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E&E Exam 4 > Clinical Pathology > Flashcards

Clinical Pathology Flashcards

1
Q

Define pollakiuria

A

Increased frequency of urination with normal urinary volume

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2
Q

Within what time frame should urine be analyzed when stored at room temperature vs. refrigerated?

A

Room temp -> within 30 minutes
Refrigerated -> within 12 hours

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3
Q

What is an artificial change on urinalysis that can be seen if urine samples were stored in the refrigerator?

A

Crystalluria

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4
Q

What effect does delayed analysis have on urine pH and USG?

A

Increased

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5
Q

T/F: Prolonged storage or urine in snow in horses can discolor urine to red-brown.

A

T

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6
Q

In which species is a slightly hazy to turbid urine sample considered normal?

A

Horses

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7
Q

Why is it preferred to use a veterinary-calibrated refractometer, especially in cats?

A

Will overestimate USG in cats

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8
Q

If a patient is PU/PD, would you expect their USG to be high or low?

A

Low

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9
Q

What 4 values are unreliable on urine dipsticks in animals?

A

USG, Urobilinogen, Nitrite, and WBC/leukocyte esterase

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10
Q

What is the typical urine pH in dogs and cats?

A

6.0-7.5

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11
Q

What is the typical urine pH in horses and cattle?

A

7.5-8.5

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12
Q

After meals in monogastrics can cause an acidotic/alkaline tide. (choose one)

A

Alkaline tide

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13
Q

Why might dogs/cats with UTIs have an alkaline urine?

A

Urease-containing bacteria

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14
Q

Why might off-the table urine samples give a false positive glucose in urine?

A

Bleach and hydrogen peroxide used to clean tables can falsely elevate glucose levels in urine

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15
Q

Which is more sensitive to cholestasis, bilirubinemia or bilirubinuria?

A

Bilirubinuria

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16
Q

Trace to 1+ protein and bilirubin in dogs is considered normal if the urine is concentrated/dilute. (choose one)

A

Concentrated

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17
Q

Alkaline urine can falsely elevate protein in urine. What test must you run to confirm the presence of proteinuria?

A

SSA test

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18
Q

What are 3 potential causes for increased glucose in urine?

A

Hyperglycemia (stress vs. DM), fanconi syndrome (rare), and some antibiotics (amoxicillin, gentamycin)

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19
Q

What are 2 general causes for increased ketones in urine?

A

Diabetes mellitus and/or negative energy balance

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20
Q

What are 2 general causes for bilirubinuria?

A

Hemolysis or hepatobiliary disease (cholestasis)

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21
Q

What is glomerular proteinuria the result of?

A

Glomerular disease -> leakage of high molecular weight proteins (primarily albumin)

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22
Q

What are 4 potential causes for glomerular proteinuria?

A

Glomerulonephritis, hypertension, CKD, and amyloidosis

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23
Q

What is tubular proteinuria the result of?

A

Tubular dysfunction -> impaired resorption of low molecular weight proteins

24
Q

What test can be performed to differentiate glomerular or tubular proteinuria?

A

UPC

25
Q

What should UPC not be used with?

A

Active urine sediment (pyuria, hematuria) and hemoglobinuria or myoglobinuria -> will falsely elevate protein

26
Q

A UPC >3 and hypoalbuminemia is indicative of glomerular or tubular proteinuria?

A

Glomerular proteinuria

27
Q

What are the 4 criteria for nephrotic syndrome?

A
  1. Proteinuria
  2. Hypoalbuminemia
  3. Hypercholesterolemia
  4. Edema
28
Q

What is a type of pre-renal proteinuria seen with multiple myeloma that may not be detectable with urine dipstick or SSA test?

A

Bence-Jones proteinuria

29
Q

You performed a cystocentesis and see 3-4pf squamous epithelial cells. Is this significant?

A

Yes - shouldn’t see squamous epithelial cells from cysto

30
Q

In what species are calcium carbonate crystals normal?

A

Horses, rabbits, and guinea pigs

31
Q

What type of crystals are uncommon in healthy dogs and cats with the exception of bulldogs and dalmations?

A

Ammonium urate crystals

32
Q

If ammonium urate crystals are seen in a urine sample from a healthy dog/cat (not dalmation or bulldog), what is it indicative of? 2 answers.

A

PSS or liver insufficiency

33
Q

What are high numbers of calcium oxalate monohydrate crystals associated with?

A

Ethylene glycol toxicity

34
Q

T/F: Crystals in urine means there are uroliths

A

F

35
Q

If there are uroliths, do the crystals seen in the urine sediment indicate the type of crystals in the urolith?

A

No -> need to send the stone in for evaluation of its composition

36
Q

Azotemia indicates increased/decreased GFR

A

Decreased

37
Q

What are non-renal causes of an increased BUN? 2 answers.

A

GI hemorrhage or high protein diets

38
Q

What is a decreased BUN indicative of?

A

Liver insufficiency (can’t convert ammonia to urea)

39
Q

Which serum analyte is more sensitive for decreased GFR and only requires 25% functional loss of nephrons?

A

SDMA

40
Q

What is a USG <1.007 called?

A

Hyposthenuria

41
Q

What is a USG 1.007-1.013 called?

A

Isosthenuria

42
Q

What is a USG >1.0.35 (dog) or > 1.030 (cat) called?

A

Hypersthenuria

43
Q

What is the most common cause of pre-renal azotemia?

A

Decreased renal perfusion (dehydration, hypovolemia, etc.)

44
Q

What do you expect the USG to be when there is pre-renal azotemia?

A

Hypersthenuria

45
Q

What is the cause of renal azotemia? Generally speaking.

A

Any disease causing at least 75% loss of nephrons

46
Q

What do you expect the USG to be when there is renal azotemia?

A

Isosthenuria or minimally concentrated urine

47
Q

What electrolyte abnormality is most suggestive of post-renal azotemia?

A

Hyperkalemia

48
Q

What is a common cause of post-renal azotemia?

A

Urinary tract obstruction

49
Q

What are 3 clinical signs that are often suggestive it is post-renal azotemia?

A

Oliguria, stranguria, anuria

50
Q

What 4 electrolyte abnormalities would you expect on chemistry with post-renal azotemia?

A

Hyponatremia, hypochloremia, hyperkalemia, and hyperphosphatemia

51
Q

What test (although not used much anymore) is used for non-azotemic patients with PU/PD and hyposthenuria to differentiate between psychogenic polydipsia, central diabetes insipidus, nephrogenic diabetes insipidus, and medullary washout?

A

Water deprivation and ADH response tests

52
Q

What CBC abnormality can be noted in end-stage CKD due to decreased EPO production?

A

Non-regenerative anemia

53
Q

Describe the differences in urine volume of patients with acute renal failure vs. chronic renal failure

A

Acute - oliguric to anuric
Chronic - polyuric most often (note end-stage CKD can progress to oliguric or anuric)

54
Q

Is the presence of proteinuria a negative prognostic indicator for acute renal failure or chronic renal failure?

A

Chronic renal failure

55
Q

Differentiate the potassium values of patients with acute renal failure vs. chronic renal failure

A

Acute - normal to hyperkalemic
Chronic - normal to hypokalemic

56
Q

Differentiate kidney size in patients with acute renal failure vs. chronic renal failure

A

Acute = +/- enlarged and/or painful kidney
Chronic = usually small and lumpy

57
Q

T/F: Any amount of protein in urine is significant with isosthenuria.

A

T

E&E Exam 4 (5 decks)

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