Clinical Pathology

Question 1

How do polyuria and diuresis differ?

Answer 1

(They are both an increase in urine production but polyuria is due to a pathologic process and diuresis is due to a non-pathologic process)

Question 2

What is pollakiuria?

Answer 2

(Increased frequency of urination with a normal urinary volume)

Question 3

What is the term for decreased urine production and can be due to both pathologic and non-pathologic processes?

Answer 3

(Oliguria)

Question 4

What is the term for minimal to no urine production?

Answer 4

(Anuria)

Question 5

If you delay analyzing a urine specimen, the pH will increase or decrease (choose one).

Answer 5

(Increase)

Question 6

If you delay analyzing a urine specimen, the USG will increase or decrease (choose one).

Answer 6

(Increase)

Question 7

What is the usual USG value range for a euhydrated dog?

Answer 7

(1.015-1.045)

Question 8

What is the usual USG value range for a euhydrated cat?

Answer 8

(1.035-1.065)

Question 9

What is the usual USG range for a euhydrated horse?

Answer 9

(1.020-1.050)

Question 10

What is the usual USG range for a euhydrated cow?

Answer 10

(1.025-1.045)

Question 11

(T/F) USG and urine volume have an inversely proportional relationship i.e. if your urine output is low, your USG will be higher and vice versa.

Answer 11

(T)

Question 12

Leukocytes; nitrite; urobiligen; protein; pH; blood; USG; ketones; bilirubin; glucose

In the list of tests on the human dipstick above, which are unreliable for animal urine?

Answer 12

(Leukocyte/WBC, nitrite, urobilinogen, and USG)

Question 13

What can cause aciduria? Two answers.

Answer 13

(Acidosis (metabolic or respiratory) and paradoxical aciduria resulting from hypochloremia metabolic alkalosis (i.e. vomiting a lot that causes alkalosis can result in a paradoxical aciduria))

Question 14

What is an alkaline tide?

Answer 14

(An increase in pH after meals in monogastric animals)

Question 15

(T/F) Normal urine should not contain any glucose.

Answer 15

(T)

Question 16

What cleaning products can cause a false positive glucosuria?

Answer 16

(Bleach and hydrogen peroxide)

Question 17

(T/F) Ketones should not be present in the urine of healthy animals.

Answer 17

(T)

Question 18

If you have a proteinuria determined via dipstick but the urine was also alkaline as per the dipstick, what test do you need to run to confirm the proteinuria is not a false positive?

Answer 18

(SSA test)

Question 19

What is overflow proteinuria?

Answer 19

(Massive excretion of low molecular weight proteins → myoglobin, hemoglobin, Bence-Jones proteins, and colostrum)

Question 20

What type of proteinuria do tubulointerstitial nephritis, Fanconi syndrome, nephrotoxins, acute kidney insufficiency, and chronic kidney disease cause?

Answer 20

(Tubular proteinuria: tubular dysfunction → impaired reabsorption of LMW proteins)

Question 21

What causes post-renal proteinuria?

Answer 21

(Inflammation or hemorrhage → pyelonephritis, cystitis, urinary tract neoplasia, urolithiasis, FLUTD/FIC, prostatitis/vaginitis, etc.)

Question 22

What type of proteinuria is characterized by the leakage of high molecular weight proteins primarily albumin?

Answer 22

(Glomerular proteinuria: glomerular disease (glomerulonephritis, hypertension, CKD, amyloidosis, membranous nephropathy) → leakage of HMW proteins)

Question 23

What is the use of a urine protein creatinine ratio test?

Answer 23

(UPC is used to detect glomerular or tubular disease)

Question 24

When should a UPC not be used?

Answer 24

(If there is active urine sediment or if there is hemoglobinuria or myoglobinuria)

Question 25

How can you determine if the proteinuria your patient has is glomerular versus tubular?

Answer 25

(Glomerular proteinuria will result in a UPC >3 while tubular will have a UPC between 0.5-3)

Question 26

Does glomerular or tubular proteinuria lead to hypoalbuminemia?

Answer 26

(Glomerular)

Question 27

What are the four criteria for nephrotic syndrome?

