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VET - ClinPath2 > Urine Midterm cards > Flashcards

Urine Midterm cards Flashcards

1
Q

What are the components of the Urinary System?

A

The urinary system consist of 2 kidneys, 2 ureters that connect the kidneys to the urinary bladder, the urinary bladder itself and the urethra

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2
Q

How are the Equine and Bovine kidneys unique?

A
  • Most animals have smooth, bean-shaped kidneys. Some species differences can be seen in the equine and bovine species
  • Horses have a right kidney that is heart-shaped where cows have kidneys that are lobulated in appearance.
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3
Q

What is the functional unit of the kidney?

A

Nephrons - are the functional unit where most of the work of the kidney is done. Majority of the nephron is housed in the renal cortex but the loop of henle and collecting ducts will descend into the renal medulla and empty into the renal pelvis

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4
Q

List the parts of the nephron?

A

Renal corpuscle (Bowman’s Capsule + Glomerulus), Juxtaglomerular apparatus, Tubule (Proximal convoluted, loop of henle, Distal convoluted, collecting duct)

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5
Q

Track the formation of urine through the nephron

A

afferent arteriole (blood) -> glomerulus (filtrate) -> Proximal convoluted (reabsorption of nutrients for the body) -> Loop of henle (controls the concentration of urine) -> Distal convoluted (regulates sodium, potassium and pH) -> Collecting duct (regualtes water and sodium reabsorption)

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6
Q

Glomerulus

A
  • filters urea, surrounded by Bowman’s Capsule
  • a network of small capillaries that extend from the renal artery and branch into afferent and efferent arterioles
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7
Q

Renal threshold

A

the maximum absorptive capabilities of the nephron for specific substances; important when certain substances are detected in the urine ( they have exceeded the renal threshold)
- Nephrons have specific limits for reabsorption of substances –> When the limit is met, the excess is excreted in urine –> The concentration of a substance dissolved in the blood above which the kidneys begin to remove it into the urine

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8
Q

Aldosterone

A
  • production is stimulated by activation of the RAAS system, by acidic blood, or hyperkalemia.
  • Stimulated by production of angiotensin II (RAAS)
  • Secreted by the adrenal gland
  • Acts on the distal tubules
  • Increases sodium reabsorption and therefore water conservation
  • Potassium excretion
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9
Q

Antidiuretic hormone

A
  • Produced by the hypothalamus
  • Stored and released from the posterior pituitary gland
  • Acts on the collecting ducts to promote resorption of water by opening aquaporins
  • Also promotes urea absorption
  • Deficiency results in Central diabetes insipidus
  • Reduced responsiveness to this hormone in renal disease is nephrogenic diabetes insipidus
  • is secreted in response to hypovolemia and hyperosmolarity of the blood.
  • A lack of ? or poor response to ? usually results in dilute or hyposthenuric urine
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10
Q

List the methods used to obtain samples for urinalysis

A
  • voided/ free catch
  • manual compression
  • table or cage floor
  • catheterization
  • cystocentesis
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11
Q

Note aspects of sample collection by free catch

A
  • Easy, non-invasive​
  • Midstream if possible​
  • Contamination​ (Distal genital tract​, Increased WBC counts from inflammation in distal tracts​)
  • Not suitable for bacterial culture​
  • Clean vulva or prepuce prior to collection​
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12
Q

What equipment is needed for catheterization and cystocentesis?

A

Catheterization ( Polypropylene or red-rubber​ (4- to 10-Fr polypropylene catheter most commonly used in dogs​/ Tom Cat catheter 3½ Fr used in male cats ), Sterile syringes for aspiration and collection​, Sterile lubricant and gloves, Speculum for females​​)
Cyctocentesis ( 22- or 20-gauge needle​ (One to 1½ inch​), 10-ml syringe, ultrasound?)

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13
Q

List advantages and disadvantages of bladder expression

A
  • Not good for bacterial culturing​
  • Gentle but steady pressure –> avoid rupture! ​
  • Contraindicated in urethral obstruction​
  • Occasionally increased RBCs​
  • Incomplete emptying​
  • Increased risk of kidney infection ​
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14
Q

List advantages and disadvantages of catheterization

A

May need sedation​
Avoid first portion collected ​
May have increased RBCs and epithelial cells​
- Bladder does not have to be distendedDisadvantages
- Can only be performed by trained personnel
- Risk for iatrogenic infection, blood and cellular contaminants
- Risk for trauma or perforation of the urethra or urinary bladder
- Not possible if there is urethral obstruction

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15
Q

List advantages and disadvantages of Cystocentesis

A
  • Sterile samples - Must have a sufficiently distended bladder​ (Must palpate bladder before the procedure​, Can use ultrasound as a guide if bladder is small​)
  • Can be done on calm or easily restrained patients​
  • Can be done standing, or dorsal or lateral recumbency​
  • May see RBCs in sediment due to insertion of needle​
  • Less risk for iatrogenic infection and contaminants
  • Localizes source of cells and/or bacteria
  • Can only be performed by trained personnel
  • Must have sufficient amount of urine in bladder to perform
  • Risk for microscopic hematuria
  • Inadvertent intestinal sampling
  • Urinary bladder tear (very rare), leakage of urine into abdomen (usually only a very small amount that is not clinically important, but risk is greatest in animals with severe bladder distension due to urethral obstruction, or those with severe disease of the bladder wall)• Contraindicated in the presence of a coagulopathy or anti-coagulant therapy
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16
Q

List advantages and disadvantages of Tom cat catheter

A

???

