Urinary System Flashcards
(126 cards)
1
Q
which part of the kidney should always be removed during necropsy in order to do a full examination
A
external fibrous capsule
2
Q
in what species does the outer cortex of the kidney parenchyma turn pale yellow due to large lipid content over time
A
cats
3
Q
what is the functional unit of the kidney
A
nephron
4
Q
what are the parts of the nephron
A
renal corpuscle
renal tubule
5
Q
what can be observed macroscopically only when accentuated by inflammation
A
glomerulus
6
Q
what specialized cells are found within the glomerulus
A
mesangial cells
podocytes
7
Q
what are formed between podocyte pedicles and fenestrated endothelial cells with shared basal lamina
A
glomerular filtration barriers
8
Q
what is the glomerular basement membrane composed of
A
type IV collagen and numerous glycoproteins
9
Q
what is the cup-shaped sac that enclosed the glomerulus
A
Bowman’s capsule
10
Q
what is the reticular meshwork of connective tissue stroma
A
interstitium
11
Q
true or false:
the amount of connective tissue in the interstitium increases with age, chronic inflammation and ischemic damage
A
true
12
Q
what are the terminal arteries that do not contain anastomoses and are therefore more susceptible to embolism leading to renal infarction
A
interlobular arteries
13
Q
describe a renal infarction
A
wedge-shaped
well demarcated
dark red or white
inflammation / chronically contracted
14
Q
what are the 5 functions of the kidney
A
produce urine
acid-base regulation
conservation of water
maintain normal extracellular potassium ion concentration
control of endocrine
15
Q
what hormone is responsible for the maintenance of normal extracellular potassium ion concentration
A
aldosterone
16
Q
what endocrine function produced by the kidney is used to regulate the blood pressure and fluid balance of the body
A
renin-angiotensin-aldosterone system
17
Q
if there is a decrease in the control of endocrine function of the kidney, what 5 hormones are impacted
A
renin-angiotensin- aldosterone
erythropoietin
vitamin D
PTH degradation
18
Q
what qualifies as renal failure
A
only under significant loss of renal function
19
Q
true or false:
the kidney will maintain endocrine and metabolic function up until 75% of it is lost
A
true
20
Q
what are some clinical indicators of renal failure
A
altered urine quantity
altered urine quality
21
Q
when it comes to altered urine quantity, when is polydipsia seen
A
chronic kidney disease
22
Q
in cases of acute renal failure, how is urine quantity affected
A
oliguria or anuria
23
Q
what are some clinical signs often associated with a decrease in renal function
A
proteinuria
azotemia
uremia
24
Q
what is characterized by the toxic levels of urea in the blood associated with renal failure
A
uremic syndrome
25
what are some way renal failure can lead to death
cardiotoxicity by elevated potassium
metabolic acidosis
pulmonary edema
26
what is the elevated serum concentration of nitrogenous waste products
azotemia
27
what kind of renal failure is due to reduced glomerular filtration due to impaired renal perfusion
prerenal
28
what can cause pre-renal kidney failure
circulatory collapse
shock
hypovolemia
severe dehydration
decreased cardiac output
29
what type of renal failure is due to damage to renal tissue such as the tubules and glomerulus
renal
30
what are some causes of renal kidney failure
acute tubular necrosis
acute glomerulonephritis
tubulointerstitial nephritis
acute pyelonephritis
31
which type of renal kidney failure is due to hypoxia/ischemia, nephrotoxicity and infections
acute tubular necrosis
32
what are the 2 mechanisms of acute tubular necrosis
leakage of tubular ultrafiltrate
intratubular obstruction
33
what are the intrarenal causes of renal kidney failure
acute glomerulonephritis
tubulointerstitial nephritis
acute pyelonephritits
34
what is the most common cause of acute glomerulonephritis
immune complex glomerulonephritis
35
what causes acute pyelonephritis
ascending bacterial infection from urethra, ureters and renal pelvis
36
what type of kidney failure is caused by urinary obstruction with pressure atrophy and necrosis
post renal kidney failure
37
what is the 'medical terminology' for post renal kidney failure
obstructive nephropathy
38
what are some causes of post renal kidney failure
urolithiasis (urinary stones)
tumors (transitional cell carcinoma)
iatrogenic (accidental ligation of ureter)
39
what can the obstructions of the kidney lead to
hydroureter and hydronephrosis
40
what can a hyroureter and hydronephrosis lead to
organ rupture with resulting uroabdomen
41
what are the 2 mechanisms uremic syndrome can cause `
endothelial injury
epithelial injury
42
what are the potential results of endothelial injury due to uremic syndrome
vasculitis thrombosis and infarction
43
what causes the epithelial injury of uremic syndrome
caustic effect of ammonia accumulation at mucosal surfaces
44
