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Clin Path Test Three > Renal Chemistry > Flashcards

Renal Chemistry Flashcards

(95 cards)

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1
Q

What is the most early and significant indicator of urinary tract disease

A

Disturbances in water intake/ output - PU/PD

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2
Q

What is oliguria

A

Decreased urine output

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3
Q

What is pollakiuria

A

Increased frequency of urination

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4
Q

What part of the kidney is responsible for concentrating urine

A

Renal tubules

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5
Q

What phases of chronic renal failure does PU/PD occur

A

Acute and progressive

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6
Q

What phase of acute renal failure does PU/PD occur

A

Recovery phase

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7
Q

5 causes of PU/PD

A

Loss of medullary gradient, decreased ADH, ADH resistance, Iatrogenic, psychogenic

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8
Q

4 causes of loss of medullary gradient

A

CRD, diabetes, fanconi syndrome, post-obstructive diuresis

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9
Q

Other than PU/PD, what conditions accompany diabetes mellitus

A

hyperglycemia and glucosuria

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10
Q

Three symptoms of fanconi syndrome

A

Normoglycemia, glucosuria, PU/PD

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11
Q

What can cause medullary washout

A

any chronic PU/PD and liver failure due to decreased urea *****5

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12
Q

Hormonal effect of central diabetes insipidus

A

Decreased ADH, usually from hypothalamus or pituitary damage

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13
Q

USG in central diabetes insipidus

A

Typically hyposthenuric (

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14
Q

pu-pd causes - more common, more rare

A

common- ADH resistance; rare- decreased ADH secretion

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15
Q

Causes of ADH resistance (2)

A

Primary nephrogenic d. insip. (rare); secondary nephrogenic d. insip (common)

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16
Q

USG- Primary nephrogenic d. insip.

A

isosthenuric (1008-1012)

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17
Q

USG- secondary nephrogenic d. insip

A

Hyposthenuric (

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18
Q

Causes of secondary nephrogenic d. insip

A

pyometra, pyelonephritis, cystitis from endotoxin, cushings, addisons, hyperthyroidism

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19
Q

Electrolyte abnormalities and their effects- secondary nephrogenic d. insip

A

Hypercalcemia (interferes with ADH at distal) and hypokalemia (decreased medullary gradient)

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20
Q

Causes of Iatrogenic PUPD (2)

A

Drugs (diuretics, corticosteroids, anticonvulsants), fluid therapy

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21
Q

Psychogenic PUPD

A

Animal just drinks too much

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22
Q

Anuria/oliguria- causes (3)

A

Pre-renal (dehydration), renal (acute/chronic), post-renal (obstruction)

