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Flashcards in Urinary Pathology Deck (311):
1

What can cause the glomerulus to become visible to the naked eye?

Glomerulonephritis

2

Microscopic appearance of the glomerulus. (3)

1. Fenestrated capillaries supported by mesangium
2. Mesangial cells
3. Podocytes

3

4 main fxns of mesangial cells

produce collagen & matrix
contract glomerular tuft
phagocytosis
secretion of inflammatory mediators

4

What are the visceral epithelial cells that participate in glomerular filtration?

podocytes

5

Glomerular filtration barrier selectively filters molecules based on:

size (< 70,000 Da)
charge (cations only)

6

Describe the glomerular filtration barrier.

filtration slits btwn podocyte pedicels & fenestrated endothelial cells w/ shared basal lamina

7

3 things that cause an increase in the amt of CT (scar tissue) in the interstitium of the kidney?

1. age
2. chronic inflammation
3. ischemic damage

8

List the path blood flows through the kidneys

renal a.--> interlobar a. ---> arcuate a--> interlobular a.--> afferent glomerular arterioles--> glomerular capillaries--> efferent glomerular arterioles--> peritubular capillary network

9

Which arteries are more susceptible to embolism leading to renal infarction? Why?

interlobular a.
terminal arteries that do NOT contain anastomoses & have a small lumen diameter

10

5 characteristics of renal infarction

1. wedge-shaped
2. well demarcated
3. dark red or white
4. acutely swollen (inflammation)
5. chronically contracted (fibrosis)

11

5 basic renal fxns

1. Urine --> eliminates metabolic waste
2. Acid-base regulation--> reclaims bicarbonate
3. Conserves H2O --> 99%
4. Maintains normal extracellular [K]--> via aldosterone--> K excretion
5. Controls endocrine fxn--> RAAS --> NaCl retention

12

What dictates plasma filtration?

Glomerular filtration barrier

13

How is BP regulated?

Renin-Angiotensin-Aldosterone System (know details)

14

The macula densa responds to low _____.

Na

15

Low Na stimulates juxtaglomerular cells to secrete______.

Renin

16

Fxn of Renin.

Converts Angiotensinogen ---> Angiotensin I
(liver)

17

Fxn of ACE.

Angiotensin I--> Angiotensin II
(lungs)

18

Fxns of Angiotensin II

1. stimulates aldosterone secretion (AG)
2. stimulates ADH (PPG)
Cumulative effect= incr. BP

19

What kind of drugs are ACE-inhibitors?

anti-hypertensive

20

7 things reabsorbed in the Proximal tubules

Na, Cl, K, albumin, Gluc, H20, bicarb

21

How does the LoH produce a hypotonic filtrate?

via a countercurrent mechanism & Na/K-ATPase pump which absorbs more NaCl from the filtrate

22

2 places H20 is reabsorbed in the kidneys?

Distal tubules
Collecting ducts

23

What hormone influences Na & H2O reabsorption & K excretion in the Distal Tubules?

Aldosterone

24

How do the Collecting Ducts promote H2O reabsorption?

increasing urea gradient

25

How are H2O & Na reabsorption controlled in the Collecting Ducts?

Na/K-ATPase pumps, under the influence of ADH

26

What provides structural support for the glomerulus, tubules, BVs, lymphatics & nerves of the kidney?

the Interstitium

27

Interstitial fibroblasts produce what 3 things?

EPO (+ peritubular cells)
Prostaglandins
Inflammatory mediators

28

Definition of renal failure.

significant loss of renal fxn
(kidneys have 75% fxnal reserve)

29

Clinical indicators of renal failure

1. Altered urine quantity - PU/PD; oliguria; anuria
2. Altered urine quality- Isosthenuria, proteinuria, azotemia, uremia

30

What does Isosthenuria inidcate? (TQ)

loss of renal fxn--> failure to concentrate urine

31

What does azotemia indicate? (TQ)

elevated serum Urea & Creatinine = >75% loss of nephrons

32

Uremia is a _______ characterized by numerous lesions & C.S.s caused by toxic levels of urea in blood.

syndrome

33

2 mechanisms by which uremia causes systemic lesions.

1. uremic vasculopathy
2.uremic toxicity

34

What is uremic vasculopathy?

direct endothelial injury resulting in vasculitis, thrombosis & infarction

35

What is the term for caustic injury to epithelium of mucosal surfaces due to production of LG amts or ammonia by urea-splitting bacteria?

uremic toxicity

36

Systemic lesions of uremic syndrome

ulcerative glossitis (ventral tongue)
ulcerative stomatitis
ammonia breath
ulcerative gastritis w/ mineralization --> Cat & Dog

37

7 additional non-renal lesions caused by uremic syndrome.

