Urinary Anatomic Path 1

Question 1

what are the 2 main functions of the lower urinary tract

Answer 1

urination
keep pathogens out (including vesicoureteral valve)

Question 2

what are the parts of the lower urinary tract

Answer 2

urethra, urinary bladder, ureters

Question 3

what is by far the number one cause of disruption in urination

Answer 3

urolithiasis

Question 4

what are the 4 causes of disrupted urination

Answer 4

• urolithiasis
• congenital/developmental anomalies (aplasia/agenesis, hypoplasia, ectopia)
• inflammation
• neoplasia

Question 5

what is the anatomic consequence of obstruction in the lower urinary tract

Answer 5

upstream dilation: hydrourethra, bladder distention/rupture, hydroureter, hydronephrosis

Question 6

what are the top 3 predisposing factors for urolithiasis

Answer 6

• high levels of calculogenic material
• pH
• decreased water intake

Question 7

what are other factors that increase risk of urolithiasis beyond the top 3 (high concentration calculogenic material, pH, lack of water intake)

Answer 7

• infection (nidus, changes pH)
• obstruction
• structural abnormalities (incomplete emptying increases [calculogenic material])
• foreign material (nidus, obstruction)

Question 8

what type of stone has recently been discovered in association with fresh diets? what is the inciting material?

Answer 8

calcium tartrate tetrahydrate; choline bitartrate

Question 9

what is historically the #1 urolith in dogs

Answer 9

struvite

Question 10

in older dogs, what is the #1 urolith?

Answer 10

calcium oxalate (NOT struvite); starting at 7y

Question 11

what are struvite uroliths composed of?

Answer 11

magnesium ammonium phosphate hexahydrate

Question 12

what are the characeristics of struvite stones?

Answer 12

• associated with infection
• more common in females
• less soluble at higher pH
• white-grey, chalky, smooth and easily broken

Question 13

T/F the frequency of struvite uroliths is decreasing in cats and cows

Answer 13

T

Question 14

what are calcium oxalate stones associated with

Answer 14

hypercalcuria, hyperoxaluria

Question 15

what is the appearance of calcium oxalate stones

Answer 15

hard, heavy white or yellow, jagged or smooth edges

Question 16

what species get calcium oxalate stones

Answer 16

dogs, cats, ruminants

Question 17

what animals are most likely to get silica stones

Answer 17

ruminants > dogs > horses

Question 18

what is preventative for silica stones

Answer 18

salt

Question 19

what type of pasture is associated with silica stones

Answer 19

unimproved/native

Question 20

what demographic of dogs is most likely to get silica stones

Answer 20

males, GSDs and old english sheepdogs

Question 21

what animals are most likely to get urate stones

Answer 21

dalmatians (have high uric acid levels)

Question 22

what is the appearance of urate stones

Answer 22

• green brown, spherical, laminated

Question 23

why do xanthine stones form

Answer 23

deficiency in xanthine oxidase (hereditary in Dalmatians)

Question 24

what causes cystine stones

Answer 24

genetic defect in cysteine metabolism

Question 25

what stone is irregular, yellow to brown red, laminated and friable

Answer 25

xanthine

Question 26

what stone is light yellow to red-brown, friable, soft and waxy

Answer 26

cysteine

Question 27

where are you most likely to see a urolith in ruminants (3)

Answer 27

ischial arch, sigmoid flexure, vermiform appendage

Question 28

where are you most likely to see a urolith in dogs

Answer 28

proximal end of the os penis

Question 29

where are you most likely to see uroliths in cats

Answer 29

anywhere

Question 30

what species can get a functional obstruction resulting in dilation of the ureters

Answer 30

pigs

Question 31

what are the normal defense mechanisms in the urinary tract

Answer 31

- urine flow - intact urothelium - various mechanisms for bacterial adhesion - acidic urine (dogs and cats), high osmolality - urothelial exfoliation - phagocytosis by superficial mucosal urothelial cells

Question 32

what mechansims exist to prevent bacterial adhesion

Answer 32

- tamm-horsfall mucoprotein - IgA, IgG - surface GAGs - urinary oligosaccharides

Question 33

what factors increase the risk of cystitis

Answer 33

- urinary stasis - epithelial trauma - diabetes - cystocentesis

Question 34

what are examples of things that can cause epithelial trauma

Answer 34

- uroliths - catheters - chemicals (bracken fern, cyclophosphamide)

Question 35

T/F causes of cystitis are usually normal cutaneous and rectal flora

Answer 35

T

Question 36

what are examples of common pathogens

Answer 36

- Uropathogenic E. coli - Proteus vulgaris - Streptococcus - Staphylococcus

Question 37

what are examples of species specific pathogens that target the urinary system in: - cows - pigs

Answer 37

Cows: Corynebacterium renale Pigs: Actinobaculum suis

Question 38

what causes "encrusted cystitis" in dogs and what stone is this associated with?

