Formative MCQ

Question 1

Acidosis is a feature of acute renal failure BECAUSE in acute renal failure the excretion of hydrogen ions is reduced.

Answer 1

True True Reason is a correct explanation

Question 2

On the following transverse image of both kidneys of a cat, which appear normal, identify the following structures by selecting the appropriate label and placing it in to the correct text box.

Answer 2

Question 3

Ethylene glycol toxicity in a cat. Common clinical signs?

Answer 3

Anuria.

Reduced or complete absence of urine production are hallmark features of acute renal failure induced by toxins

Question 4

Exertional rhadomyolysis in the horse. Common clinical signs?

Answer 4

Myoglobinuria.

While it’s difficult to distinguish haemoglobin from myoglobin on a dipstick test, it is actually myoglobinuria (from muscle breakdown) that occurs in this condition

Question 5

Idiopathic cystitis in the cat. Clinical signs?

Answer 5

Pollakiuria.

These cats don’t urinate greater volumes but they do have increased frequency of urination

Question 6

Familial nephropathy in a young dog.Clinical signs?

Answer 6

Proteinuria.

Proteinuria (without haemaglobinuria or infection to explain it) is a feature of most of these diseases

Question 7

Which breed of dog is most commonly affected by fanconi’s syndrome?

Answer 7

Basenji.

Question 8

When performing an ultrasound examination of the kidneys of a cat, which probe frequency would you select?

Answer 8

7.5 MHz

Remember higher frequency probes will produce more detailed images but with less penetration A 5 MHz probe would produce an image, but the quality would be unlikely to be diagnostic.
10 MHz probe would produce a high quality image, but would be used after a survey scan with a 7.5 MHz
12.5 MHz is not routinely used in small animal practice ). If you are struggling with this go and have a look at the routine probe sizes on our ultrasound machines and check with your notes which ones are used for what

Question 9

Which of the following is a cause of post-renal proteinuria?

1. Infection of the lower urinary tract.
2. Idiopathic renal haemorrhage.
3. Tubular nephropathy.
4. Multiple myeloma.
5. Hyperglobulinaemia.

Answer 9

Infection of the lower urinary tract.

Post renal= after the kidneys therefore this is something in the lower urinary tract. this eliminates all bar lower urinary tract infection as the answer

Question 10

Which method of urine sampling is the preferred one for collecting urine for culture and sensitivity in a male cat?

Answer 10

Cystocentesis.

You want as uncontaminated a sample as possible for culture and sensitivity. Therefore cystocentesis (taken directly with a needle from the bladder) is the preferred method.

Question 11

Which of the following is the CORRECT definition of renal agenesis?

1. Failure of kidney formation.
2. Absence of the kidneys.
3. Reduced development of the kidney.
4. Failure of the formation of the normal kidney.

Answer 11

Failure of kidney formation.

Question 12

Which of the following urine specific gravities would you expect in a dog with pre-renal renal failure?

1. 1.000
2. 1.008
3. 1.010
4. 1.040
5. 1.018

Answer 12

1.040

Pre-renal= before the kidneys. This means something that has affected the blood volume reaching the kidneys for filtration. The kidneys themselves are working normally so will concentrate the urine in response to the decreased blood volume/blood pressure, therefore you have a concentrated USG in pre-renal renal failure.

Question 13

Which antibiotic produces a direct toxic effect on the cortical cells of the kidney, related to the duration of exposure?

Answer 13

Gentamycin

Gentamycin is the only antibiotic which is directly toxic to the kidney

Question 14

Which of these statements describes the pathophysiology of proteinuria in glomerular disease?

1. There is increased perfusion to the kidneys enabling proteins to be forced through the filtration system
2. There is decreased perfusion to the kidneys which enables proteins to slip through the filtration system
3. There is damage to the flomeruli which enables proteins to leak through the filtration system
4. Toxins produced by te diseased kidneys cause proteins to be cleaved allowing their smaller components to pass through the filtration system

Answer 14

There is damage to the glomeruli which enables proteins to leak through the filtration system

Question 15

A cat presents to you with metabolic acidosis and a high anion gap.

Which of the following is a cause of such a result?

1. Ethylene glycol ingestion
2. Diarrhoea
3. Hyperkalaemia
4. Vomiting

Answer 15

Ethylene glycol ingestion

Classic causes of a high anion gap are LUKE – lactate, uraemia, ketones and exogenous toxin ingestion. There are many more causes of metabolic acidosis so quantifying the anion gap can help to narrow down your differential list.

Question 16

Which of the following would you use to confirm a suspicion of gout in avians?

1. Lime sulphur test
2. Murexide test
3. Urine culture
4. PARR
5. Creatinine quantification

Answer 16

Murexide test

Question 17

What is the most common pathologucal cause of PUPD in the horse?

1. Chronic kidney disease
2. Pars pituitary intemedia dysfunction
3. Diabetes mellitus
4. Hyperthyroidism
5. Liver failure

Answer 17

Pars pituitary intemedia dysfunction

PPID (equine Cushing’s) is by far the most common cause of PUPD in the horse, other than psychological causes which are not considered pathological. PPID in general is very common, especially in older horses and ponies. CKD, liver failure and DM are rare in the horse and hyperthyroidism has only been reported in a handful of cases.

Question 18

In a case of Babesiosis in the cow, what would you primarily expect to find on urinalysis?

1. Erythrocytes
2. Leukocytes
3. Haemoglobin
4. Crystals

Answer 18

Haemoglobin

Question 19

Which is the most appropriate treatment protocol for cystitis in the horse?

1. Alkalinising diet + bladder lavage
2. Oral TMPS 4-6 weeks + bladder lavage
3. IVFT + bladder lavage
4. Oral allopurinol + bladder lavage

Answer 19

Oral TMPS 4-6 weeks + bladder lavage

Cystitis in the horse is usually secondary to other problems which disrupt the urinary tract lining, predisposing it to infection. The infections are usually mixed so TMPS as a broad spectrum antibiotic is a logical place to start, ideally followed by C&S. Alkalinising diets and allopurinol are treatments in dogs for certain types of urolithiasis and the horse with cystitis does not usually require fluid therapy.