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BOD II > Urinary System > Flashcards

Urinary System Flashcards

1
Q

Can nephrons regenerate?

A

They have limited ability.
Irreversible damage removes them from function forever.

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2
Q

What is uremia?

A

Clinical syndrome of renal failure

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3
Q

What are signs of uremia?

A

Azotemia
PU/PD
Vomiting
Weight loss
Depression

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4
Q

Where are podocytes found?

A

In the filtration apparatus

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5
Q

What causes prerenal azotemia?

A

Insufficient blood flow
Excessive production of urea
Dehydration

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6
Q

What causes renal azotemia?

A

Renal tissue disease and failure of the filter

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7
Q

What can cause post renal azotemia?

A

Blockage in bladder, ureters, urethra

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8
Q

How does pituitary dependent diabetes insipidus affect ADH?

A

There will be insufficient ADH from the neurohypophysis:
Decreased secretion and synthesis

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9
Q

How does lack of ADH production or release affect urine concentration?

A

Causes the inability to concentrate urine. Dilute urine can still be produced.
Normality restored by ADH
No azotemia

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10
Q

How does lack or blockade of ADH receptors affect urine conentration?

A

AKA nephrogenic diabetes insipidus
Ability to make dilute urine
Inability to make concentrated urine
No response to ADH
No azotemia

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11
Q

How does nephron insufficiency (renal failure) affect urine concentration?

A

Inability to concentrate or dilute urine
No response to ADH
Usually concurrent azotemia

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12
Q

What does glomerular disease cause?

A

Damage results in loss of plasma ultrafiltration function
Contributes to degeneration and loss of other nephron segments

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13
Q

What constitutes ultrafiltrate?

A

Salt
Ions
Water
Albumin
Glucose

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14
Q

What effect can glomerulonephritis have on the podocytes?

A

Epithelial cell foot process effacement and detachment from antibodies, cytokines, toxins

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15
Q

Causes of low or lost protein

A

Amyloidosis
UTI
Hepatic insufficiency (not producing enough protein)
Malnutrition (not consuming enough protein)
Protein losing enteropathy (losing protein in gut)
Chronic hemorrhage
Chronic inflammation

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16
Q

Causes of glomerulonephritis

A

Pyometra: chronic inflammation, increased circulating ab-ag complexes
Viral antigens (FeLV, FIP)
Bacterial antigens
Microfilariae
Other antigens including self

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17
Q

Glomerular Amyloidosis Types

A

AL Amyloid light chain
-Immunoglobulin light chain
AA amyloid associated
-Acute phase protein/serum amyloid A
Abeta Amyloid precursor protein
-Alzheimers

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18
Q

Diabetic Nephropathy

A

Hyperglycemia
-Metabolic defect resulting in thickened glomerular basement membrane
-Nonenzymatic glycosylation of proteins
-Hemodynamic changes (increased GFR, hypertrophy)

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19
Q

Causes of acute renal hemorrhage

A

Viral (herpes-turkey egg kidney)
Bacterial (embolic nephritis)
Trauma
Thrombosis
Anticoagulants

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20
Q

What shape will a renal infarct usually be?

A

Pyramid

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21
Q

How can NSAIDs affect the kidney?

A

NSAID administration > decr. in COX1 and COX 2 activity > decr. in prostaglandin release > decr. vasodilative effect of prosta > decr. blood flow to nephron > ischemia

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22
Q

What is an end result of ischemic renal failure?

A

Reduced GFR > Oliguria

Via Vasoconstriction, tubule cell injury, obstruction by casts, tubular back leak…

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23
Q

What is azotemia

A

High BUN and creatinine

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24
Q

How would we diagnose tubular epithelial degeneration and necrosis?

A

Large number of granular and cellular casts in urine sediment from distal nephron segments

25
Q

What kind of crystal form in ethylene glycol toxicosis?

A

Monohydrate crystals

26
Q

What kind of toxicity do raisins and grapes cause?

A

Acute renal failure
can lead to anuria from renal tubular degeneration and necrosis

27
Q

What are 2 endogenous nephrotoxins?

A

Hemoglobin: intravascular hemolysis
Myoglobin: myonecrosis, capture myopathy, extensive muscular trauma

28
Q

Leptospirosis pathogenesis

A

Bacteremia
Migrate thru vascular epithelium
Persist in interstitial spaces
Migrate to tubule lumens > intracellular in tubular epithelium
Epithelial degeneration and necrosis
Shed in urine
Persist in environment

29
Q

What is a sign that the pyelonephritis is acute vs chronic?