1. ulcerative colitis --> cattle & horse
2. vascular thrombosis
3. fibronous pericarditis
4. pulmonary edema
5. endocardial mineralization
6. intercostal mineralization
7. other soft tissue mineralizations

38

3 ways renal failure can lead to death.

1. cardiotoxicity due to elevated serum K
2. metabolic acidosis
3. pulmonary edema

39

3 classifications of renal failure & azotemia.

pre-renal
intrarenal
post-renal

40

Why does acute pre-renal failure occur?

impaired renal perfusion causes reduced glomerular filtration &/o hypoxic injury

41

2 things that lead to acute pre-renal failure.

circulatory collaspe
renal ischemia --> vasculitis or embolic dz.

42

Why does acute intrarenal failure occur?

damage to the renal tissue

43

4 things that can cause acute intrarenal failure.

acute tubular necrosis
glomerulonephritis
tubulointerstitial nephritis
pyelonephritis

44

When form of acute intrarenal failure is most common?

acute tubular necrosis

45

2 clinical presentations that result from intrarenal failure.

oliguria
anuria

46

2 way tubular necrosis results in further renal injury.

1. leakage of tubular ultrafiltrate--> necrosis & inflammation
2. intratubular obstruction --> tubular casts

47

5 bacT infections that cause acute tubular necrosis.

1. Lepto
2. E. coli
3. Strep
4. Staph
5. Proteus

48

3 virus that cause acute tubular necrosis in dogs.

1. K9 hepatitis
2. K9 distemper
3. K9 herpes

49

A substance that accumulates to toxic conc. w/in the tubules.

nephrotoxin

50

4 general categories of nephrotoxins

pigments
heavy metals
oxalates
plants

51

3 pigments that act as nephrotoxins

Hb, myoglobin, bile/bilirubin

52

5 heavy metals that act as nephrotoxins

lead, mercury, arsenic, cadmium & thallium

53

2 oxalates that act as nephrotoxins

ethylene glycol (antifreeze)
oxalate-rich plants

54

4 plants that can act as nephrotoxins.

pigweed, oaks, grapes/raisins & lilies

55

Why can Vit D toxicosis cause acute tubular necrosis (intrarenal failure)?

due to hypercalcemia

56

Which 4 drug types are nephrotoxic and can cause acute tubular necrosis?

antimicrobials
NSAIDs
immunemodulatory drugs
antineoplastic chemotherapeutics

57

4 things that can cause acute glomerulonephritits (intrarenal failure)

immune complexes
bacT
viruses
toxins

58

What causes acute pyelonephritits (intrarenal failure)?

ascending bacT infection from urethra, ureters & renal pelvis

59

What causes urinary obstruction w/ pressure atrophy & necrosis? (a.k.a obstructive nephropathy)

post-renal failure

60

3 causes of acute post-renal failure.

urolithiasis
tumors
iatrogenic

61

What 2 things can post-renal obstructions lead to?

hydroureter & hydronephrosis
(possible organ rupture)

62

Time period of chronic renal failure.

wks, mos., or yrs

63

When can CRF lead to end-stage kidney?

when it is prolonged & progressive

64

Term used to describe renal dz which is chronic, advanced, generalized, progressive & irreversible.

end-stage kidney

65

Gross appearance of an end-stage kidney

Fibrotic
Atrophic
Shrunken renal parenchyma
Massive loss of fxnal nephrons
Fibrosis

66

What is a common pathway to CRF, despite original cause of injury?

progressive fibrosis

67

Is it possible to determine the etiology once end-stage kidney is reached?

often impossible

68

Pathophysiology of CRF? (2)

1. non-regenerative anemia
2. altered Ca:P metabolism

69

How does CRF alter Ca/P metabolism? what is this process known as?

HYPERphosphatemia--> HYPOcalcemia---> PTH secretion--> Ca mobilized from osteoclastic bone resorption--> osteopenia

Renal 2ry Hyperparathyroidism

70

Chronic hyperparathyroidism may lead to _____ ______.

fibrous osteodystrophy (bone replaces fibrous tissue)

71

Renal 2ry hyperparathyroidism is often due to what?

bilateral parathyroid gland hyperplasia

72

4 portals of entry to the kidney

1. ascending from ureter
2. hematogenous
3. glomerular filtrate
4. direct penetration

73

Ascending bacT infection results in _______.

suppurative pyelonephritis

74

What is the most important barrier (defense mechanism) of the kidney?

glomerular basement membrane

75

What prevents ascending bacT from gaining access to the kidney's interstitium?

