Urinary System Flashcards
1
Q
What can oak toxicity in cattle cause
A
renal tubular damage, streaking red-white pattern in the cortex
2
Q
What does an acute kidney infarct injury look like
A
Wedge shaped
Red
Swollen
3
Q
What does a subacute kidney infarct injury look like?
A
Wedge-shaped
Red-Rim with white/grey/tan center with a surface that is still swollen
4
Q
What does a chronic kidney infarct injury look like
A
a wedge shaped
white/grey/tan surface is sunken due to tissue loss and scarring
5
Q
What kidney pattern does Actinobacillus infection in a foal have
A
White speckles from small thrombi and bacteria in the bloodstream that have settled in the microvasculature of the glomeruli
6
Q
What kidney pattern does E coli infection in a calf have
A
White speckles from small thrombi and bacteria in the bloodstream that have settled in the microvasculature of the glomeruli
7
Q
What do white, tan, or red cortical dots on the kidney likely indicate
A
Ekbolic/septic pattern from an infectious process
likely bacterial
8
Q
What does a pinpoint pattern that is uniform tan or red dots on the cortex of the kidney likely indicate?
A
Likely Glomerular disease - glomerulonephritis, glomerular amyloid, or glomerulosclerosis
9
Q
Pyelectasia
A
distention of the renal pelvis
10
Q
Hydronephrosis
A
severe distention of the renal pelvis by fluid (urine)
Implies and obstruction without infection
11
Q
Pyelitis
A
inflammation of the renal pelvis, usually suppurative
12
Q
Pyelonephritis
A
inflammation, usually, suppurative of the pelvis and renal papilla; may cause pyelectasia (distention of pelvis)
13
Q
What is a likely cause of pyelonephritis
A
usually ascending infection from a lower urinary tract infection
14
Q
Upon necropsy you see distented renal pelvis and distended renal calyces. What is going on
A
Pyelectasia
15
Q
You observe pyelectasia what is the likely cause
A
1) obstruction (stones, stricture, neoplasia, ecotopic ureter)
2) If pus: pyelonephritis from an ascending bacterial infection
16
Q
What pattern of kidney injury is seen in ethylene glycol toxicosis
A
corticomedullary injury (streaks in the cortex)
17
Q
What pattern of kidney injury is seen in rattle snake envenomation
A
corticomedullary injury (streaks in the cortex)
tubular necrosis
18
Q
you observe kidney cortical or medullary streaks, what process is likely occurring
A
tubular necrosis or tubulointerstitial disease
19
Q
What should you ensure in your postmortem sampling of kidney for histopath
A
make sure sample has cortex, medulla, and pelvis
sample thickness should be no more than 1cm
Multiple samples are okay if one is abnormal
can submit a whole kidney if needed
20
Q
What kidney patterns can be seen in a cat with FIP?
A
1) Few to many variably sized white to yellow nodular to fuzzy masses
sometimes along the vessels
may cause infarcts so wedges can be seen
Lesion is granulomatous (nodular) phlebitis/vasculitis (may track vessels and cause infarcts)
21
Q
What disease causes kidneys to have variably size white to yellow nodular to fuzzy masses that are sometimes along the vessels and can cause infarcts
A
Feline infectious peritionitis
Confirm by ensuring also swollen belly, elevated gamma globulins, and viscous yellow fluid
22
Q
What is a result of glomerular disease
A
proteinuria (protein losing nephropathy) leading to hypoalbuminemia, immunoglobulins are usually normal
23
Q
What is the clinical pathology hallmark of glomerular disease
A
Clin Path: significant proteinuria in dilute urine especially if quiet sediment
An Path: Pinpoint white or red cortical dots
24
Q
What are the two general causes of glomerulonephritis
A
1) Primary infection of glomeruli (embolic/septic or systemic disease)
2) Immune-complex deposition (Ig-Ag)- many causes
25
What bacteria can cause glomerulonephritis
Septic conditions leading to damage of the glomerulus
1) Actinobacillus equuli in foals
2) E Coli (any species)
3) Erysipelothrix (pigs)
often has a classic embolic pattern rather than glomerular pattern
26
What viruses can cause infectious glomerulonephritis
Porcine Circovirus 2 (Pigs)
*You will see a classic pinpoint glomerular pattern
27
You necropsy a pig with Porcine Circovirus 2. What pattern do you expect to see in the kidneys
Classic pinpoint glomerular pattern due to damage to the glomerulus
28
What type of hypersensitivity lead to immune complex deposition in the glomerulus
Type 3
29
A 10yo FS mutt is brought in for lethargy and coughing. The dog test positive for heartworm. As part of your lab work you run urinalysis that shows proteinuria in dilute urine with quiet sediment. What type of renal pathology do you suspect?
