Module 17 Week 1 Flashcards
(221 cards)
1
Q
(Diagnostic Imaging of the Urinary System)
Why is a plain radiograph limited for imaging the urniary tract?
A
- Soft tissue & fluid same opacity
- Cannot distinguish between urinary fluid or renal parenchyma
- kidney and bladder may not be clearly visible esp R kidney
2
Q
What are radiographic contrast studies used for?
A
Performed when ultrasound is unavailable
Helps assess specific structures
3
Q
What structures can be assessed with contrast studies?
A
Intrapelvic structures
Urethral rupture
Bladder rupture
4
Q
What are the types of contrast media?
A
Negative contrast: Air, CO₂
Positive contrast: Iodine-based contrast medium
5
Q
What must be done before a contrast study?
A
Take plain radiographic images
Perform an enema (if remembered)
6
Q
What is Intravenous Urography (IVU)?
A
A contrast study to visualise the kidneys and ureters
Uses an iodine-based contrast medium
7
Q
How is contrast administered in IVU?
A
Injected intravenously into the cephalic vein
8
Q
What does IVU demonstrate?
A
Highlights the kidneys and ureters on radiographs
9
Q
What kind of contrast does a positive contrast cystogram use?
A
Iodine contrast medium
10
Q
How do you perform a positive contrast cystogram and what does it allow you to assess?
A
Catheter into the bladder allowing you to assess bladder position and if there are any ruptures.
11
Q
What contrast does a negative contrast cystogram use?
A
Air/Co2
12
Q
What does a negative contrast cystogram allow you to assess?
A
bladder position and wall thickness
13
Q
What contrast types does a double contrast cystogram use?
A
1-5ml contrast then air
14
Q
What does a double contrast cystogram assess?
A
Position, luminal content and wall thickness
15
Q
Who is a retrograde urethrogram performed on?
A
Males only
16
Q
Where is the catheter placed in a retrograde urethrogram?
A
Distal urethra
17
Q
hat structures does a retrograde urethrogram demonstrate?
A
The urethra
The prostate (if abnormal)
18
Q
How is a retrograde urethrogram performed?
A
A catheter is placed in the distal urethra
Contrast medium is injected
X-rays are taken to visualise the urethra
19
Q
Who is a retrograde vaginourethrogram performed on?
A
females only
20
Q
Where is the catheter places in a retrograde vaginourethrogram
A
Through the vulva
21
Q
What structures does a retrograde vaginourethrogram demonstrate
A
vestibule
vagina
urethra
22
Q
How is a retrograde vaginourethrogram performed?
A
A catheter is inserted through the vulva
contrast medium is injected
x-rays are taken to visualise
23
Q
Where should you fan the US probe when doing an renal US to view long axis?
A
Fanny from laterally to medially to see the entire organ
24
Q
Where should you fan the US probe when doing an renal US to view short axis?
A
Fan through to ensure you scan the entire organ
25
How might you scan to view right kidney?
It can be more difficukt to image so can scan between ribs
26
Compare cat kindeys to dogs lol
Cats be having more mobile kidneys so variable positions
They have a more rounded outline
27
What should you assess when doing a renal assessment an what compnents of the kidney should you identify?
Assess: Location, Size, Shape and Margins
Components: Cortex, Medulla, Corticomedullary junction, Pelvis and (ureter)
28
What is Echogenicity
The ability to bounce an echo
29
What is echotexture?
the visualized internal composition or pattern of echoes within an individual structure
30
If there is diffuse parenchymal chnages what is on you DDx?
* Acute renal disease / failure
* Chronic renal disease
* Renal dysplasia
* Chronic endstage kidney
* Neoplasia eg lymphoma
31
If there is pelvic dilation/hydronephrosis what is your DDx
* Obstruction
* Pyelonephritis
* Neoplasia
32
Describe what you would see on ultrasound of a patient with acute renal disease?
rounded, hazy kidney
33
What conditions are associated with reduced corticomedullary definition (hypertonicity)?
Nephritis
Tubular necrosis
Acute renal failure
34
What might you see in a case of ethylene glycol toxicity?
Hyperechic cortex +/- corticomedullary rim sign
35
What changes can be seen with chronic renal disease?
- Often bilateral
- Heterogenous cortices
- Reduced cortico-medullary definition
- indentations suggest old infarcts
36
What chanages can be seen with renal dysplasia?
