Urogenital

Question 1

What is the equation for blood pressure?

Answer 1

Cardiac output (stroke volume x HR) X peripheral vascular resistance

Question 2

Which cells detect low blood pressure within the RAAS ?

Answer 2

Juxtaglomerular cells of afferent arteriole of the glomerulus

Question 3

Draw the RAAS

Answer 3

Angiotensinogen from liver – (renin secreted by kidney) –> angiotensin I – (ACE from lungs) –> angiotensin II –> aldosterone + increase resorption of sodium and water in proximal tubule + vasoconstriction

Question 4

On which cells within the kidneys does aldosterone acts ?

Answer 4

Principle cells of collecting tubules (Na resorption and K excretion)
Intercalated cells of collecting tubules (H+ secretion)

Question 5

Which one is the hormone that acts to decrease volume ? When is it secreted?

Answer 5

Atrial natriuretic hormone

Secreted by the heart in response to decrease volume

Question 6

What are the characteristics of SIADH (4) ?

Answer 6

Hypotonic
Euvolemia
High urine sodium
High urine osmolality

Question 7

What is the anion gap equation?

Answer 7

Na - (CL + HCO3)

Question 8

Hyperchloric metabolic acidosis is due to the loss of which element?

Answer 8

Bicarbonate

From lower than stomach GI loss - diarrhea, renal tubular acidosis

Question 9

Stretch of the bladder signal is conducted through which nerve?

Answer 9

Pelvic

Question 10

The medulla blood supply is done through a structure called

Answer 10

Vasa recta

Question 11

Describe the 2 types of cells within the late distal and collecting tubules

Answer 11

Principle cell

• resorption of Na and water (through ADH)
• Secretes potassium (through aldosterone)

Intercalated cells = acid base regulation

• type A ( resorption of potassium and secretes H+) –> If acidosis
• type B = opposite

Question 12

What are the receptor effects of ADH?

Answer 12

Binds to V2 –> movement of aquaporin 2 to the luminal side (through AMPc and protein kinase)–> fuse with membrane to form water channels

Question 13

Where is the urea passively reabsorbed from ?

Answer 13

Medullary collecting tubules

Especially with high concentration of ADH

Question 14

On which receptor does desmopressin acts in the kidneys and which coagulation factor are also released?

Answer 14

V2 receptor

VW and 8

Question 15

Which 3 changes occur in response to increased sodium intake ?

Answer 15

1) decrease aldosterone
2) increase GFR
3) decrease proximal tubular Na reabsorption

Both 2 and 3 leads to increased distal tubular flow rate

Question 16

Where is magnesium stored ?

Answer 16

Mostly in bones and cells

Question 17

Atrial natriuretic peptide acts on the kidneys and result in which 2 effects

Answer 17

Increases GFR

Decrease sodium reabsorption

Question 18

Which reaction does carbonic anhydrase is involved with?

Answer 18

CO2 + H2O H2CO3

Question 19

What are the 3 ddx of metabolic alkalosis ?

Answer 19

Diuretic
Excess aldosterone
Vomiting upper gastric content

Question 20

Which medication can address metabolic alkalosis?

Answer 20

Ammonium chloride

Question 21

PTH stimulates ans FGF23 inhibits the activation of which hormone?

Answer 21

Calcitriol

Question 22

An acute kidney injury is defined by:

Answer 22

Increase in creatinine of > 0.3
Increase in creatinine more than 50% baseline
Oliguria of less than 0.5 ml/h/kg for more than 6 hours

Question 23

The presence of low molecular weight proteins in the urine indicates damage to which segment of the kidneys?

Answer 23

Proximal tubule

Question 24

What part of the kidney is affected by membranous glomerulopathy?

Answer 24

Immune complex in the basement membrane

Question 25

What are the stages of AKI

Answer 25

1) initiation - pathological damage following injury 2) extension - ischemia, hypoxia and inflammation leading to apoptosis and necrosis 3) maintenance - azotemia and uremia 4) recovery

Question 26

What are the 3 different mechanism of blood purification in dialysis system?

Answer 26

- diffusion (based on concentration of urea within dialyzer) - convection (blood is exposed to positive transmembrane pressure) - adhesion

Question 27

Which bacteria causes emphysematous cystitis?

Answer 27

E.coli

Question 28

What is the difference between UTI relapse and reinfection and persistent?

Answer 28

Reinfection : relapse with a different isolate (suggest decrease local or systemic immunity) Relapse: same isolate (suggest persistent nidus) Persistence: appropriate therapy fails to clear infection during or within 1 week after treatment

Question 29

What is the size of stone where hydroretropulsion can be done ?