A

Acute: Neutrophils
Chronic: macrophages and fibrosis

30
Q

What is considered end-stage renal failure?

A

75-80 % of total renal function lost
GFR < 5%

31
Q

What are non-renal lesions of renal failure?

A

Dehydration, acidosis, azotemia
Anemia (erythropoietin deficiency)
Renal secondary hyperparathyroidism
Soft tissue mineralization

32
Q

Common epithelial neoplasms of the kidney

A

Renal adenomas
Renal carcinomas: most common, older dogs
Transitional cell papillomas (renal pelvis)
Transitional cell carcinomas (pelvis and lower urinary tract)

33
Q

How can some renal epithelial tumors cause secondary, absolute, inappropriate polycythemia?

A

Can produce too much erythropoietin

34
Q

What are some primary mesenchymal tumors of the kidney?

A

Fibroma (benign)
Fibrosarcoma (malignant)
Hemangiosarcoma
Metastatic carcinomas and sarcoma

35
Q

What are urinary tract host defense mechanisms?

A

Mucosal immunity (cellular and humoral)
Urine flow
pH -acid
Osmolality - high solute conc, Urea
Epithelial barrier

36
Q

What is the vesicoureteral junction?

A

Where the ureters enter into the bladder

37
Q

Urethral developmental anomalies

A

Aplasia and ectopic ureters
Hypoplasia
Patent urachus

38
Q

How does failure of bladder to store manifest?

A
  1. irritable or spastic detrusor muscle
  2. Reduced bladder capacity
  3. Reduced urethral tone
  4. Incontinence or frequency
39
Q

How does failure of bladder to empty manifest?

A
  1. Atony of detrusor muscle
  2. Urethral obstruction or spasm
  3. Anuria, dysuria, or incontinence
40
Q

Traumatic causes of acute cystitis

A

Calculi
Iatrogenic (cysto)
Parturition
Bacterial hydrolysis of urea > ammonia damages mucosa
Glucosuria > proliferation of bacteria

41
Q

What effect does bracken fern have on the urinary tract?

A

Enzootic hematuria
Can cause transitional cell carcinoma

42
Q

Common uroliths in dogs

A

Struvite
Oxalate
Purines (urate, uric acid, xanthine)

43
Q

Common uroliths in horses

A

Ca carbonate

44
Q

Feline Lower Urinary Tract Disease (FLUTD)

A

Male predisposition
Obstructive urolithiasis -urethra
Bladder distention -necrosis, hemorrhage
Acute hemorrhagic cystitis
Rupture

45
Q

Presentation of urinary bladder neoplasia

A

Dysuria
Hematuria (ulceration)
Obstruction

46
Q

What is the most common location for transitional cell carcinomas?

A

Trigone of the bladder

47
Q

Risk factors for transitional cell carcinoma

A

Topical insecticides
Industrial waste
Female
Obesity
Breed (scotties)
Urine retention

48
Q

Can kidneys undergo hyperplasia to regenerate?

A

No

49
Q

What is the regenerative capacity of the kidney?

A

Limited
Hypertrophy NOT hyperplasia
Selective tubular epithelial repair

50
Q

What are common ways for the filtration barrier integrity to be disrupted?

A

Ag/ab complexes (Type III hypersensitivity)
Autoimmunity

51
Q

Stable protein deposits in the kidney can cause what?

A

Glomerular damage and can interfere with glomerular filtration
AB/ag complexes
Amyloid (visualized w/ congo red)
Dogs: Primarily glomerular
Cats: Primarily medullary

52
Q

Diabetic nephropathy

A

Microvascular complications
Diabetic glomerulonephropathy
Assoc. w/ chronic, uncontrolled hyperglycemia
-Formation and accumulation of advanced glycation end-products, collagen, and fibronectin
Assoc. w/ hemodynamic distrubances

53
Q

What is the kidney’s susceptibility to vascular damage determined by?

A

Normal anatomy
High blood flow
Consequence is altered function (GFR) and structure

54
Q

Ischemic renal failure can result from ______?

A

Primary or secondary obstruction of blood flow

55
Q

What is a typical gross sign of nephrosis?

A

Renal pallor

56
Q

What is nephrosis?

A

Acute tubular degeneration and necrosis

57
Q

What can cause uroliths?

A

Diet
Anatomic variability (males more common)
Urine conc. and pH
Presence of infection
Structural defects that favor infection or urine stasis
Foreign bodies
Conc of certain drugs in urine

58
Q
A

BOD II (5 decks)

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