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Clinical Reproduction & Urology > Veterinary Clin Path of Renal Dz > Flashcards

Veterinary Clin Path of Renal Dz Flashcards

1
Q

Explain how the nephron functions

A
  • blood constituents filtered by glomerulus
  • fluid flows thru proximal tubules, constituents selectively reabsorbed
  • Loop of Henle: water reabsorbed determine urine vol
  • urine continues up distal tubules to gather in collecting ducts
  • poor re-absorption = loss of glucose of protein & increase in urine
  • enzymes in urine if cells of tubules are damaged or die
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2
Q

Signs of excretion of nitrogenous wastes on biochemistry?

A

Urea, creatinine

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3
Q

Acid-base regulation on clinpath?

A

H+. HCO3-

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4
Q

Body water regulation on clin path?

A

ADH
Aldosterone
Natriuretic peptides (ANP, BNP)

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5
Q

electrolyte regulation affected by renal fxn on clin path?

A

Na, K, Cl, Phosphate, Mg, Ca (horse)

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6
Q

degradation of certain enzymes & sign of renal fxn on clin path?

A

amylase

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7
Q

Endocrine fxn & sign of renal fxn on clin path

A

EPO, renin, Vit D

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8
Q

Azotaemia

A

Increased plasma/serum conc of urea &/or creatinine (& SDMA)

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9
Q

Azotaemia are measures of

A

GFR

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10
Q

azotaemia is diminished by factors causing

A

decrease in prod’n of urea by liver
OR creatinine by muscle
OR decrease in dietary urea intake

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11
Q

GFR measurement is determined by

A

Creatinine excretion

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12
Q

Creatinine excretion

A
  • freely filtered by kidney
  • no tubular resorption
  • small amt secreted by prox tubules in dogs
  • more accurate indicator of GFR
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13
Q

Equation of creatinine clearance

A

[(Ratio of urine to serum conc) X (rate of urine production (ml/min))]/ (body weight (kg)) = ml / min / kg

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14
Q

Uraemia definition

A

syndrome w/ increase in urea concentration characterised by marked azotaemia & specific clinical signs (V, anorexia, GI ulceration)

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15
Q

Uraemia occurs in advanced…

A

renal dz

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16
Q

pre-renal azotaemia due to a decrease in renal perfusion is due to:

A

hypovolaemia, dehydration, CV dz

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17
Q

Pre-renal azotaemia leads to

A

Urea increase
Creatinine normal or increased
USG increased

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18
Q

Pre-renal azotaemia is increased in urea production due to:

A

GIT haemorrhage & high protein diet

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19
Q

GIT haemorrhage leads to…

A

increased urea
normal creatinine

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20
Q

high protein diet leads to

A

increased urea
creatinine normal or elevated

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21
Q

Renal dz is only evident when

A

75% of nephrons are compromised

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22
Q

what are signs of renal dz on clin path?

A

urea & creatinine increased
urine inadequately concentrated

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23
Q

post-renal azotaemia occurs with…

A

UT obstruction or rupture

24
Q

UT rupture causes what signs on clin path?

A

Ur, Cr increased

25
Q

What are biomarkers of electrolyte changes signaling renal dz?

A

hyperphosphatemia, hyperkalemia, hypermagnesemia, hyperamylasemia

26
Q

hyperkalemia & renal dz can occur w/

A

oliguria or anuria w/ acidosis

27
Q

hypokalemia may occur w/

A

polyuric renal failure, esp in cats/cows

28
Q

SDMA is a

A

renal biomarker specific to kidney fxn, more specific than Cr & better to detect AKI/CKD

29
Q

3 key attributes of SDMA making it a more reliable test

A
  • Biomarker for kidney fxn - more accurately reflects GFR in dogs/cats
  • earlier than creatinine (as early as 25% loss of kidney fxn)
  • specific for kidney fxn - SDMA less impacted by extra-renal factors
30
Q

Major regulators of serum phosphate & Mg & for horse - serum Ca

A

GFR & tubular reabsorption rates

31
Q

In renal failure, what primary renal regulations occur?

A

hyperphosphatemia w/ hypocalcaemia & hypermagnesaemia

32
Q

Horses w/ renal failure get what electrolyte abnormalities?

