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Flashcards in Renal Ettinger Deck (408)
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1

What is Carbamylated Hemoglobin?

(dissociated BUN that reacts with Hb) concentrations higher in dogs w/ renal disease (vs control) and higher w/ CRF vs ARF

2

What is GFR directly related to?

Functional renal mass

3

How is BUN made?

synthesis in liver via Ornithine cycle from catabolism of ammonia (from catabolism of endogenous and exogenous proteins)

4

Name 3 things that affect BUN.

Passive reabsorbed in tubules (greater extent when slow tubular flow (like with dehydration)
GI bleeding (increase nitrogenous compounds)
Drugs (increased catabolism with steroids, azathioprine), (decreased protein synthesis with tetracyclines)

5

How is creatinine made?

nonenzymatic breakdown product of phosphocreatinine in muscle, daily amount based on muscle mass

6

Which breed has higher creatinine?

Greyhounds (more muscle)

7

Describe the relationship btwn changes in BUN and creat.

Relationship of BUN or Crea concentration to GFR is a rectangular hyperbola; large changes in the early courses of renal disease cause only small increase in BUN/Crea vs small changes in GFR in advanced renal disease result in large changes

8

What does it imply when BUN and creatinine are increased?

Incr BUN & Crea implies that at least 75% of the nephrons are not functioning

9

What is cystatin C?

(small polypeptide protease inhibitor, freely filtered by glomeruli)
○ Filtered cystatin C - almost completely reabsorbed by proximal tubular cells and catabolized to AA
○ Produced at a constant rate = May serve as a marker of GFR

10

What can affect cystatin C?

inflammation or neoplasia

11

When does urinary concentrating ability lost?

When 66% of nephrons are lost

12

When does azotemia occur?

When 75% of nephrons are lost

13

When is it best to use the creatinine clearance?

When the patient is PU/PD but their BUN and creatinine are normal

14

Name agents that can be administered for a single injection to estimate GFR?

inulin, iohexol or Creatinine

15

When is dynamic renal scintigraphic methods with radioisotopes helpful?

When individual renal function information is needed

16

What is microalbuminuria an indication of ?

§ Humans: Early indication of vascular endothelial damage
Dogs/cats: 15-20% normal animals have an increase, unknown if results in progressive renal dz in vet med

17

What is the Bladder Tumor Antigen Test and what are problems with it?

latex agglutination dipstick test that detects glycoprotein antigen complex associated with bladder tumors in people
alse + occur w/ marked proteinuria, glucosuria, pyuria, hematuria
§ Good to differentiate neoplasia from normal dogs, but not good in animals with other LUT dz

18

What is the role of the water deprivation test?

tubular function test, used to decipher between DI vs psychogenic PD

19

When is the maximal stimulation of ADH release?

With 5% loss of BW!

20

What is the benefit of the gradual water deprivation test?

use to eliminate diagnostic confusion created by medullary wash out
○ Dogs with pyschogenic PD: Endogenous release of ADH, increased permeability of inner meduallary collecting ducts to urea and restoration of normal gradient of medulalary hypertonicity

21

Which electrolyte is good for pre renal vs renal disease?

Fractional excretion of Na: Pre-renal animals should have avid Na conservation!

22

What is the renal threshold for glucose in dogs and cats?

Renal threshold glucose – Cat 300, Dog 180 mg/dL

23

What ketones are noted on the dipstick?

○ Nitroprusside reagent (dipsticks) - Acetone < acetoacetate (NOT with beta-hydroxy)

24

What is the renal worm?

Dioctophyma renale

25

Which breed can get renal telangectasia?

Welsh Corgi

26

What is a caudate cells?

transitional cells w/ tapered edges that originate from the renal pelvis

27

Which casts are normal in low number?

Occasional hyaline and granular casts

28

What is a hyaline cast?

pure proteins precipitates (Tamm-Horsfall mucoprotein and albumin), dissolve in dilute or alkaline urine; Small numbers can be seen with fever/exercise; seen in diseases assoc. with proteinuria

29

What is a coarsely or fine granular cast?

degeneration of cells in other casts or precipitation of filtered plasma proteins; * suggestive of ischemic or nephrotoxic renal tubular injury

30

What is a fatty cast?

Fatty cast – type of coarsely gran cast – contain lipid granules; seen with nephrotic syndrome or DM