Urology & Nephrology

Question 1

What % of CO do the kidneys receive?

Answer 1

25%

Question 2

What is the functional unit of the kidney?

Answer 2

Nephron

Question 3

What is the term for abnormal increase in concentration of non-protein nitrogenous waste in blood?

Answer 3

Azotemia

Question 4

At what % of damage of the nephrons do you see azotemia?

Answer 4

75% damage

Question 5

Why is an increase in PTH seen with renal disease?

Answer 5

PTH increases in renal dz patients because there is a decrease in Calcitriol production. Patient is in hypocalcemia at this point because not stimulating reabsorption in the gut- so the parathyroid gland will stimulate PTH production to help increase the vitamin D production.
PTH will also counterbalance the hyperphosphatemia due to the decreased excretion of P in the kidney.

Question 6

What is the gold standard dx test for renal disease?

Answer 6

Scintigraphy

Question 7

The GFR is directly related to what?

Answer 7

Renal functional mass

Question 8

What are the four accurate GFR measurement methods?

Answer 8

Renal scintigraphy, creatinine clearance test, iohexal clearance and inulin clearance tests

Question 9

What are the three indirect GFR measurement tests?

Answer 9

Serum urea/creatinine levels, cystatin C and SDMA

Question 10

Where is urea synthesized and excreted?

Answer 10

Synthesized: liver
Excreted: kidneys

Question 11

T/F:Urea is not a reliable estimate of GFR?

Answer 11

TRUE- influenced by diet, GI bleed and intravascular hemolysis (false positives)

Question 12

What is creatinine synthesized by?

Answer 12

breakdown of creatinine phosphate in muscle

Question 13

What is creatinine dependent on?

Answer 13

Muscle mass

Question 14

Why is creatinine a better indicator of GFR than urea?

Answer 14

Creatinine is excreted unchanged by the kidney

Question 15

At what % of renal damage does SDMA increase?

Answer 15

40% damage

Question 16

What is the best method of urine collection?

Answer 16

Cystocentesis-may cause some bleeding

Question 17

What is the gold standard concentration test?

Answer 17

Osmolality-measures # of particles in sediment

Question 18

What device is most commonly used to observe urine samples?

Answer 18

Refractometer- measures specific gravity

Question 19

What are 5 things the dipstick measures?

Answer 19

Protein, pH, blood, glucose and ketones

Pee pee by grass Kevin

Question 20

SpGr of 1.00-1.007 would be classified as what?

Answer 20

Hyposthenuria

Question 21

SpGr of 1.008-1.012 would be classified as what?

Answer 21

Isosthenuria

Question 22

SpGr of 1.013-1.030 would be classified as?

Answer 22

Minimally concentrated urine

Question 23

What is the normal spgr of dogs and cats?

Answer 23

Dogs: 1.030; Cats: 1.035

Question 24

Which breeds are cystine crystals typically observed in?

Answer 24

dachshund and bulldogs

Question 25

Bilirubin crystals are commonly observed in which breeds?

Answer 25

Bulldogs and Dalmatians

Question 26

When might you see false positive urine protein creatinine ratio?

Answer 26

LUTD

Question 27

What is the normal urine production?

Answer 27

1-2 ml/kg/hr

Question 28

This is seen more commonly in dogs and presents with unilateral renomegaly and rarely associated with azotemia

Answer 28

Renal carcinoma

Question 29

This is seen more in cats and affects both kidneys and is commonly associated with renal azotemia

Answer 29

Renal lymphoma

Question 30

What breed is pre-disposed to polycystic kidney disease?

Answer 30

Persian cats | bull terriers, cairn terriers and WHW terriers

Question 31

What are three hormones that the kidney produces and what do they do?

Answer 31

EPO- stimulates BM to produce more RBC Calcitriol- stimulates reabsorption of Ca i the GI tract Renin- stimulates activation of the RAAS pathway to ultimately increase water reabsorption

Question 32

What are three hormones that act on the kidney and what do they do?

Answer 32

Aldosterone- increase reabsorption of Na/H20 and excretes K PTH- increases vitamin D production in the kidney Vasopressin (ADH)- ADH activates aquaporin channels allowing water reabsorption

Question 33

What are the causes of pre-renal azotemia?

Answer 33

Dehydration, Addison's, cardiac dz, shock and hypovolemia

Question 34

What are the causes of renal azotemia?

Answer 34

Parenchymal dz, infections, cysts, inflammation, neoplasia and toxins

Question 35

What are the causes of post-renal azotemia?

Answer 35

Blockage

Question 36

What is the normal pH of urine?

Answer 36

5.0-7.5

Question 37

What is the difference of gross, occult and pseudohematuria?

Answer 37

Gross: visualize blood with naked eye Occult: hematuria present-not with naked eye Pseudohematuria: red/brown urine w/ NO RBC (hemoglobinuria, myoglobinuria, chemicals)

Question 38

What is the most common cause of non-neoplastic cause or renomegaly?

Answer 38

Acute ureteral obstruction

Question 39

What are some different causes of non-neoplastic renomegaly?

Answer 39

``` Renal inflammation Amyloidosis Hydronephrosis PKD PSS ```