Urinary Pathology Flashcards
1
Q
What can cause the glomerulus to become visible to the naked eye?
A
Glomerulonephritis
2
Q
Microscopic appearance of the glomerulus. (3)
A
- Fenestrated capillaries supported by mesangium
- Mesangial cells
- Podocytes
3
Q
4 main fxns of mesangial cells
A
produce collagen & matrix
contract glomerular tuft
phagocytosis
secretion of inflammatory mediators
4
Q
What are the visceral epithelial cells that participate in glomerular filtration?
A
podocytes
5
Q
Glomerular filtration barrier selectively filters molecules based on:
A
size (< 70,000 Da)
charge (cations only)
6
Q
Describe the glomerular filtration barrier.
A
filtration slits btwn podocyte pedicels & fenestrated endothelial cells w/ shared basal lamina
7
Q
3 things that cause an increase in the amt of CT (scar tissue) in the interstitium of the kidney?
A
- age
- chronic inflammation
- ischemic damage
8
Q
List the path blood flows through the kidneys
A
renal a.–> interlobar a. —> arcuate a–> interlobular a.–> afferent glomerular arterioles–> glomerular capillaries–> efferent glomerular arterioles–> peritubular capillary network
9
Q
Which arteries are more susceptible to embolism leading to renal infarction? Why?
A
interlobular a.
terminal arteries that do NOT contain anastomoses & have a small lumen diameter
10
Q
5 characteristics of renal infarction
A
- wedge-shaped
- well demarcated
- dark red or white
- acutely swollen (inflammation)
- chronically contracted (fibrosis)
11
Q
5 basic renal fxns
A
- Urine –> eliminates metabolic waste
- Acid-base regulation–> reclaims bicarbonate
- Conserves H2O –> 99%
- Maintains normal extracellular [K]–> via aldosterone–> K excretion
- Controls endocrine fxn–> RAAS –> NaCl retention
12
Q
What dictates plasma filtration?
A
Glomerular filtration barrier
13
Q
How is BP regulated?
A
Renin-Angiotensin-Aldosterone System (know details)
14
Q
The macula densa responds to low _____.
A
Na
15
Q
Low Na stimulates juxtaglomerular cells to secrete______.
A
Renin
16
Q
Fxn of Renin.
A
Converts Angiotensinogen —> Angiotensin I
liver
17
Q
Fxn of ACE.
A
Angiotensin I–> Angiotensin II
lungs
18
Q
Fxns of Angiotensin II
A
- stimulates aldosterone secretion (AG)
- stimulates ADH (PPG)
Cumulative effect= incr. BP
19
Q
What kind of drugs are ACE-inhibitors?
A
anti-hypertensive
20
Q
7 things reabsorbed in the Proximal tubules
A
Na, Cl, K, albumin, Gluc, H20, bicarb
21
Q
How does the LoH produce a hypotonic filtrate?
A
via a countercurrent mechanism & Na/K-ATPase pump which absorbs more NaCl from the filtrate
22
Q
2 places H20 is reabsorbed in the kidneys?
A
Distal tubules
Collecting ducts
23
Q
What hormone influences Na & H2O reabsorption & K excretion in the Distal Tubules?
A
Aldosterone
24
Q
How do the Collecting Ducts promote H2O reabsorption?
A
increasing urea gradient
25
How are H2O & Na reabsorption controlled in the Collecting Ducts?
Na/K-ATPase pumps, under the influence of ADH
26
What provides structural support for the glomerulus, tubules, BVs, lymphatics & nerves of the kidney?
the Interstitium
27
Interstitial fibroblasts produce what 3 things?
EPO (+ peritubular cells)
Prostaglandins
Inflammatory mediators
28
Definition of renal failure.
significant loss of renal fxn
| kidneys have 75% fxnal reserve
29
Clinical indicators of renal failure
1. Altered urine quantity - PU/PD; oliguria; anuria
| 2. Altered urine quality- Isosthenuria, proteinuria, azotemia, uremia
30
What does Isosthenuria inidcate? (TQ)
loss of renal fxn--> failure to concentrate urine
31
What does azotemia indicate? (TQ)
elevated serum Urea & Creatinine = >75% loss of nephrons
32
Uremia is a _______ characterized by numerous lesions & C.S.s caused by toxic levels of urea in blood.
syndrome
33
2 mechanisms by which uremia causes systemic lesions.
1. uremic vasculopathy
| 2. uremic toxicity
34
What is uremic vasculopathy?
direct endothelial injury resulting in vasculitis, thrombosis & infarction
35
What is the term for caustic injury to epithelium of mucosal surfaces due to production of LG amts or ammonia by urea-splitting bacteria?
uremic toxicity
36
Systemic lesions of uremic syndrome
ulcerative glossitis (ventral tongue)
ulcerative stomatitis
ammonia breath
ulcerative gastritis w/ mineralization --> Cat & Dog
37
7 additional non-renal lesions caused by uremic syndrome.