Tubular basement membrane (TBM)

76

What provides the scaffold for tubular regeneration?

tubular basement membrane

77

What typically destroys the TBM & causes permanent scarring w/ loss of tubules? (TQ)

Ischemia or Infarction

78

Humoral Abs protect the interstitium at the ____ ____ of the renal pelvis.

mucosal surface

79

What 3 cells w/in the interstitium provide cell-mediated immune surveillance against Lepto?

macrophages
lymphocytes
plasma cells

80

What is a defensive barrier against bloodborne pathogens?

intact endothelial lining (healthy vasculature)

81

Intact endothelium prevents activation of ____ ____ and reduces ____ formation

clotting cascade
thrombus

82

_____ to 1 part of the nephron results in _____ damage to other components of the nephron with eventual loss of _____.

Injury
progressive
fxn

83

Glomerular injury can result from the deposition of what 4 things?

1. immune complexes (Type III)
2. thromboemboli
3. Bact emboli or direct infections
4. amyloid & fibrin (proteins)

84

2 things that cause glomerular injury?

deposition of substances
hyperfiltration

85

2 things that result in hyperfiltration and glomerular injury?

prolonged systemic hypertension
increased dietary protein (prolonged proteinuria)

86

How does glomerular injury result in hypoxia with tubular atrophy & loss of fxn?

by interfering w/ peritubular blood supply

87

What 2 proteins leak into the urine due to damage to the glomerular filtration barrier?

Albumin
Antithrombin 3

88

2 characteristics of protein losing nephropathy?

nephrotic syndrome
wt. loss

89

What causes nephrotic syndrome? List some CS.

HYPOproteinuria --> reduced plasma oncotic pressure
C.S= ascites, pleural effusion, generalized edema

90

Loss of what protein can result in a hypercoagulable state & thromboembolic dz.

Antithrombin 3

91

List 4 ACUTE responses of the glomerulus to injury

1. mesangial hypertrophy & hyperplasia
2. increased vascular permeability
3. infiltration of leukocytes
4. necrosis

92

List 3 CHRONIC responses of the glomerulus to injury.

1. atrophy
2. Glomerulosclerosis (=fibrosis)
3. 2ry atrophy of renal tubules due to ischemia

93

List some things that can cause tubular damage

bloodborne infections
ascending infections
toxins
infarction/ischemia
volume overload
abnormal glomerular filtrate

94

What are some components of abnormal glomerular filtrate?

high protein
high crystalline salts
high organic acids --> oxalic/uric/pyruvic acid

95

4 responses to tubular damage?

1. atrophy (2ry)
2. degeneration
3. regeneration
4. necrosis

96

Which type of injury generally preserves the TBM & allows for regeneration of the tubules?

Toxic injury

97

Which type of injury destroys the TBM causing permanent scars & no regeneration of the tubules?

Ischemic injury

98

What is the single most important cause of acute renal failure in animals? (TQ)

Acute tubular necrosis

99

What are the 2 most common causes of acute tubular necrosis?

ischemia or nephrotoxicity

100

Acute tubular necrosis clinically results in ____ or _____.

oliguria or anuria

101

How does nephrotoxic injury cause acute tubular necrosis?

chemicals &/o toxic metabolites become concentrated in the tubules

102

3 mechanisms by which nephrotoxins cause damage to tubules?

1. direct damage to epithelium
2. reactive metabolites damage epithelium
3. nephrotoxin-associated ischemia

103

Form of tubular necrosis that is NOT caused by inflammation? (TQ)

nephrosis

104

What typically causes nephrosis?

hypoxic injury combined w/ nephrototoxic injury

105

Type of nephrosis caused when hypoxic injury is exacerbated by hemoglobinuria during a hemolytic crisis?

Hemoglobinuric nephrosis

106

Type of nephrosis caused when hypoxic injury in exacerbated by myoglobinuria during acute muscle injury?

Myoglobinuric nephrosis

107

Gross lesions of acute tubular necrosis (often difficult to recognize)

1. swollen, pale cortex that bulges on cut surface
2. may see accentuated striations or white streaks

108

Microscopic lesions of acute tubular necrosis? (6)

1. tubular epithelial swelling
2. vacuolation
3. HYPEReosinophilia
4. pyknosis
5. karyorrhexis
6. karyolysis

109

Which tubules are more sensitive to hypoxia due to higher metabolic demands?

proximal tubules

110

Which part of the kidney is resistant to ischemia & often remain morphologically normal?

glomeruli

111

Interstitium's response to injury. (7)

1. hyperemia
2. edma
4. lymphofollicular inflammation
5. fibrosis
6. interstitial nephritis
7. tubulointerstitial nephritis

112

What is the most common response of the interstitium to chronic Lepto infection?

lymphofollicular inflammation

113

What leads to progressive loss of renal fxn? (TQ)

progressive fibrosis

114

3 causes of infectious interstitial nephritis.

1. K9 ehrlichiosis
2. Leptospirosis
3. EIA

115

When will interstitial nephritis lead to renal failure & end-stage kidney?

only when it's severe

116

4 things that can cause 2ry tubulointerstitial nephritis?

