Exam 2 Flashcards
(107 cards)
1
Q
What are the homeostatic functions of the renal system
A
Acid-base, fluid, and electrolytes
2
Q
How does the kidney do its job
A
Blood filtration, reabsorption, secretion, fluid balance regulation, hormonal influence, and elimination of hydrogen and bicarbonate
3
Q
What is diuresis
A
Excessive production of urine
4
Q
What is oliguria
A
Low urine output
5
Q
What is anuria
A
Failure to produce urine from the kidneys
6
Q
What is the kidneys hormonal influence on the body
A
Responses to ADH and aldosterone and produces renin, erythropoietin, and prostaglandins
7
Q
What is the only species where the right kidney is not more cranial than the left
A
The pig
8
Q
What are the 2 different types of kidneys
A
Multilobar and unilobar kidneys
9
Q
What is the functional unit of the kidney
A
The nephron
10
Q
What are the parts of the nephron in the renal cortex
A
Bowman’s capsule, glomerulus, PCT, and DCT
11
Q
What are the two things in the renal medulla
A
Loop of Henle and collecting duct
12
Q
What are the basic steps in urine formation
A
Afferent arteriole, blood flow, efferent arteriole, reabsorption of solutes and water, peritubular capillaries, secretion of additional wastes, and excretion
13
Q
What are the 2 main things in the renal corpuscle
A
The glomerulus and Bowman’s capsule
14
Q
What is the glomerulus
A
The capillary bed in the kidneys
15
Q
What is the Bowman’s capsule
A
A double walled capsule that covers the glomerulus that has a inner visceral layer comprised of podocytes, capsular space that continues w/ the PCT, and an outer layer parietal layer
16
Q
What is the function of the renal corpuscle
A
To filter any small molecules from the blood going thru the glomerulus
17
Q
What is the proximal convoluted tubule
A
Longest part of the tubular system of the nephron that is primarily in the cortex and is comprised of cuboidal epithelium w/ a brush border
18
Q
What is the function of the PCT
A
To reabsorb tubular filtrate such as actively Na+ and Cl-, passively K+, Ca+2, and glucose and AA via sodium cotransport
19
Q
What is the loop of Henle
A
A continuation from the PCT into the medulla that has a thinner walled narrower lumen u-turn
20
Q
What is the function of the loop of Henle
A
Water and electrolyte balance and some reabsorption
21
Q
What is the distal convoluated tubule
A
Continuation of the ascending loop of Henle that is located in the cortex
22
Q
What is the function of the DCT
A
Water balance
23
Q
What do multiple DCTs converge into
A
A collecting duct
24
Q
What is the function of the collecting duct
A
Acid-base regulation, water balance, and some Na regulation
25
What are the two sites of ADH and aldosterone action in the kidneys
Primarily the collecting duct and minorly in the DCT
26
What is the path of developing/form urine
Multiple nephrons, collecting duct, papillary duct, minor calyx, major calyx, renal pelvis, and ureter
27
What does the sympathetic nervous system do in the kidneys
Vasoconstriction of renal vessels to decrease urine production
28
What is the blood flow in the kidney
Renal artery, afferent glomerular arterioles, efferent glomerular arterioles, peritubular capillaries, venules, and renal vein
29
What does the peritubular capillaries do in the nephron
Oxygen transfer to the nephron, tubular reabsorption, and tubular secretion
30
What is the only set of capillaries where oxygenated blood enters and exits
The glomerular capillaries
31
What is the difference in diameter btw the afferent and efferent arteriole
The diameter of the afferent arteriole is larger than the efferent to help w/ glomerular pressure for efficient filtration
32
What cannot be filtered in a normal glomerulus
RBCs, WBCs, and most plasma proteins
33
When do proteins leak into the glomerular filtrate
If there is endothelial damage
34
What is glomerular filtration rate
Volume of plasma that would have to be filtered by glomeruli each minute to account for the amount of a given substance to appear in the urine
35
What is the ultimate renal function test
GFR
36
What is the GFR influenced by
The hydrostatic pressure of blood in the glomerulus, oncotic pressure of the glomerular filtrate, filtration barrier permeability, filtration barrier area, and if kidney production has decreased
37
