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Clinical Reproduction & Urology I > Veterinary Clin Path of Renal Dz > Flashcards

Veterinary Clin Path of Renal Dz Flashcards

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1
Q

Explain how the nephron functions

A
  • blood constituents filtered by glomerulus
  • fluid flows thru proximal tubules, constituents selectively reabsorbed
  • Loop of Henle: water reabsorbed determine urine vol
  • urine continues up distal tubules to gather in collecting ducts
  • poor re-absorption = loss of glucose of protein & increase in urine
  • enzymes in urine if cells of tubules are damaged or die
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2
Q

Signs of excretion of nitrogenous wastes on biochemistry?

A

Urea, creatinine

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3
Q

Acid-base regulation on clinpath?

A

H+. HCO3-

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4
Q

Body water regulation on clin path?

A

ADH
Aldosterone
Natriuretic peptides (ANP, BNP)

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5
Q

electrolyte regulation affected by renal fxn on clin path?

A

Na, K, Cl, Phosphate, Mg, Ca (horse)

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6
Q

degradation of certain enzymes & sign of renal fxn on clin path?

A

amylase

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7
Q

Endocrine fxn & sign of renal fxn on clin path

A

EPO, renin, Vit D

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8
Q

Azotaemia

A

Increased plasma/serum conc of urea &/or creatinine (& SDMA)

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9
Q

Azotaemia are measures of

A

GFR

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10
Q

azotaemia is diminished by factors causing

A

decrease in prod’n of urea by liver
OR creatinine by muscle
OR decrease in dietary urea intake

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11
Q

GFR measurement is determined by

A

Creatinine excretion

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12
Q

Creatinine excretion

A
  • freely filtered by kidney
  • no tubular resorption
  • small amt secreted by prox tubules in dogs
  • more accurate indicator of GFR
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13
Q

Equation of creatinine clearance

A

[(Ratio of urine to serum conc) X (rate of urine production (ml/min))]/ (body weight (kg)) = ml / min / kg

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14
Q

Uraemia definition

A

syndrome w/ increase in urea concentration characterised by marked azotaemia & specific clinical signs (V, anorexia, GI ulceration)

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15
Q

Uraemia occurs in advanced…

A

renal dz

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16
Q

pre-renal azotaemia due to a decrease in renal perfusion is due to:

A

hypovolaemia, dehydration, CV dz

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17
Q

Pre-renal azotaemia leads to

A

Urea increase
Creatinine normal or increased
USG increased

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18
Q

Pre-renal azotaemia is increased in urea production due to:

A

GIT haemorrhage & high protein diet

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19
Q

GIT haemorrhage leads to…

A

increased urea
normal creatinine

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20
Q

high protein diet leads to

A

increased urea
creatinine normal or elevated

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21
Q

Renal dz is only evident when

A

75% of nephrons are compromised

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22
Q

what are signs of renal dz on clin path?

A

urea & creatinine increased
urine inadequately concentrated

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23
Q

post-renal azotaemia occurs with…

Study These Flashcards
A

UT obstruction or rupture

24
Q

UT rupture causes what signs on clin path?