1. ulcerative colitis --> cattle & horse
2. vascular thrombosis
3. fibronous pericarditis
4. pulmonary edema
5. endocardial mineralization
6. intercostal mineralization
7. other soft tissue mineralizations
38
3 ways renal failure can lead to death.
1. cardiotoxicity due to elevated serum K
2. metabolic acidosis
3. pulmonary edema
39
3 classifications of renal failure & azotemia.
pre-renal
intrarenal
post-renal
40
Why does acute pre-renal failure occur?
impaired renal perfusion causes reduced glomerular filtration &/o hypoxic injury
41
2 things that lead to acute pre-renal failure.
circulatory collaspe
| renal ischemia --> vasculitis or embolic dz.
42
Why does acute intrarenal failure occur?
damage to the renal tissue
43
4 things that can cause acute intrarenal failure.
acute tubular necrosis
glomerulonephritis
tubulointerstitial nephritis
pyelonephritis
44
When form of acute intrarenal failure is most common?
acute tubular necrosis
45
2 clinical presentations that result from intrarenal failure.
oliguria
| anuria
46
2 way tubular necrosis results in further renal injury.
1. leakage of tubular ultrafiltrate--> necrosis & inflammation
2. intratubular obstruction --> tubular casts
47
5 bacT infections that cause acute tubular necrosis.
1. Lepto
2. E. coli
3. Strep
4. Staph
5. Proteus
48
3 virus that cause acute tubular necrosis in dogs.
1. K9 hepatitis
2. K9 distemper
3. K9 herpes
49
A substance that accumulates to toxic conc. w/in the tubules.
nephrotoxin
50
4 general categories of nephrotoxins
pigments
heavy metals
oxalates
plants
51
3 pigments that act as nephrotoxins
Hb, myoglobin, bile/bilirubin
52
5 heavy metals that act as nephrotoxins
lead, mercury, arsenic, cadmium & thallium
53
2 oxalates that act as nephrotoxins
```
ethylene glycol (antifreeze)
oxalate-rich plants
```
54
4 plants that can act as nephrotoxins.
pigweed, oaks, grapes/raisins & lilies
55
Why can Vit D toxicosis cause acute tubular necrosis (intrarenal failure)?
due to hypercalcemia
56
Which 4 drug types are nephrotoxic and can cause acute tubular necrosis?
antimicrobials
NSAIDs
immunemodulatory drugs
antineoplastic chemotherapeutics
57
4 things that can cause acute glomerulonephritits (intrarenal failure)
immune complexes
bacT
viruses
toxins
58
What causes acute pyelonephritits (intrarenal failure)?
ascending bacT infection from urethra, ureters & renal pelvis
59
What causes urinary obstruction w/ pressure atrophy & necrosis? (a.k.a obstructive nephropathy)
post-renal failure
60
3 causes of acute post-renal failure.
urolithiasis
tumors
iatrogenic
61
What 2 things can post-renal obstructions lead to?
hydroureter & hydronephrosis
| possible organ rupture
62
Time period of chronic renal failure.
wks, mos., or yrs
63
When can CRF lead to end-stage kidney?
when it is prolonged & progressive
64
Term used to describe renal dz which is chronic, advanced, generalized, progressive & irreversible.
end-stage kidney
65
Gross appearance of an end-stage kidney
```
Fibrotic
Atrophic
Shrunken renal parenchyma
Massive loss of fxnal nephrons
Fibrosis
```
66
What is a common pathway to CRF, despite original cause of injury?
progressive fibrosis
67
Is it possible to determine the etiology once end-stage kidney is reached?
often impossible
68
Pathophysiology of CRF? (2)
1. non-regenerative anemia
| 2. altered Ca:P metabolism
69
How does CRF alter Ca/P metabolism? what is this process known as?
HYPERphosphatemia--> HYPOcalcemia---> PTH secretion--> Ca mobilized from osteoclastic bone resorption--> osteopenia
Renal 2ry Hyperparathyroidism
70
Chronic hyperparathyroidism may lead to _____ ______.
fibrous osteodystrophy (bone replaces fibrous tissue)
71
Renal 2ry hyperparathyroidism is often due to what?
bilateral parathyroid gland hyperplasia
72
4 portals of entry to the kidney
1. ascending from ureter
2. hematogenous
3. glomerular filtrate
4. direct penetration
73
Ascending bacT infection results in _______.
suppurative pyelonephritis
74
What is the most important barrier (defense mechanism) of the kidney?
glomerular basement membrane
75
What prevents ascending bacT from gaining access to the kidney's interstitium?
