Urinary System Flashcards
which part of the kidney should always be removed during necropsy in order to do a full examination
external fibrous capsule
in what species does the outer cortex of the kidney parenchyma turn pale yellow due to large lipid content over time
cats
what is the functional unit of the kidney
nephron
what are the parts of the nephron
renal corpuscle
renal tubule
what can be observed macroscopically only when accentuated by inflammation
glomerulus
what specialized cells are found within the glomerulus
mesangial cells
podocytes
what are formed between podocyte pedicles and fenestrated endothelial cells with shared basal lamina
glomerular filtration barriers
what is the glomerular basement membrane composed of
type IV collagen and numerous glycoproteins
what is the cup-shaped sac that enclosed the glomerulus
Bowman’s capsule
what is the reticular meshwork of connective tissue stroma
interstitium
true or false:
the amount of connective tissue in the interstitium increases with age, chronic inflammation and ischemic damage
true
what are the terminal arteries that do not contain anastomoses and are therefore more susceptible to embolism leading to renal infarction
interlobular arteries
describe a renal infarction
wedge-shaped
well demarcated
dark red or white
inflammation / chronically contracted
what are the 5 functions of the kidney
produce urine
acid-base regulation
conservation of water
maintain normal extracellular potassium ion concentration
control of endocrine
what hormone is responsible for the maintenance of normal extracellular potassium ion concentration
aldosterone
what endocrine function produced by the kidney is used to regulate the blood pressure and fluid balance of the body
renin-angiotensin-aldosterone system
if there is a decrease in the control of endocrine function of the kidney, what 5 hormones are impacted
renin-angiotensin- aldosterone
erythropoietin
vitamin D
PTH degradation
what qualifies as renal failure
only under significant loss of renal function
true or false:
the kidney will maintain endocrine and metabolic function up until 75% of it is lost
true
what are some clinical indicators of renal failure
altered urine quantity
altered urine quality
when it comes to altered urine quantity, when is polydipsia seen
chronic kidney disease
in cases of acute renal failure, how is urine quantity affected
oliguria or anuria
what are some clinical signs often associated with a decrease in renal function
proteinuria
azotemia
uremia
what is characterized by the toxic levels of urea in the blood associated with renal failure
uremic syndrome
what are some way renal failure can lead to death
cardiotoxicity by elevated potassium
metabolic acidosis
pulmonary edema
what is the elevated serum concentration of nitrogenous waste products
azotemia
what kind of renal failure is due to reduced glomerular filtration due to impaired renal perfusion
prerenal
what can cause pre-renal kidney failure
circulatory collapse
shock
hypovolemia
severe dehydration
decreased cardiac output
what type of renal failure is due to damage to renal tissue such as the tubules and glomerulus
renal
what are some causes of renal kidney failure
acute tubular necrosis
acute glomerulonephritis
tubulointerstitial nephritis
acute pyelonephritis
which type of renal kidney failure is due to hypoxia/ischemia, nephrotoxicity and infections
acute tubular necrosis
what are the 2 mechanisms of acute tubular necrosis
leakage of tubular ultrafiltrate
intratubular obstruction
what are the intrarenal causes of renal kidney failure
acute glomerulonephritis
tubulointerstitial nephritis
acute pyelonephritits
what is the most common cause of acute glomerulonephritis
immune complex glomerulonephritis
what causes acute pyelonephritis
ascending bacterial infection from urethra, ureters and renal pelvis
what type of kidney failure is caused by urinary obstruction with pressure atrophy and necrosis
post renal kidney failure
what is the ‘medical terminology’ for post renal kidney failure
obstructive nephropathy
what are some causes of post renal kidney failure
urolithiasis (urinary stones)
tumors (transitional cell carcinoma)
iatrogenic (accidental ligation of ureter)
what can the obstructions of the kidney lead to
hydroureter and hydronephrosis
what can a hyroureter and hydronephrosis lead to
organ rupture with resulting uroabdomen
what are the 2 mechanisms uremic syndrome can cause `
endothelial injury
epithelial injury
what are the potential results of endothelial injury due to uremic syndrome
vasculitis thrombosis and infarction
what causes the epithelial injury of uremic syndrome
caustic effect of ammonia accumulation at mucosal surfaces
where are the epithelial injuries seen with uremic syndrome