Lepto
Adenoviruses
Lentiviruses
Herpesviruses

117

_____ tubulointerstitial nephritis leads to end-stage kidney.

Chronic

118

What causes a well-demarcated, cone-shaped area of coagulative necrosis extending from medulla to cortex?

renal infarction

119

3 portals of entry to the lower UT.

1. ascending infections
2. direct penetration from lumen
3. cyctocentensis

120

5 defensive mechanisms of the lower UT.

1. flushing action --> reduces risk of ascending infections
2. peristalsis --> eliminates bacT
3. slightly acidic urine --> reduces some bacT growth
4. protective urethral mucus layer --> decr. bacT adhesion
5. innate & adaptive immune response

121

5 developmental anomalies of the kidney.

1. renal aplasia, hypoplasia or dysplasia
2. ectopic kidney
3. fused kidney
4. renal cysts
5. polycystic kidneys

122

Juvenile progressive nephropathy is a specific form of inherited renal dysplasia common to what 3 breeds?

Lhasa apso
Shih Tzu
Golden retriever

123

"Horseshoe kidney" is an example of which developmental anomaly? What is the fxn of these kidneys?

fused kidney
usually maintain normal fxn

124

Ectopic kidney is most common in what 2 species?

dogs & pigs

125

Renal cysts are common in what 2 species?

cattle & pigs (just 1 to a few)

126

What is the clinical significance of renal cysts?

none--> usually an incidental finding

127

Term for many renal cysts affecting numerous nephrons?

Polycystic kidney

128

Polycystic Kidney Dz in an autosomal dominant trait in what 2 breeds? (TQ)

Persian cats
Bull Terriers

129

Dz caused by mutations in PKD-1 &/o PKD-2 resulting in abnormal tubulogenesis?

Polycystic Kidney Dz.

130

When can renal function by impaired in patients w/ Polycystic Kidney Dz?

severe cases --> when significant loss of parenchyma

131

List the 6 diseases of the glomerulus.

1. immune-mediated glomerulonephritis
2. glomerulosclerosis
3. glomerular amyloidosis
4. Acute suppurative glomerulitis (bacT embolic nephritis)
5. viral glomerulitis
6. chemical glomerulitis

132

Immune mediated glomerulonephritis occurs most commonly in ____ & _____.

cats & dogs

133

Immune mediated glomerulonephritis is associated with ___ ___ which enhances the formation of abundant ____ ____ in the blood plasma.

persistent infections
immune complexes

134

What results in complement fixation, leukocyte infiltration & formation of fibrin thrombi --> glomerular damage?

deposition of soluble immune complexes w/in glomeruli

135

What 5 things can cause immune-mediated glomerulonephritis in cats?

FeLV
FIV
FIP
progressive polyarteritis
neoplasia

136

What 2 things cause immune-mediated glomerulonephritis in horses?

Strept infections
EIA

137

What 2 things cause immune-mediated glomerulonephritis in cattle?

BVD
Trypanosome infections

138

What 2 viruses cause immune-mediated glomerulonephritis in swine?

Classical SF (Hog cholera)
African SF

139

What gross lesion of immune-mediated glomerulonephritis might you see?

swollen, enlarged glomeruli as red pin-point foci in the cortex

140

List the 3 histologic forms of immune-mediated glomerulonephritis. Species each is common in?

1. proliferative --> horses
2. membranous --> cats
3. mebrano-proliferative --> dogs

141

What is the condition of CHRONIC glomerulonephritis characterized by fibrosis of the glomerulus?

glomerulosclerosis

142

2 things associated with glomerulosclerosis?

high BP
unrestricted dietary protein

143

What is typically associated w/ Reactive Systemic Amyloidosis (AA amyloidosis) that occurs w/ CHRONIC inflammatory dz?

glomerular amyloidosis

144

Which 2 breeds are genetically predisposed to reactive amyoidosis? (TQ)

Abyssinian cats
Chinese Shar-Pei dogs

145

What is a common cause of protein losing nephropathy?

glomerular amyloidosis

146

What stain can be used to ID amyloid protein histologically?

Congo red stain

147

List the 4 examples of bacT & affect species that cause actute suppurative glomerulitis. (LG animals)

1. A. equuli --> foals
2. E. rhusiopathiae --> pigs
3. C. pseudotuberculosis --> goats & sheep
4. T. pyogenes --> cattle

148

List the 5 causes of viral glomerulitis? common or rare?

1. Infectious K9 hepatitis (adeno-)
2. EVA (arteri-)
3. CSF (pesti-)
4. Newcastle dz (paramyxo-)
5. neonatel porcine cytomegalovirus
Rare

149

List 4 known examples that cause chemical glomerulitis

1. puromycin aminonucleoside
2. adriamycin
3. histamine-receptor antagonists
4. cyclosporin A

150

List 2 inherited abnormalities in renal tubular FXN.

