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Y3 Urinary pathology > Urinary system pathology 4 > Flashcards

Urinary system pathology 4 Flashcards

1
Q

Name the toxic disease of the lower urinary tract that primarily affects cattle

A

Enzootic haematuria

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2
Q

Enzootic haematuria is caused by…?

A

Grazing on bracken associated toxins

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3
Q

What are the toxic effects of Enzootic haematuria?

A
  • Hyperplasia, metaplasia
  • Haemorrhagic cystitis
  • Haematuria
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4
Q

How does Enzootic haematuria affect the mucosa of the LUT?

A

Chronic squamous or mucosa metaplasia

  • transitional epithelium becomes squamous
  • thicker, keratin on the surface, develops goblet cells (mucus)
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5
Q

Where do tumours due to enzootic haematuria form?

A

Most commonly in the neck of the bladder - trigone area, adjacent to the urethral sphincter

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6
Q

Which are the signs of enzootic haematuria?

A

Chronic weight loss, common in cows with bladder tumours – inappetent due to pain in abdomen

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7
Q

Give examples of mesenchymal tumours of the bladder.

A
  • Leiomyoma or Leiomyosarcoma – s.muscle
  • Fibroma or fibrosarcoma
  • Haemangioma or haemangiosarcoma
  • Rhabdomyosarcoma
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8
Q

A rhabdomyosarcoma affects where in the LUT?

A

Urethral sphincter - forms from striated myocytes

- Young (<18m), large/giant breed dogs

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9
Q

Are mesenchymal or epithelial neoplasia’s of the LUT more common?

A

Epithelial

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10
Q

Give examples of epithelial tumours of the bladder.

A
  • Transitional cell papilloma
  • Squamous cell carcinoma
  • Transitional cell carcinoma
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11
Q

Which epithelial neoplasm is the most invasive and neoplastic?

A

Transitional cell carcinoma

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12
Q

Briefly describe squamous cell carcinoma.

A
  • Slow growing
  • Infiltrative but less likely to metastasise (only in later stages)
  • May be nodular, sessile or ulcerated
  • May arise in metaplastic epithelium
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13
Q

Briefly describe transitional cell carcinoma.

A
  • Highly invasive
  • Nodular or plaque
  • Primarily occurs at trigone
  • Metastatic (in more than 50% of cases)
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14
Q

What animals are predisposed to bladder transitional cell carcinoma?

A
  • Dogs
  • Neutered males
  • Older dogs 9+
  • Females
  • Airedale, Beagle + Scottie predisposed
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15
Q

Where does transitional cell carcinoma frequently metastasise to?

A
  • lung
  • sub-mandibular lymph node
  • pelvic bones and vertebrae
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16
Q

How does transitional cell carcinoma appear grossly?

A

Multifocal to coalescing, raised, pink and reddened nodules, both on the mucosal and serosal surface
- Dramatic spread

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17
Q

How does transitional cell carcinoma appear histologically?

A
  • Excessive proliferative folds in the lumen
  • Active invasion of the connective tissue and muscle
  • Dense numbers of tumour cells, inflammatory cells, mitotic figures
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18
Q

Define the following terms:

  • Dysuria
  • Anuria
  • Oliguria
  • Polyuria
  • Polydipsia
A
  • Dysuria = painful or difficult urine
  • Anuria = no urine output
  • Oliguria = low urine output
  • Polyuria = high urine output
  • Polydipsia = high water consumption
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19
Q

Define the following terms:

  • Isothenuria

- Hyposthenuria

A
  • Isothenuria = cannot form urine with a higher or a lower specific gravity (SG) than that of protein free plasma. SG of the urine becomes fixed around 1.010, irrespective of the fluid intake.
  • Hyposthenuria = urine of low specific gravity
20
Q

Define the following terms:

  • Azotaemia

- Uraemia

A

Azotaemia – a higher than normal blood level of urea or other nitrogen containing compounds. The basic test is the blood urea nitrogen level (BUN).
Uraemia – the clinical syndrome of toxicosis from renal failure.

21
Q

Chronic renal failure is common in which species?

A

Cats

22
Q

What are the three critical requirements for renal function where damage to any of these can send the animal into renal failure?