Study These Flashcards
A

Ur, Cr increased

25
What are biomarkers of electrolyte changes signaling renal dz?
hyperphosphatemia, hyperkalemia, hypermagnesemia, hyperamylasemia
26
hyperkalemia & renal dz can occur w/
oliguria or anuria w/ acidosis
27
hypokalemia may occur w/
polyuric renal failure, esp in cats/cows
28
SDMA is a
renal biomarker specific to kidney fxn, more specific than Cr & better to detect AKI/CKD
29
3 key attributes of SDMA making it a more reliable test
* Biomarker for kidney fxn - more accurately reflects GFR in dogs/cats * earlier than creatinine (as early as 25% loss of kidney fxn) * specific for kidney fxn - SDMA less impacted by extra-renal factors
30
Major regulators of serum phosphate & Mg & for horse - serum Ca
GFR & tubular reabsorption rates
31
In renal failure, what primary renal regulations occur?
hyperphosphatemia w/ hypocalcaemia & hypermagnesaemia
32
Horses w/ renal failure get what electrolyte abnormalities?
hypophosphataemia, hyperCa, HypoMg
33
Mg conc in serum rapidly___ in anorexia
decreases
34
Hypocalcaemia is secondary to
continuous hyperphosphataemia & hypoalbuminaemia
35
Phosphorus and calcaemia are often...
inversely related
36
Normocalcaemia or hypocalcaemia is common to
renal dz but ionised Ca is usually decreased
37
Renal osteodystrophy
bone pain, pathologic fractures, loose teeth, rubber jaw syndrome
38
Renal secondary hyperparathyroidism is assoc'd w/ compensatory increase in
PTH production
39
liver & bilirubin biomarkers related on clin path to renal dz
* hypoalbuminaemia * hypoglobulinaemia * low A/G * hypercholesterolaemia
40
What is the reaction of severe glomerular dz of the liver & gallbladder area?
Alb is lost in greater amts than globulins & the liver apparently compensates w/ an increase in production of globulins & lipoproteins carrying cholesterol
41
What are the signs of nephrotic syndrome?
Proteinuria Hypoproteinaemia Oedema Hypercholesterolaemia
42
Severe hypoalbuminaemia causes...
a decrease in plasma oncotic pressure leading to low-protein ascites &/or oedema which is most visible in the ventrum & extremities
43
Definition of Microalbuminuria
Presence of albumin greater than or equal to normal but less than or equal to the detectable range w/ a normal dipstick
44
Sensitive indicator of glomerular injury is
microalbuminuria
45
wide variability of microalbuminuria dictates
repeating testing 2-3x to confirm persistence
46
Microalbuminuria is most useful in...
cats
47
Hyperamylasemia occurs
due to its increase w/ lower GFR & lack of tissue specificity, 3-4x increases need to seen for reliable Dx of pancreatitis
48
Uremic acids may increase...
the anion gap (significant qtys of unmeasured ions often detected by determination of anion gap)
49
Progressive non-regenerative anaemia is caused by...
renal fxn loss causing a decrease in EPO which is the primary cause of the anaemia Renal haemorrhage may be present
50
Accumulation of uremic acids have
a toxic effect on BM & RBCs
51
What is a stress leucon?
mild neutrophilia monocytosis w/ lymphopenia Eosinopenia
52
Cardiac troponin in relation to renal dz
mild myocardial injury seen in dogs w/ renal failure due to accumulation of uremic acids
53
Ruptured bladder in neonatal foals/Urinary Obstruction (FUS)
* dilute urine accumulates in abd * Signs: hyponatraemia w/ hypochloridaemia (hyposaltaemia) * depressed GFR -> increase K & P (Ca for horses), urea, creatinine * dehydration from fluid sequestration causes tissue hypoxia --> metabolic acidosis & K loss from cells
54
Signs of glomerulonephritis/ nephrotic syndrome
* moderate decrease GFR w/ azotaemia --> muscle wasting * mod hypoalbuminaemia * mild hepatocellular injury * marked hypercholesterolaemia * mild hyperchloridaemia * mild hyperglycaemia * Nephrotic syndrome --> proteinuria, hypoproteinaemia, oedema, hypercholesterolaemia * UA: isosthenuria w/ azotaemia -> renal tubular dz
55
Signs of Ethylene Glycol Poisoning
Haematology * hyperalbuminaemia from dehydration * signs of inflammation * moderate lymphopaenia due to stress & uraemia * reticulocytopaenia from uraemia * eosinopenia from stress Biochemistry * chelation - oxalate * azotaemia from decreased GFR * inflammatory due to dehydration * oxalic acid, lactacidosis * uraemic acids UA * isosthenuria w/ azotaemia * proteinuria * glucosuria *oxalate crystalluria - Ca Oxalate monohydrate Blood Gas * metabolic acidosis * partial resp compensation
56
Signs of Diabetes on clin path
* marked uncontrolled, ketoacidotic diabetes * ketoacidosis w/ hyperkalaemia * azotaemia/dehydration from water loss * electrolyte loss * hyperchloridaemia - due to metabolic acidosis * muscle wasting * hepatocellular injury * haematuria/pyuria - cyststitis

Clinical Reproduction & Urology I (29 decks)

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