Tubular basement membrane (TBM)
76
What provides the scaffold for tubular regeneration?
tubular basement membrane
77
What typically destroys the TBM & causes permanent scarring w/ loss of tubules? (TQ)
Ischemia or Infarction
78
Humoral Abs protect the interstitium at the ____ ____ of the renal pelvis.
mucosal surface
79
What 3 cells w/in the interstitium provide cell-mediated immune surveillance against Lepto?
macrophages
lymphocytes
plasma cells
80
What is a defensive barrier against bloodborne pathogens?
intact endothelial lining (healthy vasculature)
81
Intact endothelium prevents activation of ____ ____ and reduces ____ formation
clotting cascade
| thrombus
82
_____ to 1 part of the nephron results in _____ damage to other components of the nephron with eventual loss of _____.
Injury
progressive
fxn
83
Glomerular injury can result from the deposition of what 4 things?
1. immune complexes (Type III)
2. thromboemboli
3. Bact emboli or direct infections
4. amyloid & fibrin (proteins)
84
2 things that cause glomerular injury?
deposition of substances
| hyperfiltration
85
2 things that result in hyperfiltration and glomerular injury?
prolonged systemic hypertension
| increased dietary protein (prolonged proteinuria)
86
How does glomerular injury result in hypoxia with tubular atrophy & loss of fxn?
by interfering w/ peritubular blood supply
87
What 2 proteins leak into the urine due to damage to the glomerular filtration barrier?
Albumin
| Antithrombin 3
88
2 characteristics of protein losing nephropathy?
nephrotic syndrome
| wt. loss
89
What causes nephrotic syndrome? List some CS.
HYPOproteinuria --> reduced plasma oncotic pressure
| C.S= ascites, pleural effusion, generalized edema
90
Loss of what protein can result in a hypercoagulable state & thromboembolic dz.
Antithrombin 3
91
List 4 ACUTE responses of the glomerulus to injury
1. mesangial hypertrophy & hyperplasia
2. increased vascular permeability
3. infiltration of leukocytes
4. necrosis
92
List 3 CHRONIC responses of the glomerulus to injury.
1. atrophy
2. Glomerulosclerosis (=fibrosis)
3. 2ry atrophy of renal tubules due to ischemia
93
List some things that can cause tubular damage
```
bloodborne infections
ascending infections
toxins
infarction/ischemia
volume overload
abnormal glomerular filtrate
```
94
What are some components of abnormal glomerular filtrate?
high protein
high crystalline salts
high organic acids --> oxalic/uric/pyruvic acid
95
4 responses to tubular damage?
1. atrophy (2ry)
2. degeneration
3. regeneration
4. necrosis
96
Which type of injury generally preserves the TBM & allows for regeneration of the tubules?
Toxic injury
97
Which type of injury destroys the TBM causing permanent scars & no regeneration of the tubules?
Ischemic injury
98
What is the single most important cause of acute renal failure in animals? (TQ)
Acute tubular necrosis
99
What are the 2 most common causes of acute tubular necrosis?
ischemia or nephrotoxicity
100
Acute tubular necrosis clinically results in ____ or _____.
oliguria or anuria
101
How does nephrotoxic injury cause acute tubular necrosis?
chemicals &/o toxic metabolites become concentrated in the tubules
102
3 mechanisms by which nephrotoxins cause damage to tubules?
1. direct damage to epithelium
2. reactive metabolites damage epithelium
3. nephrotoxin-associated ischemia
103
Form of tubular necrosis that is NOT caused by inflammation? (TQ)
nephrosis
104
What typically causes nephrosis?
hypoxic injury combined w/ nephrototoxic injury
105
Type of nephrosis caused when hypoxic injury is exacerbated by hemoglobinuria during a hemolytic crisis?
Hemoglobinuric nephrosis
106
Type of nephrosis caused when hypoxic injury in exacerbated by myoglobinuria during acute muscle injury?
Myoglobinuric nephrosis
107
Gross lesions of acute tubular necrosis (often difficult to recognize)
1. swollen, pale cortex that bulges on cut surface
| 2. may see accentuated striations or white streaks
108
Microscopic lesions of acute tubular necrosis? (6)
1. tubular epithelial swelling
2. vacuolation
3. HYPEReosinophilia
4. pyknosis
5. karyorrhexis
6. karyolysis
109
Which tubules are more sensitive to hypoxia due to higher metabolic demands?
proximal tubules
110
Which part of the kidney is resistant to ischemia & often remain morphologically normal?
glomeruli
111
Interstitium's response to injury. (7)
1. hyperemia
2. edma
4. lymphofollicular inflammation
5. fibrosis
6. interstitial nephritis
7. tubulointerstitial nephritis
112
What is the most common response of the interstitium to chronic Lepto infection?
lymphofollicular inflammation
113
What leads to progressive loss of renal fxn? (TQ)
progressive fibrosis
114
3 causes of infectious interstitial nephritis.
1. K9 ehrlichiosis
2. Leptospirosis
3. EIA
115
When will interstitial nephritis lead to renal failure & end-stage kidney?
only when it's severe
116
4 things that can cause 2ry tubulointerstitial nephritis?
