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Clinical Pathology > Urinary System > Flashcards

Urinary System Flashcards

1
Q

What are the processes that regulate urine formation?

A

Glomerular filtration
Tubular absorption
Tubular secretion

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2
Q

How is the GFR assessed?

A

Assessed by the rate some substances are cleared from the plasma

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3
Q

What does GFR depend on?

A

Renal plasma flow

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4
Q

How much Na is resorbed in the proximal tubules? Loop of Henle?

A

75%

It is passively resorbed in the loop of Henle

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5
Q

What stimulates absorption of Na in the loop of Henle?

A

ADH

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6
Q

What stimulates the absorption of Na in the collecting ducts?

A

Aldosterone

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7
Q

How much Cl is resorbed in the proximal tubules? Loop of Henle?

A

75%

Passively resorbed in loop of Henle

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8
Q

How is Cl resorbed in the distal nephron?

A

Resorbed assively due to a gradient formed by Na

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9
Q

What happens to HCO3 in the proximal tubules?

A

90% is conserved via H+ secretion

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10
Q

What increases the resorption of HCO3 in the collecting ducts?

A

Type A intercalated cells

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11
Q

What decreases the resorption of HCO3 in the collecting ducts when there is excess?

A

Type B intercalated cells

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12
Q

Where is most of the K resorbed?

A

Prior to the distal tubules

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13
Q

What is K secreted by?

A

Principal cells in the collecting ducts

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14
Q

What is the secretion of K by the principal cells in the collecting ducts promoted by?

A

Aldosterone

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15
Q

What promotes the secretion of K in the cortical collecting ducts?

A

ADH

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16
Q

What is H+ secreted by?

A

Type A intercalated cells in distal nephron

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17
Q

What promotes the process of H+ secretion?

A

Aldosterone and acidemia

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18
Q

How much Ca is resorbed in the proximal tubules and loop of Henle?

A

80 to 85%

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19
Q

What promotes resorption of Ca?

A

PTH and Vit D

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20
Q

How much PO4 is resorbed in the proximal tubule?

A

85-90%

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21
Q

What is the resorption of PO4 enhanced by?

A

Hypophosphatemia and insulin

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22
Q

What is the resorption of PO4 inhibited by?

A

Hyperphosphatemia and PTH

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23
Q

How much Mg is resorbed in the loop of Henle?

A

Almost all of it

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24
Q

What stimulates the resorption of Mg?

A 
ADH
PTH
Glucagon
Calcitonin
β-agonists
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25
Q

How much glucose is resorbed in the proximal tubules?

A

All of it

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26
Q

How much of the proteins and amino acids is resorbed in the proximal tubule?

A

Nearly all of them

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27
Q

How much urea is resorbed in the proximal tubules?

A

60 to 65%

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28
Q

What enhances the resorption of urea in the distal nephron?

A

ADH

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29
Q

Where is creatinine excreted in dogs?

A

In small amounts in the proximal tubules

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30
Q

How much of water is resorbed in the proximal tubules?

A

75%

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31
Q

What is the concentrating ability?

A

Ability to resorb water in excess to resorption of solutes

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32
Q

What is the diluting ability?

A

Ability to resorb solutes in excess to resorption of water

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33
Q

What is isosthenuria?

A

Urine osmolality is the same as plasma osmolality

USG of 1.007-1.013

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34
Q

What is hyposthenuria?

A

Urine osmolality is less than isosthenuric values

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35
Q

What is eusthenuria?

A

Osmolality that is expected for an animal with adequate renal function

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36
Q

What is hypersthenuria?

A

Very concentrated urine

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37
Q

What must be present for urine concentration?

A

ADH

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38
Q

What causes chronic renal insufficiency/failure?

A

Renal tissue is inadequate to maintain health

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39
Q

What is the criteria for staging chronic renal insufficiency/failure?

A

Diminished renal reserve

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40
Q

What is the GFR in chronic renal insufficiency?

A

20-50% of normal

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41
Q

What is the GFR in chronic renal failure?

A

< than 20-25% of normal

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42
Q

What is the GFR of end-stage renal failure?

A

<5% of normal

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43
Q

What happens when more than 2/3 of the nephrons are lost?

A

The animal will lose the ability of concentrating the urine

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44
Q

What happens when more than 3/4 of the nephrons are lost?

A

The animal will become azotemic

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45
Q

What are reasons for loss of concentrating ability?

A

More solutes are presented to the remaining nephrons

Medullary hypertonicity is not maintained

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46
Q

What is evidence of insufficiency or failure?

