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Pathology > Urinary Pathology > Flashcards

Urinary Pathology Flashcards

1
Q

What can cause the glomerulus to become visible to the naked eye?

A

Glomerulonephritis

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2
Q

Microscopic appearance of the glomerulus. (3)

A
  1. Fenestrated capillaries supported by mesangium
  2. Mesangial cells
  3. Podocytes
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3
Q

4 main fxns of mesangial cells

A

produce collagen & matrix
contract glomerular tuft
phagocytosis
secretion of inflammatory mediators

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4
Q

What are the visceral epithelial cells that participate in glomerular filtration?

A

podocytes

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5
Q

Glomerular filtration barrier selectively filters molecules based on:

A

size (< 70,000 Da)

charge (cations only)

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6
Q

Describe the glomerular filtration barrier.

A

filtration slits btwn podocyte pedicels & fenestrated endothelial cells w/ shared basal lamina

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7
Q

3 things that cause an increase in the amt of CT (scar tissue) in the interstitium of the kidney?

A
  1. age
  2. chronic inflammation
  3. ischemic damage
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8
Q

List the path blood flows through the kidneys

A

renal a.–> interlobar a. —> arcuate a–> interlobular a.–> afferent glomerular arterioles–> glomerular capillaries–> efferent glomerular arterioles–> peritubular capillary network

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9
Q

Which arteries are more susceptible to embolism leading to renal infarction? Why?

A

interlobular a.

terminal arteries that do NOT contain anastomoses & have a small lumen diameter

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10
Q

5 characteristics of renal infarction

A
  1. wedge-shaped
  2. well demarcated
  3. dark red or white
  4. acutely swollen (inflammation)
  5. chronically contracted (fibrosis)
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11
Q

5 basic renal fxns

A
  1. Urine –> eliminates metabolic waste
  2. Acid-base regulation–> reclaims bicarbonate
  3. Conserves H2O –> 99%
  4. Maintains normal extracellular [K]–> via aldosterone–> K excretion
  5. Controls endocrine fxn–> RAAS –> NaCl retention
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12
Q

What dictates plasma filtration?

A

Glomerular filtration barrier

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13
Q

How is BP regulated?

A

Renin-Angiotensin-Aldosterone System (know details)

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14
Q

The macula densa responds to low _____.

A

Na

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15
Q

Low Na stimulates juxtaglomerular cells to secrete______.

A

Renin

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16
Q

Fxn of Renin.

A

Converts Angiotensinogen —> Angiotensin I

liver

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17
Q

Fxn of ACE.

A

Angiotensin I–> Angiotensin II

lungs

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18
Q

Fxns of Angiotensin II

A
  1. stimulates aldosterone secretion (AG)
  2. stimulates ADH (PPG)
    Cumulative effect= incr. BP
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19
Q

What kind of drugs are ACE-inhibitors?

A

anti-hypertensive

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20
Q

7 things reabsorbed in the Proximal tubules

A

Na, Cl, K, albumin, Gluc, H20, bicarb

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21
Q

How does the LoH produce a hypotonic filtrate?

A

via a countercurrent mechanism & Na/K-ATPase pump which absorbs more NaCl from the filtrate

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22
Q

2 places H20 is reabsorbed in the kidneys?

A

Distal tubules

Collecting ducts

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23
Q

What hormone influences Na & H2O reabsorption & K excretion in the Distal Tubules?

A

Aldosterone

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24
Q

How do the Collecting Ducts promote H2O reabsorption?

A

increasing urea gradient

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25
Q

How are H2O & Na reabsorption controlled in the Collecting Ducts?

A

Na/K-ATPase pumps, under the influence of ADH

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26
Q

What provides structural support for the glomerulus, tubules, BVs, lymphatics & nerves of the kidney?

A

the Interstitium

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27
Q

Interstitial fibroblasts produce what 3 things?

A

EPO (+ peritubular cells)
Prostaglandins
Inflammatory mediators

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28
Q

Definition of renal failure.

A

significant loss of renal fxn

kidneys have 75% fxnal reserve

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29
Q

Clinical indicators of renal failure

A
  1. Altered urine quantity - PU/PD; oliguria; anuria

2. Altered urine quality- Isosthenuria, proteinuria, azotemia, uremia

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30
Q

What does Isosthenuria inidcate? (TQ)

A

loss of renal fxn–> failure to concentrate urine

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31
Q

What does azotemia indicate? (TQ)

A

elevated serum Urea & Creatinine = >75% loss of nephrons

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32
Q

Uremia is a _______ characterized by numerous lesions & C.S.s caused by toxic levels of urea in blood.

A

syndrome

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33
Q

2 mechanisms by which uremia causes systemic lesions.

A
  1. uremic vasculopathy

2. uremic toxicity

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34
Q

What is uremic vasculopathy?

A

direct endothelial injury resulting in vasculitis, thrombosis & infarction

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35
Q

What is the term for caustic injury to epithelium of mucosal surfaces due to production of LG amts or ammonia by urea-splitting bacteria?

A

uremic toxicity

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36
Q

Systemic lesions of uremic syndrome

A

ulcerative glossitis (ventral tongue)
ulcerative stomatitis
ammonia breath
ulcerative gastritis w/ mineralization –> Cat & Dog

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37
Q

7 additional non-renal lesions caused by uremic syndrome.

