Urology (1-5) Flashcards
(125 cards)
1
Q
what is the normal daily water consumption for a dog
A
50-100 mL/kg
2
Q
what is the normal daily water consumption for a cat
A
30-50 mL/kg
3
Q
what is the normal daily urine production for a dog?
A
50 mL/kg
4
Q
what is the normal daily urine production for a cat?
A
25-50 mL/kg
5
Q
name 6 clinical signs of uraemia
A
- urine smelling breath
- oral ulceration
- anorexia
- vomiting
- malaise
- neurological signs
6
Q
name 6 things that should be included in a clinical exam for an animal with urination problems
A
- hydration status
- body condition
- halitosis
- kidney and bladder palpation
- external genitalia
- rectal exam
7
Q
what 6 key things do you want to look at on a urine dip stick
A
- pH
- blood (or pigment)
- ketones
- bilirubin
- glucose
- protein
8
Q
what is the normal protein-to-creatinine (UP:C) ratio for cats and for dogs?
A
cats: <0.4
dogs: <0.5
9
Q
this is a marker of concentration ability that is assessed with a refractometer
A
urine specific gravity
10
Q
what is the specific gravity for hyposthenuria
A
< 1.007
11
Q
what is the specific gravity for isosthenuria
A
1.008 - 1.012
12
Q
what is the specific gravity for hypersthenuria
A
greater than 1.013
13
Q
what is the adequate urine concentration for a dog
A
greater than 1.030
14
Q
what is the adequate urine concentration for a cat
A
greater than 1.035
15
Q
what 2 nitrogenous waste products would you expect to be elevated in the blood if an animal has azotaemia
A
- creatinine
- urea
16
Q
what causes pre-renal azotaemia
A
reduced renal perfusion
17
Q
name 4 causes of reduced renal perfusion leading to pre-renal azotaemia
A
- hypovolaemia
- dehydration
- cardiac disease
- hypotension
18
Q
this is when blood flow reaches the kidneys but the kidneys are dysfunctional
A
renal azotaemia
19
Q
name 2 causes of renal azotaemia
A
- acute kidney injury
- chronic kidney disease
20
Q
what will the urine specific gravity usually be with pre-renal azotaemia
A
high
(>1.030)
21
Q
what will the urine specific gravity usually be with renal azotaemia
A
isosthenuric
(1.007 - 1.012)
22
Q
this is produced in all cells and is excreted by the kidneys;
can detect CKD when only 25% of function is lost
A
SDMA
(Symmetric DiMethylArginine)
23
Q
what is the only part of the kidney that can be biopsied
A
cortex
24
Q
name 3 risks of a kidney biopsy
A
- anaesthetic
- haemorrhage
- worsening azotaemia
25
what info can a kidney FNA provide/identify
limited;
may identify lymphoma
26
what info can a kidney biopsy provide/identify
protein losing nephropathies
27
how long must kidney disease be present for in order to be considered chronic kidney disease
at least 3 months
28
name 6 clinical signs of chronic kidney disease
1. polyuria with compensatory polydipsia
2. decr. appetite/anorexia
3. weight loss
4. vomiting
5. muscle weakness
6. constipation
29
name 7 differential diagnoses for polyuria/polydipsia
(besides chronic kidney disease)
1. Diabetes mellitus
2. Hypo/Hyperadrenocorticism
3. pyometra
4. hepatic disease
5. hyperthyroidism
6. medications (steroids, diuretics)
7. Diabetes insipidus
30
name 3 diagnostics for identifying loss of kidney function
1. reduced concentration ability
2. azotaemia
3. elevated SDMA
31
what 6 factors can be looked at to decide if kidney disease is acute or chronic?