A

Azotemia

Low USG due to loss of concentrating ability

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47
Q

What is evidence of chronicity?

A

Clinical findings including duration of signs

Lab findings: anemia, hypocalcemia

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48
Q

What is acute renal insufficiency/failure?

A

Reversible or irreversible, abrupt disease or insult that markedly decreases GFR

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49
Q

Does azotemia occur more rapidly in acute or chronic renal failure?

A

Acute

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50
Q

What is azotemia?

A

Increased BUN and/or creatinine

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51
Q

What is uremia?

A

Urinary in blood

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52
Q

What is pre-renal azotemia?

A

Any process that decreases RPF

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53
Q

What is renal azotemia?

A

Any renal disease that leads to major decreased GFR

54
Q

What is the cause of increased BUN and/or creatinine in post-renal azotemia?

A

It is distal to the nephron

55
Q

What is the pathogenesis of azotemia caused by?

A

Leakage of urine within the body

56
Q

What is the USG of a dog that is pre-renal?

A

> 1.030

57
Q

What is the USG of a cat that is pre-renal ?

A

> 1.040

58
Q

What is USG of horses and cattle that are pre-renal?

A

> 1.025

59
Q

What does azotemia develop from when it is extrarenal?

A

Hypovolemia

60
Q

What sample is needed to measure urea?

A

Serum or plasma

61
Q

What are causes of decreased urea nitrogen?

A

Hepatic insufficiency
Portosystemic shunt
Increased urea excretion

62
Q

What is the sample needed to evaluate creatinine concentration?

A

Serum or plasma

63
Q

What tests are used to look at creatinine concentration?

A

Dry chemistry and wet

Colorimetric

64
Q

What are causes of increased creatinine conentration?

A

Decreased GFR

Increased production and release from myocytes

65
Q

What does decreased creatinine do to muscle?

A

Decreased muscle mass

66
Q

What is the creatinine clearance rate?

A

Rate by which creatinine is cleared from blood

An indicator of GFR

67
Q

What are causes of decreased creatinine clearance rate?

A

Prerenal
Renal
Postrenal

68
Q

What is the endogenous procedure to check creatinine clearance rate?

A

Adequate hydration is established and confirmed

All urine is produced during a given period

69
Q

What is the exogenous procedure to check creatinine clearance rate?

A

The same as the endogenous but creatinine is injected in the animal

70
Q

What is the advantage to the exogenous creatinine clearance procedure?

A

It is a challenge to teh kidneys

71
Q

What are the disadvantages to the exogenous creatinine clearance procedure?

A

May increase tubular secretion of creatinine

Lack of standardization methods

72
Q

What are the 2 parts to a urinalysis?

A

Physical exam

Chemical exam

73
Q

What are the methods of collection for urinalysis?

A

Voided
Cystocentesis
Catheterized
Off surface

74
Q

What is the problem with voided samples?

A

Samples may have more bacteria, epithelial cells, and leukocytes from distal urethra adn genital tract

75
Q

What can cystocentesis cause?

A

Iatrogenic hemorrhage

76
Q

What is the problem with catheterized samples?

A

Epithelial cells, hemorrhage, lubricant, and bacteria

77
Q

What is the problem with off surface samples?

A

Contaminated with a variety of microscopic material

78
Q

What is the normal urine color?

A

Amber

79
Q

What does it mean if urine is red?

A

It has erythrocytes

80
Q

What does it mean if urine is red-brown?

A

It contains erythrocytes, Hgb, myoglobin or methemoglobin

81
Q

What does it mean if urine is brown to black?

A

Methemoglobin

82
Q

What does it mean if urine is yellow to orange?

A

It contains bilirubin

83
Q

What does it mean if urine is yellow-brown or yellow-green?

A

It contains bilirubin or biliverdin

84
Q

What does it mean if urine is cloudy?

A

Presence of cells, crystals, bacteria, casts, and lipid droplets in the urine

85
Q

What determines the solute concentration?

A

Dissolved ions and molecules

86
Q

What do you use to analyze solute concentration?

A

Specific gravity

Refractive index

87
Q

What is the urine pH of dogs and cats?

A

6.0 to 7.5

88
Q

What is the urine pH of horses and cows?

A

7.5 to 8.5

89
Q

What does aciduria suggest?

A

Increased secretion of H+

90
Q

What does alkalinuria suggest?

A

Decreased excretion of H+

91
Q

What are the different causes of proteinuria?

A 
Prerenal
Glomerular
Tubular proteinuria
Hemorrhagic
Inflammatory
92
Q

What is the maximum glucose transport ability in dogs?