Lepto
Adenoviruses
Lentiviruses
Herpesviruses
117
_____ tubulointerstitial nephritis leads to end-stage kidney.
Chronic
118
What causes a well-demarcated, cone-shaped area of coagulative necrosis extending from medulla to cortex?
renal infarction
119
3 portals of entry to the lower UT.
1. ascending infections
2. direct penetration from lumen
3. cyctocentensis
120
5 defensive mechanisms of the lower UT.
1. flushing action --> reduces risk of ascending infections
2. peristalsis --> eliminates bacT
3. slightly acidic urine --> reduces some bacT growth
4. protective urethral mucus layer --> decr. bacT adhesion
5. innate & adaptive immune response
121
5 developmental anomalies of the kidney.
1. renal aplasia, hypoplasia or dysplasia
2. ectopic kidney
3. fused kidney
4. renal cysts
5. polycystic kidneys
122
Juvenile progressive nephropathy is a specific form of inherited renal dysplasia common to what 3 breeds?
Lhasa apso
Shih Tzu
Golden retriever
123
"Horseshoe kidney" is an example of which developmental anomaly? What is the fxn of these kidneys?
fused kidney
| usually maintain normal fxn
124
Ectopic kidney is most common in what 2 species?
dogs & pigs
125
Renal cysts are common in what 2 species?
cattle & pigs (just 1 to a few)
126
What is the clinical significance of renal cysts?
none--> usually an incidental finding
127
Term for many renal cysts affecting numerous nephrons?
Polycystic kidney
128
Polycystic Kidney Dz in an autosomal dominant trait in what 2 breeds? (TQ)
Persian cats
| Bull Terriers
129
Dz caused by mutations in PKD-1 &/o PKD-2 resulting in abnormal tubulogenesis?
Polycystic Kidney Dz.
130
When can renal function by impaired in patients w/ Polycystic Kidney Dz?
severe cases --> when significant loss of parenchyma
131
List the 6 diseases of the glomerulus.
1. immune-mediated glomerulonephritis
2. glomerulosclerosis
3. glomerular amyloidosis
4. Acute suppurative glomerulitis (bacT embolic nephritis)
5. viral glomerulitis
6. chemical glomerulitis
132
Immune mediated glomerulonephritis occurs most commonly in ____ & _____.
cats & dogs
133
Immune mediated glomerulonephritis is associated with ___ ___ which enhances the formation of abundant ____ ____ in the blood plasma.
persistent infections
| immune complexes
134
What results in complement fixation, leukocyte infiltration & formation of fibrin thrombi --> glomerular damage?
deposition of soluble immune complexes w/in glomeruli
135
What 5 things can cause immune-mediated glomerulonephritis in cats?
```
FeLV
FIV
FIP
progressive polyarteritis
neoplasia
```
136
What 2 things cause immune-mediated glomerulonephritis in horses?
Strept infections
| EIA
137
What 2 things cause immune-mediated glomerulonephritis in cattle?
BVD
| Trypanosome infections
138
What 2 viruses cause immune-mediated glomerulonephritis in swine?
```
Classical SF (Hog cholera)
African SF
```
139
What gross lesion of immune-mediated glomerulonephritis might you see?
swollen, enlarged glomeruli as red pin-point foci in the cortex
140
List the 3 histologic forms of immune-mediated glomerulonephritis. Species each is common in?
1. proliferative --> horses
2. membranous --> cats
3. mebrano-proliferative --> dogs
141
What is the condition of CHRONIC glomerulonephritis characterized by fibrosis of the glomerulus?
glomerulosclerosis
142
2 things associated with glomerulosclerosis?
high BP
| unrestricted dietary protein
143
What is typically associated w/ Reactive Systemic Amyloidosis (AA amyloidosis) that occurs w/ CHRONIC inflammatory dz?
glomerular amyloidosis
144
Which 2 breeds are genetically predisposed to reactive amyoidosis? (TQ)
Abyssinian cats
| Chinese Shar-Pei dogs
145
What is a common cause of protein losing nephropathy?
glomerular amyloidosis
146
What stain can be used to ID amyloid protein histologically?
Congo red stain
147
List the 4 examples of bacT & affect species that cause actute suppurative glomerulitis. (LG animals)
1. A. equuli --> foals
2. E. rhusiopathiae --> pigs
3. C. pseudotuberculosis --> goats & sheep
4. T. pyogenes --> cattle
148
List the 5 causes of viral glomerulitis? common or rare?
1. Infectious K9 hepatitis (adeno-)
2. EVA (arteri-)
3. CSF (pesti-)
4. Newcastle dz (paramyxo-)
5. neonatel porcine cytomegalovirus
Rare
149
List 4 known examples that cause chemical glomerulitis
1. puromycin aminonucleoside
2. adriamycin
3. histamine-receptor antagonists
4. cyclosporin A
150
List 2 inherited abnormalities in renal tubular FXN.