Answer 29

F cat : 5 mm F dog: 15 mm M cat: 1 mm M dog: 1-3 mm

Question 30

What is the treatment of low bladder capacity?

Answer 30

``` Antimuscarinic Tricyclic antidepressant (amipramine) ```

Question 31

What is the treatment for detrusor instability?

Answer 31

Anticholinergic (emepronium)

Question 32

What would be the treatment for urethral hypertonicity?

Answer 32

A-antagonist (phenoxybenzamime, prazosin-A1 or tamsulosin-A1)

Question 33

What is the treatment for dyssynergia?

Answer 33

Diazepam | Dantrolen (inhibits calcium movement)

Question 34

What are the potential treatments for bladder atony?

Answer 34

- bethanecol - cholinesterase inhibitor (pyridostigmine) - B blocking agents - dopamine antagonist - prostaglandins - prokinetic

Question 35

Which ureter is most commonly affected with circumcaval ureter?

Answer 35

Right

Question 36

What are the 3 ways to help prevent cystine stones ?

Answer 36

Limit protein and sodium intake Thiola (binds to cysteine to form soluble complex) Neutering

Question 37

What is the mechanism of cysteine stones ?

Answer 37

Failure of tubular reabsorption of cysteine (through SLC3A1 mutation) *** Cats can also have neurological signs from lack of arginine

Question 38

Which gram bacteria usually results in pyelonephritis?

Answer 38

Negative (E.coli) because possess adhesion molecules

Question 39

Which bacteria is primarily associated with encrusted cystitis?

Answer 39

Corynebacterium urealyticum

Question 40

Which 2 medications can help prevent calcium oxalate stones?

Answer 40

Potassium citrate | Hydrochlorothiazide (enhance tubular reabsorption of calcium)

Question 41

What are the 2 ways to prevent urate stones formation?

Answer 41

Allopurinol (care for xanthine) | Reduce purine intake

Question 42

What is the mechanism behind urate stones formation?

Answer 42

Inefficient transport of uric acid into hepatocytes leading to increased allantoin (from PSS or SLC2A9 mutation)

Question 43

Which are the 2 purine based stones?

Answer 43

Urate and xanthine

Question 44

Feline ectopic ureters are mostly extra or intramural?

Answer 44

Extra

Question 45

What is the main bacteria involved in prostatitis?

Answer 45

E.colo

Question 46

Which antibiotics can be use with prostatitis?

Answer 46

TMS, chloramphenicol, fluoroquinolones

Question 47

What is cystatin C?

Answer 47

Low molecular weight proteins filtered at glomerulus and resorbed by megalin-mediated endocytosis at the proximal tubule. Can be affected by thyroid and neoplasia

Question 48

What are the 4 components of nephrotic syndrome?

Answer 48

Hypoalbuminemia Hyperchlolesterolemia Proteinuria Edema

Question 49

On ultrasound, which condition causes the kidney to be hyperechoic? To have perirenal fluid?

Answer 49

Ethylene glycol | Leptospirosis, lymphoma

Question 50

Those parasites affect which organ? Stephanurus dentalus Capillaria plica or Felis Dioctophyma renale

Answer 50

Kidneys

Question 51

Which vasopressor should I use with AKI

Answer 51

Vasopressin - affects efferent arteriole | norepinephrine affects the afferent arteriole causing decreased GFR

Question 52

Which medication can be given in AKI from leptospirosis?

Answer 52

Diltiazem

Question 53

What mechanism is use in CRRT?

Answer 53

Diffusion and convection

Question 54

Why does CKD results in metabolic acidosis?

Answer 54

- Decrease reabsorption bicarbonate - Increased excretion of H+ (with ammonia) - increased anion gap (urea)

Question 55

How much does kidney function have to be affected for the SDMA to increase?

Answer 55

30% decline in GFR

Question 56

What are the side effects of aluminum phosphorus binders?

Answer 56

Microcytosis Neurology Constipation

Question 57

What are the 3 ways of looking at renal biopsies?

Answer 57

TEM (transmission electron microscopy) IFM (immunofluorescent microscopy) Light microscopy

Question 58

Lyme disease is associated with which type of glomerulopathy?

Answer 58

Membranoproliferative

Question 59

What are the the histopathological characteristics of membranoproliferative glomerulonephritis?

Answer 59

Thickened capillaries Mesangial hypercellularity Railroad appearance Mediated by C3 immunity

Question 60

Which type of glomerulopathy is the most common in dogs ? In cats

Answer 60

Dogs: Membranoproliferative Cats: membranous nephropathy

Question 61

What are the clinical characteristics of membranous nephropathy?

Answer 61

More common in young males | Massive proteinuria and nephrotic syndrome

Question 62

What are the unique histopathological traits of membranous nephropathy ?

Answer 62

Antibodies on subepithelial side Lack of inflammation C5b-9 membrane attack complex Thickened basal membrane with spikes

Question 63

What are the histopathological characteristics of proliferative glomerulopathy?

Answer 63

Endocapillary or mesangial hyperplasia secondary to proliferation of endothelial cells IgG or IgM basement membrane and mesengium

Question 64

Immunoglobulin A nephropathy can be associated with which diseases?

Answer 64

Enteric or hepatic diseases

Question 65

Extracellular deposition of fibrils formed by polymerization of proteins with B-pleated sheet confirmation is associated with which disease?

Answer 65

Amyloidosis

Question 66

What are the histopathological characteristics of amyloidosis?

Answer 66

Diffuse glomerular deposit that are apparent on Congo red and can also be seen in walls of blood vessels and interstitial tissues

Question 67

What is the histopathological characteristic of minimal change nephropathy?

Answer 67

Marked podocyte effacement

Question 68

What is considered as a favorable response to treatment with proteinuria?

Answer 68

> 50% reduction in UPC > 25% sustained reduction in creatinine > 50% sustained improvement in albumin

Question 69

Hypertension is most commonly associated with which type of glomerulopathy?

Answer 69

Membranoproliferative

Question 70

The persistent loss of carnitine in the urine can lead to which disease?

Answer 70

DCM

Question 71

What is the maximum reabsorption capacity of the glucose in the proximal tubule?

Answer 71

Dogs: 180-220 Cats: 260-310

Question 72

Which solutes are abnormally absorb with Fanconi syndrome?

Answer 72

Glucose, cysteine, bicarbonate, sodium, potassium and urate

Question 73

Describe type II (proximal) RTA and its treatment

Answer 73

Inability to prevent loss of bicarbonate because of a defect in the basolateral membrane transporter Potassium citrate

Question 74

Describe type I (distal) RTA and its treatment

Answer 74

Inability to excrete H+ Potassium and sodium citrate

Question 75

Which metabolic conditions can lead to nephrogenic diabetes insipidus?

Answer 75

Hypokalemia and hypercalcemia

Question 76

Which 2 abnormalities can lead to ADH secretion?

Answer 76

Hyperosmolality | Hypovolemia

Question 77

What are possible treatment for nephrogenic diabetes insipidus?

Answer 77

Limit protein and sodium intake | Thiazide diuretic

Question 78

Hereditary nephritis can be seen in which 2 breeds?

Answer 78

Samoyed (COL4A5 mutation). Bad prognosis in male, slower progression in female (X-linked) Cocker spaniel (COL4A4 mutation). Autosomal recessive In both cases, immunostaining will lead to abnormal pattern of type 4 collagen

Question 79

Which cancers have been associated with neutering?

Answer 79

