Urology (1-5) Flashcards

1
Q

what is the normal daily water consumption for a dog

A

50-100 mL/kg

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2
Q

what is the normal daily water consumption for a cat

A

30-50 mL/kg

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3
Q

what is the normal daily urine production for a dog?

A

50 mL/kg

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4
Q

what is the normal daily urine production for a cat?

A

25-50 mL/kg

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5
Q

name 6 clinical signs of uraemia

A
  1. urine smelling breath
  2. oral ulceration
  3. anorexia
  4. vomiting
  5. malaise
  6. neurological signs
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6
Q

name 6 things that should be included in a clinical exam for an animal with urination problems

A
  1. hydration status
  2. body condition
  3. halitosis
  4. kidney and bladder palpation
  5. external genitalia
  6. rectal exam
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7
Q

what 6 key things do you want to look at on a urine dip stick

A
  1. pH
  2. blood (or pigment)
  3. ketones
  4. bilirubin
  5. glucose
  6. protein
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8
Q

what is the normal protein-to-creatinine (UP:C) ratio for cats and for dogs?

A

cats: <0.4
dogs: <0.5

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9
Q

this is a marker of concentration ability that is assessed with a refractometer

A

urine specific gravity

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10
Q

what is the specific gravity for hyposthenuria

A

< 1.007

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11
Q

what is the specific gravity for isosthenuria

A

1.008 - 1.012

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12
Q

what is the specific gravity for hypersthenuria

A

greater than 1.013

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13
Q

what is the adequate urine concentration for a dog

A

greater than 1.030

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14
Q

what is the adequate urine concentration for a cat

A

greater than 1.035

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15
Q

what 2 nitrogenous waste products would you expect to be elevated in the blood if an animal has azotaemia

A
  1. creatinine
  2. urea
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16
Q

what causes pre-renal azotaemia

A

reduced renal perfusion

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17
Q

name 4 causes of reduced renal perfusion leading to pre-renal azotaemia

A
  1. hypovolaemia
  2. dehydration
  3. cardiac disease
  4. hypotension
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18
Q

this is when blood flow reaches the kidneys but the kidneys are dysfunctional

A

renal azotaemia

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19
Q

name 2 causes of renal azotaemia

A
  1. acute kidney injury
  2. chronic kidney disease
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20
Q

what will the urine specific gravity usually be with pre-renal azotaemia

A

high
(>1.030)

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21
Q

what will the urine specific gravity usually be with renal azotaemia

A

isosthenuric
(1.007 - 1.012)

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22
Q

this is produced in all cells and is excreted by the kidneys;
can detect CKD when only 25% of function is lost

A

SDMA
(Symmetric DiMethylArginine)

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23
Q

what is the only part of the kidney that can be biopsied

A

cortex

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24
Q

name 3 risks of a kidney biopsy

A
  1. anaesthetic
  2. haemorrhage
  3. worsening azotaemia
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25
Q

what info can a kidney FNA provide/identify

A

limited;
may identify lymphoma

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26
Q

what info can a kidney biopsy provide/identify

A

protein losing nephropathies

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27
Q

how long must kidney disease be present for in order to be considered chronic kidney disease

A

at least 3 months

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28
Q

name 6 clinical signs of chronic kidney disease

A
  1. polyuria with compensatory polydipsia
  2. decr. appetite/anorexia
  3. weight loss
  4. vomiting
  5. muscle weakness
  6. constipation
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29
Q

name 7 differential diagnoses for polyuria/polydipsia
(besides chronic kidney disease)

A
  1. Diabetes mellitus
  2. Hypo/Hyperadrenocorticism
  3. pyometra
  4. hepatic disease
  5. hyperthyroidism
  6. medications (steroids, diuretics)
  7. Diabetes insipidus
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30
Q

name 3 diagnostics for identifying loss of kidney function

A
  1. reduced concentration ability
  2. azotaemia
  3. elevated SDMA
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31
Q

what 6 factors can be looked at to decide if kidney disease is acute or chronic?