mouth
true or false:
severe acute renal failure may lead to death without supportive therapy
true
what are some causes of death due to acute renal failure
cardiotoxicity of elevated serum potassium
metabolic acidosis
pulmonary edema
what is the pathogenesis of acute renal failure
ischemia or nephrotoxicity leads to acute tubular necrosis
what is the pathogenesis of chronic kidney disease
progressive interstitial fibrosis, tubular atrophy and loss of functional nephron
what is the gross pathology of chronic kidney disease
shrunken, firm, pale, fibrotic kidney with irregular surface
“end stage kidney”
what are the lab abnormalities with chronic kidney disease
azotemia
proteinuria
isosthenuria
nonregenerative anemia
hyperparathyroidism
what does ckd progress to
end stage kidney
what are the characteristics of chronic kidney disease
chronic
advanced
generalized
progressive
irreversible
what are the gross characteristics of chronic kidney disease
fibrotic
atrophic
shrunken renal parenchyma with massive loss of functional nephrons
replacement with scar tissue
what are some metabolic and biochemical alterations due to chronic kidney disease
non-regenerative anemia
altered calcium-phosphorus metabolism
how is phosphorus and calcium affected with chronic kidney disease
hyperphosphatemia
hypocalcemia
what process is related to the alteration of calcium-phosphorus metabolism in relation to chronic kidney disease
renal secondary hyperparathyroidism
what are some outcomes of renal secondary hyperparathyroidism
hyperphosphatemia
hypocalcemia
bilateral parathyroid gland hyperplasia
fibrous osteodystrophy
what are 4 portals of entry to the kidney
ascending from ureter
hematogenous
glomerular filtration
direct penetration
what often results form the ascending bacterial infection from the ureter
suppurative pyelonephritis
what are common cases of hematogenous entry into the kidney
neoplastic metastases
bacterial embolization
what are some common cases causes damage to the glomerular filtration decreasing the protection barrier to the kidney
toxins
drugs
anti-freeze and other insecticides
what is the most important barrier of the kidney
renal corpuscle / glomerular basement membrane
what is the role of the glomerular basement membrane
protect the nephron by filtering out most circulating bacteria and inflammatory cells
what defense mechanism of the kidney prevents ascending bacteria from gaining access to the interstitium
tubular basement membrane
what can usually destroy the TBM and cause permanent scarring with loss of tubules
ischemia / infarction
which part of the kidney provides protection through humoral antibodies, macrophages, lymphocytes and plasma cells
interstitium
glomerular injury results from deposition of …
immune complexes (type III)
thromboemboli
bacterial emboli
amyloid
true or false:
prolonged systemic hypertension can cause damage to the glomerular filtration of the kidney
true
glomerular injury may also be caused by hyperfiltration
what is the expected outcome from damage of the glomerular filtration
proteinuria
albumin
antithrombin III
what condition can cause hypoproteinemia with reduced plasma oncotic pressure leading to ascites, pleural effusion and generalized edema
protein losing nephropathy
what is the result of losing antithrombin III to nephrotic syndrome
results in a hypercoagulable state with thromboembolic disease
what are the acute responses to injury to the kidney
mesangial hypertrophy and hyperplasia
increased vascular permeability
infiltration of leukocytes
necrosis
what are the chronic responses to injury to the kidney
atrophy
fibrosis (glomerulosclerosis)
renal tubular atrophy due to blood supply loss
what are the top 2 things that cause tubular damage
toxins
infarctions/ ischemia
after what events could you expect to see atrophy of the kidney tubules
interstitial fibrosis
diminished glomerular perfusion (shock, hypovolemia, fibrosis)
reduced oxygen tension (anemia, hypoxemia)
which tubular damage response occurs due to loss of tubular epithelial cells due to injury and apoptosis
degeneration
when is tubular regeneration only possible
when tubular basement membrane is left intact
in cases of toxic injury, how is the TBM normally affected
generally preserved which allows for regeneration
in cases of ischemic injury, how is the TBM normally affected
TBM is destroyed causing permanent scar with no regeneration
what is the single most important cause of acute renal failure in animals
acute tubular necrosis
what can cause acute tubular necrosis
ischemia
nephrotoxicity
what are the clinical manifestations of acute tubular necrosis
oliguria
anuria
how does nephrotoxic injury occur
chemicals and/or toxic metabolites become concentrated in the tubules to toxic levels
