Urogenital/renal

Question 1

Dog with lower urinary signs is diagnosed with a UTI based on culture and susceptibility (susceptible to many antibiotics). Dog is treated with appropriate antibiotics and infection resolves. Two weeks following completion of antibiotics, lower urinary signs return. Urine is culture and has same organism and susceptibility profile as first culture. This is an example of what?

Answer 1

Relapse

Question 2

Adult female spayed dog with a 2 week history of blood vulvar discharge. Vaginal cytology shows degenerative and non-degenerative neutrophils with extracellular bacteria and non-cornified epithelial cells. What is the diagnosis?
What would cause cornified cells?

Answer 2

Stump pyometra

No cornification = no ovariant remnant = estrogen results in cornification

Question 3

Iris staging - what are the cutoff for borderline proteinuria and borderline hypertension

Answer 3

IRIS
Crea: 
Stage 1: <1.4 (dog) <1.6 cat
Stage 2: 1.4(6)-2.8
Stage 3: 2.9 - 5
Stage 4:> 5
Proteinuria: 
<0.2 - non-proteinuric
0.2-0.5 (dog), 0.2-0.4 (cat) - borderline proteinuric
>0.5 (dog), >0.4 (cat) - proteinuric
Hypertension: 
<140 - normal
140-160 - prehypertension
>160 hypertensive
>180 severely hypertensive
*Use breed specific guidelines

Question 4

What is the volume status of a patient with urinary Na excretion <1%

Answer 4

Severe volume depletion

Question 5

What is the mechanism of pu/pd in dog with pyometra?

Answer 5

e.coli toxin interferes with ADH on distal tubule/collecting duct which causes nephrogenic DI

Question 6

Mechanism of pu/pd with CKD

Answer 6

Increased solute load resulting in osmotic diuresis

Question 7

Bladder innervation

Answer 7

L1-L5: Hypogastric - sympathetic (filling) = relaxation of detrusor and contraction of internal urethral sphincter
S1-S3: Pelvic - parasympathetic (voiding) = contraction of the detrusor and relaxation of the internal urethral sphincter
S1-S3: Pudendal - external urethral sphincter - retention, striated muscle
Parasympathetic peeing
Sympathetic filling

Question 8

In a proteinuric animal (>0.5) what is the best treatment?

Answer 8

Enalapril

Question 9

What is an electrolyte disorder that is a cause of nephrogenic diabetes insipidus?

Answer 9

Hypokalemia

Question 10

Patient with ureteral stone 2cm from pelvis that is unresponsive to medical management - tx option?

Answer 10

Ureterotomy

Question 11

What will be the response to GFR to SIADH?

Answer 11

Normal GFR

Question 12

Role of diet treatment with calcium oxalate?

Answer 12

Promote hydration

Question 13

What is the site for glucose reabsorption in the kidney?

Answer 13

PCT

Question 14

What is a urinary consequence of metabolic alkalosis (high bicarb) and severe gastric acid loss?

Answer 14

Paradoxical aciduria.

Question 15

What hormone causes increased GFR?

Answer 15

PGE2

Question 16

What is the purpose of calcitriol administration for CKD?

Answer 16

Control of renal secondary hyperparathyroidism
*Serum phosphorus levels have to be controlled
With CKD you get hyperphosphatemia and secondary hypocalcemia (because of hyperphos) and also because of decreased vit D because of kidney dz. The hypocalcemia causes secondary hyperparathyroidism and this leads to decreased phosphorus.

Question 17

What is the most likely cause of proteinuria in Schnauzer with hypertriglyceridemia?

Answer 17

Glomerular lesions?

Question 18

What is the mechanism of Pu/pd in hypercalcemia of malignancy?

Answer 18

Inhibition of the effect of ADH

Question 19

What does the juxtaglomerular complex do?

Answer 19

Constrict afferent arteriole? (Vs sense chloride vs secrete renin - those are by cells of the macula dense and not considered par of juxtaglomerular feedback)

Question 20

Which glomerular disease would not improve with prednisone?

Answer 20

Glomerular sclerosis