Glomerular disease
30
What are the causes of Ig-Ag glomerulonephritis in dogs?
-IMHA
-IMPA (immune mediate polyarthritis)
-Chronic Heartworm
-Adenovirus
-Any chronic infection
31
You have been managing a 12yo MI mix breed dog with chronic intermittent systemic lupus erythematosus. Upon a recheck exam with CBC, chem, UA you notcie significant proteinuria in dilute urine with a quiet sediment. What do you suspect the patient has developed
Glomerulonephritis due to type III hypersensitivity
32
What are the causes of Ig-Ag glomerulonephritis in cats?
-FIP
-FIV
-FeLV
-Autoimmune disease
-Any chronic inflammatory conditons
33
What are the causes of Ig-Ag glomerulonephritis in cattle
BVDV
Trypanosomiasis
34
What are the causes of Ig-Ag glomerulonephritis in pigs?
Hog cholera (Classical Swine Fever; pestivirus)
African Swine Fever (Asfarvirus)
Streptococcal disease
35
What are the causes of Ig-Ag glomerulonephritis in horses?
Streptococcus- chronic abscesses
EIA- Equine Infectious Anemia
36
A protein deposit with b-pleated sheet secondary structure that may form out of misfolded proteins or form when excess normal proteins aggregate
difficult to remove once deposited
Amyloid
37
What is the most common form of amyloidosis in animals?
AA- amylodosis- derived from serum amyloid-A (SAA)
seen in chronic inflammatory conditions, immune mediated diseases and chronic infections
38
What form of amyloidosis is rare in animals
AL amyloidosis from monoclonal immunoglobulin light chains
seen in plasma cell neoplasia or proliferations
39
In dogs, amyloid deposits in the __________
In cats, amyloid deposits in the _____________
Renal glomeruli (dogs)
Renal medulla (cats)
40
What is the stain used to tell glomerular amyloid
Congo Red
41
What breed of cat is predisposed to renal amyloidosis
Abyssinian
42
hardening or scarring of the glomerulus, usually by fibrosis
end stage of glomerular disease
Glomerulosclerosis
43
What is very suspicious of glomerular disease
proteinuria in dilute urine with a quiet sediment
44
Name toxins that cause renal tubular necrosis (corticomedullary pattern)
-Ethylene glycol
-grapes
-Lilys (cats)
-oak- cattle
-pigweed-pigs
-Bluegreen algae (with liver failure)
-Vitamin D
-Amanitin (mushroom with liver failure)
-Lead (cattle)
45
What can help you diagnose ethylene glycol toxicity in a dog
1) Metabolic acidosis
2) Azotemia and isosthenuria renal failure
3) Calcium oxalate monohydrate crystals in urine
4) cortical to medullary streaks, red-white pattern indicating tubulointersitital pathology- tubular necrosis
46
What causes pigment nephrosis
1) Free hemoglobin from severe hemolysis
2) Free myoglobin from severe rhabdomyolysis
leading to acute kidney injury, renal tubular necrosis
47
You observe kidneys that are diffusely dark red to blue-black and pigmenturia. What is likely happening
Pigmentary nephrosis due to hemoglobin or myoglobin (hemolysis or rhabdomyolysis)
48
What are your differentials for Hb pigment nephrosis
Hemolysis
1) Wilted red maple (horses)
2)Isoerthrolysis (horses)
3) incomaptible blood transfusion
4) Copper (sheep)
5) IMHA
6) Onions (dogs)
7) Zinc
8) Acetaminophen
49
What toxin causes renal tubular necrosis with severe heinz body anemia and methemoglobinemia, hypoxia, icterus, hemoglobinuria, and splenomegaly in horses
Red Maple
50
Does neonatal isoerythrolysis occur with the first or second pregnant in horses?