- Loss of corticomedullary definition
- Distorted outline / abnormal shape
37
What is pelvic dilation or hydronephrosis best seen with?
Short axis
38
What are key features of ureteral obstruction on imaging?
Pelvis retains a normal shape
Ureter visible up to the point of obstruction
39
What should you check for when assessing ureteral obstruction?
Bladder neck
Other kidney
40
What are the internal causes of ureteral obstruction?
Pyelonephritis
Neoplasia
41
How does neoplasia affect the renal pelvis?
Causes irregular or abnormal shape of the pelvis
Leads to disrupted architecture
42
What are focal renal changes?
* Neoplasia
* Calculi
* Cysts
* Abscesses
43
What do calculi look like on US?
Hyperchoic with shadowing
44
Where are calculi located?
Calyces/pelvis
45
How do cysts on kidneys appear? where are they located?
anechoic/cloudy and located anywhere?
46
Why might cysts occur in the kidney?
- Congenital
- Associated with chronic inflammation
- Polycystic kidney disease (PKD)
47
T/F renal abcesses are hard to Dx from cysts?
True
48
What should the thickness be of the echogenic wall of the bladder?
1-2mm
49
what are the two components of the echogenic bladder wall?
- serosal layer hyperchoic line
- mucosal layer
50
If there are changes to the bladder wall what is your DDx?
- Cystitis
- Mass - neoplasia or inflammatory polys
- Rupture
51
If the content of the bladder are abnormal what could be th causes?
- Calculi
- Blood clots
- Cell debris
52
What wall chanages is seen with cystitis?
Increase in wall thickness eitheri uniform or focally.
53
What are the two types of inflammatory polyps?
sessile (flat) or penunculated (with a stalk)
54
Withe a rupture in the bladder what do we see on US?
Free fluid and wall thickened or unchanged and extravasation of contrast.
55
Which types of urinary calculi are radio-opaque?
- Struvite
- Oxalate
56
Which types of urinary calculi are radiolucent?
- Cystine
- Urate
Mnemonic: "I can't C U" (Cystine & Urate can't be seen on radiographs)
57
What ultrasound feature is often seen with calculi?
Acoustic shadowing
58
How do urinary calculi behave in the bladder?
- Variable size and shape
- Mobile – They move and settle with gravity
59
What does radiography provide when assessing urinary calculi?
- An overview of urinary stones
- Helps check the urethra
60
Which parts of the urethra should be checked for calculi?
- Perineal urethra
- Os penis
61
Which stones are not visible on radiographs?
Urate & Cystine – Cannot be seen
62
What can cause gas in the bladder?
Latrogenic (e.g., introduced during catheterisation)
Emphysematous cystitis
63
How does emphysematous cystitis appear on imaging?
Small bubbles that adhere to the bladder wall
64
What could suspened contents be in the baldder?
Concentrated urine
Cell debris
Haemorrhage
Mucous
65
What must be done before performing a prostatic ultrasound?
Ensure the bladder is full
66
Why is a full bladder necessary for prostatic ultrasound?
It serves as a landmark
Helps move the prostate into the abdomen
67
What is the shape of the prostate on ultrasound?
Bilobed
68
How does the echogenicity of the prostate compare to other organs?
Similar to the spleen
69
What structures can be visualised in a prostatic ultrasound?
Capsule of the prostate
70
What should be noted about the prostate in castrated animals?
The prostate will be smaller
71
What should be assessed during a prostatic ultrasound?
Location
Size
Shape
Margins
Echogenicity
Echotexture
72
What are the parenchymal changes that can affect the prostate?
Benign prostatic hyperplasia
Prostatitis
Neoplasia
73
What fluid-filled lesions can be identified in the prostate?
Cysts
Abscess
Para-prostatic cyst
74
What is benign prostatic hyperplasia most common in?
Entire male dogs
75
How does a benign prostatic hyperplasia appear on US
Hyperechoic
76
How does Acute inflammation of the prostate present on US?
Hypoechoic
77
How is chronic inflammation of the prostate present in the US?
Hyperchoice and mottled
78
How does the prostate appear on US when neoplasia is involved?
Mottled
Mineralisation
Locally invasive
79
Where can prostate neoplasia mestastasis too?
lungs
80
What is prostatic cysts a commone finding with?
BPH
81
Do prostatic abscesses have distinct or indistinct margins?
indistinct
82
What do bladder abscess contents appear like on US?
