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VM 610 Endocrine/Urology > Midterm > Flashcards

Midterm Flashcards

(93 cards)

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1
Q

What are examples/causes of prerenal, renal, and post renal acute kidney failure?

A

prerenal - inadequate renal perfusion, dehydration
renal - damage to kidney, lepto, toxins
postrenal - urine leakage, obstruction

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2
Q

What are the two most common causes of acute kidney injury?

A

nephrotoxins and ischemia

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3
Q

What are the criteria for diagnosing acute kidney injury/failure?

A

oliguria (can occur without), decreased GFR, inc creatinine, lack of anemia

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4
Q

What are the 5 goals for treatment of acute kidney failure?

A 
minimize further injury
correct ECF volume
hyperkalemia
acid-base imbalances
reduce nitrogenous and uremic waste
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5
Q

What is the clinical definition/signs of chronic renal disease?

A

existed for 3 months or reduction in GFR by 50%

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6
Q

What are the 6 types of chronic renal disease that are potentially reversible?

A 
bacterial pyelonephritis
obstructive uropathy
nephrolithiasis
renal lymphoma
perinephric pseudocysts
some glomerulopathies
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7
Q

What are the lab findings in a patient with CKD?

A 
azotemia
hyperphosphatemia
hyper/hypo calcemia and hypomagnesia
metabolic acidosis
hypokalemia
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8
Q

What are factors that cause progression of CKD?

A 
intraglomerular hypertension
glomerular hypertrophy
proteinuria
hyperlipidemia
uremic toxins
metabolic acidosis
chronic hypoxia
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9
Q

What are the two negative prognostic indicators for cats with CKD?

A

anemia and proteinuria

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10
Q

What are the two negative prognostic indicators for dogs with CKD?

A

proteinuria and arterial hypertension

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11
Q

What are the 4 goals of treating CKD?

A

improve c/s of uremia
fix electrolytes
nutrition
modify progression of CKD

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12
Q

What are the CS of a uremic crisis?

A

Pu/Pd, anorexia, vomiting, mucosal ulcerations, halitosis, diarrhea

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13
Q

What are the 3 most comon glomerular diseases in dogs and cats? (TQ)

A

renal amyloidosis
glomeruloclerosis
glomerulonephritis

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14
Q

What is the clinical pathology hallmark of glomerular disease?

A

proteinuria

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15
Q

What is most common glomerular disease in cats?

A

membranous nephropathy

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16
Q

What is the most common site of amyloid deposition in shar peis?

A

renal medulla - less proteinuria

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17
Q

What are the goals for treatment for glomerular disease?

A

treat underlying dz
reduction of proteinuria - ACE inhibitors,
mgmt of uremia and other complications

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18
Q

What kind of animals are associated with asymptomatic bacteriuria?

A

immunodeficiency or polyuria - glucocorticoids, diabetes, CRF, hyperthyroidism

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19
Q

What are the first line of antimicrobials for uncomplicated UTIs?

A
  1. amoxi
  2. cephalosporins
  3. trimepthoprim-sulfonamide
    treat for 7-10 days
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20
Q

What is the most common type of ectopic ureter in dogs?

A

unilateral intramural

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21
Q

What is the treatment for intramural ectopic ureters? extramural?

A

intramural - neoureterostomy

extramural - neouretercystostomy

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22
Q

Where are injections given for insulin?

A

lateral thorax, SC

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23
Q

What 2 breeds are predisposed to diabetes?

A

australian terrier and schnauzersa

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24
Q

What two common endocrinopathies do ferrets get?

