Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urology > Urology > Flashcards

Urology Flashcards

1
Q

LOFTUS progression of CKD signs

A

high SDMA > isosthenuria > high creatinine

hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

LOFTUS histopathology of CKD

A

inflammation ( glomerular and/or tubular)
lymphoma
amyloidosis
fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

LOFTUS clinical pathology signs of CKD

A

increasing SDMA. creatinine, high P, low D3, 2* hyperparathyrioidism
U/S - enlargement (acute), misshapen, smaller (chronic), cystic, stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

LOFTUS criteria for IRIS CKD staging

A

creatinine level, SDMA level, USG, UPC ratio, BP, imaging abNLs – all based on trends and presentation (healthy visit vs signs of disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

LOFTUS cornerstones of CKD mgmt

A

*P restriction
*omega 3 FAs
*antioxidants
*dietary protein restriction
BP mgmt - amlodipine&raquo_space; ace inhibitor
avoid nephrotoxic drugs
adjust doses for all drugs eliminated via kidneys
maintain hydration (cats picky)
hypokalemia
metabolic acidosis
chronic anemia (give EPO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

LOFTUS four categories of proteinuria with some examples

A

pre renal - stress, exercise, paraneoplasic
glomerular - ICGN, amyloid, neoplasia, non ICGN =immune complex glomerulonephritis (like lyme)
tubular - fanconi’s, CKD, inf dz, neoplasia
post-renal - UTI, neoplasia, cystitis, repro dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

LOFTUS six main causes of glomeular dz

A 
amyloidosis
inflammation (glom nephritis)
sclerosis (2ndary to trauma/injury)
familial glom nephritis
autoimmune (lupus)
idiopathic (minimal change glomerulopathies)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

LOFTUS why use enalipril/benazipril and amlopidine for proteinuria

A

ACEi - preferential efferential arteriole vasodilation, decreasing GFR unless paired with B antagonist

Amlopidine - preferential afferent vasodilation, increasing GFR

both decrease pressure in the glomerulus, pushing through less protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

benefit of SSA
what it is
is this the best indicator of urine protein concentration?

A

detects globulins and bence jones proteins

sulfo salicylic acid

no, 24 hr urine protein is most accurate or UPCR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are bence jones proteins and what is the disease cause them to appear?

A

product of plasma cells found in urine in patients with multiple myeloma

MM = neoplasia of plasma cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

lists some causes of hypertension

A
  • pheochromocytoma
  • cushings
  • hyperthyroid
  • DM
  • renal disease (pathologic raas activation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

lists common tx for renal derived hypertension

A
  • dietary sodium restriction
  • ACE inhibitors enalapril or benazapril
  • amlodipine ( B antagonist)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

medical mgmt of urate stones

A
  • diet:high sodum, low purine, acidifying diet with bicarb PO supp. high Na drives thirst and duiresis to decrease urine osmolarity
  • allopurinol to inhibit uric acid production, but maybe increase pathologically to produce xanthine stones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

four components of nephrotic syndrome

A
  • hypoalbuminemia
  • pathologic proteinuria
  • hypercholesterolemia
  • third space fluid sequestration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

name some comorbities that that are associated with UTIs in cats/dogs

A

cushings, DM, CKD, IVDD, u cath hx, obesity, incontinence, urolithiasis, hyperthyroidism, P/U hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which comes first the uti or the stone?

A

generally all stones act as the nidus for infection, except for struvite usually forming secondary to infection only in dogs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  • differentiate between pollakiuria and polyuria

- also dysuria, stranguria, periuria

A
  • pollakiuria - increased frequency of urination
  • polyuria - increased total volume
  • stranguria - decreased ability to empty the bladder
  • dysuria - painful, burning
  • periuria - cats urinating outside of the box/ in abn spots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what parameter is used to identify true infections on free catch vs cystocentesis urine sample

A

free catch = >100k CFU/mL

cystcentesis = >1k CFU/mL

19
Q

define MIC, MBC, MPC and breakpoint

A

MIC - minimum inhib conc
MBC - min bactericidal conc
MPC - mutant prevention conc
breakpoint - highest available conc given the acceptable dose range

20
Q

dx and tx of sporadic cystitis

A

dx - <3 confirmed bacterial cystitis cases in the past year

tx - often empirical abx, narrow spectrum, culture if resistant before re-prescribing

21
Q

dx and tx of recurrent bact cystitis

A

dx - >3 episodes within a year or 2 episodes <3 months apart

tx - culture for abx choice gold standard to determine if the bact is persistent or new. tx to clinical resolution, not urine sterility

22
Q

Struvite:
Characteristics
mechanism of formation
treatment/mgmt

A
  • Mg NH4 P = MAP, may also have Ca apatitem ammonium acid urates, #2 most common
  • in dogs often bacteria present first –> alkalize urine –> decreased ion solubility
  • st/ox diets (beware of non-maintenance diets), avoid urine stasis, acidify urine, urease inhibitors for dogs
23
Q

