PLN

Question 1

Albumin has an overall _____ charge

Answer 1

Negative

Question 2

AGTII, Thromboxane, and ET-1 are all _______ substances

Answer 2

Vasoconstrictive

Question 3

4 key features of nephrotic syndrome:

Answer 3

Hypoproteinemia (decreased TP)

Proteinuria

Hypercholesterolemia

Ascites

Question 4

PLN should be on your radar if proteinuria has been present for how long?

Answer 4

At least 2 weeks

Question 5

If UPC is >2, patient likely has:

Answer 5

Glomerular disease

Question 6

If UPC is <2, patient might have:

Answer 6

Glomerular or tubular disease

Question 7

UPC >0.5 with an inactive sediment is characteristic of:

Answer 7

Glomerular disease

Question 8

Normal UPC in a dog is ______

Answer 8

< 0.5

Question 9

Normal UPC in cats is:

Answer 9

< 0.4

(Ideally, less than 0.2)

Question 10

4 differentials for hypoalbuminemia?

Answer 10

PLN

PLE

Liver failure

Blood loss

Question 11

Defining feature of PLN on a chem profile is ______

Answer 11

Hypercholesterolemia

Question 12

5 differentials for Hypercholesterolemia?

Answer 12

PLN

Recent meal

Lipid disorder

Cushing’s

Hypothyroidism

Question 13

Contraindications for renal biopsy?

Answer 13

Severe, chronic azotemia

Moderate- severe Hypertension

Severe uremia

Question 14

Severe chronic azotemia is a contraindication for renal biopsy for 2 key reasons:

Answer 14

Chronic, Severe azotemia = you’re likely just going to find irreversible fibrosis

Azotemia causes platelet dysfunction; patient is at increased risk of bleeding!!

Question 15

What is severe uremia a contraindication for renal biopsy?

Answer 15

Risk of bleeding!

Uremia causes platelet dysfunction, patient can’t clot as well!

Question 16

Where do you want to biopsy from for kidney biopsy?

Answer 16

Renal cortex!

This is where glomeruli live

Question 17

Omega-3 fatty acids are ______ protective in dogs

Answer 17

Renal
Can also help with suppressing inflammation

Question 18

3 drug classes that block RAAS:

Answer 18

ACE inhibits, angiotensin receptor blockers, aldosterone antagonists

Question 19

Effect of AGII on the kidneys =

Answer 19

Works on proximal tubule to increase sodium reabsorption

Question 20

Effect of AGII on blood vessels =

Answer 20

Vasoconstriction!
Increases systemic pressure, increases tissue perfusion!

Question 21

Effect of AGII on the adrenals =

Answer 21

Release of aldosterone

Aldosterone makes distal tubule reabsorb Na+ and secrete K+

Question 22

RAAS is stimulated when ____ ___ _____

Answer 22

Flow is low!

If flow is low, to RAAS we go!
(To maintain our systemic BP yo)

Question 23

AGII constricts the _______ arteriole more than the _______ arteriole

Answer 23

EFFERENT

Afferent

Question 24

Block AGII = decrease vasoconstriction = _________

Answer 24

Decreases glomerular blood pressure
Decrease the force that is pushing protein through the glomerular barrier!

Question 25

3 side effects of ACE inhibitors:

Answer 25

Hyperkalemia Hypotension Azotemia

Question 26

How can ACE inhibitors cause Azotemia?

Answer 26

If you decrease BP enough, you can decrease GFR to levels that result in azotemia Ace inhibitors overcome efferent arteriole constriction!

Question 27

You started a patient on enalapril one week ago. You recheck a chem and BP a week later Creatinine has increased by 35%, what should you do?

Answer 27

>20% increase = decrease dose or discontinue med

Question 28

How low does albumin need to be for plasma to leak out and cause ascites?

Answer 28

VERY LOW <2 mg/dL

Question 29

Good drug for mild-moderate hypertension?

Answer 29

ACE Inhibitors

Question 30

Good drug for SEVERE hypertension?

Answer 30

Amlodipine

Question 31

Severe hypertension = ______ Hypertensive = ________ Normotensive = _________

Answer 31

>180 mm Hg 140-180 mm Hg <140 mm hG

Question 32

Inherited forms of PLN will not respond to Immunosuppressive drugs. True or false?

Answer 32

TRUE

Question 33

Why can’t we use steroids to treat PLN?

Answer 33

steroids cause proteinuria in dogs

Question 34

What are common side effects of mycophenolate?

Answer 34

Diarrhea, GI upset

Question 35

If you’re losing albumin in your urine, you’re also losing:

Answer 35

Antithrombin III (Same size as albumin)

Question 36

Loss of ATIII is bad because

Answer 36

Now patient is at risk of clotting!

Question 37

What drug can be used to combat loss of antithrombin III?

Answer 37

Plavix! (Clopidogrel) It prevents platelet clumping and clot formation

Question 38

_____ is the term used to describe apoptosis that occurs due to detachment from the basement membrane

Answer 38

Anoikis