``` Prostatic Bladder Lymphoma in male golden OSA HSA ```

Question 80

What are the treatments for mammary hyperplasia?

Answer 80

``` OVH (takes up to 6 months do remission) Progesterone blocker (aglepristone) ```

Question 81

Which 6 infections can lead to abortion in dogs?

Answer 81

Brucella, toxoplasma gondii, neospora, herpesvirus type 1, parvovirus and cryptosporidium canos

Question 82

Which 5 infections can lead to abortion in cats ?

Answer 82

FeLV, panleukopenia, herpesvirus, FIV and toxoplasmose

Question 83

Which antibiotics should be used to treat mastitis or metritis

Answer 83

Clavamox or cephalexin

Question 84

Which hormone causes endometrial hyperplasia and pyometra?

Answer 84

Progesterone

Question 85

What is the medical management of pyometra?

Answer 85

Amoxicillin Prostaglandins +/- Progesterone receptor blocker

Question 86

Which neoplasm is the most common in the penis?

Answer 86

SCC

Question 87

Sperm agglutination can be seen with which disease?

Answer 87

Brucella

Question 88

Which mutation leads to polycystic kidney disease in Persian?

Answer 88

PKD1

Question 89

In minimal change disease, lesions on glomeruli are present only with which type of histopathological evaluation?

Answer 89

Transmission electron microscopy | Normal on light microscopy and immunofluorescence