1. 1ry renal glucosuria --> trouble reabsorbing Gluc--> Norwegian elkhounds
2. Basenji dog Fanconi Syndrome

151

Are there any lesions associated with 1ry Renal Glucosuria?

no, only a fxnal deficit

152

What other dz must by distinguished from 1ry Renal Glucosuria?

Diabetes mellitus

153

C.S. of acute tubular necrosis? (TQ)

oliguria or anuria w/ severe azotemia

154

Hemoglobinuria nephrosis & hemoglobinuria w/ hemolysis occurs in what 4 things? Species?

1. Cu toxicity --> sheep
2. Lepto or Babesia --> cattle
3. Red maple toxicity --> horse
4. Babesia or IMHA--> dogs

155

3 things that cause myoglobinuria (myoglobinuric nephrosis)?

1. exertional myopathy (azotemia, tying up) --> horses
2. capture myopathy (rhabdomyolysis)--> wild animals
3. severe mm. trauma

156

List the 3 histologic changes seen in acute tubular necrosis.

tubular necrosis
tubular degeneration
IN inclusion bodies

157

When can nephrotoxic drugs cause acute tubular necrosis?

when administered at excessive doses or too frequently

158

Which drugs decrease the synthesis of renal prostaglandins which are responsible for maintaining normal renal blood flow?

NSAIDs

159

NSAIDs cause renal ____________.

vasoconstriction

160

NSAIDs cause acute tubular necrosis & ___ ___ ___.

renal papillary necrosis

161

Which mycotoxin from contaminated feed can result in acute tubular necrosis?

aflatoxin

162

What 2 things do mycotoxins cause?

tubular degeneration
tubular necrosis

163

List the 4 oxalate-rich plants

Halogeton
Sarcobatus
Rheum
Rumex

164

What happens when Ca oxalates precipitate in renal tubules froming oxalate crystals w/ subsequent epithelial injury & renal failure?

Oxalate nephrosis

165

Grapes & raisins can cause acute tubular necrosis in what species?

dogs

166

Lilies can cause acute tubular necrosis in what species?

cats

167

Oak toxicity can cause acute tubular necrosis in what 2 species?

cattle
horses

168

Ethylene glycol (antifreeze) results in ___ ____ & ___ ____.

nephrotoxic metabolites --> oxalate & glycolic acid
oxalate nephrosis

169

What 2 pet food contaminants cause distal tubular necrosis w/ characteristic irregular brown birefringent crystals?

Melamine
Cyanuric acid

170

Vit D toxicosis leads to ____calcemia.

hypercalcemia

171

Hypercalcemia causes ______ mineralization of tubular & glomerular basement membranes.

metastatic

172

Metastaic mineralization is followed by what 4 things?

degeneration
necrosis
fibrosis
loss of fxn

173

Pulpy Kidney is a typical dz seen in what animals?

small ruminants

174

What causes Pulpy Kidney?

enteric proliferation of C. perfringes type D

175

What exotoxin is produced in Pulpy Kidney dz?

Epsilon exotoxin

176

What 3 things do epsilon exotoxin cause in small ruminants?

Bilateral acute tubular degeneration & necrosis
Interstitial edema
Hemorrhage

177

What is caused by dilation of the renal pelvis due to obstruction of urine outflow?

Hydronephrosis

178

Pyelonephritis leads to infection of the ____ ____ w/ extension to the ____ ___.

renal pelvis
renal tubules

179

Pyelonephritis is often unilateral or bilateral?

bilateral (can do either or)

180

Gross lesion of pyelonephritis

expansion of renal pelvis by purulent exudate

181

Microscopic lesions of pyelonephritis

suppurative inflammation of pelvis & medulla w/ necrotic transitional epithelium

182

Papillary necrosis is due to ischemic injury caused by what drugs?

NSAIDs

183

Papillary necrosis is most frequently seen in _____. Can be seen in ___ & ___ due to accidental ingestion.

horses
cats & dogs

184

Hairy vetch toxicosis in cattle causes ______ _____ & accompanies systemic granulomatous dz.

granulomatous nephritis

185

What animals get Xanthogranulomas?

cats w/ inherited hyperlipoproteinmia

186

List the 3 types of epithelial tumors.

Renal adenoma
Renal carcinoma
Transitional cell papilloma & carcinoma

187

What is the most common primary renal neoplasm of the kidney? Common species?

renal carcinoma
older dogs

188

In what dog breed is renal carcinoma associated with nodular dermatofibrosis?