1. duration of clinical signs
2. kidney signs
3. renal pain
4. body condition
5. tolerance of azotaemia
6. response to treatment
32
name 5 things that can cause acute worsening of a stable patient with chronic kidney disease
1. dehydration
2. hypokalaemia
3. UTI
4. hypertension
5. anaemia
33
name 3 reasons for cachexia with chronic kidney disease
1. inappetence/anorexia
2. inflammation
3. disuse atrophy
34
why is dehydration common with chronic kidney disease
even if not drinking anything, unable to conentrate urine to conserve water
35
why is hyperphosphataemia common with chronic kidney disease
decreased GFR
(1. insufficient PO4- excretion
2. PTH stimulation
3. calcium leaching from bone
4. secondary renal hyperparathyroidism)
36
what are the 2 steps for phosphate restriction to control renal secondary hyperparathyroidism
1. dietary management
2. phosphate binders
37
why is proteinuria common with chronic kidney disease
damage to glomeruli and tubules secondary to underlying inflammation
38
what effect do ACE inhibitors have on the efferent arteriole
dilation
| (decr. filtration pressure & GFR)
39
this can be used as an alternative to ACE inhibitors;
avoids the locale 'ACE escape' that can occur where angiotensin continues to be produced via chymase rather than ACE
Angiotensin Receptor Blockers
40
name 2 reasons for hypertension with chronic kidney disease
1. altered renal blood flow
2. focal infarction/ischaemia
| (activation of RAAS, sympathetic drive, further vascular damage)
41
what is the first line therapy in dogs to treat hypertension;
reduce angiotensin, blood volume
ACE inhibitors
42
what is the first choice therapy in cats to treat hypertension;
calcium channel blocker, causes arteriolar dilation, including afferent arteriole
Amlodipine besylate
43
name 3 reasons for urinary tract infections with chronic kidney disease
1. dilute urine
2. polyuria
3. immunodeficiency
44
name 4 reasons for hypokalaemia with chronic kidney disease
1. polyuria
2. anorexia
3. fluid therapy
4. RAAS activation
45
name 3 supportive treatments to manage nausea/uraemic gastritis
| (assoc. with CKD)
1. maropitant
2. H2 blockers
3. sucralfate
46
name 4 ways to maintain appetite in an animal with CKD
1. warm food
2. offer palatable food
3. vit B12 injections
4. Mirtazapine
47
# name the IRIS stage of kidney disease
creatinine: <125 (dog), <140 (cat);
SDMA: <18 (dog), <18 (cat);
no clinical signs;
imaging/biopsy/exam findings;
proteinuria of renal origin
stage 1
48
# name the IRIS stage of kidney disease
creatinine: 125-250 (dog), 140-250 (cat);
SDMA: 18-35 (dog), 18-25 (cat);
clinical signs usually mild if present
stage 2
49
# name the IRIS stage of kidney disease
creatinine: 251-440 (dog), 251-440 (cat);
SDMA: 36-54 (dog), 26-38 (cat);
clinical signs usually present;
less signs more consistent with early of this stage and more signs consistent with late of this stage
stage 3
50
# name the IRIS stage of kidney disease
creatinine: >440 (dog), >440 (cat);
SDMA: >54 (dog), >38 (cat);
severe clinical signs and risk of uraemic crisis
stage 4
51
what is the urine protein-to-creatinine ratio (UPC) for a proteinuric dog and cat
greater than 0.5 (dog)
greater than 0.4 (cat)
52
what is the systolic pressure for a normotensive dog/cat
less than 140 mmHg
53
what is the systolic blood pressure for a severely hypertensive dog/cat
greater than 180 mmHg
54
name the 4 stages of acute kidney injury
1. initiation
2. extension
3. maintenance
4. recovery
55
# name the stage of acute kidney injury
exposure to causal agent;
precedes clinical signs;
intervention now may prevent progression
initiation
56
# name the stage of acute kidney injury
inflammation and hypoxia → further nephron damage
extension
57
# name the stage of acute kidney injury
irreversible damage has occurred;
on-going signs of decr. tubular function
maintenance
58
# name the stage of acute kidney injury
repair of damage and regeneration of nephrons over weeks to months
recovery
59
why are kidneys at a high risk of injury
1. blood supply
2. high metabolic and high oxygen demand
60
name 7 clinical signs of acute kidney injury
1. PUPD
2. anuria
3. lethargy
4. vomiting/diarrhea
5. weakness
6. altered mentation
7. abd. pain
61
name 6 clinical exam signs of acute kidney injury
1. paraspinal pain
2. normal or enlarged kidney
3. hallitosis
4. oral ulceration
5. bradycardia
6. bladder size
62
name 7 diagnostics that should be done for suspected acute kidney injury
1. haematology