Second
During the first the foal inherits RBC antigen from a sire that is foreign to mare. Mare sensitized to RBC antigen during pregnancy. Mare produces antibodies against the RBC antigen. Foal #2 has same foreign RBC antigen so the mare's antibodies concrentrated in the colostrum causes a type II hypersensitivity reaction and hemolysis
51
What type of hypersensitivity reaction is neonatal isoerythrolysis in foals?
Type II
52
Low amounts of the metal_________ can cause copper toxicity in small ruminants
molybdenum
53
What is the effect of copper on the kidney
Storage of excess Cu in the liver raises release and oxidation of Hb where heinz body anemia occurs with hemoglobinuric acute tubular necrosis; Hb-uria and diffusely dark red/black cortex
54
What are your differentials besides copper toxicity for HB pigment nephrosis in small ruminants
IMHA
-Erythroparasite
Clostridium perfringens type A
55
What can cause myoglobin pigment nephrosis
Capture myopathy
Exertional rhabdomyolysis
Compartment syndrome in large animal
56
Describe the pathogenesis of capture myopathy/exertional myopathy
1) Prolonged sympathetic tone activation and exhaution- relative muscle hypoxia
2) Muscle exertion leading to a production of lactic acid - lactic acidosis
3) Exacerbated by heat/hyperthermia and other stressors
4) Myoglobin is released from daged/dead myofibers (CK and K+ will be elevated)
5) Circulating Mb is toxic to renal tubular epithelium leading to acute tubular necrosis and acute renal failure
57
What is compartment syndrome
caused by long term recumbency in large animal where the weight of the animal upon the side that is down can cut off the blood supply
Muscle ischemia lead to muscle necrosis, edema
Restriction by fascia casues increased pressure in the compartment and causes more muscle damge to the muscle belly in that fascia plane
58
What causes renal papillary necrosis
1) NSAID administration (overdose or chronic use) especiallyequines with bute,bamaine- alter renal blood flow and cause ischemia of the renal papilla
2) Can also see with pelvic stones leading to pressure necrosis
3) Can also see with pyelonephritis leading to infection and necrosis
59
What does papillary necrosis look like? and what are its likely causes
Yellow/green/ or brownish discoloration at the renal pelvis
NSAIDs, pelvic stones, or pyelonephritis
60
What are the infectious causes of tubulointerstitial disease
-Leptospirosis
-Malignant catarrhal fever (bovines, ungulates)
-Encephalitozoon cuniculi (rabbits)
61
Spiral bacteria that is shed in the urine by infected animals.
infection via contact with urine or water or soil contaminated with urine
contact with the mucous membrane or breaks in the skin
cause tubulointerstitial disease
Acute renal AND hepatic failure (but serovar dependent)
Leptospirosis
62
What is the classical canine presentation of Leptospirosis
Acute Renal AND Hepatic Failure
63
What pattern does malignant catarrhal fever have on the kidney
Systemic disease with vasculitis
Renal lesion is multifocal with intersitital nephritis
Patchy white areas of pallor
64
What causes Malignant catarrhal fever
Ovine herpesvirus 2 or alcelaphine herpesvirus
65
Caused by a microsporidian parasite
Most infected rabbits are asymptomatic
Can cause encephalitis, catarct, granulomatous tubulointerstitial nephritis
Potentially zoonotic to immune compromised people
Encephalitozoon cuniculi
66
What is seen in a kidney of a rabbit with Encephalitozoon cuniculi
-Granulomatous tubulointerstitial nephritis
infected renal tubular epithelial cells
Kidney has pitted surface
67
You have a rabbit with a stiffneck posture (torticollis), catarcts, and granulomatous tubulointersititial nephritis with a kidney with a pitted surface . What is the likely cause?