A
  1. ulcerative colitis –> cattle & horse
  2. vascular thrombosis
  3. fibronous pericarditis
  4. pulmonary edema
  5. endocardial mineralization
  6. intercostal mineralization
  7. other soft tissue mineralizations
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38
Q

3 ways renal failure can lead to death.

A
  1. cardiotoxicity due to elevated serum K
  2. metabolic acidosis
  3. pulmonary edema
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39
Q

3 classifications of renal failure & azotemia.

A

pre-renal
intrarenal
post-renal

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40
Q

Why does acute pre-renal failure occur?

A

impaired renal perfusion causes reduced glomerular filtration &/o hypoxic injury

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41
Q

2 things that lead to acute pre-renal failure.

A

circulatory collaspe

renal ischemia –> vasculitis or embolic dz.

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42
Q

Why does acute intrarenal failure occur?

A

damage to the renal tissue

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43
Q

4 things that can cause acute intrarenal failure.

A

acute tubular necrosis
glomerulonephritis
tubulointerstitial nephritis
pyelonephritis

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44
Q

When form of acute intrarenal failure is most common?

A

acute tubular necrosis

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45
Q

2 clinical presentations that result from intrarenal failure.

A

oliguria

anuria

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46
Q

2 way tubular necrosis results in further renal injury.

A
  1. leakage of tubular ultrafiltrate–> necrosis & inflammation
  2. intratubular obstruction –> tubular casts
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47
Q

5 bacT infections that cause acute tubular necrosis.

A
  1. Lepto
  2. E. coli
  3. Strep
  4. Staph
  5. Proteus
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48
Q

3 virus that cause acute tubular necrosis in dogs.

A
  1. K9 hepatitis
  2. K9 distemper
  3. K9 herpes
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49
Q

A substance that accumulates to toxic conc. w/in the tubules.

A

nephrotoxin

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50
Q

4 general categories of nephrotoxins

A

pigments
heavy metals
oxalates
plants

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51
Q

3 pigments that act as nephrotoxins

A

Hb, myoglobin, bile/bilirubin

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52
Q

5 heavy metals that act as nephrotoxins

A

lead, mercury, arsenic, cadmium & thallium

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53
Q

2 oxalates that act as nephrotoxins

A 
ethylene glycol (antifreeze)
oxalate-rich plants
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54
Q

4 plants that can act as nephrotoxins.

A

pigweed, oaks, grapes/raisins & lilies

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55
Q

Why can Vit D toxicosis cause acute tubular necrosis (intrarenal failure)?

A

due to hypercalcemia

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56
Q

Which 4 drug types are nephrotoxic and can cause acute tubular necrosis?

A

antimicrobials
NSAIDs
immunemodulatory drugs
antineoplastic chemotherapeutics

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57
Q

4 things that can cause acute glomerulonephritits (intrarenal failure)

A

immune complexes
bacT
viruses
toxins

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58
Q

What causes acute pyelonephritits (intrarenal failure)?

A

ascending bacT infection from urethra, ureters & renal pelvis

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59
Q

What causes urinary obstruction w/ pressure atrophy & necrosis? (a.k.a obstructive nephropathy)

A

post-renal failure

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60
Q

3 causes of acute post-renal failure.

A

urolithiasis
tumors
iatrogenic

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61
Q

What 2 things can post-renal obstructions lead to?

A

hydroureter & hydronephrosis

possible organ rupture

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62
Q

Time period of chronic renal failure.

A

wks, mos., or yrs

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63
Q

When can CRF lead to end-stage kidney?

A

when it is prolonged & progressive

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64
Q

Term used to describe renal dz which is chronic, advanced, generalized, progressive & irreversible.

A

end-stage kidney

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65
Q

Gross appearance of an end-stage kidney

A 
Fibrotic
Atrophic
Shrunken renal parenchyma
Massive loss of fxnal nephrons
Fibrosis
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66
Q

What is a common pathway to CRF, despite original cause of injury?

A

progressive fibrosis

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67
Q

Is it possible to determine the etiology once end-stage kidney is reached?

A

often impossible

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68
Q

Pathophysiology of CRF? (2)

A
  1. non-regenerative anemia

2. altered Ca:P metabolism

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69
Q

How does CRF alter Ca/P metabolism? what is this process known as?

A

HYPERphosphatemia–> HYPOcalcemia—> PTH secretion–> Ca mobilized from osteoclastic bone resorption–> osteopenia

Renal 2ry Hyperparathyroidism

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70
Q

Chronic hyperparathyroidism may lead to _____ ______.

A

fibrous osteodystrophy (bone replaces fibrous tissue)

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71
Q

Renal 2ry hyperparathyroidism is often due to what?

A

bilateral parathyroid gland hyperplasia

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72
Q

4 portals of entry to the kidney

A
  1. ascending from ureter
  2. hematogenous
  3. glomerular filtrate
  4. direct penetration
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73
Q

Ascending bacT infection results in _______.

A

suppurative pyelonephritis

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74
Q

What is the most important barrier (defense mechanism) of the kidney?

A

glomerular basement membrane

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75
Q

What prevents ascending bacT from gaining access to the kidney’s interstitium?

A

Tubular basement membrane (TBM)

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76
Q

What provides the scaffold for tubular regeneration?

A

tubular basement membrane

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77
Q

What typically destroys the TBM & causes permanent scarring w/ loss of tubules? (TQ)

A

Ischemia or Infarction

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78
Q

Humoral Abs protect the interstitium at the ____ ____ of the renal pelvis.