Answer 38

Corynebacterium urealyticum; struvite stones

Question 39

lymphonodular cystitis is acute/chronic

Answer 39

chronic

Question 40

what is the appearance of polypoid cystitis? is this acute or chronic? what is a clinical sign?

Answer 40

- diffuse polyps over surface consisting of lymphocytes and plasma cells - chronic - hematuria

Question 41

emphysaematous cystitis is associated with ___________ in dogs and ____________ in cows

Answer 41

diabetes; milk fever (treated with propylene glycol)

Question 42

is neoplasia of the lower urinary tract common or uncommon? what animals get LUT neoplasia

Answer 42

uncommon cows, dogs, cats

Question 43

what is the most common LUT neoplasia

Answer 43

urothelial cell carcinoma (TSC)

Question 44

what are the 4 "types" of urothelial cell carcinoma

Answer 44

- papillary -polypoid - sessile - grossly inapparent

Question 45

T/F urothelial cell carcinomas are invasive and malignant

Answer 45

T

Question 46

how do you differentiate urothelial cell carcinomas

Answer 46

IHC (uroplakin)

Question 47

how can urothelial cell carcinomas lead to SCC and ACs

Answer 47

squamous metaplasia as a response to chronic irritation -> division through metaplasia leads to SCC and ACs

Question 48

stromal tumors constitute ____% of LUT tumors; are they usually benign or neoplastic

Answer 48

20; usually benign

Question 49

what is the difference in the behaviour of fibrosarcomas and leiomyosarcomas

Answer 49

fibrosarcs met but leiomyosarcs not as often

Question 50

what are botyroid rhabdomyosarcomas and the epidemiology

Answer 50

skeletal mm tumor associated with immature cell types; common in animals < 2yo, big dogs, and females > females

Question 51

what is the prognosis of botyroid rhabdomyosarcomas and why

Answer 51

guarded; infiltrates the wall and can metastasise

Question 52

botyoid rhabdomyosarcomas are associated with _________ in dogs

Answer 52

hypertrophic osteopathy

Question 53

what is bovine enzootic hematuria

Answer 53

a (usually mixed) benign and malignant tumor secondary to bracken fern toxicity

Question 54

what types of neolpasias are associated with bovine enzootic pneumonia? how many are mixed?

Answer 54

- papillomas - fibromas - hemangiomas - carcinomas - hemangiosarcomas 50% are mixed

Question 55

how does bracken fern cause neoplasia

Answer 55

production of carcinogenic compounds (ptaquiloside, quercetin...)

Question 56

where are most tumors associated with bovine enzootic pneumonia

Answer 56

usually ventral abdomen

Question 57

the kidney is ____% of BW, ___% of cardiac output and ____% of O2

Answer 57

0.5; 25; 10

Question 58

how does hydronephrosis form and lead to eventual death of the kidney

Answer 58

obstruction -> buildup of urine -> increased pressure in kidney -> obstruction of vessels -> apoptosis -> kidney death

Question 59

what is juvenile nephropathy

Answer 59

an umbrella term encompassing congenital/hereditary/familial breed-associated clinical diseases that causes uremia at 6-9 or 4-18 months

Question 60

what are 3 different causes of juvenile nephropathy form

Answer 60

- type IV collagen defect in the glomerular BM - membranoproliferative glomerulonephritis - tubular disease of unknown cause with tubular atrophy and interstitial fibrosis

Question 61

what types of abnormal structures are associated with renal dsyplasia

Answer 61

- blind ended collecting ducts - atypical tubular epithelium - primitive ducts

Question 62

what types of inappropriate structures are associated with renal dysplasia

Answer 62

- immature glomeruli - undifferentiated mesenchyme (cortex or medulla)

Question 63

renal dysplasia is rarely associated with __________

Answer 63

osseous or cartilaginous metaplasia

Question 64

renal dysplasia predisposes to pyelonephritis because

Answer 64

there are often concurrent ureteral abnormalities

Question 65

T/F renal dysplasia is also associated with hypoplasia and aplasia

Answer 65

T