1. 1ry renal glucosuria --> trouble reabsorbing Gluc--> Norwegian elkhounds
2. Basenji dog Fanconi Syndrome
151
Are there any lesions associated with 1ry Renal Glucosuria?
no, only a fxnal deficit
152
What other dz must by distinguished from 1ry Renal Glucosuria?
Diabetes mellitus
153
C.S. of acute tubular necrosis? (TQ)
oliguria or anuria w/ severe azotemia
154
Hemoglobinuria nephrosis & hemoglobinuria w/ hemolysis occurs in what 4 things? Species?
1. Cu toxicity --> sheep
2. Lepto or Babesia --> cattle
3. Red maple toxicity --> horse
4. Babesia or IMHA--> dogs
155
3 things that cause myoglobinuria (myoglobinuric nephrosis)?
1. exertional myopathy (azotemia, tying up) --> horses
2. capture myopathy (rhabdomyolysis)--> wild animals
3. severe mm. trauma
156
List the 3 histologic changes seen in acute tubular necrosis.
tubular necrosis
tubular degeneration
IN inclusion bodies
157
When can nephrotoxic drugs cause acute tubular necrosis?
when administered at excessive doses or too frequently
158
Which drugs decrease the synthesis of renal prostaglandins which are responsible for maintaining normal renal blood flow?
NSAIDs
159
NSAIDs cause renal ____________.
vasoconstriction
160
NSAIDs cause acute tubular necrosis & ___ ___ ___.
renal papillary necrosis
161
Which mycotoxin from contaminated feed can result in acute tubular necrosis?
aflatoxin
162
What 2 things do mycotoxins cause?
tubular degeneration
| tubular necrosis
163
List the 4 oxalate-rich plants
Halogeton
Sarcobatus
Rheum
Rumex
164
What happens when Ca oxalates precipitate in renal tubules froming oxalate crystals w/ subsequent epithelial injury & renal failure?
Oxalate nephrosis
165
Grapes & raisins can cause acute tubular necrosis in what species?
dogs
166
Lilies can cause acute tubular necrosis in what species?
cats
167
Oak toxicity can cause acute tubular necrosis in what 2 species?
cattle
| horses
168
Ethylene glycol (antifreeze) results in ___ ____ & ___ ____.
nephrotoxic metabolites --> oxalate & glycolic acid
| oxalate nephrosis
169
What 2 pet food contaminants cause distal tubular necrosis w/ characteristic irregular brown birefringent crystals?
Melamine
| Cyanuric acid
170
Vit D toxicosis leads to ____calcemia.
hypercalcemia
171
Hypercalcemia causes ______ mineralization of tubular & glomerular basement membranes.
metastatic
172
Metastaic mineralization is followed by what 4 things?
degeneration
necrosis
fibrosis
loss of fxn
173
Pulpy Kidney is a typical dz seen in what animals?
small ruminants
174
What causes Pulpy Kidney?
enteric proliferation of C. perfringes type D
175
What exotoxin is produced in Pulpy Kidney dz?
Epsilon exotoxin
176
What 3 things do epsilon exotoxin cause in small ruminants?
Bilateral acute tubular degeneration & necrosis
Interstitial edema
Hemorrhage
177
What is caused by dilation of the renal pelvis due to obstruction of urine outflow?
Hydronephrosis
178
Pyelonephritis leads to infection of the ____ ____ w/ extension to the ____ ___.
renal pelvis
| renal tubules
179
Pyelonephritis is often unilateral or bilateral?
bilateral (can do either or)
180
Gross lesion of pyelonephritis
expansion of renal pelvis by purulent exudate
181
Microscopic lesions of pyelonephritis
suppurative inflammation of pelvis & medulla w/ necrotic transitional epithelium
182
Papillary necrosis is due to ischemic injury caused by what drugs?
NSAIDs
183
Papillary necrosis is most frequently seen in _____. Can be seen in ___ & ___ due to accidental ingestion.
horses
| cats & dogs
184
Hairy vetch toxicosis in cattle causes ______ _____ & accompanies systemic granulomatous dz.
granulomatous nephritis
185
What animals get Xanthogranulomas?
cats w/ inherited hyperlipoproteinmia
186
List the 3 types of epithelial tumors.
Renal adenoma
Renal carcinoma
Transitional cell papilloma & carcinoma
187
What is the most common primary renal neoplasm of the kidney? Common species?
renal carcinoma
| older dogs
188
In what dog breed is renal carcinoma associated with nodular dermatofibrosis?