A

mucosal surface

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79
Q

What 3 cells w/in the interstitium provide cell-mediated immune surveillance against Lepto?

A

macrophages
lymphocytes
plasma cells

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80
Q

What is a defensive barrier against bloodborne pathogens?

A

intact endothelial lining (healthy vasculature)

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81
Q

Intact endothelium prevents activation of ____ ____ and reduces ____ formation

A

clotting cascade

thrombus

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82
Q

_____ to 1 part of the nephron results in _____ damage to other components of the nephron with eventual loss of _____.

A

Injury
progressive
fxn

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83
Q

Glomerular injury can result from the deposition of what 4 things?

A
  1. immune complexes (Type III)
  2. thromboemboli
  3. Bact emboli or direct infections
  4. amyloid & fibrin (proteins)
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84
Q

2 things that cause glomerular injury?

A

deposition of substances

hyperfiltration

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85
Q

2 things that result in hyperfiltration and glomerular injury?

A

prolonged systemic hypertension

increased dietary protein (prolonged proteinuria)

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86
Q

How does glomerular injury result in hypoxia with tubular atrophy & loss of fxn?

A

by interfering w/ peritubular blood supply

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87
Q

What 2 proteins leak into the urine due to damage to the glomerular filtration barrier?

A

Albumin

Antithrombin 3

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88
Q

2 characteristics of protein losing nephropathy?

A

nephrotic syndrome

wt. loss

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89
Q

What causes nephrotic syndrome? List some CS.

A

HYPOproteinuria –> reduced plasma oncotic pressure

C.S= ascites, pleural effusion, generalized edema

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90
Q

Loss of what protein can result in a hypercoagulable state & thromboembolic dz.

A

Antithrombin 3

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91
Q

List 4 ACUTE responses of the glomerulus to injury

A
  1. mesangial hypertrophy & hyperplasia
  2. increased vascular permeability
  3. infiltration of leukocytes
  4. necrosis
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92
Q

List 3 CHRONIC responses of the glomerulus to injury.

A
  1. atrophy
  2. Glomerulosclerosis (=fibrosis)
  3. 2ry atrophy of renal tubules due to ischemia
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93
Q

List some things that can cause tubular damage

A 
bloodborne infections
ascending infections
toxins
infarction/ischemia
volume overload
abnormal glomerular filtrate
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94
Q

What are some components of abnormal glomerular filtrate?

A

high protein
high crystalline salts
high organic acids –> oxalic/uric/pyruvic acid

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95
Q

4 responses to tubular damage?

A
  1. atrophy (2ry)
  2. degeneration
  3. regeneration
  4. necrosis
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96
Q

Which type of injury generally preserves the TBM & allows for regeneration of the tubules?

A

Toxic injury

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97
Q

Which type of injury destroys the TBM causing permanent scars & no regeneration of the tubules?

A

Ischemic injury

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98
Q

What is the single most important cause of acute renal failure in animals? (TQ)

A

Acute tubular necrosis

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99
Q

What are the 2 most common causes of acute tubular necrosis?

A

ischemia or nephrotoxicity

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100
Q

Acute tubular necrosis clinically results in ____ or _____.

A

oliguria or anuria

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101
Q

How does nephrotoxic injury cause acute tubular necrosis?

A

chemicals &/o toxic metabolites become concentrated in the tubules

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102
Q

3 mechanisms by which nephrotoxins cause damage to tubules?

A
  1. direct damage to epithelium
  2. reactive metabolites damage epithelium
  3. nephrotoxin-associated ischemia
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103
Q

Form of tubular necrosis that is NOT caused by inflammation? (TQ)

A

nephrosis

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104
Q

What typically causes nephrosis?

A

hypoxic injury combined w/ nephrototoxic injury

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105
Q

Type of nephrosis caused when hypoxic injury is exacerbated by hemoglobinuria during a hemolytic crisis?

A

Hemoglobinuric nephrosis

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106
Q

Type of nephrosis caused when hypoxic injury in exacerbated by myoglobinuria during acute muscle injury?

A

Myoglobinuric nephrosis

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107
Q

Gross lesions of acute tubular necrosis (often difficult to recognize)

A
  1. swollen, pale cortex that bulges on cut surface

2. may see accentuated striations or white streaks

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108
Q

Microscopic lesions of acute tubular necrosis? (6)

A
  1. tubular epithelial swelling
  2. vacuolation
  3. HYPEReosinophilia
  4. pyknosis
  5. karyorrhexis
  6. karyolysis
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109
Q

Which tubules are more sensitive to hypoxia due to higher metabolic demands?

A

proximal tubules

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110
Q

Which part of the kidney is resistant to ischemia & often remain morphologically normal?

A

glomeruli

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111
Q

Interstitium’s response to injury. (7)

A
  1. hyperemia
  2. edma
  3. lymphofollicular inflammation
  4. fibrosis
  5. interstitial nephritis
  6. tubulointerstitial nephritis
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112
Q

What is the most common response of the interstitium to chronic Lepto infection?

A

lymphofollicular inflammation

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113
Q

What leads to progressive loss of renal fxn? (TQ)

A

progressive fibrosis

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114
Q

3 causes of infectious interstitial nephritis.

A
  1. K9 ehrlichiosis
  2. Leptospirosis
  3. EIA
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115
Q

When will interstitial nephritis lead to renal failure & end-stage kidney?