Encephalitozoon cuniculi (Microsporidian parasite)
68
What genes are mutated in polycystic kidney disease
PKD1and/or PKD2 genes
69
What does mutation of PKD1 and/or PKD2 result in
Dilation of the renal tubules (polycystic kidney disease)
70
What breeds are predisposed to Polycystic kidney disease
Persian cats and Bull terriers
71
Congenital condition resulting in dilation of renal tubules. Most cases are mild and incidental but severe cases may progress to renal failure
Persians and Bull terriers are predisposed
Polycystic kidney disease
72
What is the result of chronic kidney disease in cats
Nephron loss and decrements of GFR
-leading to failure to concentrate,
-failure to excrete BUN
-Failure to excrete acids, K, PO4
-Failure to make erythropoietin
-RASS pathway activation (bc dehydration) and resulting hypotension
-Uremic halitosis
73
Uremic halitosis
Bad breath due to kidney failure and the inability to excrete urea
74
When do owners typically notice the signs of chronic kidney disease
When the are Stage III (PU/PD, reduced appetite, weight loss, dehydration, vomiting, dull unkempt coat, weakness)
75
What signs are noticed in Stage IV CKD in cats (worst stage)
1) Mouth ulcers from uremia
2) Blindness from hypertension
3) Severe vomititng
4) Refusal to eat
5) Dehydration
6) Weakness and lethargy (anemia and acidosis)
76
By the time that owners notice clinical signs of CKD, what percent of nephrons are left
Stage III (when first noticed)- 25-10%
Stage IV <10% nephrons left
77
What gross kidney patterns are seen in a cat with CKD?
it is very variable but chronic infarct (wedge), glomerular (white dots), pelvic pathology
78
Obstruction of the renal pelvis or ureter to leads to______
pyelectasia/hydronephrosis
79
4 Causes of renal obstruction
1) Uroliths
2) Neoplasia
3) Urethral/pelvic trauma- physical, inflammatory, or radiation
4) iatrogenic- accidental ligature during spay
80
A vague term for a stone anywhere in the urinary tract
Urolith
81
A stone in the kidney
Nephrolith
82
A stone in the ureter
Ureterolith
83
A stone in the bladder
Cystolith
84
A stone in the urethra
urethrolith
85
Urolithiasis
the condition of having a stone anywhere in the urinary tract
86
condition of having a stone in kidney
nephrolithiasis
87
condition of having a stone in ureter
ureterolithiasis
88
condition of having a stone in the bladder
cystolithiasis
89
What are the clinical signs of urethroliths in males
stranguria, inability to urinate, distended turgid bladder- can rapidly progress to death due to hyperkalemia
90
What are the common sites of obstructions in sheep and goat males
urethral process
plexure
91
What is a problematic point for urinary obstructions in male dogs
os penis
92
What is the most common stone type in dogs
Struvite
93
What crystal are females predisposed to because they are associated with UTI
Struvite
94
What can help dissolve struvite crystals
acidify the urine to help dissolve small struvite stones and prevent new ones
also you can surgical, cystoscopic/lithotripsic option may be needed
95
What UTI pathogens produce urease to cleave urea and produce bicarbonates and ammonia, ultimately increasing pH
Staphylococcus and Proteus
96
Stella is a 4yo FI mix breed dog who has recurrent episodes of stranguria with hematuria and she has been diagnosed by culture of urine with Staphylococcal UTI. Her signs have been partially responsive to appropriate antibiotics based on sensitivity. Owners permit you to perform abdominal radiographs and you identify cystoliths. They are most likely:
Struvite
97
What is the cause of small ruminant struvites?