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17
Q

How is the proper handling and processing of urine samples done?

A
  • Analysis should be performed within 30 minutes (up to 1 hour)​
  • If not possible – refrigerate for up to 6 to 12 hours​
  • Centrifuge immediately for microscopic examination​
  • must also adequately label the specimen
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18
Q

What are the physical properties of urine?

A

Volume, color, transparency, odor, specific gravity

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19
Q

What is the normal urine output of adult dogs and cats

A

20-40 ml/kg

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20
Q

In what species does freshly voided urine appear not transparent or clear?

A

Horses and rabbits

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21
Q

What substances can cause urine to be different colors?

A

Urochromes/urobilin (pigments), concentration (high/low), RBCs/hemoglobin, Melanin, methemoglobin, myoglobin, porphyrins or bilirubin
Red - erythrocytes, hemoglobin, myoglobin
Red-brown - erythrocytes, hemoglobin, myoglobin, methemoglobin
Brown to black - methemoglobin from hemoglobin or myoglobin
Yellow-orange bilirubin
Yellow-green bilirubin or biliverdin
Yellow-brown bilirubin or biliverdin

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22
Q

What substances can cause urine to be cloudy (influences turbidity)?

A

Crystals, Mucus, Semen, Fecal contamination, Bacterial proliferation, Increases in any cells (RBC/WBC), Fat

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23
Q

What is Urine Specific Gravity?

A

Weight (density) of a quantity of liquid compare with that of an equal amount of distilled water; The number and molecular weight of dissolved solutes determine the SG of urine, determines the kidneys concentrating and diluting ability

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24
Q

How is Urine specific gravity evaluated?

A

using a refractometer

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25
Q

When/ how are urine samples diluted?

A

a 1:2 dilution should be made with distilled water

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26
Q

How is the refractometer calibrated?

A

Calibrate the refractometer using distilled water to SG = 1.000

27
Q

What dilution technique is used for SG when it is too high?

A

Dilution technique for SG > upper limit : 1:2 dilution with distilled water, read new measurement and double last 2 digits ​

28
Q

Anuria

A

Absence of urine formation

29
Q

Oliguria

A

decreased formation and excretion of urine

30
Q

Polyuria

A

increased urine formation and excretion

31
Q

Polydipsia

A

abnormal increase in thirst

32
Q

Pollakiuria

A

frequent, abnormal uringation during the day

33
Q

Flocculent

A

(google) having a loosley clumped texture

34
Q

Isosthenuria

A

The excretion of urine whose specific gravity (concentration) is neither greater nor less than that of protein-free plasma (1.008-1.012)

35
Q

Urease

A

an enzyme that catalyzes the hydrolysis of urea, forming ammonia and carbon dioxide

36
Q

Urinometer

A

a simple piece of equipment for determining urine specific gravity. A typical urinometer is composed of a float, a weight, and a stem

37
Q

Urochromes

A

a yellow pigement to which the color of normal urine is principally due

38
Q

Urobilin(ogen?)

A

Urobilinogen comes from bilirubin. Your body makes bilirubin during the normal process of breaking down old red blood cells. Your liver uses the bilirubin to make bile, a fluid that helps you digest food in your intestines. Some bile flows through ducts (small tubes) from your liver directly into your intestines.

39
Q

Uroerythrin

A

Uroerythrin is a red pigment present in the urine, where it is part of a group of yellow, brown and red pigments generally designated as urochrome.

40
Q

What crystals are considered normal?

A

Acidic urine : Calcium Oxalate, Uric Acid, Amorphous
Alkaline urine : Triple phosphate, Calcium Carbonate, Ammoniu, Biruates, Amorphous

41
Q

What crystals are considered abnormal?

A

Cystine Bilirubin, Leucine, Tyrosine, Ammonium Biurate

42
Q

How are casts formed? (Where?)

A
  • Secreted protein precipitates in acidic conditions and forms casts shaped like the tubules​
  • Formed in lumen of distal and collecting tubules of kidney​
  • Will represent mold of the tubules where they were formed due to temporary blockage or decrease in glomerular filtrate flow​
  • Cast will dislodge and be released in the urine where it is identified​
43
Q

What parasites can be seen in urine?

A

Dioctophyma renale, Pearsonema plica, Capillaria, Trichuris

44
Q

compare the staining techniques Sedi-stain vs Line smear

A

???

