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Urinalysis & Renal Flashcards

(47 cards)

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1
Q

ADH

A

Hypthalamus –> posterior pituitary –> AHD release –> DCT and collecting duct –> increased urine concentration

release triggered by-
increased plasma sodium
hypovolemia
hypotension

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2
Q

Diabetes Insipidus

A

low ADH
Too much water released
polyuria and polydipsia

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3
Q

Addisons

A

high potassium –> aldosterone release

low aldosterone

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4
Q

Diabetes Mellitus

A

increased blood glucose
glucose in urine
increased volume
increased USG and osmolality

signs - weight loss, polyphagia, lehtargy, cataracts

mix up with stress hyperglycemia in cats

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5
Q

stranguria

A

straining to pass urine

lower urinary or genital tract
obstructive or non-obstructive
bladder inflammation
bladder atony
urinary tract obstruction
caliculi or mineralised masses

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6
Q

hematuria

A

blood in urine

macro or micros
iatrogenic
pathological
genital source
coagulopathies - look for hemorrhage at other sites
pigmenturia - hemoglobinuria or myoglobinuria
gross - >150 RBCs/hpf
occult - >5 RBCs/hpf

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7
Q

dysuria

A

difficult/painful urination

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8
Q

pollakiruria

A

frequent urination insmall amounts

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9
Q

periuria

A

urination at inappropriate sites

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10
Q

anuria

A

failure of urine production at kidneys

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11
Q

oliguria

A

reduction of urine production by kidneys

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12
Q

polyuria

A

increased urine production

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13
Q

polydipsia

A

increased thirst

2x normal maintenance drinking - around 100ml/kg/day

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14
Q

Free catch

A

ideally mid flow

pros - easy, owner can do, non-invasive, non-traumatic, modified cat litter
cons - manual expression can rupture bladder, contamination

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15
Q

Cystocentesis

A

pros - don’t have to wait or force, easy in cats, aseptic - culture, better tolerated than catheter, easy, low risk of iatrogenic hematuria and infection
cons - some experience needed, needs enough urine in bladder, may cause rupture if severe disease or clotting problems, risk of hitting other organs - sample contamination

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16
Q

Catheterisation

A

pros - low contamination risk, don’t have to wait
cons - needs experience, easier in males, infection, hematurria, mucosal damage, contamination from lower urinary tract

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17
Q

USG

A

Normal ranges
dogs - 1.015-1.045
cats 1.035-1.060

hypostheniuria - <1.008 - actively diluting
isosthenuria - 1.008-1.012 - neither diluting or concentrating
hypersthenuria - >1.012 - actively concentrating
dehydration - >1.030

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18
Q

pH

A

high - UTI - urease producing bacteria
low - UTI - acid-producing bacteria

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19
Q

dipstick - bilirubin

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A

RBC breakdown

20
Q

dipstick - haem/blood

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A

presence of hemoglobin - or alkaline urine can lyse RBCs (false positive)

21
Q

dipstick - glucose

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A

diabetes mellitus or stress induced hyperglycemia

22
Q

dipstick - ketones

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A

diabetes mellitus

23
Q

dipstick - protein

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A

kidney damage

24
Q

Crystals

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A

struvite - most common
cystine - hexagonal
calcium oxalate dihydrate - envelope
calcium oxalate monohydrate - picket fence
bilirubin - orange-brown spikes
ammonium biurate - round
amorphous - random shape - urates in acidic urine, phosphates in alkaline

25
Nephrolith
kidney calculus often asymptomatic, pain, pyuria, pyrexia, PUPD
26
Ureterolith
ureter calculus renomegaly, renal failure, PUPD
27
Cystolith
bladder calculus lower urinary tract signs, sometimes palpable, PUPD
28
Urethroliths
urethra calculus lower urinary tract signs, abdominal discomfort, licking at penis/vagina most likely to be emergency
29
Urolithiasis - imaging
radiograph - radiopaque - struvite, calcium oxalate, calcium phosphate radiolucent - ammonium urate, cystine Ultrasound - hard to spot
30
PUPD - signs (6)
needing to go out more frequently having accidents long stream of urine filling bowl more frequently at bowl more often puddle drinking
31
primary polyuria with secondary polydipsia
more common primary central diabetes insipidus - hypothalamus dysfunction, lack of ADH primary nephrogenic diabetes insipidus - inability of DCT to respond to ADH - due to mutation secondry nephrogenic diabetes insipidus - inability of DCT to respond to ADH - reduced sensitivity - ecoli toxins or Addisons osmotic diuresis - diabetes mellitus, CKD, liver disease, medications reduced medullary concentration gradient - fluid therapy, corticosteroids, addisons, liver failure
32
Primary polydipsia with secondary polyuria
cerebrocortical disorders - lesion affecting thirst centre psychogenic endocrine disorders
33
CKD
signs - hallitosis, decreased BCS, inappetance, oral ulcers lost nephrons --> reduced water reabsorption diagnosis - renal azotemia, non-regen anemia, hypokalemia, hyperphosphatemia, USG low, proteinuria
34
pyelonephritis
inflammation of renal pelvis loss of nephrons --> eventual CKD signs - lower UT signs, hematuria, pollakiuria, stranguria, spine pain, renomegaly, pyrexia, lethargy diagnostics - US, left shift in inflammatory leukogram, urine culture and sensitivity
35
Pyometra
infection in progesterone primed uterus - usually ecoli open and closed type - purulent discharge or lethargy, pyrexia, inappetence, vomiting, diarrhoea diagnostics - left shift leukogram, azotemia, ultrasound
36
hyperthyroidism
over production of thyroid hormones signs - poor condition, weigh loss, v++, d++, hyperactivity and weirdness, tachycardia, heart murmur, gallop rhythm, thyroid goitre diagnostic - ALT and T4 increase
37
hyperadrenocortisim (cushings)
signs - polyphagia, pot belly, tinning skin, coat changes diagnostics - high ALP, low USG, ACTH stimulation, low dose dexmethadone suppresion test, urine cortisol:creatinine ratio (rule out not confirm)
38
hypoadrenocorticism (addisons)
loss of adrenal cortical cells signs - vague, GI signs, collapse, shock diagnostics - Na:K under 23, ACTH stim
39
hypercalcemia
range of conditions but usually result of neoplasia increase total calcium in blood
40
hepatic disease
increased liver enzymes (ALP, ALT, GGT), decreased urea, cholesterol albumin and glucose, bile acid stim test, imaging
41
Azotemia
accumulation of non-protein nitrogenous compounds in blood - urea and cretinine
42
uremia
azotemia that is causing clinical signs of renal failure
43
renal disease - pre-renal
reduced renal blood flow expected USG >1.030 increased urine volume resolves with fluid therapy dehydration, hypovolemia, hypotension, shock
44
renal disease - renal
reduced GFR expected USG - 1.007-1.013 azotemia sustains after fluid therapy dehydration
45
renal disease - post renal
defective excretion distal to nephron obstruction or rupture of urinary tract dysuria usually reversible unless renal component with nephron damage
46
Causes of renal disease (3)
glomerular (excretory) dysfunction - BUN, creatinine metabolism failure - insulin, glucagon, GH failure to synthesise - erythropoieitin, calcitrol
47
acid-base homeostasis
kidneys reabsorb bicarb in PCT excrete metabolic acid load at DCT dysfunction --> lost bicarb in urine --> reduced acid secretion --> metabolic acidosis

PCP (10 decks)

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