Not associated with UTI
but:
1) Avoid alfalfa/legumes and grains as they are a source of ammonium (NH4) and calcium
both predispose to struvite stones
2) Timing of castration: delayed (at 6 months) allows urethra to develop to maximum diameter possible... early castration predisposed to an obstruction
98
You are claled to a hobby ranch with a bunch of goats. Prized 5yo buck has been straining to urinate for the past 6 hours. you arrive, perform a complete sedated exam, note that the urehtral appendage is swollen and dark red, and after discussion with the owner you want to remove the urethral appendage. Instantly, urine begins rushed out under high pressure. What do you want to discuss with the owner before you leave
What the goats are eating- quit feeding alfalfa, grain, legumes
*also the time of castration for young males
99
What crystal is associated with portosystemic shunts
Ammonium biurate stones
Liver normally metabolize ammonia in the portal blood stream to BUN
extra ammonia and uric acid are excreted in the urine, predisposing to ammonium biurate crystals and stones
100
What allows the formation of ammonium biurate stones
portosystemic shunts
101
What stone is normal in horses and rabbits
Calcium carbonate stones
102
Why are calcium carbonate formed
because rabbits and horses excrete a lot of calcium in their urine
-avoid alfalfa (high in calcium)
-avoid grains (also high in calcium)
103
What stone is most common in cat urine
Calcium oxalate
104
Why have calcium oxalate crystals become the most popular crystal in cats ?
acidifying the diets
*Try non-acidifying diets and encourage hydration by offering canned food and a water fountain
105
What causes death in a urethral obstruction
hyperkalemia
106
outflow obstruction pathogenesis
elevated pressure causes stretching
stretching tears vessels in bladder wall
hemorrhage from torn vessels causes the wall to be dark red-black and the urine to be red
107
What could be the cause for a distended, turgid, red bladder
Urethral obstruction
108
What are the causes of bladder hemorrhage
1) obstruction
2) UTI
3) Malignant catarrhal fever (cattle, bison/buffalo)
4) Bracekn fern (cattle)
5) Blister beetle (canthardin toxin, horses)
6) Cyclophosphamide (side effect in small animals)
109
What are your main differentials for a bladder that is red, not turgid, and not distended
Stones
UTI
Malignant catarrhal fever (cattle, bison/buffalo)
Bracken fern (cattle)
Blister beetle
cyclophosphamide
110
What helps to prevent UTIs
-Periodic emptying
-Valve at ureter insertion
-Urothelial mucous
-Urine USPG, pH
111
What factors predispose animals to UTIs
-Failure to empty fully (urachal remnant, stones, neurogenic)
-ectopic ureter
-hyposthenuria/isothenuria
112
a congenital remnant fetal duct that in utero transferred waste to placenta and dam for excretion. allows predisposition to UTI from failure to empty completely
Urachal remnant
113
What three conditions may prevent the bladder from emptying completely
1) Neurogenic
Spinal cord trauma (degen disk disease or hit by care)
cauda equina in horses
a tumor in T10-sacral spinal
Disk Disease/herniation
other spinal problem
other spinal problem
2) Urachal Remnant (failure to empty completely)
3) Stones
114
a ureter that does not connect properly to the bladder trigone and predisposition to UTI
ectopic ureter
115
What are the causes of hypo/isothenuria that can presdipose to UTI
Impaired renal concentrating ability like seen with renal failure, DI, Cushings, Addisons, Hypercalcemia, Hypokalemia, Psychological polydipsia, Hepatic failure, pyometra and other sepsis, uncontrolled DM
116
What causes a pattern of TNTC pinpoint red, grey, white bladder
Follicular (lymphofollicular) cystitis due to chronic inflammation and irritation
117
What causes Follicular (lymphofollicular) cystitis
chronic inflammation and irritation
118
Name the dx:
Broad based single or multiple masses on the bladder with a history of UTI/stones
polypoid cystitis
inflammatory polyp- nonspecific indicator of chronic inflammation
main differential is cancer
119
Polypoid cystitis
inflammatory polyps
nodular inflammation with fibroplasia and epithelial hyperplasia
Associated with chronic inflammation/irritation