A
  1. duration of clinical signs
  2. kidney signs
  3. renal pain
  4. body condition
  5. tolerance of azotaemia
  6. response to treatment
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32
Q

name 5 things that can cause acute worsening of a stable patient with chronic kidney disease

A
  1. dehydration
  2. hypokalaemia
  3. UTI
  4. hypertension
  5. anaemia
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33
Q

name 3 reasons for cachexia with chronic kidney disease

A
  1. inappetence/anorexia
  2. inflammation
  3. disuse atrophy
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34
Q

why is dehydration common with chronic kidney disease

A

even if not drinking anything, unable to conentrate urine to conserve water

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35
Q

why is hyperphosphataemia common with chronic kidney disease

A

decreased GFR
(1. insufficient PO4- excretion
2. PTH stimulation
3. calcium leaching from bone
4. secondary renal hyperparathyroidism)

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36
Q

what are the 2 steps for phosphate restriction to control renal secondary hyperparathyroidism

A
  1. dietary management
  2. phosphate binders
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37
Q

why is proteinuria common with chronic kidney disease

A

damage to glomeruli and tubules secondary to underlying inflammation

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38
Q

what effect do ACE inhibitors have on the efferent arteriole

A

dilation

(decr. filtration pressure & GFR)

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39
Q

this can be used as an alternative to ACE inhibitors;
avoids the locale ‘ACE escape’ that can occur where angiotensin continues to be produced via chymase rather than ACE

A

Angiotensin Receptor Blockers

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40
Q

name 2 reasons for hypertension with chronic kidney disease

A
  1. altered renal blood flow
  2. focal infarction/ischaemia

(activation of RAAS, sympathetic drive, further vascular damage)

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41
Q

what is the first line therapy in dogs to treat hypertension;
reduce angiotensin, blood volume

A

ACE inhibitors

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42
Q

what is the first choice therapy in cats to treat hypertension;
calcium channel blocker, causes arteriolar dilation, including afferent arteriole

A

Amlodipine besylate

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43
Q

name 3 reasons for urinary tract infections with chronic kidney disease

A
  1. dilute urine
  2. polyuria
  3. immunodeficiency
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44
Q

name 4 reasons for hypokalaemia with chronic kidney disease

A
  1. polyuria
  2. anorexia
  3. fluid therapy
  4. RAAS activation
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45
Q

name 3 supportive treatments to manage nausea/uraemic gastritis

(assoc. with CKD)

A
  1. maropitant
  2. H2 blockers
  3. sucralfate
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46
Q

name 4 ways to maintain appetite in an animal with CKD

A
  1. warm food
  2. offer palatable food
  3. vit B12 injections
  4. Mirtazapine
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47
Q

name the IRIS stage of kidney disease

creatinine: <125 (dog), <140 (cat);
SDMA: <18 (dog), <18 (cat);
no clinical signs;
imaging/biopsy/exam findings;
proteinuria of renal origin

A

stage 1

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48
Q

name the IRIS stage of kidney disease

creatinine: 125-250 (dog), 140-250 (cat);
SDMA: 18-35 (dog), 18-25 (cat);
clinical signs usually mild if present

A

stage 2

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49
Q

name the IRIS stage of kidney disease

creatinine: 251-440 (dog), 251-440 (cat);
SDMA: 36-54 (dog), 26-38 (cat);
clinical signs usually present;
less signs more consistent with early of this stage and more signs consistent with late of this stage

A

stage 3

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50
Q

name the IRIS stage of kidney disease

creatinine: >440 (dog), >440 (cat);
SDMA: >54 (dog), >38 (cat);
severe clinical signs and risk of uraemic crisis

A

stage 4

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51
Q

what is the urine protein-to-creatinine ratio (UPC) for a proteinuric dog and cat

A

greater than 0.5 (dog)
greater than 0.4 (cat)

52
Q

what is the systolic pressure for a normotensive dog/cat

A

less than 140 mmHg

53
Q

what is the systolic blood pressure for a severely hypertensive dog/cat

A

greater than 180 mmHg

54
Q

name the 4 stages of acute kidney injury

A
  1. initiation
  2. extension
  3. maintenance
  4. recovery
55
Q

name the stage of acute kidney injury

exposure to causal agent;
precedes clinical signs;
intervention now may prevent progression

