Exam 2 Flashcards Preview

Urinary > Exam 2 > Flashcards

Flashcards in Exam 2 Deck (39)
Loading flashcards...
1

How do renal insufficiency and renal failure differ in regard to amount of nephrons lost?

insufficiency--66% (2/3) are lost

failure--75% (3/4) are lost (azotemic)

2

What amount would be considered polyuric in small animals?

>50ml/kg/day

3

If azotemia is present, you would expect the USG to be at least ______ to call it pre-renal

*Give value for both dog and cat

dog: >1.030

Cat: >1.035

4

What are the 4 phases of renal failure

induction
extension
maintenance
recovery

5

4 most likely causes of death during initial management of acute renal failure in small animals

1) hyperkalemia
2) metabolic acidosis
3) severe azotemia
3) overhydration/pulmonary edema

6

When selecting fluid therapy for acute renal failure, what two things influence your choice?

1) acid/base status of patient
2) electrolyte status of patient

7

concerning fluid composition, which fluid:
1) has highest Na concentration? lowest?
2) has highest pH? lowest?

1) highest= 0.9% NaCl;
lowest= LRS

2) highest= plasma (7.4)
lowest= 0.9% NaCl (5.6)

8

What 3 components of fluid therapy do you add together to determine amount needed

rehydration volume
maintenance volume
estimated ongoing losses

9

Concerning fluid calculations:
1) how do you calculate fluids needed for dehydration?
2) what is the maintenance rate for dogs? Cats?

1) bodyweight(kg) x (%dehydration)= total deficit in L (convert!!!! x1000 to ml)

2) dogs= 60ml/kg/day
cats= 40ml/kg/day

10

Which treatment for hyperkalemia does NOT alter serum K levels? What does it do instead?

10% Ca gluconate

cardioprotective--protects heart from effects of hyperkalemia

11

When managing oliguric renal failure, how does your fluid calculation change?

Instead of calculating dehydration deficit and replacing it, you measure the urine output and add that to maintenance and ongoing losses

*Delivered over 4hr*

12

When monitoring CVP for overhydration, you don't want it to be greater than?

8cm H2O

13

Fanconi syndrome primarily affects which breed? It's due to a defect in ______ ________

Basenji

proximal tubule

14

Staging of CKD is based on? What do we look at to determine substage?

based on creatinine levels

substage: is there presence of hypertension or proteinuria

15

cervical ventroflexion in cats is commonly due to which electrolyte abnormality?

Hypokalemia

16

What dietary factors in cats are risk factors for hypokalemia (3)

1) acidifying ingredients
2) low Mg
3) high protein

17

CKD diets should be low in (3 things) and high in (2 things)?

LOW:
--protein, phosphorous, Na

High:
--B vitamins, caloric density

18

Calcitriol would be contraindicated in CKD patients with which electrolyte abnormality?

Hyperphosphatemia

**remember, Vit D increases absorption of both Ca AND PO4 from gut...

19

Which medication commonly used to manage hypertension in CKD patients may potentiate hypokalemia

Amlodipine

20

Describe the how ACE inhibitors can be used to treat PLN. Name 2.

Two drugs: Benazepril, enalapril

they block formation of angiotensin II so there is no constriction of efferent arteriole--> decreased glomerular pressure

21

The 3 main categories of diseases assoc. with acute intrinsic renal failure (i.e. not pre or post-renal)

Acute glomerlonephritis

Acute interstitial nephritis

Acute tubular necrosis (majority*)

22

Concerning polycystic kidney disease (PKD):
1) what are the two forms of inheritance
2) which spp/breeds are predisposed to each form
3) what is the age (young or old) of those who get the different forms

1) Autosomal dominant and autosomal recessive

2) Dominant= bull terriers & persian cats

Recessive= west highland whites, Cairn terrier, perendale sheep

3) dominant= adults
recessive= young

23

What are the 3 components of the selective filtration system in the glomerulus

1) fenestrated endothelium
2) basement membrane
3) podocytes

24

What is the hallmark of glomerular disease?

proteinuria in the absence of urinary tract inflammation

25

Which disease of the glomerulus involves sticky of the basement membrane to bowman's capsule?

Focal segmental glomerulosclerosis

26

Where are the immune complexes deposited with:
1) membranoproliferative GN
2) membranous GN

1) subendothelial & mesangial (hypercellularity)

2) subepithelial (spikes with JMS stain)

27

Which form of amyloidosis is most common in animals?

Secondary (AA amyloidosis)

28

Two important metabolites of ethylene glycol

Glycoaldehyde
Glyoxylate

29

Pyelonephritis implies involvement of which two areas of the kidney

renal pelvis and renal parenchyma

30

How do embolic nephritis and pyelonephritis differ in their primary cause?

Embolic= secondary to bacteremia

Pyelonephritis= ASCENDING infection from cystitis

31

How does the appearance of an infarct vary based on the affected artery?

renal artery--entire kidney necroses

arcuate artery--wedge-shaped area in cortex and medulla (most common)

interlobular--necrosis of cortex only

32

What type of lesion/necrosis is seen in the kidney with NSAIDs

renal medullary/papillary necrosis

**blocked PGE2 production

33

For horses:
1) normal water intake
2) normal urine production

1) 40-60ml/kg/day (less if grazing, more if hot/lactating/working)

2) 15-30ml/kg/day

34

Normal USG for:
1) adult horses
2) foals

1) 1.020-1.050
2) 1.001-1.027

35

Most common cause of tubular necrosis in horses?

Aminoglycoside antimicrobials

36

If you are trying to improve renal perfusion and urine production in a horse secondary to aminoglycoside toxicity, which medication should you avoid?

Furosemide--exacerbates aminoglycoside toxicity

37

What are the 3 hallmarks of chronic interstitial disease in horses

azotemia
hypercalcemia
USG 1.008-1.014

38

What are the 2 forms of renal tubular acidosis in horses and how do they differ?

RTA I--can't excrete hydrogen

RTA II--can't reabsorb bicarb

39

What is considered a low USG in food animals?

<1.020