GSD

189

Transitional cell papilloma & carcinoma occur most commonly where?

urinary bladder

190

Which neoplastic dz has a very high metastatic potential?

transitional cell carcinoma

191

Another term for nephroblastoma.

embryonal neophroma
Wilm's tumor

192

Nephroblastoma is common in which species?

pigs
chickens
some fish

193

What is a common metastatic tumor of the kidney?

renal lymphoma

194

2 invasive tumors of the adrenal glands that effect the kidney

1. pheochromocytoma
2. adrenocortical carcinoma

195

5 developmental anomalies of the lower UT

1. aplasia (rare)
2. hypoplasia
3. ectopic ureters
4. patent urachus
5. urinary bladder diverticulum

196

What is the most common malformation of the urinary bladder?

patent urachus

197

What causes patent urachus?

fetal urachus fails to close & completely involute --> channel btwn bladder's apex & umbilicus

198

Where can one see urine coming from in patients with patent urachus?

urine dribbles from the umbilicus (navel region)

199

What 2 things are frequently observed with patent urachus?

neonatal omphalitis
abscess formation

200

Which animals are most commonly affected by patent urachus?

foals

201

Developmental abnormalities of the urinary bladder diverticulum can do what 3 things?

1. be associated w/ obstructive dz (acquired form)
2. predispose to systitis & calculi formation
3. predispose to bladder rupture

202

Syndrome that occurs when familial, congenital, &/o pathophysiological factors increase the precipitation of stone-forming salts resulting in urinary calculi formation.

Urolithiasis

203

What is the essential precursor to initiation of crystal & urolith formation?

supersaturation of urine --> due to supersaturation of mineral salts & protein

204

What is only partially responsible for calculogenesis?

crystal formation

205

What type of crystal is most common in dogs & cats? What type of urine favors their formation?

struvite crystals
alkaline urine

206

Struvite crystals are also known as?

Infection calculi

207

Which breed of dog is predisposed to struvite uroliths and Ca oxalate dihydrate w/ urolith formation?

Mini Schnauzers

208

Bilirubinuria +/- bilirubin crystals is an abnormal finding in what 4 species?

cats
horses
cattle
camels

209

Ca carbonate crystals are not common in what 2 species' urine?

cats & dogs

210

List the 4 UNCOMMON types of urinary crystals seen in animals.

1. Ca oxalate MONOhydrate
2. Ammonium biurate crystals
3. Cystine crystals
4. Drug-associated crystals

211

What shape of Ca oxalate monohydrate crystals are observed in the urine of dogs & cats w/ ethylene glycol toxicosis?

"picket fence" crystals

212

2 things that together indicate ethylene glycol toxicosis?

acute renal failure & picket fence crystalluria

213

What type of urinary crystal is commonly seen in dogs & cats w/ congenital or acquired portal vascular anomalies?

ammonium biurate crystals

214

Ammonium biurate crystals are NORMAL in what 2 breeds of dog? (TQ)

Dalmatians & bulldogs

215

Cystine crystalluria &/o urolithiasis is an indication of what genetic abnormality?

cystinuria

216

What animals are almost exclusively affected by cystinuria?

male dogs

217

Which drug most commonly causes drug-associated urinary crystals? Do these cause significant renal dz?

trimethoprim-sulfadiazine
No

218

What is the most common cause of obstructive uropathy?

Urolithiasis

219

Acute cystitis is common in all domestic animals. Which gender is more prone? Why?

females
due to shorter & wider urethra

220

Acute cystitis may have concurrent ____ & ____.

ureteritis & urethritis

221

What 4 bacT are the most common source of acute cystitis?

E. coli
Proteus sp.
Strept sp.
Staph sp.

222

C. renale commonly causes acute cystitis in what species?

cattle

223

A. suis commonly causes acute cystitis in what species?

pigs

224

E. faecalis commonly causes acute cystitis in what species?

cats

225

Klebsiella sp. commonly cause acute cystitis in what species?

horses

226

List some risk factors for acute bacterial cystitis. (8)

1. stagnation of urine
2. trauma
3. vaginoscopy, vaginitis, coitus, AI
4. urinary incontinence
5. prolonged antibiotic use
6. diabetes mellitus
7. prolonged corticosteroid use or Cushing's dz
8. immunosuppression

227

Cantharidin toxicosis occurs in? from ingestion of what?

horses
blister beetles in alfalfa hay

228

2 causes of mycotic cystitis?

Aspergillus sp.
Candida albicans

229

What can cause cystitis, hematuria & urinary bladder neoplasia in cattle?

bracken fern toxicosis

230

Gross lesions of acute cystitis. (4)

edema
hemorrhage
ulceration
purulent exudate

231

Microscopic lesions of acute cystitis. (6)

epithelial denudation
ulceration
hemorrhage
edema
suppurative infiltration
bacterial colonies

232

C.S. of acute cystitis

dysuria, stranguria or hematuria
sedimentation, blood, +/- bacT on UA
pyrexia

233

2 most common causes of chronic cystitis

chronic bacT infection
urolithiasis

234

3 types of chronic cystitis (based on morphologic pattern)

diffuse
lymphofollicular
polypoid

235

Gross lesions of chronic cystitis.

diffusely reddened, roughened & thickened mucosa
may see lymphoid follicles or polypoid hyperplasia

236

Microscopic lesions of chronic cystitis.

epithelial HYPERplasia
fibrosis
hemorrhage
mononuclear infiltration w/ few neutrophils

237

Where to most neoplasms occur in the lower UT?

urinary bladder

238

Transitional cell carcinoma is most common in ____.

dogs

239

What area of the bladder is transitional cell carcinoma most common?

trigone area

240

What is the most common mesenchymal tumor of the lower UT?

leiomyoma (less common that epithelial tumors)

241

Bacterial embolic nephritis is caused by what normal inhabitant of the alimentary tract?