A

only when it’s severe

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116
Q

4 things that can cause 2ry tubulointerstitial nephritis?

A

Lepto
Adenoviruses
Lentiviruses
Herpesviruses

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117
Q

_____ tubulointerstitial nephritis leads to end-stage kidney.

A

Chronic

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118
Q

What causes a well-demarcated, cone-shaped area of coagulative necrosis extending from medulla to cortex?

A

renal infarction

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119
Q

3 portals of entry to the lower UT.

A
  1. ascending infections
  2. direct penetration from lumen
  3. cyctocentensis
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120
Q

5 defensive mechanisms of the lower UT.

A
  1. flushing action –> reduces risk of ascending infections
  2. peristalsis –> eliminates bacT
  3. slightly acidic urine –> reduces some bacT growth
  4. protective urethral mucus layer –> decr. bacT adhesion
  5. innate & adaptive immune response
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121
Q

5 developmental anomalies of the kidney.

A
  1. renal aplasia, hypoplasia or dysplasia
  2. ectopic kidney
  3. fused kidney
  4. renal cysts
  5. polycystic kidneys
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122
Q

Juvenile progressive nephropathy is a specific form of inherited renal dysplasia common to what 3 breeds?

A

Lhasa apso
Shih Tzu
Golden retriever

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123
Q

“Horseshoe kidney” is an example of which developmental anomaly? What is the fxn of these kidneys?

A

fused kidney

usually maintain normal fxn

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124
Q

Ectopic kidney is most common in what 2 species?

A

dogs & pigs

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125
Q

Renal cysts are common in what 2 species?

A

cattle & pigs (just 1 to a few)

126
Q

What is the clinical significance of renal cysts?

A

none–> usually an incidental finding

127
Q

Term for many renal cysts affecting numerous nephrons?

A

Polycystic kidney

128
Q

Polycystic Kidney Dz in an autosomal dominant trait in what 2 breeds? (TQ)

A

Persian cats

Bull Terriers

129
Q

Dz caused by mutations in PKD-1 &/o PKD-2 resulting in abnormal tubulogenesis?

A

Polycystic Kidney Dz.

130
Q

When can renal function by impaired in patients w/ Polycystic Kidney Dz?

A

severe cases –> when significant loss of parenchyma

131
Q

List the 6 diseases of the glomerulus.

A
  1. immune-mediated glomerulonephritis
  2. glomerulosclerosis
  3. glomerular amyloidosis
  4. Acute suppurative glomerulitis (bacT embolic nephritis)
  5. viral glomerulitis
  6. chemical glomerulitis
132
Q

Immune mediated glomerulonephritis occurs most commonly in ____ & _____.

A

cats & dogs

133
Q

Immune mediated glomerulonephritis is associated with ___ ___ which enhances the formation of abundant ____ ____ in the blood plasma.

A

persistent infections

immune complexes

134
Q

What results in complement fixation, leukocyte infiltration & formation of fibrin thrombi –> glomerular damage?

A

deposition of soluble immune complexes w/in glomeruli

135
Q

What 5 things can cause immune-mediated glomerulonephritis in cats?

A 
FeLV
FIV
FIP
progressive polyarteritis
neoplasia
136
Q

What 2 things cause immune-mediated glomerulonephritis in horses?

A

Strept infections

EIA

137
Q

What 2 things cause immune-mediated glomerulonephritis in cattle?

A

BVD

Trypanosome infections

138
Q

What 2 viruses cause immune-mediated glomerulonephritis in swine?

A 
Classical SF (Hog cholera)
African SF
139
Q

What gross lesion of immune-mediated glomerulonephritis might you see?

A

swollen, enlarged glomeruli as red pin-point foci in the cortex

140
Q

List the 3 histologic forms of immune-mediated glomerulonephritis. Species each is common in?

A
  1. proliferative –> horses
  2. membranous –> cats
  3. mebrano-proliferative –> dogs
141
Q

What is the condition of CHRONIC glomerulonephritis characterized by fibrosis of the glomerulus?

A

glomerulosclerosis

142
Q

2 things associated with glomerulosclerosis?

A

high BP

unrestricted dietary protein

143
Q

What is typically associated w/ Reactive Systemic Amyloidosis (AA amyloidosis) that occurs w/ CHRONIC inflammatory dz?

A

glomerular amyloidosis

144
Q

Which 2 breeds are genetically predisposed to reactive amyoidosis? (TQ)

A

Abyssinian cats

Chinese Shar-Pei dogs

145
Q

What is a common cause of protein losing nephropathy?

A

glomerular amyloidosis

146
Q

What stain can be used to ID amyloid protein histologically?

A

Congo red stain

147
Q

List the 4 examples of bacT & affect species that cause actute suppurative glomerulitis. (LG animals)

A
  1. A. equuli –> foals
  2. E. rhusiopathiae –> pigs
  3. C. pseudotuberculosis –> goats & sheep
  4. T. pyogenes –> cattle
148
Q

List the 5 causes of viral glomerulitis? common or rare?

A
  1. Infectious K9 hepatitis (adeno-)
  2. EVA (arteri-)
  3. CSF (pesti-)
  4. Newcastle dz (paramyxo-)
  5. neonatel porcine cytomegalovirus
    Rare
149
Q

List 4 known examples that cause chemical glomerulitis

A
  1. puromycin aminonucleoside
  2. adriamycin
  3. histamine-receptor antagonists
  4. cyclosporin A
150
Q

List 2 inherited abnormalities in renal tubular FXN.