Cloudy with a surrounding reaction
83
(Approach to Azotaemia and Acute Kidney Injury in Small Animals)
what is the main rolde of the kidneys?
To maintain the volume and balanced composition of the ECF.
84
What are the other functions of the kidneys?
- Filtration of blood & excretion of metabolic waste
- Acid-base balance
- Water/volume regulation
- Electrolyte & mineral homeostasis
- Blood pressure regulation
- Erythropoietin release- involved in creation of RBCs
85
What is the clinical Presentations of Kidney Disease
PUPD (Polyuria/Polydipsia)
Inappetence/Weight Loss
Depression/Lethargy
GI Signs (Vomiting/Nausea/Diarrhoea)
Ascites/Subcutaneous Oedema
Haematuria
Pain
Abdominal Mass
86
What is Azotaemia?
Abnormal increase in non-protein nitrogenous wastes in the blood
87
What does azotaemia suggest?
Suggests failure of filtration & excretion of metabolic waste.
88
Does Azotaemia Always Mean Kidney Disease?
No! Kidney disease ≠ azotaemia
89
What are the Types of Azotaemia?
Pre-Renal Azotaemia – Decreased blood flow to kidneys (e.g. dehydration, shock)
Renal Azotaemia – Intrinsic kidney disease, nephron damage
Post-Renal Azotaemia – Urinary obstruction, bladder rupture
90
Hoow is urea made?
Urea is made in the liver from ammonia via the urea cycle.
91
How is ammonia made
Ammonia is mostly made during degradation of amino acids
92
What Factors Affect Urea Secretion?
- Age
- Liver function
- Dietary protein content (including GI bleeding)
- Endogenous protein catabolism
- Hydration
93
What Factors Affect Urea Excretion?
- Renal function
- Lower urinary tract function
94
What is creatinine?
Creatinine is a waste product that comes from the breakdown of muscle.
95
What is the rate of production of creatinine?
It is produced at a constant rate which is determined by muscle mass and is then filtered in the glomerulus.
96
Serum concentration of creatinine is decreased with what?
Reduced muscle mass
97
Serum concentration of creatinine is increased with what?
- Reduced renal clearance
- Urine excretion failure (eg. urinary tract rupture)
98
What is the GFR?
Flow rate of filtered fluid through the kidneys
99
What reduces the GFR?
- Decreased renal perfusion
- Decreased renal function
- Obstruction of urine flow
100
Why are meaasurements of urea and creatinine used as inidrect markers for GFR?
cheap and easy tests
101
Describe how clinical signs work with azotaemia?
- Not all azotaemic patients have clinical signs
- Severity of clinical signs not directly proportional to magnitude of increase
- Rate of accumulation has an effect on severity of signs
102
What is the clinical symptoms of uraemia?
- inappetance
- Depression
- Vomiting/nausea
- Halitosis
- oral ulceration/stomatitis
- Diarrhoea
103
T/F All uraemic patients are azotaemic but not all azotaemic patients are uraemic
true
104
what are your differentials for pre-renal axotemia?
- Hypovolaemia
- Hypotension
- Aortic/renal thromboembolism
105
what are your differentials for renal axotemia?
- Nephron damage
- Nephron loss
106
What are your differentials for post-renal axotemia?
- Ureterolith
- Urethrolith
- Bladder rupture
107
If on history you have a animal thats not drinking and has increased losses (vom or diarrhoea) what kind of axotaemia do you potentially have?
Pre-renal
108
If your patients had dysuria or stranguria what kind of azotemia might you have?
Post-renal
109
If on history your patient they are failing to pass urine, is post-renal the only option for diagnosis?
No could be a faulure to produce urine rather than not peeing at all so renal too
110
If the bladder is huge and there is localised subcutaneous fluid around perineum or ventral abdomen, what type of azotaemia is most likely?
Post-renal
111
If there is free peritoneal fluid (urine) what kind of azoteamia is it most likely to be?
Post-renal
112
When should urine concentration be assessed?
Before fluid therapy
113
What does hypersthenuric (very concentrated) urine suggest?
Pre-renal azotaemia
114
Can pre-renal azotaemia have dilute urine?
Yes! If due to:
Diuretics
Steroids
Hypoadrenocorticism
115
What urinalysis finding suggests renal azotaemia?
Active sediment with tubular casts
116
What urinalysis finding suggests renal or post-renal azotaemia?
