Urinary Flashcards

Question

infectious AKI

Answer 1

pyelonephritis - infection of kidneys - usually e coli pyelonephrosis - dilation of renal pelvis with pus more common in acute on chronic risk factors - obstruction diabetes renal and non renal neoplasia signs - pyrexia neutrophilia renal pain renal pelvic/uretal dilation or free fluid on ultrasound diagnosis - cystocentesis - culture treatment - antibiotics with good renal perfusion lepto - doxy or amoxyclav sepsis - amoyclav surgical drainage

Answer 2

hypovolemia and distrubutive shock --> marked pre renal azotemia hyperkalemia and hyperphosphatemia looks like AKI - check basal cortisol to rule out addisonian crisis if high suspicion then ACTH stim and treat preemptively

Answer 3

supportive care maintain hydration maintain calorie intake assessing and treating systemic hypertension address electrolyte and acid base imbalance discontinue nephrotoxic drugs

Answer 4

fluids electrolytes feeding tube/assisted feeding

Answer 5

stages of fluid therapy - resuscitation - replacing intravascular deficits, only needed if signs of shock optimisation - rehydration of total body deficits - based on % dehydration signs and monitored stabilisation - maintenance water requirements - if not able to do themselves, consider ins and outs evacutation - de escalation - reduce until drinking on its own with regular hydration assessments lactated ringers potassium supplementation if needed creatinine will go up when stop - removing dilution effect note oliguria and anuria - ins and outs approach

Answer 6

uremia --> nausea --> anorexia oral ulceration - pain medications - anti nausea (maropitant), appetite stimulants if can't eat 75% required intake by 48 hours - tube

Answer 7

lots of animals with AKI get hypertension some antihypertensive medications are nephrotoxic amlopidine RAAS inhibitors can worsen AKI, can use in CKD so when reclassified at 3 months can reevaluate

Answer 8

hyperkalemia - in obstructive AKI - IV or oral supplements hyperphosphatemia - always present in AKI hypernatremia - usually resolves with rehydration

Answer 9

rare synthesis and deposition of misfolded proteins in tissues profuse diarrhoea - fibrin deposition in intestinal mucosa enlarged kidney - palpable per rectum subcutaneous oedema weight loss protein losing nephropathy - foamy urine amyloid deposition in renal glomeruli euthanasia, condemned at slaughter

Answer 10

cattle and pigs bacterial infection - renal pelvis actinobacterium suis or e coli in pigs range of bacteria in cattle pus in ureters at pm

Answer 11

pigs in prepuce and preputial diverticulum of boars infection through natural service pus abscesses cystitis - common reason for culling pain (hunched back) anorexia polydipsia loss of condition vulval discharge hematuria may die suddenly urine test - bacteriology treatment - antibiotics (success dependent on stage of infection)

Answer 12

pyelonephritis in sows that are AI'd ascending infection from fecal contamination of vulva predisposed by restricted water (not flushing out enougyh) cystitis pyelonephritis increased urine frequency - little and often pus/blood in urine treatment - antibiotics, renal damage may be permanent if pyelonephritis set in prevention - hygiene and unrestricted water access

Answer 13

more in older beef cattle range of bacteria acute - pain, dullness, frequent urination, coloured urine, pyrexia, enlarged kidney chronic - loss of condition, drop in yield, urination little and often treatment - antibiotics probably won't work condemnation of carcass at salughter if systemic infection

Answer 14

ruminants nephrotoxins - oak, oxalates, heavy metals, aminoglycosides, tetracyclines renal ischemia - caused by mastitis, metritis, abomasal torsion, salmonellosis depression inappetance mild bloat diarrhoea treatment, supportive care, remove toxin

Answer 15

lambs up to 4 months dull anorexia weight loss death swollen pale kidneys at PM usually following coccicia, menatodirus or crypto infection

Answer 16

Clostridium Novyi B necrotic liver damage

Answer 17

Clostridium chauvoei muscle tissue damage

Answer 18

clostridium botulinum nervous, flaccid paralysis

Answer 19

clostridium tetani nervous, after open wounds, rigidity

Answer 20

clostridium perfringens D 4-10 week old lambs - unvaccinated dam older weaned lambs that aren't vaccinated often triggered by move onto better pasture or supplemental feeding sudden death enterotexmia - from clostridial toxins, not from kidney disease convulsion pulmonary oedema friable kidneys at PM prevent - vaccinate pregnant ewes, vaccinate lambs twice before weaning

Answer 21

zoonosis - abortion material and urine splash high risk for humans abortion, still birth, weak calves, infertility milk drop colonises renal tubules and intermittently excreted in urine - infected waterways serology for diagnosis vaccination available

Answer 22

coffee coloured hematuria ixodes ricinus - heather, fern, tall grass, hilly regions - peak in spring and autumn zoonosis - rare but serious signs - dullness inappetence pyrexia loud heart sounds hematuria pipe stem feces --> constipation young animals usually have no signs early exposure - immunity in endemic areas prevention - tick control treatment - imidocarb (long withdrawal), blood transfusion, symptomatic treatment (laxative for constipation)