GSD
189
Transitional cell papilloma & carcinoma occur most commonly where?
urinary bladder
190
Which neoplastic dz has a very high metastatic potential?
transitional cell carcinoma
191
Another term for nephroblastoma.
embryonal neophroma
| Wilm's tumor
192
Nephroblastoma is common in which species?
pigs
chickens
some fish
193
What is a common metastatic tumor of the kidney?
renal lymphoma
194
2 invasive tumors of the adrenal glands that effect the kidney
1. pheochromocytoma
| 2. adrenocortical carcinoma
195
5 developmental anomalies of the lower UT
1. aplasia (rare)
2. hypoplasia
3. ectopic ureters
4. patent urachus
5. urinary bladder diverticulum
196
What is the most common malformation of the urinary bladder?
patent urachus
197
What causes patent urachus?
fetal urachus fails to close & completely involute --> channel btwn bladder's apex & umbilicus
198
Where can one see urine coming from in patients with patent urachus?
urine dribbles from the umbilicus (navel region)
199
What 2 things are frequently observed with patent urachus?
neonatal omphalitis
| abscess formation
200
Which animals are most commonly affected by patent urachus?
foals
201
Developmental abnormalities of the urinary bladder diverticulum can do what 3 things?
1. be associated w/ obstructive dz (acquired form)
2. predispose to systitis & calculi formation
3. predispose to bladder rupture
202
Syndrome that occurs when familial, congenital, &/o pathophysiological factors increase the precipitation of stone-forming salts resulting in urinary calculi formation.
Urolithiasis
203
What is the essential precursor to initiation of crystal & urolith formation?
supersaturation of urine --> due to supersaturation of mineral salts & protein
204
What is only partially responsible for calculogenesis?
crystal formation
205
What type of crystal is most common in dogs & cats? What type of urine favors their formation?
struvite crystals
| alkaline urine
206
Struvite crystals are also known as?
Infection calculi
207
Which breed of dog is predisposed to struvite uroliths and Ca oxalate dihydrate w/ urolith formation?
Mini Schnauzers
208
Bilirubinuria +/- bilirubin crystals is an abnormal finding in what 4 species?
cats
horses
cattle
camels
209
Ca carbonate crystals are not common in what 2 species' urine?
cats & dogs
210
List the 4 UNCOMMON types of urinary crystals seen in animals.
1. Ca oxalate MONOhydrate
2. Ammonium biurate crystals
3. Cystine crystals
4. Drug-associated crystals
211
What shape of Ca oxalate monohydrate crystals are observed in the urine of dogs & cats w/ ethylene glycol toxicosis?
"picket fence" crystals
212
2 things that together indicate ethylene glycol toxicosis?
acute renal failure & picket fence crystalluria
213
What type of urinary crystal is commonly seen in dogs & cats w/ congenital or acquired portal vascular anomalies?
ammonium biurate crystals
214
Ammonium biurate crystals are NORMAL in what 2 breeds of dog? (TQ)
Dalmatians & bulldogs
215
Cystine crystalluria &/o urolithiasis is an indication of what genetic abnormality?
cystinuria
216
What animals are almost exclusively affected by cystinuria?
male dogs
217
Which drug most commonly causes drug-associated urinary crystals? Do these cause significant renal dz?
trimethoprim-sulfadiazine
| No
218
What is the most common cause of obstructive uropathy?
Urolithiasis
219
Acute cystitis is common in all domestic animals. Which gender is more prone? Why?
females
| due to shorter & wider urethra
220
Acute cystitis may have concurrent ____ & ____.
ureteritis & urethritis
221
What 4 bacT are the most common source of acute cystitis?
E. coli
Proteus sp.
Strept sp.
Staph sp.
222
C. renale commonly causes acute cystitis in what species?
cattle
223
A. suis commonly causes acute cystitis in what species?
pigs
224
E. faecalis commonly causes acute cystitis in what species?
cats
225
Klebsiella sp. commonly cause acute cystitis in what species?
horses
226
List some risk factors for acute bacterial cystitis. (8)
1. stagnation of urine
2. trauma
3. vaginoscopy, vaginitis, coitus, AI
4. urinary incontinence
5. prolonged antibiotic use
6. diabetes mellitus
7. prolonged corticosteroid use or Cushing's dz
8. immunosuppression
227
Cantharidin toxicosis occurs in? from ingestion of what?
horses
| blister beetles in alfalfa hay
228
2 causes of mycotic cystitis?
Aspergillus sp.
| Candida albicans
229
What can cause cystitis, hematuria & urinary bladder neoplasia in cattle?
bracken fern toxicosis
230
Gross lesions of acute cystitis. (4)
edema
hemorrhage
ulceration
purulent exudate
231
Microscopic lesions of acute cystitis. (6)
```
epithelial denudation
ulceration
hemorrhage
edema
suppurative infiltration
bacterial colonies
```
232
C.S. of acute cystitis
dysuria, stranguria or hematuria
sedimentation, blood, +/- bacT on UA
pyrexia
233
2 most common causes of chronic cystitis
chronic bacT infection
| urolithiasis
234
3 types of chronic cystitis (based on morphologic pattern)
diffuse
lymphofollicular
polypoid
235
Gross lesions of chronic cystitis.
diffusely reddened, roughened & thickened mucosa
| may see lymphoid follicles or polypoid hyperplasia
236
Microscopic lesions of chronic cystitis.
epithelial HYPERplasia
fibrosis
hemorrhage
mononuclear infiltration w/ few neutrophils
237
Where to most neoplasms occur in the lower UT?
urinary bladder
238
Transitional cell carcinoma is most common in ____.
dogs
239
What area of the bladder is transitional cell carcinoma most common?
trigone area
240
What is the most common mesenchymal tumor of the lower UT?
leiomyoma (less common that epithelial tumors)
241
Bacterial embolic nephritis is caused by what normal inhabitant of the alimentary tract?