where are the epithelial injuries seen with uremic syndrome
mouth
45
true or false:
severe acute renal failure may lead to death without supportive therapy
true
46
what are some causes of death due to acute renal failure
cardiotoxicity of elevated serum potassium
metabolic acidosis
pulmonary edema
47
what is the pathogenesis of acute renal failure
ischemia or nephrotoxicity leads to acute tubular necrosis
48
what is the pathogenesis of chronic kidney disease
progressive interstitial fibrosis, tubular atrophy and loss of functional nephron
49
what is the gross pathology of chronic kidney disease
shrunken, firm, pale, fibrotic kidney with irregular surface
"end stage kidney"
50
what are the lab abnormalities with chronic kidney disease
azotemia
proteinuria
isosthenuria
nonregenerative anemia
hyperparathyroidism
51
what does ckd progress to
end stage kidney
52
what are the characteristics of chronic kidney disease
chronic
advanced
generalized
progressive
irreversible
53
what are the gross characteristics of chronic kidney disease
fibrotic
atrophic
shrunken renal parenchyma with massive loss of functional nephrons
replacement with scar tissue
54
what are some metabolic and biochemical alterations due to chronic kidney disease
non-regenerative anemia
altered calcium-phosphorus metabolism
55
how is phosphorus and calcium affected with chronic kidney disease
hyperphosphatemia
hypocalcemia
56
what process is related to the alteration of calcium-phosphorus metabolism in relation to chronic kidney disease
renal secondary hyperparathyroidism
57
what are some outcomes of renal secondary hyperparathyroidism
hyperphosphatemia
hypocalcemia
bilateral parathyroid gland hyperplasia
fibrous osteodystrophy
58
what are 4 portals of entry to the kidney
ascending from ureter
hematogenous
glomerular filtration
direct penetration
59
what often results form the ascending bacterial infection from the ureter
suppurative pyelonephritis
60
what are common cases of hematogenous entry into the kidney
neoplastic metastases
bacterial embolization
61
what are some common cases causes damage to the glomerular filtration decreasing the protection barrier to the kidney
toxins
drugs
anti-freeze and other insecticides
62
what is the most important barrier of the kidney
renal corpuscle / glomerular basement membrane
63
what is the role of the glomerular basement membrane
protect the nephron by filtering out most circulating bacteria and inflammatory cells
64
what defense mechanism of the kidney prevents ascending bacteria from gaining access to the interstitium
tubular basement membrane
65
what can usually destroy the TBM and cause permanent scarring with loss of tubules
ischemia / infarction
66
which part of the kidney provides protection through humoral antibodies, macrophages, lymphocytes and plasma cells
interstitium
67
glomerular injury results from deposition of ...
immune complexes (type III)
thromboemboli
bacterial emboli
amyloid
68
true or false:
prolonged systemic hypertension can cause damage to the glomerular filtration of the kidney
true
glomerular injury may also be caused by hyperfiltration
69
what is the expected outcome from damage of the glomerular filtration
proteinuria
albumin
antithrombin III
70
what condition can cause hypoproteinemia with reduced plasma oncotic pressure leading to ascites, pleural effusion and generalized edema
protein losing nephropathy
71
what is the result of losing antithrombin III to nephrotic syndrome
results in a hypercoagulable state with thromboembolic disease
72
what are the acute responses to injury to the kidney
mesangial hypertrophy and hyperplasia
increased vascular permeability
infiltration of leukocytes
necrosis
73
what are the chronic responses to injury to the kidney
atrophy
fibrosis (glomerulosclerosis)
renal tubular atrophy due to blood supply loss
74
what are the top 2 things that cause tubular damage
toxins
infarctions/ ischemia
75
after what events could you expect to see atrophy of the kidney tubules
interstitial fibrosis
diminished glomerular perfusion (shock, hypovolemia, fibrosis)
reduced oxygen tension (anemia, hypoxemia)
76
which tubular damage response occurs due to loss of tubular epithelial cells due to injury and apoptosis
degeneration
77
when is tubular regeneration only possible
when tubular basement membrane is left intact
78
in cases of toxic injury, how is the TBM normally affected
generally preserved which allows for regeneration
79
in cases of ischemic injury, how is the TBM normally affected
TBM is destroyed causing permanent scar with no regeneration
80
what is the single most important cause of acute renal failure in animals
acute tubular necrosis
81
what can cause acute tubular necrosis
ischemia
nephrotoxicity
82
what are the clinical manifestations of acute tubular necrosis
oliguria
anuria
83
how does nephrotoxic injury occur
chemicals and/or toxic metabolites become concentrated in the tubules to toxic levels