Answer 23

NB often due to predisposing disease, common in hospitalised horses uremia --> anorexia colic signs uremic encephalopathy - nervous signs attempting to urinate and showing discomfort (obstruction) pyrexia - acute septic nephritis (rare) signs often masked by primary condition

Answer 24

history, signs azotemia isosthenuria electrolyte abnormalities - variable potassium (reduced excretion but diet can compensate) serum magnesium - high in renal or pre renal calcium - elevated in Chronic renal failure minimal proteinuria bacteremia rare USG - differentiate pre ranl azotemia from kidney disease

Answer 25

treat underlying disease correct dehydration and hypertension avoid nephrotoxic drugs surgery - remove obstructions

Answer 26

irreversible greater than 3 months less common than acute

Answer 27

non specific wight loss dull PUPD peripheral oedema dull coat anemia inappetence change in mentation mild diarrhoea uremic encephalopathy

Answer 28

azotemia mild anemia low albumin hyperkalemia - distinct feature urinalysis - renal casts, WBCs, proteinuria (more often in AKI) Ultrasound - more useful in chronic than acute biopsy - not that useful, can cause haemorrhage

Answer 29

progressive and irreversible symptomatic treatment steroids avoid dehydration avoid nephrotpxic drugs vegetable oil - increase calorie intake high energy low calcium diet stone removal - probably won't bother poor prognosis long term

Answer 30

increase in creatinine and/or urea

Answer 31

clinical signs associated with azotemia

Answer 32

normal - gradual inflammation and destruction of kidney functional units, 2/3 gone to signs acute kidney insult - causing long lasting inflammation and damage --> follows normal pattern acute on chronic - acute attack with existing CKD, once acute attack over then return to CKD state, usually worse off neoplasia - grows and reduces function degenerative (eg polycystic kidney disease) - cysts spread in increase in size --> reduced function juvenile onset CKD - start reducing function, over time clinical glomerular disease - marked proteinuria, excess protein, reduction in function tubulo-interstitial nephritis most common cause

Answer 33

Creatinine - produced in muscles filtered by kidneys main parameter no increase until 75% loss also affected by muscle mass, hydration state and hyper thryoidism urea - produced by liver filtered by kidneys more variable than creatinine less reliable SDMA - produced by most cells filtered by kidneys less affected by external factors earlier diagnosis not affected by muscle mass less good for monitoring progression -m normal day to day variation USG - urine concentrating ability phosphates - disurption of phosphate calcium vitamin D cycle higher may mean more discomfort anemia - anemia of chronic disease reduced erythropoietin production pH - metabolic acidemia in very advanced CKD FGF-23 - novel biomarker for CKD only in cats currently early indication of phosphate increases

Answer 34

uremia - weight loss, halitosis, dullness, anorexia, nausea, mouth ulcers, muscle and condition loss signs relating to underlying cause different sized kidneys signs vary a lot with degree of azotemia

Answer 35

renal diet - adequate calorie, digestible, good quality protein, supplements slow transition onto new diet assisted feeding appetite stimulants - metazopine, capromorelin anti nausea - ondansetron, metazpoine (don't use metazopine and ondansetron together) gastroprotectants - omeprazole (only if ulceration) readily available water, water falvour enhancer early renal diets - low phosphate and restricted protein fluids

Answer 36

target lower than range interval dietary restriction phosphate binders - given with foodm calcium or aluminium based monitor with FGF-23

Answer 37

protein restricted diet monitor RAAS inhibitors - dogs angiotension receptor blocks, cats ace inhibitors

Answer 38

treat at PCV <0.2 erythropoeitin and iron supplements may need transfusion

Answer 39

can lead to issues with other organs and seizures reliable BP measurements dogs - ace inhibitor cat - amlodipine or angiotension receptor blocker

Answer 40

nephrotoxic drugs - NSAIDs - discontinue positive urine cultures - treat as pyelpnephritis hypokalemia - seen in advanced cases, lethary anorexia and muscle weakness, supplement oral potassium hypercalcemia - complicated acidemia - muscle wastage and anorexia, can supplement potassium cirtate or sodium bicarbonate but can put them off food

Answer 41

iris 1 - every 6 months iris 2 - 3-6 months iris 3 - 1-3 months iris 4 - 1-2 months starved sample - blood/urine BCS muscle condition hydration creatinine (and urea but not as important) phosphates urine protein:creatinine BP - doppler PCV - anemia of chronic disease optional - acid:base, ionised calcium, FGF-23 cysto centesis - if suspicious of pyelonephritis

Answer 42

glomerular filtration marker increases earlier in damage still affected by pre- and post-renal causes day-to-day variation so not as good for tracking progress as creatinine not affected by muscle mass will definitely be up if creatinine already increased

Answer 43

only in cats indicator of phosphate levels - assessment of whether phosphate restriction working assess need for early renal diet in early stages

Urinary Flashcards

(68 cards)