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23
Q

Anuria/oliguria- phases of renal disease

A

Unresolved ARF or end stage CRF

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24
Q

Lab diagnostics- uroabdomen

A

High BUN/Creat, low sodium, high postassium

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25
Lab dx- ethylene glycol toxicity
Low Ca, high anion gap, seizures, oliguria 1-4 days post
26
What is the cause of anemia in chronic renal failure
Decreased EPO production *****10
27
What is dysuria an indicator of
Lower urinary tract disease (bladder and/or urethra)
28
Neuro causes of dysuria
UMN- tight, distended bladder, difficult to express; LMN- flaccid bladder, easy to express
29
Which dogs are prone to incontinence
Older, spayed female
30
What electrolytes may be abnromal in urinary disease
Ca, Cl, K, Na, CO2, Phos
31
BUN/Creat are markers for
GFR,
32
Decrease in GFR can cause (2)
azotemia or uremia
33
Azotemia- define
Increased BUN and/or creat due to decreased GFR
34
Uremia- define
Clinical condition of azotemia + clinical signs
35
BUN- increases due to (3)
decreased kidney flow leading to increased reabsorption; increased protein catabolism (eating many rawhides); hemorrhage in GI tract
36
Renal disease and BUN in ruminants- diagnostics
unreliable bc cows excrete urea elsewhere
37
BUN source
Urea formed in liver from N waster like NH3 from gut protein breakdown
38
BUN reabsorption
Inversely proportional to flow rate
39
Fate of ammonia in body
Ammonia dangerous to pH so convert to urea despite energy cost
40
Pre-renal azotemia (2)
increased BUN- decreased filtration rate due to dehydration or shock= decreased blood flow; high protein diet, GI hemorrhage
41
What chem results would indicate GI hemorrhage
Increased BUN, normal creat
42
Renal azotemia
Increased BUN due to decreased filtration rate
43
Post-renal azotemia
Obstruction or rupture leading to decreased filtration
44
USG- pre-renal azotemia
elevated
45
Pre-renal azotemia elevations
USG, RBC, PCV, Na, Cl, plasma protein/albumin
46
Renal azotemia- when?
75% loss of nephron function
47
When is urine concentration ability lost
66% nephron loss
48
First indicator of renal azotemia
Altered USG - because concentration lost before BUN/creat elevation
49
Adequate concentration of urine USG
1008-1030 (1035 cats)
50
Reduced concentration USG
1012-1030
51
No concentration- USG
1008-1012
52
Diagnose USG
NOT renal- likely ADH related (d. insip)
53
Post renal azotemia- causes (2)
Obstruction, uroabdomen
54
Chem findings- post renal disease
Azotemia with hyperkalemia, hyponatremia - USG not helpful
55
Diagnose post renal azotemia
Abdominal fluid- low protein, BUN increase
56
Without azotemia- diagnose renal disease
Urinalysis- proteinuria, glucosuria (without hyperglycemia), casts, reduced urine concentration in dehydrated animal
57
What should be monitored in animals on aminoglycosides-
Can become azotemic- UA, BUN/creat
58
BUN- helpful in cows/horses? Why/why not
No- gut bacteria
59
Low BUN- causes
Liver failure, low protein diet, overhydration
60
Creatinine- source
Skeletal muscle metabolism product
61
Creatinie changes- sources
Muscle wasting or necrosis- not diet/GI
62
Breed with greatest mean serum [Creat]
Greyhounds
63
What does creat measure
GFR
64
When will creat rise
After BUN rises, as GFR decreases.
65
Increased creat- artifact
acetoacetate, glucose, vitamin C, uric acid, pyruvate, cephalosporins, amino acids
66
Physio increased creat
Foals, muscular horses, greyhounds, after protein meal
67
Decreased creat (3)
Artifact of increased bili, pregnancy (increaseD CO = increased GFR), significant muscle mass loss
68
2x higher creat in abdomen than serum =
Uroabdomen
69
Elevated potassium- conditions
Post-renal and renal azotemia
70
Polyuric renal failure- consequence
Hypokalemia (mostly cats, cows, rare in dogs)
71
Sodium elevation - conditions
pre-renal due to dehydration concurrent with increased Na, Cl, alb
72
CRF effect on sodium
Hyponatremic due to loss of ability to retain
73
Distinguish renal from pre-renal azotemia
Pre-renal- Na 1 *******22
74
Diagnose- hyponatremic and hyperkalemic
Uroabdomen
75
TCO2 =
HCO3-
76
Why is HCO3 often reduced in renal patients
Become acidotic due to organic waste build up
77
Two types of metabolic acidosis
Normal anion gap- Loss of bicarb/retention Cl; increased anion gap- bicarb not lost, no Cl retention *****24
78
Phosphorus- how effected by renal failure
Hyper due to decreased excretion
79
What species will not have hyperphosphatemia in renal disease
Cattle (not a route of excretion), horses- will be hypo
80
Why must phos be controlled in renal disease
Can develop secondary hyperparathyroidism with bone resorption and renal mineralization ( because thyroid wants to raise calcium and dump extra phos )
81
How can phos be controlled in renal disease
Oral phosphate binders to lower level
82
Calcium in horses with renal disease
Hyper (bc kidney route of excretion), rare in other species
83
What species see hypocalcemia with CRF, why?
Cats and cattle due to polyuria
84
Acid-base effect of renal disease in dogs/cats
Metabolic acidosis due to decreased H and organic acid product excretion, loss of ability to conserve bicarb
85
Acid base effect of renal disease in cattle
none to alkalosis (rumen stasis and HCl sequestering)
86
Pre-renal azotemia albumin
Increased
87
Renal azotemia albumin
Normal or decreased from protein losing nephropathy
88
DIagnose protein losing nephropathy
Protein:creatinine ratio
89
Cattle in renal failure- random findings
High fibrinogen
90
Dogs in renal failure- random findings
Elevated amylase and lipase bc degraded/excreted by kidney
91
ARF vs CRF- urine output initial/later, K, Na, acidosis, anion gap
ARF- oliguria initially, PU later; K high, high anion gap CRF- PUPD initially, an/oliguric at end stage; Na/K low, normal anion gap, anemic (non-regen) *** CRF usually anemic due to lack of EPO production Phos high in both, metabolic acidosis in both
92
When should a water deprivation test be used
PUPD, not azotemic, urine not concentrated (but not in hyposthenuria)
93
What is urine creat used to measure
Fractional clearance; can distinguish renal/prerenal azo
94
Renal vs pre-renal azotemia- distinguish via
Creatinine- >50:1 - pre-renal;
95
What does UPC measure
Urine protein:creatinine - for magnitude of proteinuria to diagnose PLN; radio >0.5 indicates PL glomerular nephropathy

Clin Path Test Three (2 decks)

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