Exam II Material

Question 1

Yellow-orange coloration of urine indicates the presence of:

Answer 1

bilirubin

Question 2

Yellow-green/Yellow-brown coloration of urine indicates the presence of:

Answer 2

bilirubin & biliverdin

Question 3

Red coloration of urine indicates the presence of:

Answer 3

RBCs, Hemoglobin, & Myoglobin

Question 4

Red-Brown coloration of urine indicates the presence of:

Answer 4

Methemoglobin

Question 5

T/F: Horse urine tends to be turbid/cloudy normally

Answer 5

True

Question 6

Name a few things that may cause cloudiness or turbidity of urine:

Answer 6

Cells, crystals, bacteria, casts, & lipid droplets

Question 7

Specific gravity of urine is created by dissolved ions and molecules. USG should only be measured on room temperature urine.

Cold fluids are more dense, and falsely ________ urine specific gravity.

(increase or decrease)

Answer 7

Cold fluids are more dense, and falsely increase urine specific gravity.

Question 8

Which USG value would indicate adequate concentrating ability in a dog?

Answer 8

> 1.030

Question 9

Which USG value would indicate adequate concentrating ability in a cat?

Answer 9

> 1.035

Question 10

Which USG value would indicate adequate concentrating ability in horses & cattle?

Answer 10

> 1.025

Question 11

Name your top differentials for hyperglycemic glucosuria:

Answer 11

• Diabetes Mellitus
• Hyperadrenocorticism
• Drugs (dextrose, glucocorticoids, progesterone)
• Postprandial
• Acute Pancreatitis
• Extreme Stress
• Pheochromocytoma
• Glucagonoma
• Head Trauma

Question 12

Name your top differentials for normoglycemic glucosuria:

Answer 12

Question 13

T/F: In dogs, it is normal to expect bilirubinuria before bilirubinemia

Answer 13

True

**In any other species, bilirubinuria is ABNORMAL**

Bilirubinuria could be due to liver disease, bile duct obstruction, hemolysis, etc.

Question 14

Ketogenesis produces 3 kinds of “ketone bodies.” Only two of them are true ketones (and are detected by the dipstick). What are the two true ketones?

Answer 14

Acetoacetic acid and acetone

Question 15

T/F: Ketogenesis produces 3 kinds of ketone bodies: β-hydroxybuterate, acetoacetic acid, & acetone. All three are detected by dipstick.

Answer 15

False

Only acetoacetic acid & acetone are detected by dipstick.

β-hydroxybuterate is not detected

Question 16

What is the predominant type of ketone body seen in ruminants?

Answer 16

β-hydroxybuterate

You should expect to see β-hydroxybuterate in bovine ketosis and pregancy toxemia in ewes

Question 17

Ketonuria is indicative of excessive/defective lipid or carbohydrate metabolism and is detected prior to ketonemia.

Which two differentials should be high on your list for ketonuria?

Answer 17

Negative energy balance and Diabetic Ketoacidosis [DKA]

Question 18

Blood is detected on urine dipstick.

T/F: if it is due to hematuria, it will clear with centrifugation

Answer 18

True

Question 19

Name a few causes of hematuria:

Answer 19

Trauma, infection, inflammation, infarction, calculi, neoplasia, coagulopathy

Question 20

What color would you expect the urine to be in the case of hemoglobinuria?

Answer 20

Reddish-brown

**The urine supernatant will NOT be clear after centrifugation! It will still be red colored!**

Question 21

What is the normal pH for the urine of dogs & cats?

Answer 21

6.5 - 7.5

Question 22

What is the normal pH for the urine of horses & cows?

Answer 22

7.5 - 8.5

Question 23

Urine dipstick analysis is insensitive to Bence Jones proteins and globulins. Which test would you use instead to detect these proteins?

Answer 23

Sulphosalicylic Acid Test

Question 24

What is the most common type of crystal found in the urine of dogs and cats?

Answer 24

Struvite

Struvite crystals are large, prism-like crystals (“Coffin lids”) and can be found in clinically normal patients

Question 25

Upon urinalysis, you note orange-copper colored granules present in small bundles. What type of crystals are these?