2. serum biochemistry (potassium)
3. urine analysis
4. blood pressure
5. Leptospirosis testing
6. U/S
7. radiographs
63
name 3 differential diagnoses for acute kidney injury
1. chronic kidney disease
2. acute-on-chronic
3. hypoadrenocorticism
64
name 4 emergency treatments for hyperkalaemia with acute kidney injury
1. calcium gluconate
2. fluid boluses
3. glucose
4. insulin
65
what is the emergency treatment for hypocalcaemia with acute kidney injury
calcium gluconate
66
name 5 treatment options if fluid balance has been restored but there is still no urine output
1. furosemide
2. mannitol
3. peritoneal dialysis
4. haemodialysis
5. euthanasia
67
# name the disease
autumn/winter in UK;
skin lesions initially;
AKI develops 3-4 days later;
thrombocytopaenia;
poor prognosis
Cutaneous Renal Glomerular Vasculopathy (CRGV)
('Alabama Rot')
68
this is abnormal development of renal tissue with foetal glomeruli present;
insidious, stunted growth, PUPD, acute-on-chronic;
histopathology necessary to confirm
renal dysplasia
69
this is absence of one kidney from birth;
remaining kidney usually hypertrophic to compensate;
can have normal life expectancy
renal agenesis/hypoplasia
70
# name the disease
may or may not be present at birth;
PKD-1 gene;
as cysts enlarge, volume of functional nephrons reduces;
treat as CKD
polycystic kidney disease
71
name 6 defence mechanisms of the kidney against infections (pyelonephritis)
1. concentrated urine produced
2. peristaltic unidirectional flow of urine
3. oblique entry of ureters into bladder
4. frequent voiding of urine
5. closed urethral sphincter
6. urothelium protective barrier
72
name 3 features of haematology seen with pyelonephritis
1. leukocytosis
2. anaemia of chronic disease
3. thrombocytopaenia
73
name 3 ultrasound signs that may indicate pyelonephritis
1. hyperechoic kidney
2. pelvic dilation
3. bladder sediment
74
what are the 2 most common breeds to get amyloidosis
Shar Pei
Siamese
75
name 5 effects/problems caused by protein losing nephropathy (PLN)
1. significant proteinuria
2. reduced oncotic pressure
3. thromboembolic disease
4. hypertension
5. lipid imbalance
76
name the 4 clinical consequences of nephrotic syndrome
1. hypoalbuminaemia
2. proteinuria
3. hypercholesterolaemia
4. peripheral oedema
77
# name the tubular disease
affects proximal tubule;
inherited (Basenji) OR acquired (toxins-jerky treats/infections-Lepto);
tubules unable to reabsorb glucose, bicarb. electrolytes, minerals, amino acids
Fanconi's syndrome
78
# name the tubule disease
proximal tubule unable to reabsorb glucose;
osmotic diuresis with PU/PD;
recurrent UTIs;
loss of calories
primary renal glucosuria
79
# name the type of renal tubular acidosis
failure to reabsorb HCO3-;
less severe acidosis;
alone or part of Fanconi's;
mild to moderate hypokalaemia
type 2 (Proximal)
80
# name the type of renal tubular acidosis
failure to excrete acid;
usually only anomaly;
severe acidosis;
moderate to severe hypokalaemia
type 1 (distal)
81
# name the disease
loss of ability to concentrate urine;
large volumes of hyposthenuric urine;
compensatory polydipsia;
water deprivation test
Diabetes insipidus
82
name 6 predisposing factors for bacterial cystitis
1. dilute urine
2. incontinence
3. urine retention
4. catheter
5. immunocompromise
6. damaged urothelium
83
name the 2 main bacterias causing bacterial cystitis
1. E. coli
2. Enterococci
84
name 3 reasons to do a urine culture to diagnose bacterial cystitis
1. to confirm
2. to identify causal organism
3. to guide antibiotic choice
85
name 3 conditions that can gi ve a false negative for bacterial cystitis on urine analysis
1. dilute urine
2. Diabetes
3. Cushings
86
name 2 things that can give a false positive for bacterial cystits on urine analysis
1.stain
2.fat droplets
87
what is the 2 best empirical treatment options for gram negative bacterial cystitis
1. TMPS
2. Amoxi-Clav
88
what is the 2 best empirical treatment options for gram positive bacterial cystitis
1. ampicillin
2. amoxicillin
89
# name the condition
sterile inflammatory cystitis;
young cats;
male > female;
neutered
feline idiopathic cystitis (FIC)
90
name 7 predisposing factors for feline idiopathic cystitis (FIC)
1. multi-cat household
2. nervous/anxious personality
3. obesity
4. indoor
5. dry food
6. black and white coloring
7. stressful home environment
91
name 3 features of feline idiopathic cystitis (FIC) that may be seen on urine analysis
1. very concentrated urine
2. blood likely present (inflamm.)