Answer 27

(Proteinuria, hypoalbuminemia, hypercholesterolemia, and edema)

Question 28

What type of pre-renal proteinuria is seen with multiple myeloma?

Answer 28

(Bence-Jones proteinuria → overflow proteinuria)

Question 29

What test can be performed to detect Bence-Jones proteinuria?

Answer 29

(Urine protein electrophoresis and immunofixation)

Question 30

(T/F) It is normal to see squamous epithelial cells in free-catch and catheterized urine specimens.

Answer 30

(T but should be 0/lpf in a cystocentesis sample)

Question 31

Why does the presence of bacteria in the urine increase urine pH?

Answer 31

(Bacterial urease breaks urea down into ammonia which will increase urine pH)

Question 32

What does increased cyllindruria indicate?

Answer 32

(Renal tubular damage)

Question 33

What are the three types of crystals that are normally present in the urine of dogs and cats?

Answer 33

(Amorphous, small amounts of calcium oxalate mono/dihydrate, triple phosphate/struvite crystals)

Question 34

What diseases/disorders are indicated by the presence of ammonium urate crystals in urine?

Answer 34

(Portosystemic shunt and/or liver insufficiency)

Question 35

High numbers of calcium oxalate monohydrate crystals are associated with what toxicity?

Answer 35

(Ethylene glycol intoxication)

Question 36

(T/F) Crystals in urine typically means there is a urolith.

Answer 36

(F, crystals in urine do not mean there are uroliths)

Question 37

How can you determine the composition of the uroliths your patient has?

Answer 37

(Send it out for evaluation, this is the only way!)

Question 38

What is the term for increased non-protein nitrogenous compounds in the blood?

Answer 38

(Azotemia, specifically urea nitrogen and creatinine)

Question 39

What is uremia?

Answer 39

(Clinicals signs associated with renal failure → vomiting, diarrhea, coma, convulsions, ammonia odor to breath)

Question 40

What non-renal causes can increase a patient’s BUN?

Answer 40

(GI hemorrhage or a high-protein diet)

Question 41

How does liver insufficiency impact BUN values?

Answer 41

(It will decrease them because the liver converts ammonia to urea so if it is insufficient, that occurs at a lower rate and will decrease BUN)

Question 42

What are two cases in which an increased urine creatinine is expected?

Answer 42

(Healthy greyhounds (high muscle mass) and neonatal foals born to dams with a dysfunctional placenta (this should diminish rapidly after birth, if it doesn’t then that indicates a renal issue))

Question 43

Prerenal azotemia is characterized by increased BUN and/or creatinine, hyper or hyposthenuria (choose one), and a quiet urine sediment.

Answer 43

(Hypersthenuria)

Question 44

What are the three causes of prerenal azotemia?

Answer 44

(Decreased renal perfusion → dehydration, hypovolemia, cardiac insufficiency, shock, and blood loss; increased protein metabolism/catabolism → fever, starvation, necrosis, GI bleeding, hyperadrenocorticism; and decreased plasma oncotic pressure → severe hypoalbuminemia)

Question 45

Renal azotemia is characterized by increased BUN and/or creatinine, a quiet urine sediment, and what kind of urine concentration? Two answers.

Answer 45

(Isosthenuria or minimally concentrated urine)

Question 46

Post-renal azotemia is characterized by increased BUN and/or creatinine, a variable USG, and what on sediment?

Answer 46

(Depends on lesions location and duration → hematuria, casts, renal cells)

Question 47

What electrolyte abnormalities are associated with post-renal azotemia?

Answer 47

(Hyponatremia, hypochloremia, hyperkalemia, and hyperphosphatemia)

Question 48

What are water deprivation and ADH response tests used for?

Answer 48

(Non-azotemia patients with PU/PD and hyposthenuria → differentiates psychogenic polydipsia, central diabetes insipidus, nephrogenic diabetes insipidus and medullary washout)

Question 49

What are three causes for nephrogenic diabetes insipidus (a non-renal disease which decreases the kidneys response to ADH)?

Answer 49

(Hypercalcemia, canine pyometra, and hypokalemia)