What does a high GFR reflect on kidney production
If the GFR is increased that means the kidney function is low
38
What things are reabsorbed by the ascending LOH and DCT
K+, CA+2, and Na+ that is exchanged for H+, ammonium, or K+
39
What is reabsorbed by the ascending LOH and the CD
Mg+2
40
What is the renal threshold
The limit to reabsorption by the kidney
41
What wastes products are secreted thru the DCT
H+, K+, ammonia, urea, penicillin, and sulfonamides
42
What are the 2 ways the kidneys maintain the acid-base balance of the body
Secrete H+ in the PCT and CD and reabsorb HCO3-
43
What are the urine pH buffers that bind the excess H+
Ammonia and phosphate
44
Where do ureters exit the kidneys
The hilus
45
Why are ureters comprised of smooth muscle
Because they use peristalsis to push the urine into the bladder
46
Where on the bladder does the ureter enter
The trigone
47
What does the detrusor muscle of the baldder contain that communicates w/ the CNS
Stretch receptors that activate a spinal reflex arc when full and the parasympathetic pelvic nerve
48
Where can you find an empty bladder in carnivores
The pelvic cavity and abdomen
49
What is the internal urethral sphincter
Comprised of smooth muscle at the neck of the bladder and cranial urethra and has an innervated by the parasympathetic pelvic nerve and hypogastric sympathetic nerve
50
What is the external urethral sphincter
Striated urethral sphincter comprised of the urethralis muscle encircles the caudal urethra and is innervated by the pudendal somatic nerve
51
What are urethral characteristics in females
Shorter, wider, and straighter that exits the pelvic canal ventrally in the vestibule
52
What are urethral characteristics of males
Longer, narrower, and curved in males that is broken up into the prostatic, membranous, and penile urethra
53
What is the external opening of the urethra reffered to
The urinary meatus or external urethral orifice
54
What are common urinary tract diseases
UTIs, urinary calculi (stones), urinary incontinence, feline lower urinary tract disease (FLUTD), prostatic disease, and renal failure, and glomerulonephropathy
55
What are diagnostics for suspected urinary cases
UA, culture/sensitivity, blood chemistry profile, rads, and ultrasound
56
What are we looking for in a UA and culture/sensitivity
Infection, pH abnormality, crystalluria, and concentration
57
What are we looking at on a blood chemistry profile in urinary cases
Blood urea nitrogen (BUN), creatinine, SDMA, HCT, PCV, RBC, and WBC
58
What are looked at in rads for urinary cases
Kidney size, shape, number, and location and bladder size, shape, density, and location
59
What are we looking at in ultrasounds in urinary cases
Kidney and bladder internal structures
60
What is the type of microorganisms are looked for in a urine culture and what does it tell us
Aerobic and it tells us what antibiotics the bacteria is sensitive to
61
What are common causes of renomegaly
Neoplasia, hydronephrosis, perirenal cyst, and pyelonephritis
62
What patients are more likely to get UTIs
Females are more likely than males, dogs are more likely than cats, and older cats are more likely than younger cats
63
What is feline lower urinary tract disease
FLUTD is lower urinary tract inflammation that is present in most overweight male cats above 3 years of age
64
What are causes of FLUTD
Feline idiopathic cystitis (FIC) is secondary to stress/anxiety, struvite crystalluria, urolithiasis, mucus plug, and rarely a UTI
65
How do you treat FLUTD
Specific to underlying cause, may involve anti-anxiety supplements/medications, stress reduction in home, diet change, increased water consumption, and urine pH management
66
What surgery can be done to treat FLUTD
Perineal urethrostomy if there is a severe or repeated urinary blockage
67
What value will show kidney disease earliest
SDMA
68
What are the different types of uroliths
Nephrolith/renolith, ureteroliths, cystoliths, and urethroliths
69
What breeds are more likely to get uroliths
Miniature schnauzer, shih tzu, miniature poodles, and cocker spaniels
70
What type of urine are struvite uroliths typically found w/
UTIs w/ alkaline urine
71
How can you diagnosis struvite uroliths
Radiographs, ultrasound, urinalysis, and palpation
72
How can you treat struvite uroliths