A
  • Adequate renal blood flow
  • Sufficient functioning nephrons
  • Expulsion of continuous urinary output
23
Q

Describe pre-renal failure and its causes

A
  • inadequate blood flow causes hypoperfusion
  • haemorrhage, shock, cardiac failure
  • Renal parenchyma undamaged initially.
  • Potentially reversible if blood flow is restored before excessive anoxic damage occurs.
24
Q

Describe intrinsic renal failure and its causes

A
  • inflammation, toxins, neoplasia, fibrosis, congenital defects
  • Damage occurs which requires time for repair or compensatory hypertrophy.
  • Requires aggressive therapy to correct fluid + electrolyte balance
25
Q

Describe post-renal failure and its causes

A
  • LUT obstruction, inflammation, bladder dysfunction, bladder rupture
  • may affect both kidneys causing anuria
26
Q

Post-renal failure causes what changes in the blood?

A

Rapid rise in blood urea and creatinine

- Reduced GFR and renal blood flow

27
Q

What is the renal reserve?
When does renal insufficiency occur?
When does renal failure occur?

A
  • Up to 50% capacity is the renal reserve
  • There is renal insufficiency when only 30-50% of the capacity remains
  • When capacity falls below 30%
28
Q

What is acute renal failure and give 3 example causes?

A

Sudden loss of 70-100% of capacity

- Ischaemia, toxins, outflow obstruction

29
Q

What are the signs of acute renal failure?

A
  • Anuria or oliguria (no or minor urine output)

- Isosthenuric urine - an inability to concentrate or dilute urine

30
Q

Describe chronic renal failure

A
  • Gradual loss of renal capacity

- Usually irreversible

31
Q

What are the signs of chronic renal failure?

A
  • Polyuria with polydipsia

- Hyposthenuria (dilute urine)

32
Q

What are some of the effects of chronic renal failure?

A
  • Build-up of waste products (urea, creatinine)
  • Failure of acid-base regulation
  • Failure of fluid volume regulation
  • Death due to: Dehydration, acidosis, hyperkalaemia, pulmonary oedema, hypocalcaemia,
33
Q

How would a kidney appear grossly at end stage chronic kidney failure?

A

Diffuse severe firm texture with shrunken kidney, interstitial fibrosis + scarring of the cortical surface.

34
Q

How would a kidney appear histologically at end stage chronic kidney failure?

A

Tubules are widely separated by an increase in interstitial tissue which is probably inflammatory cells (fine purple stippling) and fibrous tissue. Eosinophilic material in dilated tubules.

35
Q

Azotaemia is a biochemical finding of?

A

Increased urea and creatinine

36
Q

How good is azotaemia as a measure of renal function?

A

Relatively insensitive - require 70% of renal function to be lost

37
Q

Is uraemia better tolerated if it is rapid or chronic onset?

A

Chronic (speed of onset will affect tolerance to its effects)

38
Q

What are the two types of pathological uraemia lesions?

A

Causative - primary disease process: pre-renal, intrinsic, post-renal
Resultant - secondary pathological changes as a result of toxaemia

39
Q

Give examples of clinical signs resulting from uraemic toxicosis

A
  • PU/PD
  • Pallor
  • Anorexia
  • Weakness
  • Muscle wasting
  • Hypothermia
  • Vomiting
40
Q

Define Cachexia

A

Chronic weight loss due to poor appetite and proteinuria

41
Q

List the secondary pathological changes associated with uraemia - 9 possibilities

A
  • Cachexia
  • Pulmonary oedema
  • Haemorrhagic gastritis
  • Fibrinous pericarditis
  • Aortic and atrial thrombosis
  • Soft tissue mineralisation
  • Non-regenerative anaemia
  • Secondary renal hyperparathyroidism
  • Hypertension
42
Q

How does uraemia cause pulmonary oedema?

A

Toxaemia damages pulmonary endothelium leading to leakage of plasma - firmer lung tissue which is radiolucent

43
Q

How does uraemia cause haemorrhagic gastritis?

A

Uraemic vasculitis and thrombosis lead to necrosis and sloughing of the mucosa

44
Q

How does uraemia cause non-regenerative anaemia?

A
  • Reduced erythropoietin production
  • Haemorrhage
  • Toxic effect of uraemia on bone marrow RBC production
  • Reduced RBC life span
  • Pale mm colour
45
Q

How does uraemia cause secondary renal hyperparathyroidism?

A

Parathyroid hormone overproduction

46
Q

How can CRF cause blindness?

A

Intraocular haemorrhage developing from hypertension due to reduced renal blood flow

Y3 Urinary pathology (5 decks)

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