A. equuli

242

How do foals get bacterial embolic nephritis?

via contamination of the umbilicus

243

What 2 NSAIDs can cause papillary necrosis?

phenylbutazone
flunixin meglumine

244

List the 5 disorders specific to horses.

bacterial embolic nephritis
myoglobinuric nephritis (rhabdomyolysis)
papillary necrosis
patent urachus
Klossiella equi infection

245

List the 10 disorders specific to ruminants

oak toxicity
pulpy kidney dz.
embolic nephritis (white spotted kidney)
tubulointerstitial nephritis
granulomatus nephritis
pyelonephritis
renal lymphosarcoma
urolithiasis
bracken fern toxicosis
renal amyloidosis

246

White Spotted Kidney (embolic nephritis) occurs in ruminants due to ? Is it noticeable?

bacT embolize the kidney leading to microabscesses & abscess formation
no, commonly subclinical

247

What can cause tubulointerstitial nephritis in cattle?

Lepto. interrogans
Serovars- hardjo, pomona, & grippotyphosa

248

Tubulointerstitial nephritis causes direct damage to what 3 parts of the kidney?

endothelium
tubules
interstitium

249

Granulomatous nephritis in ruminants is due to ___ ____ toxicosis. (TQ)

hairy vetch

250

Is pyelonephritis common in cattle?

no

251

What is the most common isolate of Contagious Bovine Pyelonephritis?

C. renale

252

What viral dz in cattle can be associated with renal lymphosarcome?

Bovine Leukosis Virus (BLV)

253

List the common locations of urolith obstruction in bulls, rams & bucks.

bulls - sigmoid flexure
rams & bucks- urethral process

254

Why are uroliths typically silica calculi in ruminants?

due to the high silica content of pasture grasses

255

Bracken fern toxicosis is also known as ____ _____.

enzootic hematuria

256

What is the most common toxicosis of cattle? (TQ)

bracken fern toxicosis

257

Prolonge ingestion of bracken fern (P. aquilinum) causes what 3 things in cattle?

hemolysis
BM damage
immunosuppression

258

Repeated low level exposure to bracken fern causes what in cattle?

urinary bladder neoplasia --> transitional cell carcinoma

259

List the 7 disorders specific to swine.

glomerulonephritis
toxic nephritis
leptospirosis
Viral interstital nephritis
urolithiasis
erysipelothrix
kidney worm

260

What plant can cause acute tubular necrosis leading to acute renal failure in swine?

pigweed

261

Which 3 Leptospira serovars cause leptospirosis in swine?

pomona
tarassovi
australis

262

Which virus can cause granulomatous interstitial nephritis in swine?

Circovirus--> Postweaning Multisystemic Wasting Syndrome (PMWS)

263

What is the most common cause of embolic nephritis in pigs? (TQ)

Erysipelothrix (diamond skin dz)

264

Kidney worm of swine?

Stephanurus dentatus

265

List the 5 disorders specific to cats.

Granulomatous nephritis --> FIP (non-effusive form)
Renal lymphosarcoma
Feline Lower UT Dz (FLUTD)
Hemorrhagic urocystitis
Toxic tubulointerstitial nephritis

266

FLUTD is most commonly seen in what cats?

middle-aged, overweight cats w/ little exercise, indoor litter box & dry food diet

267

What is the term for a collection of diseases affecting the urethra & bladder of cats?

feline lower urinary tract disease (FLUTD)

268

3 things that cause FLUTD in cats?

Feline idiopathic cystitis
urolithiasis
chronic &/o recurring bacT UTIs

269

Older male acts typically form ____ calculi leading to urethral obstruction.

struvite

270

In what cats may inflammation predispose to formation of protein matrix plugs?

younger male cats

271

What is the consequence of urethral obstruction in male cats?

hemorrhagic urocystits

272

Pathology of hemorrhagic urocystitis.

urinary bladder becomes severely distended leading to pressure necrosis, hemorrhagic & ulceration

273

Chronic fibrosis limits bladder ____ & leads to poor ____ voiding & increased susceptibility to ____ infections.

fxn
urine
bacterial

274

3 things that cause toxic tubulointerstitial nephritis in cats

ethylene glycol toxicosis
melamine & cyanuric acid
lily toxicity

275

List the 15 disorders specific to dogs

Greyhound cutaneous glomerular vasculopathy
Ethylene glycol toxicity
Aminoglycoside toxicosis
Leptospirosis
Infectious K9 hepatits
K9 herpesvirus
Pyelonephritis
Progressive juvenile nephropathy
Urolithiasis
Chronic urocystitis
Transitional cell carcinoma
Renal carcinoma
Toxic tubulointerstitial nephritis
Grape or raisin toxicity
Giant kidney worm

276

What is a rare idiopathic vascular dz w/ genetic predisposition in Greyhounds?