A

hypophosphataemia, hyperCa, HypoMg

33
Q

Mg conc in serum rapidly___ in anorexia

A

decreases

34
Q

Hypocalcaemia is secondary to

A

continuous hyperphosphataemia & hypoalbuminaemia

35
Q

Phosphorus and calcaemia are often…

A

inversely related

36
Q

Normocalcaemia or hypocalcaemia is common to

A

renal dz but ionised Ca is usually decreased

37
Q

Renal osteodystrophy

A

bone pain, pathologic fractures, loose teeth, rubber jaw syndrome

38
Q

Renal secondary hyperparathyroidism is assoc’d w/ compensatory increase in

A

PTH production

39
Q

liver & bilirubin biomarkers related on clin path to renal dz

A
  • hypoalbuminaemia
  • hypoglobulinaemia
  • low A/G
  • hypercholesterolaemia
40
Q

What is the reaction of severe glomerular dz of the liver & gallbladder area?

A

Alb is lost in greater amts than globulins & the liver apparently compensates w/ an increase in production of globulins & lipoproteins carrying cholesterol

41
Q

What are the signs of nephrotic syndrome?

A

Proteinuria
Hypoproteinaemia
Oedema
Hypercholesterolaemia

42
Q

Severe hypoalbuminaemia causes…

A

a decrease in plasma oncotic pressure leading to low-protein ascites &/or oedema which is most visible in the ventrum & extremities

43
Q

Definition of Microalbuminuria

A

Presence of albumin greater than or equal to normal but less than or equal to the detectable range w/ a normal dipstick

44
Q

Sensitive indicator of glomerular injury is

A

microalbuminuria

45
Q

wide variability of microalbuminuria dictates

A

repeating testing 2-3x to confirm persistence

46
Q

Microalbuminuria is most useful in…

A

cats

47
Q

Hyperamylasemia occurs

A

due to its increase w/ lower GFR & lack of tissue specificity, 3-4x increases need to seen for reliable Dx of pancreatitis

48
Q

Uremic acids may increase…

A

the anion gap (significant qtys of unmeasured ions often detected by determination of anion gap)

49
Q

Progressive non-regenerative anaemia is caused by…

A

renal fxn loss causing a decrease in EPO which is the primary cause of the anaemia
Renal haemorrhage may be present

50
Q

Accumulation of uremic acids have

A

a toxic effect on BM & RBCs

51
Q

What is a stress leucon?

A

mild neutrophilia
monocytosis w/ lymphopenia
Eosinopenia

52
Q

Cardiac troponin in relation to renal dz

A

mild myocardial injury seen in dogs w/ renal failure due to accumulation of uremic acids

53
Q

Ruptured bladder in neonatal foals/Urinary Obstruction (FUS)

A
  • dilute urine accumulates in abd
  • Signs: hyponatraemia w/ hypochloridaemia (hyposaltaemia)
  • depressed GFR -> increase K & P (Ca for horses), urea, creatinine
  • dehydration from fluid sequestration causes tissue hypoxia –> metabolic acidosis & K loss from cells
54
Q

Signs of glomerulonephritis/ nephrotic syndrome

A
  • moderate decrease GFR w/ azotaemia –> muscle wasting
  • mod hypoalbuminaemia
  • mild hepatocellular injury
  • marked hypercholesterolaemia
  • mild hyperchloridaemia
  • mild hyperglycaemia
  • Nephrotic syndrome –> proteinuria, hypoproteinaemia, oedema, hypercholesterolaemia
  • UA: isosthenuria w/ azotaemia -> renal tubular dz
55
Q

Signs of Ethylene Glycol Poisoning

A

Haematology
* hyperalbuminaemia from dehydration
* signs of inflammation
* moderate lymphopaenia due to stress & uraemia
* reticulocytopaenia from uraemia
* eosinopenia from stress
Biochemistry
* chelation - oxalate
* azotaemia from decreased GFR
* inflammatory due to dehydration
* oxalic acid, lactacidosis
* uraemic acids
UA
* isosthenuria w/ azotaemia
* proteinuria
* glucosuria
*oxalate crystalluria - Ca Oxalate monohydrate
Blood Gas
* metabolic acidosis
* partial resp compensation

56
Q

Signs of Diabetes on clin path

A
  • marked uncontrolled, ketoacidotic diabetes
  • ketoacidosis w/ hyperkalaemia
  • azotaemia/dehydration from water loss
  • electrolyte loss
  • hyperchloridaemia - due to metabolic acidosis
  • muscle wasting
  • hepatocellular injury
  • haematuria/pyuria - cyststitis

Clinical Reproduction & Urology (29 decks)

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