Urology AI 1 Flashcards
What can cause acute kidney injury (AKI)?
Severe hypercalcemia related to ingestion of certain rat poisons or psoriasis creams, and ethylene glycol intoxication.
What are the potential causes of hypocalcemia?
Ethylene glycol intoxication.
What concurrent changes in liver damage and function parameters are highly suspicious for possible leptospirosis?
Increased ALT, AST, ALP, bilirubin.
In suspected leptospirosis, what additional parameters, if present, suggest the possibility of active infection?
Anemia and/or thrombocytopenia on a complete blood count.
What is the importance of obtaining urine in AKI cases?
To check the specific gravity and exclude pre-renal azotemia.
What might sediment examination of urine reveal in cases of AKI?
Clues to the cause of AKI, such as calcium oxalate monohydrate crystals associated with ethylene glycol ingestion or concurrent bacterial infection suggesting pyelonephritis.
What does the presence of casts in the urine indicate?
Tubular damage in the kidneys, particularly cellular casts which represent the sloughing of tubular epithelium into the urine.
What imaging techniques can provide helpful information in diagnosing AKI?
Radiographs and ultrasound of the kidney.
What can be observed in cats with lymphoma on ultrasound?
Enlargement of both kidneys with hypoechoic subcapsular infiltrates.
What is the medullary rim sign observed in cases of ethylene glycol ingestion?
A line of increased opacity between the cortex and medulla of the kidney.
How can the diagnosis of leptospirosis be made in dogs?
By detecting specific antibodies through the microagglutination test (MAT) or detecting the organism itself by PCR in the blood or urine.
What is the diagnostic criteria for leptospirosis using the microagglutination test?
An acute titre >1:800 (or 1:1600 in a vaccinated dog) in the acute sample, or a four-fold increase in titre from acute to convalescent samples.
How can the diagnosis of ethylene glycol toxicity be challenging?
Because the animal is rarely seen ingesting it.
What clinical neurological signs in the initial presentation may help in diagnosing ethylene glycol toxicity?
Stupor or obtundation.
What are the biochemical abnormalities associated with ethylene glycol toxicity?
Azotemia, hypocalcemia, hyperglycemia.
What would be observed in the urine of an ethylene glycol toxic patient?
Calcium oxalate monohydrate crystals.
What can a Woods lamp reveal in cases of ethylene glycol toxicity?
The urine may fluoresce.
What is metabolic acidosis and how is it associated with ethylene glycol toxicity?
Metabolic acidosis is an acidosis of metabolic origin associated with a large anion gap, which is seen in ethylene glycol toxicity.
How is the anion gap calculated and what is considered a normal value?
The anion gap is calculated using the equation [Na+] - ([HCO3-] + [Cl-]). A normal value would be.
What is the preferred method for diagnosing leptospirosis?
Detecting specific antibodies through the microagglutination test (MAT).
Why is antibiotic treatment less likely to affect serology compared to PCR in diagnosing leptospirosis?
Because the immune response to the organism continues, whereas PCR may be affected by antibiotic treatment.
What features can help in diagnosing ethylene glycol toxicity?
Clinical neurological signs, biochemistry abnormalities, presence of calcium oxalate crystals in urine, and metabolic acidosis.
What can ultrasound reveal in dogs suspected of having leptospirosis?
Dilation of the renal pelvis (pyelectasia) and mass lesions in the kidney.
What is the significance of a line of increased opacity between the cortex and medulla of the kidney?
It is observed in ethylene glycol ingestion but is an unreliable sign of hypercalcemia.