A
  1. 1ry renal glucosuria –> trouble reabsorbing Gluc–> Norwegian elkhounds
  2. Basenji dog Fanconi Syndrome
151
Q

Are there any lesions associated with 1ry Renal Glucosuria?

A

no, only a fxnal deficit

152
Q

What other dz must by distinguished from 1ry Renal Glucosuria?

A

Diabetes mellitus

153
Q

C.S. of acute tubular necrosis? (TQ)

A

oliguria or anuria w/ severe azotemia

154
Q

Hemoglobinuria nephrosis & hemoglobinuria w/ hemolysis occurs in what 4 things? Species?

A
  1. Cu toxicity –> sheep
  2. Lepto or Babesia –> cattle
  3. Red maple toxicity –> horse
  4. Babesia or IMHA–> dogs
155
Q

3 things that cause myoglobinuria (myoglobinuric nephrosis)?

A
  1. exertional myopathy (azotemia, tying up) –> horses
  2. capture myopathy (rhabdomyolysis)–> wild animals
  3. severe mm. trauma
156
Q

List the 3 histologic changes seen in acute tubular necrosis.

A

tubular necrosis
tubular degeneration
IN inclusion bodies

157
Q

When can nephrotoxic drugs cause acute tubular necrosis?

A

when administered at excessive doses or too frequently

158
Q

Which drugs decrease the synthesis of renal prostaglandins which are responsible for maintaining normal renal blood flow?

A

NSAIDs

159
Q

NSAIDs cause renal ____________.

A

vasoconstriction

160
Q

NSAIDs cause acute tubular necrosis & ___ ___ ___.

A

renal papillary necrosis

161
Q

Which mycotoxin from contaminated feed can result in acute tubular necrosis?

A

aflatoxin

162
Q

What 2 things do mycotoxins cause?

A

tubular degeneration

tubular necrosis

163
Q

List the 4 oxalate-rich plants

A

Halogeton
Sarcobatus
Rheum
Rumex

164
Q

What happens when Ca oxalates precipitate in renal tubules froming oxalate crystals w/ subsequent epithelial injury & renal failure?

A

Oxalate nephrosis

165
Q

Grapes & raisins can cause acute tubular necrosis in what species?

A

dogs

166
Q

Lilies can cause acute tubular necrosis in what species?

A

cats

167
Q

Oak toxicity can cause acute tubular necrosis in what 2 species?

A

cattle

horses

168
Q

Ethylene glycol (antifreeze) results in ___ ____ & ___ ____.

A

nephrotoxic metabolites –> oxalate & glycolic acid

oxalate nephrosis

169
Q

What 2 pet food contaminants cause distal tubular necrosis w/ characteristic irregular brown birefringent crystals?

A

Melamine

Cyanuric acid

170
Q

Vit D toxicosis leads to ____calcemia.

A

hypercalcemia

171
Q

Hypercalcemia causes ______ mineralization of tubular & glomerular basement membranes.

A

metastatic

172
Q

Metastaic mineralization is followed by what 4 things?

A

degeneration
necrosis
fibrosis
loss of fxn

173
Q

Pulpy Kidney is a typical dz seen in what animals?

A

small ruminants

174
Q

What causes Pulpy Kidney?

A

enteric proliferation of C. perfringes type D

175
Q

What exotoxin is produced in Pulpy Kidney dz?

A

Epsilon exotoxin

176
Q

What 3 things do epsilon exotoxin cause in small ruminants?

A

Bilateral acute tubular degeneration & necrosis
Interstitial edema
Hemorrhage

177
Q

What is caused by dilation of the renal pelvis due to obstruction of urine outflow?

A

Hydronephrosis

178
Q

Pyelonephritis leads to infection of the ____ ____ w/ extension to the ____ ___.

A

renal pelvis

renal tubules

179
Q

Pyelonephritis is often unilateral or bilateral?

A

bilateral (can do either or)

180
Q

Gross lesion of pyelonephritis

A

expansion of renal pelvis by purulent exudate

181
Q

Microscopic lesions of pyelonephritis

A

suppurative inflammation of pelvis & medulla w/ necrotic transitional epithelium

182
Q

Papillary necrosis is due to ischemic injury caused by what drugs?

A

NSAIDs

183
Q

Papillary necrosis is most frequently seen in _____. Can be seen in ___ & ___ due to accidental ingestion.

A

horses

cats & dogs

184
Q

Hairy vetch toxicosis in cattle causes ______ _____ & accompanies systemic granulomatous dz.

A

granulomatous nephritis

185
Q

What animals get Xanthogranulomas?

A

cats w/ inherited hyperlipoproteinmia

186
Q

List the 3 types of epithelial tumors.

A

Renal adenoma
Renal carcinoma
Transitional cell papilloma & carcinoma

187
Q

What is the most common primary renal neoplasm of the kidney? Common species?

A

renal carcinoma

older dogs

188
Q

In what dog breed is renal carcinoma associated with nodular dermatofibrosis?

A

GSD

189
Q

Transitional cell papilloma & carcinoma occur most commonly where?

A

urinary bladder

190
Q

Which neoplastic dz has a very high metastatic potential?

A

transitional cell carcinoma

191
Q

Another term for nephroblastoma.

A

embryonal neophroma

Wilm’s tumor

192
Q

Nephroblastoma is common in which species?