A

initiation

56
Q

name the stage of acute kidney injury

inflammation and hypoxia → further nephron damage

A

extension

57
Q

name the stage of acute kidney injury

irreversible damage has occurred;
on-going signs of decr. tubular function

A

maintenance

58
Q

name the stage of acute kidney injury

repair of damage and regeneration of nephrons over weeks to months

A

recovery

59
Q

why are kidneys at a high risk of injury

A
  1. blood supply
  2. high metabolic and high oxygen demand
60
Q

name 7 clinical signs of acute kidney injury

A
  1. PUPD
  2. anuria
  3. lethargy
  4. vomiting/diarrhea
  5. weakness
  6. altered mentation
  7. abd. pain
61
Q

name 6 clinical exam signs of acute kidney injury

A
  1. paraspinal pain
  2. normal or enlarged kidney
  3. hallitosis
  4. oral ulceration
  5. bradycardia
  6. bladder size
62
Q

name 7 diagnostics that should be done for suspected acute kidney injury

A
  1. haematology
  2. serum biochemistry (potassium)
  3. urine analysis
  4. blood pressure
  5. Leptospirosis testing
  6. U/S
  7. radiographs
63
Q

name 3 differential diagnoses for acute kidney injury

A
  1. chronic kidney disease
  2. acute-on-chronic
  3. hypoadrenocorticism
64
Q

name 4 emergency treatments for hyperkalaemia with acute kidney injury

A
  1. calcium gluconate
  2. fluid boluses
  3. glucose
  4. insulin
65
Q

what is the emergency treatment for hypocalcaemia with acute kidney injury

A

calcium gluconate

66
Q

name 5 treatment options if fluid balance has been restored but there is still no urine output

A
  1. furosemide
  2. mannitol
  3. peritoneal dialysis
  4. haemodialysis
  5. euthanasia
67
Q

name the disease

autumn/winter in UK;
skin lesions initially;
AKI develops 3-4 days later;
thrombocytopaenia;
poor prognosis

A

Cutaneous Renal Glomerular Vasculopathy (CRGV)
(‘Alabama Rot’)

68
Q

this is abnormal development of renal tissue with foetal glomeruli present;
insidious, stunted growth, PUPD, acute-on-chronic;
histopathology necessary to confirm

A

renal dysplasia

69
Q

this is absence of one kidney from birth;
remaining kidney usually hypertrophic to compensate;
can have normal life expectancy

A

renal agenesis/hypoplasia

70
Q

name the disease

may or may not be present at birth;
PKD-1 gene;
as cysts enlarge, volume of functional nephrons reduces;
treat as CKD

A

polycystic kidney disease

71
Q

name 6 defence mechanisms of the kidney against infections (pyelonephritis)

A
  1. concentrated urine produced
  2. peristaltic unidirectional flow of urine
  3. oblique entry of ureters into bladder
  4. frequent voiding of urine
  5. closed urethral sphincter
  6. urothelium protective barrier
72
Q

name 3 features of haematology seen with pyelonephritis

A
  1. leukocytosis
  2. anaemia of chronic disease
  3. thrombocytopaenia
73
Q

name 3 ultrasound signs that may indicate pyelonephritis

A
  1. hyperechoic kidney
  2. pelvic dilation
  3. bladder sediment
74
Q

what are the 2 most common breeds to get amyloidosis

A

Shar Pei
Siamese

75
Q

name 5 effects/problems caused by protein losing nephropathy (PLN)

A
  1. significant proteinuria
  2. reduced oncotic pressure
  3. thromboembolic disease
  4. hypertension
  5. lipid imbalance
76
Q

name the 4 clinical consequences of nephrotic syndrome

A
  1. hypoalbuminaemia
  2. proteinuria
  3. hypercholesterolaemia
  4. peripheral oedema
77
Q

name the tubular disease

affects proximal tubule;
inherited (Basenji) OR acquired (toxins-jerky treats/infections-Lepto);
tubules unable to reabsorb glucose, bicarb. electrolytes, minerals, amino acids

A

Fanconi’s syndrome

78
Q

name the tubule disease

proximal tubule unable to reabsorb glucose;
osmotic diuresis with PU/PD;
recurrent UTIs;
loss of calories