Cutaneous Glomerular Vasculopathy

277

Lesions seen in Greyhounds w/ Cutaneous Glomerular Vasculopathy.

glomerular thrombotic microangiopathy (can look like DIC)

278

Why is ethylene glycol (antifreeze) so toxic to dogs?

Readily absorbed by the GIT & converted to toxic metabolites by hepatic alcohol dehydrogenase

279

What is the degree of nephrotoxicity of aminoglycosides in dogs. (-mycins)

Neo> Kana>Genta> Strepto> Tobra> Amikacin

280

Aminoglycoside toxicosis causes what 2 things in dogs?

acute tubular degeneration & necrosis

281

What other parts of the dog's body can be affected by aminoglycoside toxicosis?

inner ear
neuromuscular jxn

282

2 most common Lepto isolates in dogs?

L. icterohaemorrhagiae
L. canicola

283

How do dogs pick up Leptospirosis?

infections obtained from wet, contaminated environments through compromised mucus membranes

284

Where does Lepto persists in dogs?

renal tubular epithelial cells

285

C.S. of Leptospirosis in dogs?

fever
anorexia
vomiting
dehydration
icterus
mm. pain
bleeding

286

Chronic causes of Lepto in dogs will present with what 2 signs.

wt loss
sometimes uveitis

287

Lepto causes what 2 things in dogs

acute tubular damage
acute to chronic tubulointerstitial nephritis

288

Is Lepto zoonotic?

Yes!!

289

How do young puppies (< 6 wks) get K9 herpesvirus?

due to intrauterine or neonatal infection from the dam w/ CHV-1

290

K9 herpesvirus causes what?

multifocal acute tubular necrosis w/ hemorrhage

291

CHV-1 neonatal mortality is associated in puppies w/ _____.

HYPOthermia

292

Most common organisms to cause pyelonephritis in dogs

E. coli
S. aureus
P. mirabilis
Strept sp.
K. pneumoniae
P. aeruginosa
Enterobacter sp.

293

CS of pyelonephritis in dogs.

fever
depression
arched back
PU

294

When is pyelonephritis likely to occur in dogs?

when there is altered lower UT defense

295

Inherited disorder in dogs leading to development of severe bilateral renal fibrosis, dysplasia & progressive loss of fxnal nephrons.

progressive juvenile nephropathy

296

Progressive juvenile nephropathy clinical resembles what?

CRF & end-stage kidney

297

Variable degrees of severity w/ progressive fibrosis leading to progressive loss of renal fxn in younger dogs.

progressive juvenile nephropathy

298

What breeds of dogs are over-represented w/ progressive juvenile nephropathy?

samoyeds
bull terriers
shih tzus

299

4 most common uroliths in dogs

struvite
urate
xanthine
cystine

300

What 2 dog breeds are predisposed to urate calculi due to inefficient hepatic uric acid metabolism?

Dalmatians
English bulldogs

301

Therapy for Dalmatians & English bulldogs w/ inefficient hepatic uric acid metabolism

low purine diets
Allopurinol --> lowers uric acid in blood

302

2 main dog breeds that are genetically predisposed to Ca oxalate urolithiasis.

Mini Schnauzers
Bichon Frises

303

What common symptoms to dogs develop with chronic urocystitis?

lymphofollicular & polypoid cystitis
hematuria

304

What is the most common primary kidney neoplasm in dogs?

renal dogs

305

Renal carcinoma occurs sporadically in ____ dogs.

older

306

Where can renal carcinoma metastasize to? (4)

lungs
lymph nodes
liver
adrenal glands

307

What cause distal tubular necrosis with characteristic irregular brown birefringent crystals in dogs? (TQ)

Melamine & Cyanuric acid toxicosis from contaminated pet food

308

Ingestion of grapes/raisins by dogs leads to these 3 things.

acute renal failure
uremic syndrome
diarrhea

309

What is the kidney worm that affects mostly fish eating mammals, especially dog & mink?

Dioctophyma renale

310

What may be the only initial C.S. of D. renale (giant kidney worm) infection?

hematuria

311

D. renale causes what 2 things in dogs.

hemorrhagic & purulent pylitis
hydronephrosis due to obstruction