A

pigs
chickens
some fish

193
Q

What is a common metastatic tumor of the kidney?

A

renal lymphoma

194
Q

2 invasive tumors of the adrenal glands that effect the kidney

A
  1. pheochromocytoma

2. adrenocortical carcinoma

195
Q

5 developmental anomalies of the lower UT

A
  1. aplasia (rare)
  2. hypoplasia
  3. ectopic ureters
  4. patent urachus
  5. urinary bladder diverticulum
196
Q

What is the most common malformation of the urinary bladder?

A

patent urachus

197
Q

What causes patent urachus?

A

fetal urachus fails to close & completely involute –> channel btwn bladder’s apex & umbilicus

198
Q

Where can one see urine coming from in patients with patent urachus?

A

urine dribbles from the umbilicus (navel region)

199
Q

What 2 things are frequently observed with patent urachus?

A

neonatal omphalitis

abscess formation

200
Q

Which animals are most commonly affected by patent urachus?

A

foals

201
Q

Developmental abnormalities of the urinary bladder diverticulum can do what 3 things?

A
  1. be associated w/ obstructive dz (acquired form)
  2. predispose to systitis & calculi formation
  3. predispose to bladder rupture
202
Q

Syndrome that occurs when familial, congenital, &/o pathophysiological factors increase the precipitation of stone-forming salts resulting in urinary calculi formation.

A

Urolithiasis

203
Q

What is the essential precursor to initiation of crystal & urolith formation?

A

supersaturation of urine –> due to supersaturation of mineral salts & protein

204
Q

What is only partially responsible for calculogenesis?

A

crystal formation

205
Q

What type of crystal is most common in dogs & cats? What type of urine favors their formation?

A

struvite crystals

alkaline urine

206
Q

Struvite crystals are also known as?

A

Infection calculi

207
Q

Which breed of dog is predisposed to struvite uroliths and Ca oxalate dihydrate w/ urolith formation?

A

Mini Schnauzers

208
Q

Bilirubinuria +/- bilirubin crystals is an abnormal finding in what 4 species?

A

cats
horses
cattle
camels

209
Q

Ca carbonate crystals are not common in what 2 species’ urine?

A

cats & dogs

210
Q

List the 4 UNCOMMON types of urinary crystals seen in animals.

A
  1. Ca oxalate MONOhydrate
  2. Ammonium biurate crystals
  3. Cystine crystals
  4. Drug-associated crystals
211
Q

What shape of Ca oxalate monohydrate crystals are observed in the urine of dogs & cats w/ ethylene glycol toxicosis?

A

“picket fence” crystals

212
Q

2 things that together indicate ethylene glycol toxicosis?

A

acute renal failure & picket fence crystalluria

213
Q

What type of urinary crystal is commonly seen in dogs & cats w/ congenital or acquired portal vascular anomalies?

A

ammonium biurate crystals

214
Q

Ammonium biurate crystals are NORMAL in what 2 breeds of dog? (TQ)

A

Dalmatians & bulldogs

215
Q

Cystine crystalluria &/o urolithiasis is an indication of what genetic abnormality?

A

cystinuria

216
Q

What animals are almost exclusively affected by cystinuria?

A

male dogs

217
Q

Which drug most commonly causes drug-associated urinary crystals? Do these cause significant renal dz?

A

trimethoprim-sulfadiazine

No

218
Q

What is the most common cause of obstructive uropathy?

A

Urolithiasis

219
Q

Acute cystitis is common in all domestic animals. Which gender is more prone? Why?

A

females

due to shorter & wider urethra

220
Q

Acute cystitis may have concurrent ____ & ____.

A

ureteritis & urethritis

221
Q

What 4 bacT are the most common source of acute cystitis?

A

E. coli
Proteus sp.
Strept sp.
Staph sp.

222
Q

C. renale commonly causes acute cystitis in what species?

A

cattle

223
Q

A. suis commonly causes acute cystitis in what species?

A

pigs

224
Q

E. faecalis commonly causes acute cystitis in what species?

A

cats

225
Q

Klebsiella sp. commonly cause acute cystitis in what species?

A

horses

226
Q

List some risk factors for acute bacterial cystitis. (8)

A
  1. stagnation of urine
  2. trauma
  3. vaginoscopy, vaginitis, coitus, AI
  4. urinary incontinence
  5. prolonged antibiotic use
  6. diabetes mellitus
  7. prolonged corticosteroid use or Cushing’s dz
  8. immunosuppression
227
Q

Cantharidin toxicosis occurs in? from ingestion of what?

A

horses

blister beetles in alfalfa hay

228
Q

2 causes of mycotic cystitis?

A

Aspergillus sp.

Candida albicans

229
Q

What can cause cystitis, hematuria & urinary bladder neoplasia in cattle?

A

bracken fern toxicosis

230
Q

Gross lesions of acute cystitis. (4)

A

edema
hemorrhage
ulceration
purulent exudate

231
Q

Microscopic lesions of acute cystitis. (6)

A 
epithelial denudation
ulceration
hemorrhage
edema
suppurative infiltration
bacterial colonies
232
Q

C.S. of acute cystitis

A

dysuria, stranguria or hematuria
sedimentation, blood, +/- bacT on UA
pyrexia

233
Q

2 most common causes of chronic cystitis

A

chronic bacT infection

urolithiasis

234
Q

3 types of chronic cystitis (based on morphologic pattern)

A

diffuse
lymphofollicular
polypoid

235
Q

Gross lesions of chronic cystitis.

