blood supply
  2. high osmolarity inhibiting neutrophil function
  3. high ammonia concentration inhibiting comlement activation
73
Q

what is a classic example of an organism causing pyelonephritis in cattle?
organism adheres to the urinary epithelium via pili

A

Corynebacterium renale

74
Q

name the 3 components of the glomerular filter

A
  1. vascular endothelium
  2. glomerular basement membrane
  3. podocyte foot processes
75
Q

name 3 types of primary renal tumors that may occur

A
  1. renal adenocarcinoma
  2. renal adenoma
  3. nephroblastoma
76
Q

what is the most common primary renal neoplasm in dogs, cattle and sheep

A

renal adenocarcinoma

77
Q

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

A

ectopic ureter

78
Q

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

A

patent urachus

79
Q

these are congenitally weak areas of the bladder wall, usually at the vertex;
can progress to cystitis

A

diverticuli

80
Q

name the bladder displacement

sequel of vaginal prolapse or perineal hernia;
can result in hydronephrosis or bladder rupture

A

retroflexion

81
Q

name the bladder displacement

reflex dyssynergia;
failure of spincter relaxation during micturition

A

neuromuscular dysfunction

82
Q

name the major predisposing factor of urinary tract inflammation

A

urine stasis

83
Q

name the term

inflammation of the bladder

A

cystitis

84
Q

what is the usual cause of cystitis

A

bacterial infection from the urethra

85
Q

name 3 bacterial pathogens involved with cystitis

A
  1. E. coli
  2. staphs
  3. streps
86
Q

name an important bacterial pathogen involved with cystitis in cattle

A

C. renale

87
Q

name an important bacterial pathogen involved with cystitis in pigs

A

E. suis

88
Q

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

A

acute cystitis

89
Q

name the type of cystitis

thickened mucosa and submucosa +/- hypertrophy of muscularis;
mononuclear cell inflammatory reaction

A

diffuse chronic cystitis

90
Q

name the type of cystitis

multifocular nodular proliferation of mononuclear cells (usually lymphocytes);
often in association with chronic uritholiasis

A

follicular chronic cystitis

91
Q

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

A

polypoid chronic cystitis

92
Q

name the type of cystitis

in dogs and cats with diabetes mellitus; relates to fermentation of sugar by glucose-fermenting bacteria

A

emphysematous cystitis

93
Q

name the type of cystitis

colonization of bladder by opportunistic fungi;
can cause extensive inflammation and ulceration

A

mycotic cystitis

94
Q

name the common site of obstruction for dogs with urolithiasis

A

base of os penis

95
Q

name the common site of obstruction for bulls with urolithiasis

A

ischial arch
proximal end of sigmoid flexure

96
Q

name the common site of obstruction for rams with urolithiasis

A

vermiform appendage

97
Q

name the common site of obstruction for cats with urolithiasis

A

urethra generally

98
Q

obstruction caused by calculi (urolithiasis) is more common in this sex due to the anatomy of the lower urinary tract

A

males

99
Q

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

A

enzootic hematuria

100
Q

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

A

transitional cell carcinoma (TCC)

101
Q

name the type of bladder neoplasia

common;
occurs in smooth muscle of the bladder wall forming well defined white nodular projections

A

leiomyoma

102
Q

name the type of bladder neoplasia

young large breed dogs (<18mo, St. Bernards);
occurs as large fungating mass which is infiltrative and can metastasize

A

botyroid rhabdomyosarcoma

103
Q

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

A

benign prostatic hyperplasia (BPH)

104
Q

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

A

squamous metaplasia

105
Q

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

A

suppurative prostatitis / prostatic abscess

106
Q

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

A

prostatic cysts

107
Q

what is the commonest form of prostatic neoplasia

A

prostatic adenocarcinoma

108
Q

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

A

prostatic adenocarcinoma (prostatic neoplasia)