Dissolution w/ special diet and antibiotics, cystotomy, urohydropropulsion, urethrotomy/urethrostomy
73
What does the dissolution treatment do to break down uroliths
Promote acidic urine and restrict protein, phosphorus, and magnesium
74
What type of urine can cause calcium oxalate uroliths
Acidic urine
75
How can calcium oxalate uroliths be diagnosised
Rads, ultrasound, and UA
76
How can calcium oxalate uroliths be treated
Diet to prevent future stones, B6 or hydrochlorothiazide, urohydropropulsion, cystotomy, urethrotomy/urethrstomy
77
What causes urate uroliths
High excretion of ammonium biurate crystals
78
What can increase the risk of getting urate uroliths
Portosystemic shunt and being a dalmatian
79
How can urate uroliths be diagnosised
Radiolucent so ultrasound is best
80
How do you treat urate uroliths
Urohydropropulsion, cystotomy, and urethrotomy/urethrostomy
81
What can increase the risk of cystine uroliths
Excessive elimintaion of cystine such as disorder of renal tubular transport, high concentrations of cystine in an acidic environment, and in male dachshunds 3-6 yrs
82
How can cystine uroliths be diagnosised
Stones may be difficult to see on rads and ultrasound
83
How can cystine uroliths be treated
Urohydropropulsion, cystotomy, and urethrotomy/urethrostomy
84
What can we link w/ the formation of silicate uroliths
Corn gluten and soy bean hull consumption
85
What breeds are specifically prone to silicate uroliths
German shepherds, old english sheepdogs, shih tzus, and labs
86
How can silicate uroliths be diagnosised
Radiographs and ultrasound
87
How can silicate uroliths be treated
Urohydropropulsion, cystotomy, urethrotomy/urethrosotomy, and alkalinzing urine can help prevent in the future
88
What are the 3 types of urethral catheters we can use for unblocking cats
Tom cat, slippery sam, and milia
89
What urethral catheters do we typically use for unblocking dogs
Red rubber catheter and a foley catheter
90
What are neurogenic reasons for urinary incontinence
IVDD, trauma, degenerative myelopathy, and malformed spinal cord
91
What are non neurogenic issues that lead to urinary incontinence
Urethral sphincter mechanism incompetence, ectopic ureters, UTI, urethroliths or urethral disease
92
How can you treat spay incontinence
Diethylstilbestrol (DES), phenylpropanolamine (proin and proin ER), and estrogen
93
What are causes of prostatic disease
Prostatitis typically from infection, benign prostatic hyperplasia, and neoplasia
94
What are clinical signs of prostatic disease
Strangiuria, difficulty having bowel movements, hematuria, abdominal pain, and prostatomegaly on digital rectal exam
95
What can progression of renal disease lead to
Inability to excrete wastes or maintain homeostasis, azotemia, and then uremia/uremic syndrome
96
How much of renal function must be lost for clinical signs to begin
2/3
97
How can CKD be diagnosised
Clinical signs, CBC, chemistry, UA, UPC, rads, and ultrasound
98
What are treatments of CKD
To slow progression we can change the diet, subcutaneous fluids, and if hypertension is present we can give amlodipine (cats), enalapril (dogs), and telmisartan (cats)
99
What is the goal w/ changing the diet in CKD patients
Limit phosphorus and protein
100
What is uremia
Clinical sighs of dogs/cats w/ azotemia
101
What are clinical signs of uremic syndrome
Vomiting, nausea, anorexia, oral/lingual ulcerations, halitosis, lingual necrosis, gastroenteropathy, oliguria, anuria, dehyrdation, injected mm, melena, diarrhea, hypothermia, optic neuropathy, vision loss, and seizures
102
How can uremic syndrome diagnositics
CBC, chem, UA, abdominal radiographs, ultrasound, direct blood pressure, renal biopsy, screening for toxins, and fundic exam
103
What are treatments of uremic syndrome
IV fluids, correct hyperkalemia, correct metabolic acidosis, treat oliguria if not resolved, renal diet, feeding tubes, parenteral feeding, antiemetics, gastroprotectants, and dialysis
104
What is azotemia
Increased nitrogen containing compounds in the blood such as BUN and or creatinine
105
What is the classification of azotemia based on
Urine specific gravity
106
What are the USG vales for pre renal azotemia
>1.035 in dogs and >1.040 in cats
107
What is the range of USG values for renal azotemia
1.007