A

diffusely reddened, roughened & thickened mucosa

may see lymphoid follicles or polypoid hyperplasia

236
Q

Microscopic lesions of chronic cystitis.

A

epithelial HYPERplasia
fibrosis
hemorrhage
mononuclear infiltration w/ few neutrophils

237
Q

Where to most neoplasms occur in the lower UT?

A

urinary bladder

238
Q

Transitional cell carcinoma is most common in ____.

A

dogs

239
Q

What area of the bladder is transitional cell carcinoma most common?

A

trigone area

240
Q

What is the most common mesenchymal tumor of the lower UT?

A

leiomyoma (less common that epithelial tumors)

241
Q

Bacterial embolic nephritis is caused by what normal inhabitant of the alimentary tract?

A

A. equuli

242
Q

How do foals get bacterial embolic nephritis?

A

via contamination of the umbilicus

243
Q

What 2 NSAIDs can cause papillary necrosis?

A

phenylbutazone

flunixin meglumine

244
Q

List the 5 disorders specific to horses.

A 
bacterial embolic nephritis
myoglobinuric nephritis (rhabdomyolysis)
papillary necrosis
patent urachus
Klossiella equi infection
245
Q

List the 10 disorders specific to ruminants

A 
oak toxicity
pulpy kidney dz. 
embolic nephritis (white spotted kidney)
tubulointerstitial nephritis
granulomatus nephritis
pyelonephritis
renal lymphosarcoma
urolithiasis
bracken fern toxicosis
renal amyloidosis
246
Q

White Spotted Kidney (embolic nephritis) occurs in ruminants due to ? Is it noticeable?

A

bacT embolize the kidney leading to microabscesses & abscess formation
no, commonly subclinical

247
Q

What can cause tubulointerstitial nephritis in cattle?

A

Lepto. interrogans

Serovars- hardjo, pomona, & grippotyphosa

248
Q

Tubulointerstitial nephritis causes direct damage to what 3 parts of the kidney?

A

endothelium
tubules
interstitium

249
Q

Granulomatous nephritis in ruminants is due to ___ ____ toxicosis. (TQ)

A

hairy vetch

250
Q

Is pyelonephritis common in cattle?

A

no

251
Q

What is the most common isolate of Contagious Bovine Pyelonephritis?

A

C. renale

252
Q

What viral dz in cattle can be associated with renal lymphosarcome?

A

Bovine Leukosis Virus (BLV)

253
Q

List the common locations of urolith obstruction in bulls, rams & bucks.

A

bulls - sigmoid flexure

rams & bucks- urethral process

254
Q

Why are uroliths typically silica calculi in ruminants?

A

due to the high silica content of pasture grasses

255
Q

Bracken fern toxicosis is also known as ____ _____.

A

enzootic hematuria

256
Q

What is the most common toxicosis of cattle? (TQ)

A

bracken fern toxicosis

257
Q

Prolonge ingestion of bracken fern (P. aquilinum) causes what 3 things in cattle?

A

hemolysis
BM damage
immunosuppression

258
Q

Repeated low level exposure to bracken fern causes what in cattle?

A

urinary bladder neoplasia –> transitional cell carcinoma

259
Q

List the 7 disorders specific to swine.

A 
glomerulonephritis
toxic nephritis 
leptospirosis
Viral interstital nephritis
urolithiasis
erysipelothrix
kidney worm
260
Q

What plant can cause acute tubular necrosis leading to acute renal failure in swine?

A

pigweed

261
Q

Which 3 Leptospira serovars cause leptospirosis in swine?

A

pomona
tarassovi
australis

262
Q

Which virus can cause granulomatous interstitial nephritis in swine?

A

Circovirus–> Postweaning Multisystemic Wasting Syndrome (PMWS)

263
Q

What is the most common cause of embolic nephritis in pigs? (TQ)

A

Erysipelothrix (diamond skin dz)

264
Q

Kidney worm of swine?

A

Stephanurus dentatus

265
Q

List the 5 disorders specific to cats.

A 
Granulomatous nephritis --> FIP (non-effusive form)
Renal lymphosarcoma
Feline Lower UT Dz (FLUTD)
Hemorrhagic urocystitis 
Toxic tubulointerstitial nephritis
266
Q

FLUTD is most commonly seen in what cats?

A

middle-aged, overweight cats w/ little exercise, indoor litter box & dry food diet

267
Q

What is the term for a collection of diseases affecting the urethra & bladder of cats?

A

feline lower urinary tract disease (FLUTD)

268
Q

3 things that cause FLUTD in cats?

A

Feline idiopathic cystitis
urolithiasis
chronic &/o recurring bacT UTIs

269
Q

Older male acts typically form ____ calculi leading to urethral obstruction.

A

struvite

270
Q

In what cats may inflammation predispose to formation of protein matrix plugs?

A

younger male cats

271
Q

What is the consequence of urethral obstruction in male cats?

A

hemorrhagic urocystits

272
Q

Pathology of hemorrhagic urocystitis.

A

urinary bladder becomes severely distended leading to pressure necrosis, hemorrhagic & ulceration

273
Q

Chronic fibrosis limits bladder ____ & leads to poor ____ voiding & increased susceptibility to ____ infections.