Answer 25

**Bilirubin**

Question 26

After doing urinalyses on many of the animals in your guinea pig and goat farm, you notice the large spherical crystals with radial striations in the urine. What type of crystals are they?

Answer 26

**Calcium Carbonate** Calcium carbonate crystals are normal in horses, rabbits, guinea pigs, and goats. There are no reports in canine or feline urine

Question 27

Upon urinalysis of your Miniature Schnauzer, you notice colorless squares that looked like little envelopes. What are these crystals?

Answer 27

**Calcium oxalate dihydrate**

Question 28

Which canine breed is predisposed to calcium oxalate urolithiasis?

Answer 28

**Miniature Schnauzers**

Question 29

The presence of renal casts in the urine is referred to as:

Answer 29

**Cylindruria**

Question 30

T/F: It is normal to see 1 renal cast per low powered field (LPF) when performing a urinalysis

Answer 30

**True** \<2/LPF is normal \>2/LPF is abnormal and is indicative of proteinuria of renal or extra-renal disease

Question 31

T/F: Epithelial casts and fatty casts are a good indicator of the extent of renal injury

Answer 31

**False** They are indicative of ***active tubular degeneration or necrosis***, but are NOT evidence of extent or reversibility of injury

Question 32

What is the significance of **WBC casts** in a urine sample?

Answer 32

**tubular inflammation** The presence of WBC casts in a urine sample is indicative of tubular inflammation (e.g. pyelonephritis)

Question 33

What is the significance of **RBC casts** in a urine sample?

Answer 33

**tubular hemorrhage** The presence of RBC casts in a urine sample is indicative of tubular hemorrhage (e.g. pyelonephritis)

Question 34

T/F: **Waxy casts** are always of pathologic significance and are associated with chronic renal disease

Answer 34

**True**

Question 35

Which USG range is associated with isosthenuria?

Answer 35

**1.008 - 1.012**

Question 36

Which USG range is associated with **hyposthenuria**?

Answer 36

**USG \< 1.007**

Question 37

Though rarely seen, which type of crystal are you most likely to find in the urine associated with ethylene glycol toxicosis?

Answer 37

**Calcium oxalate monohydrate**

Question 38

What is the top differential for pre-renal azotemia along with ↑BUN?

Answer 38

**Upper GI Bleed**

Question 39

What is the top differential for pre-renal azotemia along with ↓ GFR

Answer 39

**Dehydration**

Question 40

T/F: In a dehydrated animal with normal renal function, urine volume is decreased and USG is increased

Answer 40

**True**

Question 41

**Renal Azotemia** implies \_\_\_% loss of functioning nephrons

Answer 41

Renal Azotemia implies **_75%_** loss of functioning nephrons ## Footnote *\*\*the remainder undergo functional hypertrophy\*\**

Question 42

T/F: An animal with azotemia and inappropriately low USG is always in renal failure

Answer 42

**False**

Question 43

T/F: Origin of azotemia may be determined by the USG

Answer 43

**True**

Question 44

T/F: Poluria occurs before azotemia

Answer 44

**True**

Question 45

If your patient has azotemia and isosthenuria, it is safe to assume they have renal disease until proven otherwise. It urine is **not** concentrated, the cause of azotemia is *probably* renal. Which species are an exception to this rule?

Answer 45

**Cats** Cats can maintain some concentrating capacity with renal failure

Question 46

What is the clinical significance of **decreased CREA**?

Answer 46

**None!**

Question 47

On a serum protein electrophoresis, which globulin fraction do we find immunoglobulin molecules?

Answer 47

**gamma globulin**

Question 48

What would you expect to see with regard to albumin and globulin levels in a foal with failure of passive transfer (FPT)?

Answer 48

**normal albumin, decreased globulin**

Question 49

T/F: Blood loss (hemorrhage) and protein-losing glomerulopathy are typically characterized by proportional decreases in both albumin & globulin

Answer 49

**False** **Blood loss (hemorrhage) and protein-losing *enteropathy*** are both typically characterized by ↓ albumin and ↓ globulin

Question 50

Where is urea synthesized and what is the precursor molecule?

Answer 50

**Liver, ammonia**

Question 51

What does 'discrete' mean?

Answer 51

apart or detached from others