45
Q

How can method of collection influence formed elements

A

Free catch/ void - increased epithelial cells, WBCs, bacteria
Manual compression - increased RBCs, bacteria, WBCs
Catheterization - increased epithelial cells (transitional), lubricant droplets, increased RBCs
Cystocentesis - may see increased RBCs
Cage floor - increased artifacts, bacteria, debris, interference with chemical analysis

46
Q

Why would you see RBC/WBC/Epithelial cells in urine?

A

???

47
Q

How can temp or pH influence crystal formation?

A

decreasing the temperature decreases the solubility of many constituents
- calcium oxalate crystals are enhanced with refrigeration
- amorphous phosphate and urate crystals may also form as a result of refrigeration
- as urine becomes more alkaline RBCs and casts degrade

48
Q

What composes casts?

A

Casts composed of Tamm-Horsfall Mucoprotein
Cast formation always occurs in the distal convoluted tubule and collecting duct of the nephron→ this means
there is some irritation or disease occurring with the kidneys.

49
Q

Glomerulonephritis

A

Glomerulonephritis is inflammation of the tiny filters in the kidneys (glomeruli). The excess fluid and waste that glomeruli remove from the bloodstream exit the body as urine. Glomerulonephritis can come on suddenly (acute) or gradually (chronic).

50
Q

Pyelonephritis

A

infection of the kidney

51
Q

Tubular necrosis

A

Acute tubular necrosis is a condition that causes the lack of oxygen and blood flow to the kidneys, damaging them. Tube-shaped structures in the kidneys, called tubules, filter out waste products and fluid. These structures are damaged in acute tubular necrosis.

When this happens acute kidney failure may occur, with electrolytes and fluids increasing in the body, possibly past safe levels.

52
Q

Waxy cast vs Hyalin cast

A

Waxy - Absence of differentiated structure, Homogeneous with opaque, “waxy” appearance, Higher refractive index than hyaline cast​, Irregular broken ends with cracks in sides​
(Significance​) Indicates renal stasis​, Final step in disintegration of cellular cast​, Indicates nephron obstruction or kidney failure​, Occasionally in animals with amyloid starch degeneration of kidney (associated with Diabetes mellitus)​

Hyaline - Homogeneous, semitransparent, and colorless​, Parallel sides (biopsy of tubules), Composed mainly of T-H Protein matrix​, Very low refractive index- can miss identification of these with improper microscopic technique​

53
Q

Sources of error of microscopic urinalysis

A

Failure to mix urine specimen, analysis of contaminated specimen, analysis of unrefrigerated specimen, careless reconstitution, excessive centrifugatiion speeds, using dirty slides, allowing sediment to dry on the slide, using too much light, inaccurate reporting of results

54
Q

Hypertrophic vs Hypotrophic RBCs

A

???

55
Q

Why would casts disintegrate?

A

???

56
Q
  • production is stimulated by activation of the RAAS system, by acidic blood, or hyperkalemia.
  • Stimulated by production of angiotensin II (RAAS)
  • Secreted by the adrenal gland
  • Acts on the distal tubules
  • Increases sodium reabsorption and therefore water conservation
  • Potassium excretion
A

What hormone am I?

57
Q
  • Produced by the hypothalamus
  • Stored and released from the posterior pituitary gland
  • Acts on the collecting ducts to promote resorption of water by opening aquaporins
  • Also promotes urea absorption
  • Deficiency results in Central diabetes insipidus
  • Reduced responsiveness to this hormone in renal disease is nephrogenic diabetes insipidus
  • is secreted in response to hypovolemia and hyperosmolarity of the blood.
  • A lack of ? or poor response to ? usually results in dilute or hyposthenuric urine
A

What hormone am I?

58
Q

Azotemia

A

A build up of the nitrogenous wastes (BUN / creatinine); (Pre-renal = circulatory disturbance -> reduced GFR; dehydration), (Renal = >3/4 nephron function is lost; isosthenuric urine), (Post-renal = obstruction or rupture)

59
Q

Hematuria

A

presence of intact RBCs

60
Q

Hemoglobinuria

A

presence of intact RBCs in hemoglobin

61
Q

Myoglobinuria

A

presence of myoglobin

62
Q

Describe the procedure for preparing urine and performing the microscopic examination

A

????

63
Q
A

A - Peritubular Capillaries
B - Proximal Convoluted Tubule
C - Renal Cortex
D - Renal Medulla
E - Collecting duct
F - Peritubular Capillaries
G - Ascending loop of Henle
H - Descending loop of Henle
I - Branch of the Renal vein
J - Branch of the Renal artery
K - Distal convoluted tubule
L - Juxtaglomerular apparatus
M - Afferent Arteriole
N - Efferent Arteriole
O - Glomerulus
P - Bowman’s capsule
Q - Capsular space
R - Renal corpuscle

VET - ClinPath2 (10 decks)

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