A

primary renal glucosuria

79
Q

name the type of renal tubular acidosis

failure to reabsorb HCO3-;
less severe acidosis;
alone or part of Fanconi’s;
mild to moderate hypokalaemia

A

type 2 (Proximal)

80
Q

name the type of renal tubular acidosis

failure to excrete acid;
usually only anomaly;
severe acidosis;
moderate to severe hypokalaemia

A

type 1 (distal)

81
Q

name the disease

loss of ability to concentrate urine;
large volumes of hyposthenuric urine;
compensatory polydipsia;
water deprivation test

A

Diabetes insipidus

82
Q

name 6 predisposing factors for bacterial cystitis

A
  1. dilute urine
  2. incontinence
  3. urine retention
  4. catheter
  5. immunocompromise
  6. damaged urothelium
83
Q

name the 2 main bacterias causing bacterial cystitis

A
  1. E. coli
  2. Enterococci
84
Q

name 3 reasons to do a urine culture to diagnose bacterial cystitis

A
  1. to confirm
  2. to identify causal organism
  3. to guide antibiotic choice
85
Q

name 3 conditions that can gi ve a false negative for bacterial cystitis on urine analysis

A
  1. dilute urine
  2. Diabetes
  3. Cushings
86
Q

name 2 things that can give a false positive for bacterial cystits on urine analysis

A

1.stain
2.fat droplets

87
Q

what is the 2 best empirical treatment options for gram negative bacterial cystitis

A
  1. TMPS
  2. Amoxi-Clav
88
Q

what is the 2 best empirical treatment options for gram positive bacterial cystitis

A
  1. ampicillin
  2. amoxicillin
89
Q

name the condition

sterile inflammatory cystitis;
young cats;
male > female;
neutered

A

feline idiopathic cystitis (FIC)

90
Q

name 7 predisposing factors for feline idiopathic cystitis (FIC)

A
  1. multi-cat household
  2. nervous/anxious personality
  3. obesity
  4. indoor
  5. dry food
  6. black and white coloring
  7. stressful home environment
91
Q

name 3 features of feline idiopathic cystitis (FIC) that may be seen on urine analysis

A
  1. very concentrated urine
  2. blood likely present (inflamm.)
  3. crystals present
  4. no bacteria
92
Q

what 3 environmental treatments can be done for a cat with feline idiopathic cystitis (FIC)

A
  1. incr. water intake
  2. incr. litter trays and beds
  3. pheromones
93
Q

what 2 medications should be given to treat a cat with feline idiopathic cystitis (FIC)

A
  1. analgesia (opioids, meloxicam)
  2. spasmolytics
94
Q

what 3 things should be evaluating during a neuro assessment for an animal with incontinence

A
  1. anal tone & sensation
  2. bulbocavernosus and perineal reflexes
  3. urethral sphincter tone
95
Q

name the condition

involuntary passage of urine;
not consciously aware;
wet patch where lying;
dribbling urine when walking

A

urinary incontinence

96
Q

name the bladder nerve

symopathetic;
alpha and beta adrenergic;
detruser relaxation;
internal sphincter muscle (ISM) contraction

A

hypogastric nerve

97
Q

name the bladder nerve

parasympathetic;
muscarinic;
contraction of detrusor muscle

A

pelvic nerve

98
Q

name the bladder nerve

somatic;
contraction of external sphincter muscle

A

pudendal nerve

99
Q

3 features of the bladder if there is a spinal lesion in the neck (cranial to hypogastric, pelvic, and pudendal nerve origins)

A
  1. large bladder
  2. tense bladder
  3. difficult to express
100
Q

3 features of the bladder if there is a spinal lesion caudal to where the hypogastric nerve originates (cranial to pudendal and pelvic nerve origins)

A
  1. large bladder
  2. soft bladder
  3. easy to express
101
Q

name the condition

adrenaline acting on oestrogen sensitised receptors;
incontinence while sleeping;
normal clinical exam;
diagnosis of exclusion

A

urinary sphincter mechanism incompetence (USMI)