Haematuria
117
Whats the urine specific gravity 1.00 to 1.007 called?
hyposthenuria
118
Whats the urine specific gravity 1.008 to 1.012 called?
isosthnuria
119
Whats the urine specific gravity 1.013 to 1.055 called?
hypersthenuria
120
If you found a dehydrated to have hyposthenuric, isothenuric or minimla concentrated urine what would this suggest?
Problem with renal
121
What is renal disease?
Damage or functional impairment of kidneys with varying severity
122
What is renal insufficiency?
Functional impairment not severe enough to cause axotaemia but sufficient to cause loss of renal reserve
123
What is renal failure?
Functional impairment severe enough to cause azoteamia and urine concentrating ability is usually impaired
124
What is acute kidney injury?
It is a sudden and often reversible reduction of the elimination and metabolic function of the kidneys
125
Why are kidneys at such a high risk to being damaged?
- High blood floe
- Toxins may be secreted/reabsorbed by tubular cells
- Potential concentrating effects of toxins in urine
- Play a role in biotransformation of drugs/toxins
126
What things can lead to reduced renal perfusion and, ultimately, acute kidney injury?
- Dehydration
- Hypovolaemia
- Decreased cardiac output
- Hypotension
- Shock
127
What nephrotoxic drugs can cause acute renal injury?
- NSAIDs
- Aminoglycosides
- Doxorubicin
- Cisplatin
128
What infections can cause acute renal injury?
- Leptospirosis*
- Borreliosis (Lyme disease)
129
What toxins can cause acute renal injury?
- Lilies (cats)
- Grapes/raisins (dogs)
- Ethylene glycol (anti-freeze)
130
Describe the initiation phase of acute renal injury?
Something damages part of some of the nephron leading to dysfunction
131
Describe the extension phase of acute renal injury?
Ischemia, hypoxia, inflammation & cellular injury result in cell death & further nephron damage.
132
Describe the maintenance phase of acute renal injury?
Ongoing cell death occurs with cell recovery and early repair
133
Describe the recovery phase of acute renal injury?
Gradually reversible renal lesions are repaired & viable nephrons hypertrophy
134
What can you find on clinical examination of patient with acute renal injury?
- Often dehydrated
- May have uraemic ulcers
- halitosis
- Usually normal to large kidneys and could be painful
- There should also be urine produaction
135
How should you diagnose acute kideny injury?
- Collect blood and urine before fluid therapy
- Identify azotaemia
- rule out post-renal causes by history and clinical exam
- identify reduced urine conc ability via urinalysis
- differentiate acute from chronic kidney disease
136
How would you differentiate acute from chronic kindey dosease? and why?
- history, clinicale xamination, lab findings
- It affects treatment and short to long-term prognosis
137
What are other typical clinopathological abnormalities see with acute kidney injury?
- Initial hyperkalaemia
- Initially normal phosphate then hyperphosphataemia
- Total calcium may be high, low or normal but if marked high consider hypercalcaemia as cause
- PCV may be increases due to dehydration
138
What is anuria?
No urine production
139
What is oliguria?
output less thatn 0.25ml/kg/hr
140
What is polyuria?
more than 2ml/kg/hr
141
What is normal urine output?
1-2ml/kg/hr
142
What are the general principles for treating acute kidney injury?
- Remove the inciting cause
- Restore renal perfusion
- Monitor urine output and consider drugs to increase urine output
- Monitor electrolytes, acid-base balance, hydration status
- Treat uraemic complications & provide nutrition
- Investigate underlying causes
143
(Approach to and Management of chronic kidney disease in Small Animals)
What is chronic kindey disease?
It is a loss of functional renal tissue due to prolonged process. It is usually progessive and irreversible
144
Is chronic renal failure a end-stage process?
Yes obvs die
145
Why is CKD important?
- Prevalence of 1-3% in cats, 0.5-1.5% in dogs
- Affects animals of all ages
- Incurable diseases
- Treatment can modify disease progression
- Prolonged survival is common (especially in cats)
146
What are the degenrative causes of CKD?
- Chronic interstitial nephritis
- Renal infarcts
147
what are the developmental causes of CKD?
- Familial renal dysplasia
- Polycystic kidney disease
148
What are the metabolic causes of CKD?
Hypercalcaemia
149
What are the neoplastic causes of CKD?
- Renal lymphoma
- Renal carcinoma
150
What are the iatrogenic causes of CKD?
Vitamin D supplememtaion
Nephrotoxic drugs
151
What are idiopathic causes of CKD?
renal amyloidosis
primary glomerulopathies
152
What are immune-mediated causes of CKD?