A

fxn
urine
bacterial

274
Q

3 things that cause toxic tubulointerstitial nephritis in cats

A

ethylene glycol toxicosis
melamine & cyanuric acid
lily toxicity

275
Q

List the 15 disorders specific to dogs

A 
Greyhound cutaneous glomerular vasculopathy
Ethylene glycol toxicity
Aminoglycoside toxicosis
Leptospirosis
Infectious K9 hepatits
K9 herpesvirus 
Pyelonephritis
Progressive juvenile nephropathy
Urolithiasis
Chronic urocystitis
Transitional cell carcinoma
Renal carcinoma
Toxic tubulointerstitial nephritis
Grape or raisin toxicity 
Giant kidney worm
276
Q

What is a rare idiopathic vascular dz w/ genetic predisposition in Greyhounds?

A

Cutaneous Glomerular Vasculopathy

277
Q

Lesions seen in Greyhounds w/ Cutaneous Glomerular Vasculopathy.

A

glomerular thrombotic microangiopathy (can look like DIC)

278
Q

Why is ethylene glycol (antifreeze) so toxic to dogs?

A

Readily absorbed by the GIT & converted to toxic metabolites by hepatic alcohol dehydrogenase

279
Q

What is the degree of nephrotoxicity of aminoglycosides in dogs. (-mycins)

A

Neo> Kana>Genta> Strepto> Tobra> Amikacin

280
Q

Aminoglycoside toxicosis causes what 2 things in dogs?

A

acute tubular degeneration & necrosis

281
Q

What other parts of the dog’s body can be affected by aminoglycoside toxicosis?

A

inner ear

neuromuscular jxn

282
Q

2 most common Lepto isolates in dogs?

A

L. icterohaemorrhagiae

L. canicola

283
Q

How do dogs pick up Leptospirosis?

A

infections obtained from wet, contaminated environments through compromised mucus membranes

284
Q

Where does Lepto persists in dogs?

A

renal tubular epithelial cells

285
Q

C.S. of Leptospirosis in dogs?

A 
fever
anorexia
vomiting
dehydration
icterus
mm. pain
bleeding
286
Q

Chronic causes of Lepto in dogs will present with what 2 signs.

A

wt loss

sometimes uveitis

287
Q

Lepto causes what 2 things in dogs

A

acute tubular damage

acute to chronic tubulointerstitial nephritis

288
Q

Is Lepto zoonotic?

A

Yes!!

289
Q

How do young puppies (< 6 wks) get K9 herpesvirus?

A

due to intrauterine or neonatal infection from the dam w/ CHV-1

290
Q

K9 herpesvirus causes what?

A

multifocal acute tubular necrosis w/ hemorrhage

291
Q

CHV-1 neonatal mortality is associated in puppies w/ _____.

A

HYPOthermia

292
Q

Most common organisms to cause pyelonephritis in dogs

A 
E. coli
S. aureus
P. mirabilis
Strept sp.
K. pneumoniae
P. aeruginosa
Enterobacter sp.
293
Q

CS of pyelonephritis in dogs.

A

fever
depression
arched back
PU

294
Q

When is pyelonephritis likely to occur in dogs?

A

when there is altered lower UT defense

295
Q

Inherited disorder in dogs leading to development of severe bilateral renal fibrosis, dysplasia & progressive loss of fxnal nephrons.

A

progressive juvenile nephropathy

296
Q

Progressive juvenile nephropathy clinical resembles what?

A

CRF & end-stage kidney

297
Q

Variable degrees of severity w/ progressive fibrosis leading to progressive loss of renal fxn in younger dogs.

A

progressive juvenile nephropathy

298
Q

What breeds of dogs are over-represented w/ progressive juvenile nephropathy?

A

samoyeds
bull terriers
shih tzus

299
Q

4 most common uroliths in dogs

A

struvite
urate
xanthine
cystine

300
Q

What 2 dog breeds are predisposed to urate calculi due to inefficient hepatic uric acid metabolism?

A

Dalmatians

English bulldogs

301
Q

Therapy for Dalmatians & English bulldogs w/ inefficient hepatic uric acid metabolism

A

low purine diets

Allopurinol –> lowers uric acid in blood

302
Q

2 main dog breeds that are genetically predisposed to Ca oxalate urolithiasis.

A

Mini Schnauzers

Bichon Frises

303
Q

What common symptoms to dogs develop with chronic urocystitis?

A

lymphofollicular & polypoid cystitis

hematuria

304
Q

What is the most common primary kidney neoplasm in dogs?

A

renal dogs

305
Q

Renal carcinoma occurs sporadically in ____ dogs.

A

older

306
Q

Where can renal carcinoma metastasize to? (4)

A

lungs
lymph nodes
liver
adrenal glands

307
Q

What cause distal tubular necrosis with characteristic irregular brown birefringent crystals in dogs? (TQ)

A

Melamine & Cyanuric acid toxicosis from contaminated pet food

308
Q

Ingestion of grapes/raisins by dogs leads to these 3 things.

A

acute renal failure
uremic syndrome
diarrhea

309
Q

What is the kidney worm that affects mostly fish eating mammals, especially dog & mink?

A

Dioctophyma renale

310
Q

What may be the only initial C.S. of D. renale (giant kidney worm) infection?

A

hematuria

311
Q

D. renale causes what 2 things in dogs.

A

hemorrhagic & purulent pylitis

hydronephrosis due to obstruction

Pathology (13 decks)

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