A

insulinomas and adrenal dz

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25
What are the three suspected etiologies of adrenal dz in ferrets?
photoperiod - LH and FSH -> hyperplasia early age neutering - no neg feedback to GnRH genetics
26
How are insulinomas diagnosed in ferrets?
Blood glucose less than 70 insulin levels higher than 200 (not always) paired together
27
Diagnostic protocol to diagnose adrenal dz in ferrets.
Abdominal ultrasound most important, measure adrenal glands | CBC, chem, ferret adrenal panel
28
What are CS of adrenal dz in ferrets
progressive alopecia, pruritis, vulvar or prostatic enlargement, muscle wasting
29
What are CS of insulinomas in ferrets?
weakness, dullness, increased catecholamines, nausea
30
How are insulinomas treated in ferrets?
ER - dextrose IV, diazepam control CS - pred, diazoxide (decreases insulin, reduces uptake of glucose) surgery - sometimes curative
31
How is adrenal dz treated in ferrets?
Melatonin implant leuprolide acetate depot - synthetic GnRH (choice) Deslorelin - MOA similar to leuprolide Surgical if malignant
32
What is the most common endocrine disease in the horse?
pituitary pars intermedia dysfunction (PPID)
33
What are the 3 components of PPID in horses?
hirsuitism, weight loss, laminitis
34
What is the pathogenesis of PPID in horses?
loss of dopaminergic regulatory control of pars intermedia, hypertrophies
35
What part of the pituitary is under glucocorticoid negative feedback?
pars distalis
36
What parts of the pituitary produce POMC?
pars distalis - primary product | pars intermedia - minor product
37
What causes the increased ACTH production in PPID?
increased PC1 activity
38
What are the challenges with diagnosing for PPID in horses?
gradual progression seasonal variability in hormones overlap in endocrine response to variety of dzs
39
What is the most common laboratory diagnostic test for PPID in horses?
dexamethsone suppression test
40
What is the most common field test for PPID in horses?
endogenous plasma ACTH - variability
41
What is the drug of choice for PPID in horses?
pergolide mesylate - dopamine receptor agonist, lowest effective dose can add cyproheptadine - serotonin antagonist
42
What are the 3 components of equine metabolic syndrome?
obesity, insulin resistance, laminitis
43
What is the age of horses with equine metabolic syndrome? PPID?
EMS: 5-15 yrs PPID: >15 yrs
44
What is the potential mechanism for the link between equine metabolic syndrome and laminitis?
digital vasocontriction/endothelial cell dysfunction
45
What is the cause of neurogenic diabetes insipidus?
decreased ADH production
46
What is the cause of nephrogenic diabetes insipidus in horses?
decreased ADH sensitivity in kidney
47
What type of diabetes insipidus does the horse respond to exogenous ADH?
neurogenic DI
48
What are the definitions for PU/PD in horses?
urine ouput >40-50 ml/kg/day | water intake >100 ml/kg/day
49
What are the 3 common Ddx for Pu/pd in horses?
renal insufficiency psychogenic PD PPID
50
What is the diagnostic plan for diabetes insipidus?
serum chem and urinanalysis endogenous ADH levels water deprivation test vasopressin (ADH) response test
51
What is the treatment for nephrogenic DI in horses?
restrict sodium intake, thiazide diuretics, prostaglandin inhibitors
52
What is the tx for neurogenic DI in horses?
hormone replacement | desmopressin
53
What are some extrathyroidal factors that decrease T3?
diet, fasting, drugs, exercise, hormones (estrogen), euthyroid sick syndrome
54
How should thyroid hormones be measured in horses?
multiple measurements | total and free fractions of T3 and T4
55
What are the hormones involved in calcium and phosphorus homeostasis in horses?
PTH - saves calcium, gets rid of PO4 Vit D - increases CA and PO4 Calcitonin - inhibits osteoclasts
56
What is the main chronic cause of hypophosphatemia in horses?
hyperparathyroidism | aslo decreased intake, chronic renal failure
57
What is an acute cause of hypophosphatemia in horses?
refeeding syndrome - abrupt shift to CHO for energy, increase in insulin
58
What are some causes of hyperphosphatemia in horses?
acute renal failure, hypoparathyroidism, increased ingestion, false increases with cellular lysis
59
What are acute CS of hypocalcemia in horses?
neurmuscular excitabiltiy | synchronous diaphragmatic flutter (thumps)
60
What dietary ratio of calcium and phosphorus causes nutritional 2ndary hyperparathyroidism in horses?
P04 to Ca >3:1
61
What is the most common cause of hypoparathyroidism in horses?
secondary - sepsis, inflammation
62
What toxin interferes with GI calcium absorption in horses?
oxalates
63
What toxin causes GI disease and acute renal failure in horses?
cantharidiasis (blister beetles)
64
Does acute or chronic renal failure in horses cause hypocalcemia?
acute
65
What are the 4 causes of hypercalcemia in horses?
primary hyperparathyroidism chronic renal failure hypervitaminosis D hypercalcemia of malignancy
66
How are horses different in hypercalcemia in chronic renal failure?
result of renal calcium retention (NOT renal secondary hyperparathyroidism)
67
What is the best screening test for cushings?
LDDS
68
What is the best monitoring test for cushings?
ACTH stim
69
What are the MOA of the cushings drugs?
Trilostane - enzyme inhibitor | mitotane - toxic to adrenal gluco cells
70
What are classic lab findings with addisons dogs?
hyponatremia, hyperkalemia non regen anemia lymphocytosis
71
What is the gold standard test to confirm addisons disease?
ACTH stimulation test
72
What test is a good screening test for addisons?
basal cortisol
73
What specific kidney marker is helpful for CKD?
SDMA
74
Does post renal proteinuria cause hypoproteinemia?
NO
75
What 3 organ systems are most affected by hypertension?
CNS, ocular, CVS
76
What is nephrotic syndrome characterized by?
proteinuria, hypoalbuminemia, hypercholesteronemia, accumulation of transudates --> poor prognosis
77
What is the most common cause of glomerulonephritis in dogs?
immune complex glomerulonephropathies
78
What group of drugs can help in reducing proteinuria and preserving kidney function?
ace inhibitors
79
How do you calculate fluid deficit for a calf?
% dehydration x calfs body weight
80
What is the maintenence for fluid in calves?
60-80 ml/kg/day
81
When can you treat calf acidosis with just oral fluids?
ph is greater than 7.2
82
How should hypertonic saline be given to calves?
4 ml/kg over 4 minutes in conjunction with 2L oral fluids
83
What oral fluid is preferred for mild acidemia in calves? severe acidemia?
mild - acetate (more than 7.2) | severe - bicarbonate
84
What indicates hyperkalemia in calves? What is treatment?
bradycardia, arrythmias | IV bicarbonate or dextrose
85
What is a strong indication of renal disease in adult cow?
tubular casts
86
What disease is there a change to urine constituents but no primary damage to urine tract in cow?
postparturient hemoglobinuria
87
What is the best CS for obstructive urithroliasis in a goat?
crystals on preputial hair
88
What lab results will you see with bladder rupture in ruminant?
azotemia, hyponatremia, hypochloremia, hyperkalemia
89
When can corticosteroids be given to pancreatitis patients?
chronic pancreatitis in cats
90
What is the main electrolyte disturbance in cows? calves?
cows - hypochloremic, metabolic alkalosis | calves - hyponatremic, acidotic
91
What are the common stones in SA?
struvite, magnesium, ammonium and phosphate
92
What is the most common urinary calculi in cats and can not be treated with diet?
calcium oxalate
93
WHat part of the feline urethra is used in perineal urethrostomy?
pelvic urethra at level of bulbourethral glands

VM 610 Endocrine/Urology (2 decks)

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