Immune-complex mediated glomerulonephritis
153
what are the infectious causes of CKD?
pyelonephritis
borreliosis
154
What could CKD be a sequel too?
Urinary obstruction or acute renal failure
155
Descrine the pathophysiology of CKD?
CKD leads to nephron damage and kidneys have limited ways to respond. Nephrons cannot regen or replicate as nephrons are lost, remaining nephrons have to filter more blood leading to glomerular hypertension and hyper filtaration.
156
What can prolonged nephron injury lead to?
- infiltration of inflammatory cells
- profibrotic cytokine production
- Hypoxia leading to further injury
157
If number of fephrons falls below a third of normal amount what happens?
The urine concenrating ability becomes impaired
158
If number of nephrons falls below a quarter of normal amount what happens?
azotaemia develops
159
What are consequences of CKD?
- Azotaemia and uraemia – due to reduced GFR
- PUPD – due to tubular damage & fewer nephrons
- Hyperphosphataemia
- Increased PTH (renal secondary hyperparathyroidism)
- Hypokalaemia
- Anaemia
- Haemorrhage
- Hypertension
- Proteinuria
- Metabolic acidosis
160
What is hyperphosphatemia?
Phosphate excreted vua filtration through glomeruli
161
What is Hyperphosphatemia
Hyperphosphatemia is a condition in which you have too much phosphate in your blood
162
How is hyperphosphataemia a consequence of CKD?
Phosphate excreted via filtration through glomeruli and due to reduced Glomeruli filtration rate with CKD phospahte retained in blood.
163
What are the effects of Hyperphosphatemia?
unlikely to directly cause clinical signs but it does drive secondary hyperparathyroidism which leads to disease progression and reduced survival
164
What are the neuro effects of hyperparathyroidism?
Neurological: Likely uraemic toxin leading to depression
165
What are the skeletal effects of HYperparathyroidism
Skeletal: Can lead to osteopenia, tooth loosening, pathological fractures
166
What are the renal effects of Hyperparathyroidism
Renal: Causes renal cell tubular damage
167
What are the causes of hypokalaemia in CKD?
Reduced intake, reduced renal potassium reabsorption, renal tubular acidosis.
168
What are the clinical signs of hypokalaemia in CKD?
Neuromuscular weakness (ventroflexion of neck), arrhythmias, metabolic acidosis, anorexia, weight loss.
169
What is hypokalaemic nephropathy?
A condition where low potassium levels promote PU/PD and worsen kidney function in CKD patients.
170
What type of anaemia is seen in CKD?
Non-regenerative, normocytic, normochromic anaemia.
171
What are the causes of anaemia in CKD?
Erythropoietin deficiency, reduced RBC lifespan, nutritional abnormalities, chronic GI haemorrhage, iron deficiency.
172
What are the effects of anaemia in CKD?
Lethargy, inappetence, possible disease progression due to renal hypoxia.
173
What are common causes of haemorrhage in CKD?
Ocular haemorrhage, GI haemorrhage secondary to ulceration.
174
Why does hypertension occur in CKD?
Impaired sodium excretion, activation of the renin-angiotensin-aldosterone system (RAAS).
175
What organs can be damaged by hypertension in CKD?
Kidneys, eyes, brain, cardiovascular system.
176
Why does proteinuria occur in CKD?
Increased glomerular capillary pressure and fewer tubules to reabsorb protein.
177
Why is proteinuria concerning in CKD?
It contributes to CKD progression and is a risk factor for mortality.
178
What causes metabolic acidosis in CKD?
Reduced excretion of H+ ions, retention of phosphate and organic acids, increased loss of chloride (vomiting).
179
Why is CKD a progressive disease?
Ongoing triggers, systemic and glomerular hypertension, mineral imbalances, proteinuria, renal fibrosis, inflammation.
180
What are important targets for CKD treatment?
Hypertension, phosphate control, proteinuria reduction, reducing inflammation and fibrosis.
181
What are common clinical signs of CKD?
PUPD, weight loss, depression, dehydration, haematuria, oedema, acute blindness, fractures.
182
What findings are seen on clinical examination of CKD patients?
Dehydration, poor body condition, small kidneys, pale MM, hypertensive retinopathy, fractures.
183
What laboratory findings indicate CKD?
Azotaemia, reduced GFR, low urine specific gravity, hyperphosphataemia, hypokalaemia, anaemia.