A. equuli
242
How do foals get bacterial embolic nephritis?
via contamination of the umbilicus
243
What 2 NSAIDs can cause papillary necrosis?
phenylbutazone
| flunixin meglumine
244
List the 5 disorders specific to horses.
```
bacterial embolic nephritis
myoglobinuric nephritis (rhabdomyolysis)
papillary necrosis
patent urachus
Klossiella equi infection
```
245
List the 10 disorders specific to ruminants
```
oak toxicity
pulpy kidney dz.
embolic nephritis (white spotted kidney)
tubulointerstitial nephritis
granulomatus nephritis
pyelonephritis
renal lymphosarcoma
urolithiasis
bracken fern toxicosis
renal amyloidosis
```
246
White Spotted Kidney (embolic nephritis) occurs in ruminants due to ? Is it noticeable?
bacT embolize the kidney leading to microabscesses & abscess formation
no, commonly subclinical
247
What can cause tubulointerstitial nephritis in cattle?
Lepto. interrogans
| Serovars- hardjo, pomona, & grippotyphosa
248
Tubulointerstitial nephritis causes direct damage to what 3 parts of the kidney?
endothelium
tubules
interstitium
249
Granulomatous nephritis in ruminants is due to ___ ____ toxicosis. (TQ)
hairy vetch
250
Is pyelonephritis common in cattle?
no
251
What is the most common isolate of Contagious Bovine Pyelonephritis?
C. renale
252
What viral dz in cattle can be associated with renal lymphosarcome?
Bovine Leukosis Virus (BLV)
253
List the common locations of urolith obstruction in bulls, rams & bucks.
bulls - sigmoid flexure
| rams & bucks- urethral process
254
Why are uroliths typically silica calculi in ruminants?
due to the high silica content of pasture grasses
255
Bracken fern toxicosis is also known as ____ _____.
enzootic hematuria
256
What is the most common toxicosis of cattle? (TQ)
bracken fern toxicosis
257
Prolonge ingestion of bracken fern (P. aquilinum) causes what 3 things in cattle?
hemolysis
BM damage
immunosuppression
258
Repeated low level exposure to bracken fern causes what in cattle?
urinary bladder neoplasia --> transitional cell carcinoma
259
List the 7 disorders specific to swine.
```
glomerulonephritis
toxic nephritis
leptospirosis
Viral interstital nephritis
urolithiasis
erysipelothrix
kidney worm
```
260
What plant can cause acute tubular necrosis leading to acute renal failure in swine?
pigweed
261
Which 3 Leptospira serovars cause leptospirosis in swine?
pomona
tarassovi
australis
262
Which virus can cause granulomatous interstitial nephritis in swine?
Circovirus--> Postweaning Multisystemic Wasting Syndrome (PMWS)
263
What is the most common cause of embolic nephritis in pigs? (TQ)
Erysipelothrix (diamond skin dz)
264
Kidney worm of swine?
Stephanurus dentatus
265
List the 5 disorders specific to cats.
```
Granulomatous nephritis --> FIP (non-effusive form)
Renal lymphosarcoma
Feline Lower UT Dz (FLUTD)
Hemorrhagic urocystitis
Toxic tubulointerstitial nephritis
```
266
FLUTD is most commonly seen in what cats?
middle-aged, overweight cats w/ little exercise, indoor litter box & dry food diet
267
What is the term for a collection of diseases affecting the urethra & bladder of cats?
feline lower urinary tract disease (FLUTD)
268
3 things that cause FLUTD in cats?
Feline idiopathic cystitis
urolithiasis
chronic &/o recurring bacT UTIs
269
Older male acts typically form ____ calculi leading to urethral obstruction.
struvite
270
In what cats may inflammation predispose to formation of protein matrix plugs?
younger male cats
271
What is the consequence of urethral obstruction in male cats?
hemorrhagic urocystits
272
Pathology of hemorrhagic urocystitis.
urinary bladder becomes severely distended leading to pressure necrosis, hemorrhagic & ulceration
273
Chronic fibrosis limits bladder ____ & leads to poor ____ voiding & increased susceptibility to ____ infections.
fxn
urine
bacterial
274
3 things that cause toxic tubulointerstitial nephritis in cats
ethylene glycol toxicosis
melamine & cyanuric acid
lily toxicity
275
List the 15 disorders specific to dogs
```
Greyhound cutaneous glomerular vasculopathy
Ethylene glycol toxicity
Aminoglycoside toxicosis
Leptospirosis
Infectious K9 hepatits
K9 herpesvirus
Pyelonephritis
Progressive juvenile nephropathy
Urolithiasis
Chronic urocystitis
Transitional cell carcinoma
Renal carcinoma
Toxic tubulointerstitial nephritis
Grape or raisin toxicity
Giant kidney worm
```
276
What is a rare idiopathic vascular dz w/ genetic predisposition in Greyhounds?
