Week 3- Clinical Investigation of urological disease Flashcards
What is Polyuria/ Polydipsia ?
- Excessive urine production
- Excessive water consumption
What is dysuria?
Painful or difficult urination
What is stranguria?
Straining to urinate, increased effort and decreased volume
What is pollakiuria?
Increased frequency of urination
What is periuria?
Inappropriate urination
What is urinary incontinence?
Lack of voluntary control over urination
What are the three main collection methods for collecting urine?
- Free catch sample
- Catheterisation
- Cystocentesis
What are the three different measures of urine specific gravity?
- Hyposthenuric
- Isothenuric
- Hypersthenuric
In what animal species is billirubin always abnormal?
Cats
How can you differentiate RBC’s and free haemoglobin?
Differentiate with sediment exam
What does it mean when blood is seen at the beginning of the urinary tract?
- Problem is in the lower urinary tract
Problem is in the genital tract
What does it mean if blood is seen at the end of the urinary tract?
- Intermittent bleeding from kidneys, ureters or ventral bladder
- blood settles in the bladder before voiding
What does it mean if blood is persistently seen throughout the urine?
- Persistent bleeding from the upper tract
- Generalised bladder disease
How would a pre-renal disease present in terms of protein?
- Excessive delivery of protein via the blood
- Immunoglobulin/ pigment proteins
How would a post-renal disease present in terms of protein?
Protein enters distal to the kidney
* inflammation
* infection
What Protein: Creatinine ratio is considered normal?
<0.2
How would you do a urine sediment exam?
- Centrifuge urine to obtain sediment
- Examine sample under microscope
- identify casts, crystals and bacteria
- active sediment versus inactive sediment
What is the gold-standard test if you suspect a UTI?
culture and sensitivity
* helpes ensure true infection and not contamination
What is pre-renal azotaemia?
- any process that reduces renal blood flow
- dehydration/ hypovolaemia
- hypotension/ shock
- decreased urine volume
- increased USG
What is post-renal azotaemia?
- obstruction
- rupture of the urinary tract
- decreased urine volume
- variable urine SG
What is renal azotaemia?
Primary renal disease that results in reduced GFR
* Glomerular disease
* Tubular disease
* Interstitial Disease
* Increased urine volume
How does azotaemia respond to fluid therapy?
- 40-50% reduction in 24 hours
- returns to normal after 72 hours
- prolonged azotaemia indicates renal disease
What is the function of renal ultrasound?
- assess renal size, position etc.
- identify any masses or renal calculi
- can aid in obtaining renal biopsies
What is the function of a bladder ultrasound?
- assess bladder wall thickness, presence of soft tissue masses
- intraluminal calculi
What is the function of urethroscopy/ cytoscopy?
- more commonly used in larger animals
- rigid/ flexible scope passed into the bladder via the urethra
- allows direct visualisatio of stones/ masses and possible biopsy
Name some of the indications for using urethroscopy/ cytoscopy?
- Chronic cystitis
- Dysuria
- Haematuria
- Incontinence
- Neoplastic cells in sediment
- Vaginal discharge
- Breeding issues
What is a renal biopsy generally indicated for?
- patients whos treatment may be directed on the basis of renal tissue histopathology
- Patients that are likely to have reversible damage
- contraindicated for patients with chronic renal disease