184
What urine-specific gravity suggests CKD in dogs and cats?
Dogs: 1.008-1.020, Cats: 1.008-1.030
185
Why is proteinuria monitored in CKD?
It increases risk of mortality and contributes to renal injury.
186
What imaging methods help diagnose CKD?
Ultrasonography (small kidneys, renal lymphoma), Radiography (mineralization, uroliths)
187
Why is blood pressure measurement important in CKD?
Hypertension can cause kidney damage and target organ damage.
188
What are the main treatment goals for CKD?
Treat underlying causes, improve quality of life, slow disease progression.
189
How is hypertension managed in CKD?
ACE inhibitors (dogs), Amlodipine (cats), ARBs, moderate salt restriction.
190
How is dehydration managed in CKD?
IV fluids (short-term), oral fluids, subcutaneous fluids, feeding tube if needed.
191
What medications help control nausea in CKD?
Maropitant, metoclopramide, ondansetron, H2 antagonists, proton pump inhibitors.
192
What are treatment options for anaemia in CKD?
Erythropoietin therapy (rHuEPO or darbepoietin-α), iron supplementation, treating underlying causes
193
Why is phosphate restriction important in CKD?
Prevents secondary hyperparathyroidism and slows disease progression.
194
What are common phosphate binders used in CKD?
Aluminium hydroxide, calcium carbonate, Ipakitine, Pronefra
195
How do ACE inhibitors benefit CKD patients?
Reduce glomerular pressure, proteinuria, sodium retention, and renal fibrosis.
196
What is Telmisartan used for in CKD?
Reduces proteinuria and treats hypertension in cats
197
Why are renal diets beneficial in CKD?
Reduce uraemic crises, prolong survival, improve quality of life.
198
What nutrients are controlled in renal diets?
Phosphate, protein, sodium, potassium, omega-3, antioxidants, B vitamins.
199
How should a diet change be introduced for CKD patients?
Gradually over 3-4 weeks, not during uraemic crisis or hospitalization.
200
Why is long-term monitoring important in CKD?
To track disease progression, manage complications, and adjust treatments.
201
How often should CKD patients be monitored?
Depends on severity, but regular check-ups are essential.
202
What is 'acute on chronic' kidney disease?
An acute worsening of CKD due to another illness, dehydration, UTI, or obstruction.
203
What is the typical prognosis for CKD?
Dogs: months to a few years; Cats: often ~2 years, depending on treatment and stage.
204
How would a patient present who has a kidney disease?
- PUPD
- Inappetence/weightloss
- Depression
- GI signs like vom/naus/diarrhoea
- ascites/subcut oedema
- haematuria
- pain
- abdominal mass
205
what is proteinuria?
It is an increase in the amount of protein in the urine
206
What are physiological/transient causes of protienuria?
Strenuous excercise, seizure, fever and stress
207
What are pre-renal causes of proteinuria?
Abnormal concentration of protein presented to kidney
208
What are renal causes of proteinuria?
Defective renal function or inflammation of renal tissue
209
What are post-renal causesof proteinuria?
Inflammation in the ureter, bladder, urethra or prostate
210
What are the presenting signs of proteinuria?
- none and have to detect on dipstick
- Could be signs of underlying disease such as neoplasia , infection or renal failure
- Could be signs kdure to low serum levels so weight loss, lethargy, poor appetite, ascites and pitting oedema
211
What protein is a dipstick more senstive than others?
Albumin
212
Why might a dipstick give a false positive result for proteinuria?
If urine is alkaline or contaminated
213
How would you identify pre-renal causes of proteinuria?
Haem and biochem that bitch
214
How would you identify physiological causes of proteinuria?
Via history and clinical examination
214
Why might a dipstick give a false negative result for proteinuria?
If the urine is acidic or bence jones proteinuria
215
How would you identify post-renal causes of proteinuria?
History, clinical exam, urinalysis and imaging
216
How would you identify a renal or post-renal inflammation as the cause of proteinuria?
Examine urine sediment for inflammatory cells and perform urine culture and sensitivity
217
Why should you quantify proteinuria?
- To evaluate severity of renal lesions
- assess disease prgression
- assess response to treatment
218
How should you quantify proteinuria?
24hr urine protein measurement is gold standard but difficult so like okay whatev so urine protein:creatinine ratio da fuck
219
What can renal inflammation cauas einterms of protein?
Cause protein to leak into filtrate
220