Cutaneous Glomerular Vasculopathy
277
Lesions seen in Greyhounds w/ Cutaneous Glomerular Vasculopathy.
glomerular thrombotic microangiopathy (can look like DIC)
278
Why is ethylene glycol (antifreeze) so toxic to dogs?
Readily absorbed by the GIT & converted to toxic metabolites by hepatic alcohol dehydrogenase
279
What is the degree of nephrotoxicity of aminoglycosides in dogs. (-mycins)
Neo> Kana>Genta> Strepto> Tobra> Amikacin
280
Aminoglycoside toxicosis causes what 2 things in dogs?
acute tubular degeneration & necrosis
281
What other parts of the dog's body can be affected by aminoglycoside toxicosis?
inner ear
| neuromuscular jxn
282
2 most common Lepto isolates in dogs?
L. icterohaemorrhagiae
| L. canicola
283
How do dogs pick up Leptospirosis?
infections obtained from wet, contaminated environments through compromised mucus membranes
284
Where does Lepto persists in dogs?
renal tubular epithelial cells
285
C.S. of Leptospirosis in dogs?
```
fever
anorexia
vomiting
dehydration
icterus
mm. pain
bleeding
```
286
Chronic causes of Lepto in dogs will present with what 2 signs.
wt loss
| sometimes uveitis
287
Lepto causes what 2 things in dogs
acute tubular damage
| acute to chronic tubulointerstitial nephritis
288
Is Lepto zoonotic?
Yes!!
289
How do young puppies (< 6 wks) get K9 herpesvirus?
due to intrauterine or neonatal infection from the dam w/ CHV-1
290
K9 herpesvirus causes what?
multifocal acute tubular necrosis w/ hemorrhage
291
CHV-1 neonatal mortality is associated in puppies w/ _____.
HYPOthermia
292
Most common organisms to cause pyelonephritis in dogs
```
E. coli
S. aureus
P. mirabilis
Strept sp.
K. pneumoniae
P. aeruginosa
Enterobacter sp.
```
293
CS of pyelonephritis in dogs.
fever
depression
arched back
PU
294
When is pyelonephritis likely to occur in dogs?
when there is altered lower UT defense
295
Inherited disorder in dogs leading to development of severe bilateral renal fibrosis, dysplasia & progressive loss of fxnal nephrons.
progressive juvenile nephropathy
296
Progressive juvenile nephropathy clinical resembles what?
CRF & end-stage kidney
297
Variable degrees of severity w/ progressive fibrosis leading to progressive loss of renal fxn in younger dogs.
progressive juvenile nephropathy
298
What breeds of dogs are over-represented w/ progressive juvenile nephropathy?
samoyeds
bull terriers
shih tzus
299
4 most common uroliths in dogs
struvite
urate
xanthine
cystine
300
What 2 dog breeds are predisposed to urate calculi due to inefficient hepatic uric acid metabolism?
Dalmatians
| English bulldogs
301
Therapy for Dalmatians & English bulldogs w/ inefficient hepatic uric acid metabolism
low purine diets
| Allopurinol --> lowers uric acid in blood
302
2 main dog breeds that are genetically predisposed to Ca oxalate urolithiasis.
Mini Schnauzers
| Bichon Frises
303
What common symptoms to dogs develop with chronic urocystitis?
lymphofollicular & polypoid cystitis
| hematuria
304
What is the most common primary kidney neoplasm in dogs?
renal dogs
305
Renal carcinoma occurs sporadically in ____ dogs.
older
306
Where can renal carcinoma metastasize to? (4)
lungs
lymph nodes
liver
adrenal glands
307
What cause distal tubular necrosis with characteristic irregular brown birefringent crystals in dogs? (TQ)
Melamine & Cyanuric acid toxicosis from contaminated pet food
308
Ingestion of grapes/raisins by dogs leads to these 3 things.
acute renal failure
uremic syndrome
diarrhea
309
What is the kidney worm that affects mostly fish eating mammals, especially dog & mink?
Dioctophyma renale
310
What may be the only initial C.S. of D. renale (giant kidney worm) infection?
hematuria
311
D. renale causes what 2 things in dogs.
hemorrhagic & purulent pylitis
| hydronephrosis due to obstruction