A

180-220 mg/dL

93
Q

What is the maximum glucose transport ability in cats?

A

290 mg/dL

94
Q

What are the analytical methods of glucose in urine?

A

Strip

Copper reduction method

95
Q

What does it mean if an animal is hyperglycemic?

A

More glucose in the ultrafilterate that can be resorbed

96
Q

What will glucosuria cause?

A

Osmotic diuresis
Decreased concentration ability
Increased urine volume

97
Q

What are the ketone bodies?

A

Acetoacetate
β-hydroxybutyrate
Acetone

98
Q

What are the analytical methods for ketones?

A

Strip

Acetest table method

99
Q

What can cause ketonuria?

A

Increased metabolism of lipids

100
Q

If a test for heme is positive, what could be seen?

A

Hematuria
Hemoglobinuria
Myoglobinuria
Methemoglobinuria

101
Q

What are methods of testing bilirubin in urine?

A

Strip method

Icotest

102
Q

What are causes of bilirubinuria?

A

Hemolytic states or decreased excretion of bilirubin
Concentrated urine from healthy dogs frequently produces a small bilirubin reaction
May be present before hyperbilirubinemia or icterus are present

103
Q

What is the clinical relevance of urobilinogen?

A

It is not very clinically relevant

104
Q

Why is nitrite not very clinically relevant?

A

Inconsistency of results

105
Q

What can leukocyte esterase cause in the urinalysis?

A

False negative in dogs

False positive in cats

106
Q

How can you get a more accurate and clinically relevant results when looking at urine sediments?

A

Consistently using the same volume

107
Q

What are causes of hematuria?

A

Pathological hemorrhage
Iatrogenic hemorrhage
Urogenital tract (estrus)

108
Q

Should there be bacteria in the urine?

A

No, urine is sterile

109
Q

Because a false negative is possible when looking a bacteria on a urinalysis, what is recommended if infection is suspected?

A

Urine culture

110
Q

What are casts?

A

Cylindrical concretions

Shape mirrors the tubular segment where it was formed

111
Q

What forms the urinary tract mucosa?

A

Epithelial cells

112
Q

What are the type of epithelial cells that form the mucosa?

A

Renal tubular cells
Transitional cells
Squamous epithelial cells

113
Q

What is teh clinical significance of epithelial cells on urinalysis?

A

Present in healthy animals
Inflammation can increase release of cells
Neoplastic cells may be present

114
Q

What are crystals?

A

Precipitation of salts

115
Q

What may dictate the formation or dissolution of crystals?

A

pH

116
Q

What is crystalluria a risk factor for?

A

Urolith formation

117
Q

What is the shape of calcium oxalate dihydrate and monohydrate crystals?

A

Envelope shaped

118
Q

In what animals can you find calcium oxalate dihydrate and monohydrate crystals?

A

Healthy dogs and cats
Dogs and cats with calcium oxalate uroliths
Dogs intoxicated with ethylene glycol (monohydrate kind is more common)

119
Q

In what animals can you find calcium phosphate crystals?

A

Healthy dogs
Dogs with persistent alkaline urine
Dogs with calcium phosphate urolith
Infection induced struvite crystalluria

120
Q

In what animals can you find cholesterol crystals?

A

Healthy dogs

121
Q

What is the shape of cystine crystals?

A

Hexagonal

122
Q

Where can find cystine crystals?

A

Concentrated acidic urine

Dogs and cats with cystinuria

123
Q

What may cause cytine crystals to dissolve?

A

Alklaine urine due to infection or contamination with urease-producing bacteria

124
Q

What is the shape of magnesium ammonium phosphate (struvite) crystals?

A

Coffin-like prisms

125
Q

Where can you find stuvite crystals?

A

Normal dogs and cats
Infection with urease-producing bacteria
Sterile struvite uroliths
Other uroliths

126
Q

What do urate crystals look like?

A

Yellow to brown spherules with long irregular profusions

127
Q

Where can you find urate crystals?

A

Dogs with portal vascular anomalies
Dogs and cats with ammonium urate uroliths
Uncommon in healthy dogs and cats

128
Q

What do bilirubin crystals look like?

A

Needle-like

Yellow to brown

129
Q

Where can you find bilirubin crystals?

A

Concentrated urine
Healthy dogs
Cholestatic disease in cats, horses, bovine, and camelids

130
Q

Where can you find calcium carbonate crystals?

A

Healthy horses and goats

131
Q

What organisms, other than bacteria, can be found on urinalysis?

A

Yeasts
Hyphal structures
Algae
Parasitic structures (may be due to fecal contamination)

Clinical Pathology (16 decks)

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