Urinary

Question 1

What electrolytes are considered intracellular?

Answer 1

K+, P

Question 2

What electrolytes are considered extracellular?

Answer 2

Na, Cl, HCO3

Question 3

How does PTH control P levels in the body?

Answer 3

PTH causes P and Ca2+ release from bones. In order to prevent hyperphosphataemia it also results in the excretion of P from the kidney

Question 4

What five mechanisms lead to hyperphosphataemia?

Answer 4

Failure to excrete (renal failure/ obstuction)
Increased release from bone (hyperthyroid)
Increased intake (hyper vitD3)
Increased renal reabsorption (hyperPTH)
Spurious (haemolysis)

Question 5

What mechanisms can lead to hypophosphataemia?

Answer 5

Anorexia
Decreased renal resorption
Primary hyperPTH
Paraneoplastic

Question 6

What is the reference value for hyponautraemia?

Answer 6

<140mmol/L

Question 7

What mechanisms can lead to hyponautraemia?

Answer 7

Increased loss - V+, D+, renal, hypoAC, effusion loss, iatrogenic
Volume overload - CHF, renal failure
Increased plasma osmolality

Question 8

What is the reference value for hypernautraemia

Answer 8

> 160mmol/L

Question 9

What mechanisms can lead to hypernautraemia?

Answer 9

Free water loss - DI, heat stroke, water deprivation, pyrexia
Hypotonic fluid loss - GI, renal, diuresis, DM
Excessive intake
Excessive resorption - hyperaldosteronism
Iatrogenic

Question 10

What mechanisms control potassium levels in the body?

Answer 10

Aldosterone, insulin, SNS

Question 11

What clinical signs are associated with hyperkalaemia

Answer 11

Bradycardia, atrial standstil!

Question 12

What substance can lead to an artefactual hyperkalaemia of the blood?

Answer 12

EDTA

Question 13

What clinical signs are associated with hypokalaemia?

Answer 13

Muscle weakness, PUPD, low USG, ileus, constipation, myopathy (cats)

Question 14

What mechanisms can lead to hyperkalaemia?

Answer 14

Decreased excretion (UT obstruction, hypoAC), extracellular translocation (tumour, trauma, necrosis, KDM), increased intake (iatrogenic)

Question 15

What mechanisms can lead to hypokalaemia?

Answer 15

Decreased intake, intracellular translocation (catecholamines, hypothermia, fluid therapy), increased loss (V+, D+, iatrogenic)

Question 16

What clinical signs are associated with hypercalcaemia?

Answer 16

pupd

Question 17

What clinical signs are associated with hypocalcaemia?

Answer 17

Muscle tremors, seizures, facial pruritis, lethargy, weakness

Question 18

What aetiologies can lead hypercalcaemia?

Answer 18

Paraneoplastic, anal-gland carcinoma, Tcell lymphoma, renal dz, primary hyperPTH, hypoadrenocorticism, vitD3 tox

Question 19

What aetiologies can lead hypercalcaemia?

Answer 19

ethylene glycol, hypoPTH, renal dz, pancreatitis

Question 20

What chemical markers are used to assess GFR?

Answer 20

Creatinine, urea, SMDA

Question 21

What percentage of produced urea is resorbed in the nephron?

Answer 21

40%

Question 22

Why can urea NOT be used as a marker of GFR in ruminants?

Answer 22

It is degraded in the rumen by microbes!

Question 23

What does an increase in blood urea mean?

Answer 23

Reduced GFR

Question 24

What aetiology may lead to increased blood urea?

Answer 24

GI haemorrhage - protein breakdown/ hypovolaemia and dehydration - MILD
Renal dysfunction

Question 25

What aetiology may lead to a decrease in blood urea?

Answer 25

Aggressive fluid therapy | Decreased urea production - low protein diet, liver disease, PSS

Question 26

Why is creatinine no necessarily the best marker for GFR?

Answer 26

It is also increased with increased muscle mass (eg staffy, GH etc)

Question 27

Azotaemia

Answer 27

Increased serum BUN and creatinine

Question 28

Uraemia

Answer 28

Clinical syndrome characterising kidney disease as azotaemia + clinical signs (PUPD, regenerative anaemia, v+ depression, lethargy and wt loss)

Question 29

What type of azotaemia is characterised by concentrated urine, urea greater than creatinine and clinical signs of dehydration/ hypovolaemia?

Answer 29

Pre-renal - dehydration or decreased cardiac output

Question 30

What type of azotaemia is characterised by concentrated urine, urea increased and normal creatinine?

Answer 30

Pre-renal - increase in nitrogen (high protein diet, GI haemorrhage

Question 31

What type of azotaemia is characterised by a poor concentrating ability?

Answer 31

Renal

Question 32

What type of azotaemia may be characterised by hyperkalaemia, an/ oligouria and a hypercreatinine abdominocentesis fluid?

Answer 32

Post-renal - urinary tract rupture

Question 33

Why is SMDA a more sensitive measurement of GFR?

Answer 33

It is not affected by muscle mass

Question 34

USG> 1.029

Answer 34

Optimal concentration (check for dehydration)

Question 35

USG 1.030 dog/ 1.035 cat

Answer 35

Functioning tubules, supporting dehydration

Question 36

USG 1.012-1.030

Answer 36

Normal if ell hydrated or partial impairment of the concentrating ability

Question 37

USG 1.008 - 1.012

Answer 37

Over hydrated or not concentrating (if dehydrated)

Question 38

USG 1.000-1.007

Answer 38

ADH problem (eg DI)

Question 39

What extra renal causes can lead to azotaemia/ dehydration/ poor concentrating abilities?

Answer 39

ADH, aldosterone, iatrogenic, washout, infection

Question 40

What may proteinuria + low USG indicate?

Answer 40

Glomerular disease, protein overload

Question 41

Describe the interpretation of UP/C ratio.

Answer 41

If the ratio is >0,5 (dog) or 0.4 (cat) it indicated proteinuria

Question 42

What may an elevated UP/C without hyperproteinaemia indicate?

Answer 42

Glomerular disease