3. crystals present
4. no bacteria
92
what 3 environmental treatments can be done for a cat with feline idiopathic cystitis (FIC)
1. incr. water intake
2. incr. litter trays and beds
3. pheromones
93
what 2 medications should be given to treat a cat with feline idiopathic cystitis (FIC)
1. analgesia (opioids, meloxicam)
2. spasmolytics
94
what 3 things should be evaluating during a neuro assessment for an animal with incontinence
1. anal tone & sensation
2. bulbocavernosus and perineal reflexes
3. urethral sphincter tone
95
# name the condition
involuntary passage of urine;
not consciously aware;
wet patch where lying;
dribbling urine when walking
urinary incontinence
96
# name the bladder nerve
symopathetic;
alpha and beta adrenergic;
detruser relaxation;
internal sphincter muscle (ISM) contraction
hypogastric nerve
97
# name the bladder nerve
parasympathetic;
muscarinic;
contraction of detrusor muscle
pelvic nerve
98
# name the bladder nerve
somatic;
contraction of external sphincter muscle
pudendal nerve
99
3 features of the bladder if there is a spinal lesion in the neck (cranial to hypogastric, pelvic, and pudendal nerve origins)
1. large bladder
2. tense bladder
3. difficult to express
100
3 features of the bladder if there is a spinal lesion caudal to where the hypogastric nerve originates (cranial to pudendal and pelvic nerve origins)
1. large bladder
2. soft bladder
3. easy to express
101
# name the condition
adrenaline acting on oestrogen sensitised receptors;
incontinence while sleeping;
normal clinical exam;
diagnosis of exclusion
urinary sphincter mechanism incompetence (USMI)
102
how to treat intramural ectopic ureter
laser ablation
103
how to treat extramural ectopic ureter
transection and re-implantation
104
name 4 clinical signs that may be seen with benign prostatic hyperplasia
(often none - incidental finding)
1. preputial discharge
2. penile bleeding or haematuria
3. dysuria/stranguria
4. faecal tenesmus/flattened stool
105
name 5 treatment options for benign prostatic hyperplasia
1. surgical castration
2. osaterone acetate (Ypozane)
3. delmadinone acetate (Tardak)
4. Deslorelin
5. Finasteride
106
# name the condition
bacterial infection of the prostate;
usualy ascending infection;
may haematogenous;
concurrent cystitis;
reflux of prostatic secretions into bladder
prostatitis
107
name 3 clinical signs of acute prostatitis
1. caudal abdominal pain
2. stilted gait
3. systemically unwell (v+, pyrexia, sepsis)
108
name 3 signs of chronic prostatitis
1. signs of 'cystitis' (stranguria, dysuria, haematuria)
2. penile discharge/haemorrhage
3. dyschezia
109
what distinguishes acute prostatitis from chronic prostatitis
ability to cross blood-prostate barrier
| (chronic can cross, acute can NOT)
110
name 6 prostatic diseases
1. benign prostate hyperplasia
2. prostatitis
3. sqaumous metaplasia
4. prostatic carcinoma
5. prostatic abscess
6. prostatic/paraprostatic cysts
111
this is the start of a bladder stone;
can be bacteria, epithelial cells, foreign material
nidus
112
this is part of bladder stone formation;
aggregation of crystals;
can occur with or without a nidus
nucleus
113
name 4 general treatment options for urotliths
1. shock wave therapy
2. endoscopic nephrolithotomy
3. surgical intervention
4. SUBS/stent if obstruction
114
name 5 clinical signs of uteroliths
1. asymptomatic
2. post-renal azotaemia
3. big kidney little kidney (BKLK)
4. calcium oxalate/struvite
5. pain
115
name 4 treatment indication for uteroliths
1. obstructive
2. hydronephrosis
3. azotaemia
4. hyperkalaemia
116
name 5 general treatment options for ureteroliths
1. medical therapy
2. subcutaneous ureteral bypass (SUB)
3. ureteric stenting
4. shockwave therapy
5. surgical intervention
117
name 5 general management options for urethroliths
1. catheter placement
2. retrograde hydropulsion
3. urethrotomy
4. urethrostomy
5. laser lithotripsy
118
name 5 types of uroliths
1. struvite
2. calcium oxalate
3. urate
4. cystine
5. Xanthine/Silicate
119
what are struvite uroliths made up of
1. Mg
2. NH3
3. PO4
| (MAP)
120
what 2 types of uroliths can NOT be seen on radiographs
1. Urate
2. Cystine
121
# name the type of urolith
calculi: spherical, multiple, variable sizes, radio-opaque;
neutral to alkaline urine;
commonly associated with UTI (in dogs, not cats);
females > males
struvite
122
# name the type of urolith
calculi: white often with jagged adges, single or multiple, radio-opaque;
most common nephrolith;
more common in males;
neutral to acidic urine;
may be assoc. with hypercalcaemia
calcium oxalate
123
# name the urolith type
calculi: multiple, small, brownish-green, radio-lucent;
more common in males;
neutral to acidic urine;
breed related;
can be assoc. with cPSS/liver failure
uric acid / urates
124
# name the urolith type
calculi: round, smooth, light brown/yellow, usually multiple, faintly radio-opaque;
more common in males;
acidic urine;
error in metabolism → amino aciduria
cystine
125
# name the urolith type
calculi: jack stone appearance, moderately radio-opaque, usually multiple;
rare;
more common in males;
neutral to acidic urine;
surgical removal required
silicate