Patients often have a history of stones and recurrent UTIs
Main differential is cancer
120
Name that dx:
gas bubbles in the bladder
Emphysematous cystitis
causes: glucouria causing UTI with gas producing bacteria like E coli, Pseudomonas, Klebsiella, Proteus, Enterobacter, and Clostridium ferment glucose to CO2
culture to detet UTI
121
What causes Emphysematous cystitis
glucosuria allowing gas producing bacteria like E coli, Pseudomonas, Klebsiella, Proteus, Enterobacter, and Clostridium to ferment glucose to CO2
122
What breed is predisposed to transitional cell carcinoma
Scottish terriers
123
Arises from the transitional epithelium of the renal pelvis, ureter, bladder and urethra (trigone most commonly) and can metastasize to the sublumbar LN, bone, and more and/or block urethra/ureters, leading to hydroureter, hydronephrosis
transitional cell carcinoma
124
What is the most common site for transitional cell carcinoma to develop from
transitional epithelium of the bladder trigone
125
BRAF gene
a gene that when mutated has a 85% chance for the dog to develop transitional cell carcinoma
can be detected in urine, sometimes before a mass is obvious
126
BRAF testing
testing for the BRAF gene as 85% of dogs with TCC have a mutation. can be detected in urine, sometime before a mass is obvious
127
BRAF Plus testing
detect other gene varient associated with TCC. If performed with BRAF can be 95% sensitive.
Test needs 30mL of urine
128
contain ptaquiloside toxin and chronic ingestion can predispose the animal to multiple neoplasms of the bovine bladder like TCC or hemagioma "enzootic hematuria'
Bracken Fern
129
What neoplasms does the chronic ingestion of Bracken fern predispose cows to
1) Transitional cell carcinoma
2) Hemagioma/iosarcoma "enzootic hematuria"
130
How do animals with trigone TCC typically present
hematuria and stranguria
131
A 10 yo male castrated mix breed dog present to you after owner notes a 1month hx of hematuria and stranguria. Rule out UTI via urine sediment and negative urine culture. On physical exam you palpate a mass in the caudoventral abdomen and via ultrasound you confirm this is a trigonal bladder mass. What is your top differential
Trigonal transitional cell carcinoma- super common especially in older dogs
132
Ingestion of what plant over time prediposes cattle to tumors of the urinary bladder
Bracken Fern (ptaquiloside)
133
Causes heinz body anemia and pigmentary nephrosis in horses
Red maple leaf
134
when ingested causes acute tubular necrosis in pigs (corticomedullary pattern)
pigweed
135
when ingested causes acute tubular necrosis in cattle (corticomedullary pattern)
oak
136
What are the five potential primary tumors of the kidney
1) Transitional cell carcinoma (TCC) **
2) Rhabdomyosarcoma -rare
3) Leiomyoma/myosarcoma-rare
4) Hemagiosarcoma/TCC of bovids- rare
5) other rare
137
What are the 4 possible tumors of the kidney
1) Lymphoma- cats and chickens especially
2) Nephroblastoma- rare
3) Renal cell carcinoma - rare
4) others (sarcomas)- rare
138
What is the most common primary renal tumor in pigs, chickens, and fish
Nephroblastoma
-arises from primitive remnants of kidney due to mutation in WT1 (wilms tumor 1)
139
A 2 year old dog presents to you with renal failure, hematuria, a suspected UTI but upon investigation you notice bilateral renal masses and polycythemia. What is a likely ddx?
Nephroblastoma - rare in dogs
140
If a nephroblastoma has spinal involvement what might you see?
hindlimb paresis and paraylsis typically T10-L3
141
How can nephroblastomas be spinal?
due to abnormal cellular migration of kidney cells out of the mesoderm during embryogenesis
prekidney elements migrate incorrectly and trapped in spinal cord
classic site: T10-L3
142
What location on the spinal cord is a nephroblastoma typically at?
T10-L3
143
A neoplasia of the renal tubular epithelium
rare in all species
presents as a large effacing mass
Renal cell carcinoma (RCC)
144
What are you differentials for a large effacing mass on the kidney
Renal Neoplasia (eg. RCC, nephroblastoma, Lyphoma)
Granulomatous disease (Like Halicephalobus)
Tumors like lymphomas or sarcomas that spread to the kidney parenchyma
145
What might lymphoma that spread to the kidney look like?