102
Q

how to treat intramural ectopic ureter

A

laser ablation

103
Q

how to treat extramural ectopic ureter

A

transection and re-implantation

104
Q

name 4 clinical signs that may be seen with benign prostatic hyperplasia
(often none - incidental finding)

A
  1. preputial discharge
  2. penile bleeding or haematuria
  3. dysuria/stranguria
  4. faecal tenesmus/flattened stool
105
Q

name 5 treatment options for benign prostatic hyperplasia

A
  1. surgical castration
  2. osaterone acetate (Ypozane)
  3. delmadinone acetate (Tardak)
  4. Deslorelin
  5. Finasteride
106
Q

name the condition

bacterial infection of the prostate;
usualy ascending infection;
may haematogenous;
concurrent cystitis;
reflux of prostatic secretions into bladder

A

prostatitis

107
Q

name 3 clinical signs of acute prostatitis

A
  1. caudal abdominal pain
  2. stilted gait
  3. systemically unwell (v+, pyrexia, sepsis)
108
Q

name 3 signs of chronic prostatitis

A
  1. signs of ‘cystitis’ (stranguria, dysuria, haematuria)
  2. penile discharge/haemorrhage
  3. dyschezia
109
Q

what distinguishes acute prostatitis from chronic prostatitis

A

ability to cross blood-prostate barrier

(chronic can cross, acute can NOT)

110
Q

name 6 prostatic diseases

A
  1. benign prostate hyperplasia
  2. prostatitis
  3. sqaumous metaplasia
  4. prostatic carcinoma
  5. prostatic abscess
  6. prostatic/paraprostatic cysts
111
Q

this is the start of a bladder stone;
can be bacteria, epithelial cells, foreign material

A

nidus

112
Q

this is part of bladder stone formation;
aggregation of crystals;
can occur with or without a nidus

A

nucleus

113
Q

name 4 general treatment options for urotliths

A
  1. shock wave therapy
  2. endoscopic nephrolithotomy
  3. surgical intervention
  4. SUBS/stent if obstruction
114
Q

name 5 clinical signs of uteroliths

A
  1. asymptomatic
  2. post-renal azotaemia
  3. big kidney little kidney (BKLK)
  4. calcium oxalate/struvite
  5. pain
115
Q

name 4 treatment indication for uteroliths

A
  1. obstructive
  2. hydronephrosis
  3. azotaemia
  4. hyperkalaemia
116
Q

name 5 general treatment options for ureteroliths

A
  1. medical therapy
  2. subcutaneous ureteral bypass (SUB)
  3. ureteric stenting
  4. shockwave therapy
  5. surgical intervention
117
Q

name 5 general management options for urethroliths

A
  1. catheter placement
  2. retrograde hydropulsion
  3. urethrotomy
  4. urethrostomy
  5. laser lithotripsy
118
Q

name 5 types of uroliths

A
  1. struvite
  2. calcium oxalate
  3. urate
  4. cystine
  5. Xanthine/Silicate
119
Q

what are struvite uroliths made up of

A
  1. Mg
  2. NH3
  3. PO4

(MAP)

120
Q

what 2 types of uroliths can NOT be seen on radiographs

A
  1. Urate
  2. Cystine
121
Q

name the type of urolith

calculi: spherical, multiple, variable sizes, radio-opaque;
neutral to alkaline urine;
commonly associated with UTI (in dogs, not cats);
females > males

A

struvite

122
Q

name the type of urolith

calculi: white often with jagged adges, single or multiple, radio-opaque;
most common nephrolith;
more common in males;
neutral to acidic urine;
may be assoc. with hypercalcaemia

A

calcium oxalate

123
Q

name the urolith type

calculi: multiple, small, brownish-green, radio-lucent;
more common in males;
neutral to acidic urine;
breed related;
can be assoc. with cPSS/liver failure

A

uric acid / urates

124
Q

name the urolith type

calculi: round, smooth, light brown/yellow, usually multiple, faintly radio-opaque;
more common in males;
acidic urine;
error in metabolism → amino aciduria

A

cystine

125
Q

name the urolith type

calculi: jack stone appearance, moderately radio-opaque, usually multiple;
rare;
more common in males;
neutral to acidic urine;
surgical removal required

A

silicate