84
what 3 mechanisms do nephrotoxins use to cause damage
direct damage to epithelium
produce reactive metabolites
indirectly stimulate vasoconstriction (nephrotoxin-associated ischemia)
85
what is the most common way to indirectly stimulate vasoconstriction in the kidney leading to nephrotoxicity
drugs such as NSAIDs
86
what is a form of acute tubular necrosis that is not caused by an inflammatory process
nephrosis
87
what causes nephrosis
hypoxic injury combined with nephrotoxicity
88
true or false:
hypoxic injury is exacerbated by hemoglobinuria during a hemolytic crisis
true
89
what are 5 responses to injury of the interstitium
hyperemia
edema
inflammation
lymphofollicular inflammation
fibrosis
90
what type of inflammation is typically seen in the interstitium in response to injury
nonsuppurative, lymphoplasmacytic
91
what disease/infection is most commonly associated with lymphofollicular inflammation of the kidney
leptospirosis
92
true or false:
progressive fibrosis leads to progressive loss of renal function
true
93
what are some infectious examples that cause interstitial nephritis
canine ehrlichiosis
leptospirosis
equine infectious anemia
94
what is tubulointerstitial nephritis
inflammation directed against the interstitium and the tubules
95
what are some infections that lead to tubulointerstitial nephritis
leptospirosis
adenoviruses
lentiviruses
herpesviruses
96
what is a localized area of coagulative necrosis that results from vascular occulsion
infarction
97
how would you describe an infarction
well-demarcated, cone shaped area of coagulative necrosis
98
what is the most important lesion associated with acute kidney injury and acute renal failure
acute tubular necrosis
99
where do the ureters enter the bladder wall
trigone
100
what type of epithelium lines the ureters
transitional epithelium
101
what are sources of bacteria that can cause ascending infection in the lower urinary tracts
GI tract
genital tract
bacterial dermatitis
102
what is the asynchronous differentiation of nephrons and/or the persistence of primitive mesenchyme and metanephric ducts
renal dysplasia
103
what is an inherited disease described in Lhasa Apso, Shih Tzu, and Golden Retrievers
juvenile progressive nephropathy
104
what is juvenile progressive nephropathy
a specific form of renal dysplasia
105
what is the abnormal migration of renal tissue during fetal development
ectopic kidney
106
describe a fused kidney
"horse shoe shaped"
result from the fusion of the left and right kidneys during nephrogenesis
107
what are spherical, thin-walled, distended tubules filled with clear watery fluid
renal cysts
108
what do renal cysts result from
tubular obstruction or tubular dysplasia
109
in what specie are renal cysts more common
pigs
cows
110
what is defined as many renal cysts affected numerous nephrons
polycystic kidneys
111
in what species is inherited polycystic kidney more common
persian cats
bull terries
112
what are the 6 diseases of the glomerulus
immune-mediated glomerulonephritis
glomerulosclerosis
glomerular amyloidosis
acute suppurative glomerulitis
viral glomerulitis
chemical glomerulitis
113
what is associated with persistent infections or other causes of prolonged antigenemia that enhances the formation of abundant soluble immune complexes in the blood plasma
immune complex glomerulonephritis
114
what is the true issue causing the damage associated with immune complex glomerulonephritis
deposition of soluble immune complexes within glomeruli
115
what diseases are associated with ICGN with cats
FeLV
FIV
FIP
116
what diseases are associated with ICGN with horses
streptococcus infections
equine infectious anemia
117
what are the gross lesions associated with ICGN
subtle or non-existent
may see swollen, enlarged glomeruli as red or pale pin-point foci in the cortex
118
what is a condition of aging and chronic renal injury characterized by increased extracellular mesangial matrix leading to obliteration of capillaries and consolidation of the tuft
glomerulosclerosis (GS)
119
what is glomerulosclerosis associated with
high blood pressure
unrestricted dietary protein
120
what is the outcome of GS
reduces the blood flow to the tubules causing secondary tubular degeneration and atrophy
121
what urinary disorder is associated with reactive systemic amyloidosis
glomerular amyloidosis
122
what breeds/species are genetically predisposed to reactive amyloidosis
abyssinian cats
chinese shar-pei
123
what disorder would you suspect kidneys to be enlarged, pale and have a waxy smooth to finely granular capsular surface
glomerular amyloidosis
124
what stain is specific for glomerular amyloidosis
congo red stain
125
what disease is the result of bacteremia
acute suppurative glomerulitis
bacterial embolic nephritis
126
what is characteristic of a kidney with bacterial embolic nephritis
multiple, randomly distributed foci of suppurative inflammation