-FIP
-Granulomatous process (like Halicephalobus)
146
If a kidney has multiple large masses, what are the likely differentials
metastatic neoplasia or granulomatous disease
147
Name 4 differentials for a dog with acute liver AND renal failure
-Leptospirosis
-Amanita toxicosis (mushroom)
-Blue/green algae
-Heat stroke
148
What is the likely diagnosis for a horse with renal insufficiency or failure with white-tan masses on rectal palpation/US or necropsy
+/- CNS signs
Halicephalobus
149
What are the 5 nonrenal gross lesions consistent with renal failure
1) Uremic glossitis
2) Mineralization (stomach, lung, pleura, kidney)
3) CKD associated metabolic bone disease
4) 2ndary parathyroid hyperplasia
5) Hypertension, retinal detachment
150
small bilateral and symmetric ulcers on the tongue due to urea causing endothelial damage
notice lingual ulcers and smell of ammonia on PE
uremic glossitis
due to azotemia with excess urea (BUN)
151
How does renal failure cause metastatic mineralization
Due to increased PO4
Ca may be normal of low- dogs and cats
Ca may be high- horses
commonly in stomach, lung, pleura, and kidney
152
What sites are common for metastatic mineralization
Stomach, lung, pleura, and kidney
153
How does secondary renal hyperparathyroidism occur
first through Renal failure leading to
No production of Vitamin D (hypovitamonosis D)
This leads to hypocalcemia
Triggers endocrine feedback loop
Parathyroid is stimulated by hypocalcemia
PTH increases serum calcium
Bilateral parathyroid hyperplasia due to chornic stimulation of the gland
154
How does secondary renal hyperparathyroidism occur
renal failure leading to hypocalcemia and bilateral parathyroid hyperplasia due to chronic stimulation of glands
155
What are the effects of secondary hyperparathyroidism
-Bilateral parathyroid hyperplasia
-Bone pain and osteopenia (especially in the jaw) bone replaced with fibrous connective tissue over time
156
CKD-metabolic bone disease
disease called big head or rubber jaw where bone in the head/jaw is replaced with fibrous connective tissue due to secondary renal hyperparathyroidism in response to kidney failure
157
How does chronic renal failure result in hypertension
Renal failure leads to water loss and constant dehydration (hypovolemia)
Activation of the renin-angiotensin-aldosterone system (RAAS)- causes hypertension by vasoconstriction and sodium/water retention
158
How might their be retinal hemorrhages with chronic renal failure
Hypertension (via activation of RAAS in response to persistent dehydration/hypovolemia)
can lead to severe retinal hemorrhages and acute blindness
159
A 16yo cat is presented to you for sudden blindness. You confirm that cat is blind and note a BCS 3/9 and that she has a poor hair coat, bilateral lingual ulcers and ammonia halitosis, and irregular kidneys on abdominal palpation. Upon the query, the owner says the cat drinks and urinates a lot. What do you suspect is the cause of the acute blindness
Hypertension due to renal failure
160
what is the most common tumor of the equine penis, common of paints and appaloosa
UV-associated
Eqine penile squamous carcinoma
161
What dogs have a higher rate of TVT
Intact dogs (Behavioral- genital contact and sniffing)
Shelter Dogs
Dogs in Central/South America and where spay/neuter is less common
162
What are the common sites for transmissible venereal tumor (TVT)
Penial/preputial
Vaginal
Perineal
Rectal
Nasal lesio n
163
How can you diagnose TVT
History
PE
Cytology +/- biospy
Cytology- big round cells with abundant cytoplasm and many small clear cytoplasmic vacuoles
164
Anemia accompanies chronic renal failure because of
failure to synthesize erythropoietin
165
In mammals nephroblastoma is caused by mutations in:
a) PKD1
b) Mum-1
c) WT1
d) BRAF
c) WT1
166