what 3 mechanisms do nephrotoxins use to cause damage
direct damage to epithelium
produce reactive metabolites
indirectly stimulate vasoconstriction (nephrotoxin-associated ischemia)
what is the most common way to indirectly stimulate vasoconstriction in the kidney leading to nephrotoxicity
drugs such as NSAIDs
what is a form of acute tubular necrosis that is not caused by an inflammatory process
nephrosis
what causes nephrosis
hypoxic injury combined with nephrotoxicity
true or false:
hypoxic injury is exacerbated by hemoglobinuria during a hemolytic crisis
true
what are 5 responses to injury of the interstitium
hyperemia
edema
inflammation
lymphofollicular inflammation
fibrosis
what type of inflammation is typically seen in the interstitium in response to injury
nonsuppurative, lymphoplasmacytic
what disease/infection is most commonly associated with lymphofollicular inflammation of the kidney
leptospirosis
true or false:
progressive fibrosis leads to progressive loss of renal function
true
what are some infectious examples that cause interstitial nephritis
canine ehrlichiosis
leptospirosis
equine infectious anemia
what is tubulointerstitial nephritis
inflammation directed against the interstitium and the tubules
what are some infections that lead to tubulointerstitial nephritis
leptospirosis
adenoviruses
lentiviruses
herpesviruses
what is a localized area of coagulative necrosis that results from vascular occulsion
infarction
how would you describe an infarction
well-demarcated, cone shaped area of coagulative necrosis
what is the most important lesion associated with acute kidney injury and acute renal failure
acute tubular necrosis
where do the ureters enter the bladder wall
trigone
what type of epithelium lines the ureters
transitional epithelium
what are sources of bacteria that can cause ascending infection in the lower urinary tracts
GI tract
genital tract
bacterial dermatitis
what is the asynchronous differentiation of nephrons and/or the persistence of primitive mesenchyme and metanephric ducts
renal dysplasia
what is an inherited disease described in Lhasa Apso, Shih Tzu, and Golden Retrievers
juvenile progressive nephropathy
what is juvenile progressive nephropathy
a specific form of renal dysplasia
what is the abnormal migration of renal tissue during fetal development
ectopic kidney
describe a fused kidney
“horse shoe shaped”
result from the fusion of the left and right kidneys during nephrogenesis
what are spherical, thin-walled, distended tubules filled with clear watery fluid
renal cysts
what do renal cysts result from
tubular obstruction or tubular dysplasia
in what specie are renal cysts more common
pigs
cows
what is defined as many renal cysts affected numerous nephrons
polycystic kidneys
in what species is inherited polycystic kidney more common
persian cats
bull terries
what are the 6 diseases of the glomerulus
immune-mediated glomerulonephritis
glomerulosclerosis
glomerular amyloidosis
acute suppurative glomerulitis
viral glomerulitis
chemical glomerulitis
what is associated with persistent infections or other causes of prolonged antigenemia that enhances the formation of abundant soluble immune complexes in the blood plasma
immune complex glomerulonephritis
what is the true issue causing the damage associated with immune complex glomerulonephritis
deposition of soluble immune complexes within glomeruli
what diseases are associated with ICGN with cats
FeLV
FIV
FIP
what diseases are associated with ICGN with horses
streptococcus infections
equine infectious anemia
what are the gross lesions associated with ICGN
subtle or non-existent
may see swollen, enlarged glomeruli as red or pale pin-point foci in the cortex
what is a condition of aging and chronic renal injury characterized by increased extracellular mesangial matrix leading to obliteration of capillaries and consolidation of the tuft
glomerulosclerosis (GS)
what is glomerulosclerosis associated with
high blood pressure
unrestricted dietary protein
what is the outcome of GS
reduces the blood flow to the tubules causing secondary tubular degeneration and atrophy
what urinary disorder is associated with reactive systemic amyloidosis
glomerular amyloidosis
what breeds/species are genetically predisposed to reactive amyloidosis
abyssinian cats
chinese shar-pei
what disorder would you suspect kidneys to be enlarged, pale and have a waxy smooth to finely granular capsular surface
glomerular amyloidosis
what stain is specific for glomerular amyloidosis
congo red stain
what disease is the result of bacteremia
acute suppurative glomerulitis
bacterial embolic nephritis
what is characteristic of a kidney with bacterial embolic nephritis
multiple, randomly distributed foci of suppurative inflammation