Ca oxalate:
Characteristics
mechanism of formation
treatment/mgmt

A
  • mono vs dihydrate different stones. #1 most common. in cats: often renal or ureteral. requires excess Ca and oxalate (vitamin c)
  • hypercalcemic disorders vs non-hypercalcemic disorders
  • control Ca and vitamin C intake (non essential in dogs/cats anyway)
24
Q

cystine:
Characteristics
mechanism of formation
treatment/mgmt

A
  • d penicillamine, alkalinize urine, increase water intake, low purine diet
25
Q

urate:
Characteristics
mechanism of formation
treatment/mgmt

A
  • metabolics errors ( ex:dalmatians), liver shunts (urate excess, severe liver dz
  • low purine diet, correct PVSA, allopurinol (beware xanthine production), lactulose, metronidazole =(
26
Q

common clinical signs of urolithiasis: upper vs lower tract

A
  • lower - asymptomatic to obstructed/anuric

- upper - asymptomatic to non-specific to hematuria/pain

26
Q

common clinical signs of urolithiasis: upper vs lower tract

A
  • lower - asymptomatic to obstructed/anuric

- upper - asymptomatic to non-specific to hematuria/pain

27
Q

methods of detecting uroliths

A

U/S, rectal palpation, XR, bladder contrast study

28
Q

surgical options for uroliths

A

cystotomy, nephrotomy, ureterotomy, subcut bypass, ureteral stent, laser lithotripsy

29
Q

medical mgmt for uroliths

A
  • increase urine volume to dilute solutes and maintain continuous flow
  • increase crystallization inhibtiors,
  • decrease sources of the specific stone crystalloids (urea vs calcium vs xanthine)
29
Q

medical mgmt for uroliths

A
  • increase urine volume to dilute solutes and maintain continuous flow
  • increase crystallization inhibtiors,
  • decrease sources of the specific stone crystalloids (urea vs calcium vs xanthine)
30
Q

three main mechanisms of AKI

A
  • ischemic events - shock, anesthesia, trauma, coagulopathy/DIC, hyperviscosity, nsaids, extreme temperatures, low cardiac output
  • renal dz (1* or 2*) - neoplasia, IM dz, pyelo-, lepto, borreliosis, babesia, leish, endocarditis, SIRS/sepsis/DIC, pancreatitis, malignant hypertension
  • nephrotoxins - refer to common toxins (exogenous vs endogenous)
31
Q

common nephrotoxic drugs

A

aminoglycosides, cephalosporins, sulfa drugs, amphotericin B, acyclovir, platins, doxor, azothioprine, cyclosporine, nsaids, diuretics, contrast agents, ACEi, heavy metals, ethylene glycol, raisins, venms, lilies, vit D

32
Q

classification and treatment for uremic complications in AKI patients

A
  • lyte abNLs, metabolic acidosis, hypertension & coagulopathy –> targeted organ damage/hemorrhages,
  • hemorrhages into: gi, CNS, eyes, cardiac, renal. prognosis poor is dialysis required
33
Q

monitoring plan for AKI patients

A
  • weight and hydration status
  • BP monitoring
  • cardiac monitoring PRN
  • urine monitoring - ins/outs, casts, etc
34
Q

lyme nephritis (borreliosis) -characteristics (5) and treatment plan (4)

A

characteristics - anemia, thrombocytopenia, proteinuria, hypertension, edema
tx plan - doxy, dex, mycophenalate, std prot losing nephr (PLN) therapy

35
Q

describe the path of nerves involved in storage of urine

A

storage = sympathetic

  • thoracolumbar branches leaving spinal cord –> caudal mesenteric ganglia –> hypogastric nerve –> adrenergic inhibition –> detrusor relaxation
  • S1-3 pudendal n –> Ach excitation of urethralis m –> internal urethral sphincter closure
36
Q

describe the path of nerves involved in peeing

A

peeing = parasympathetic = pelvic n

  • S1-3 –> pelvic n –> Ach excitation of detrusor m
  • IUS relaxation
37
Q

subjective of SOAP questions for urinary hx

A
  • signalment
  • duration of signs (new or since birth)
  • u leakage? when? amount?
  • pt aware of incontinence?
  • posture and stream quality NL?
38
Q

neurologic vs non-neuro ddx for micturiction disorders

A

neuro - UMN, LMN, Detrusor m disorders

non-neuro - congenital abNL, hormone responsive incontinence, mechanical obstruction, mechanical trauma

39
Q

urethral sphincter mechanism incompetence USMI clinical appearance and tx

A
  • several years post -spay, female&raquo_space; male, large breed > small, leak at night, NL posture & emptying, neuro NL
  • tx - estriol, phenyl propanolamine (a agonist), urethral bulking
40
Q

Ectopic ureters clinical appearance and tx

A
  • congenital abNL, appears young, female > male, intramural vs extramural
  • tx - intramural –> ablation of fenestrated ureter. extramural –> sx to reattach ureter into bladder
41
Q

detrusor urethral dyssynergy DUD appearance and tx

A
  • fcnal urethral obstruction, middle age large breed male dogs, abNL urinary reflex arc
  • a antagonists = prazosin, tamsulosin
  • skele m relaxants = benzos, ace, methocarbamol

Urology (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions