2nd path test > Urinary (farina) > Flashcards

Urinary (farina) Flashcards

(54 cards)

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1
Q

nephron

A
  • functional unit of kidney
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2
Q

Renal dz may affect

A
  • glomeruli
  • tubules
  • interstitium
  • blood vessels
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3
Q

GLomeruli

A
  • Selective filter for molecules based on
    • size
    • charge
    • shape
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4
Q

Mesangial cells

A
  • phagocytose macromolecules and immune complexes
  • contract to autoregulate glomerular blood flow
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5
Q

Tubules

A
  • selectively secrete or reabsorb water and organic/inorganic subst
  • can regenerate
    • basement membrane must be intact for scaffolding (regenerating epithelial cells)
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6
Q

Endocrine functions of kidney

A
  • Erytropoietin
    • stimulates erythrocyte production
  • Renin
    • released in response to Na depletion or low blood volume
    • converts angiotensinogen to angiotensin I
  • Vitamin D activation
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7
Q

Renal aplasia

A
  • absense 1 or both
  • congenital
  • can be incidental finding
  • can have compensatory hyperplasia of rem kidney
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8
Q

Renal hypoplasia

A
  • smaller kidney
  • congenital
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9
Q

Horseshoe kidney

A
  • kidneys fused at renal pole
  • congenital
  • these function ok
  • incidental finding
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10
Q

Polycystic kidney disease (PKD)

A
  • primarily cats (persians)
  • aut dom (adult onset)
  • can also have liver cysts
  • renal failure over 7
  • ultrasound at 10 mo
  • bilateral
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11
Q

Acute renal infarct

A
  • red - tan after 2-3 days, then fibrosis
  • most common circulatory abnormality seen
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12
Q

Papillary necrosis

A
  • common in horses
  • common in dehydration wtih lots of NSAID admin
    • inhibit prostaglandin synthase PGE2 which maintains vasodilation in arterioles in juxtamedullary nephrons
    • Loss of vasodilatory effect => ischemia and subsequent ischemic necrosis
      • green gross - loss of tissue if survive
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13
Q

Hydronephrosis/hydroureter

A
  • hydronephrosis - dilation of renal pelvis/calyces
  • hydroureter - dilation of ureters
  • typically secondary to an obstruction

*goat reprocarcinoma pic

*horse pic

*sheep pic

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14
Q

Glomerulonephritis

A
  • immune complexes depositing at/in basement membrane
    • antibodies formed against glomerular basement membrane
  • Complement fixation, leukocytic infiltration and production inflammatory mediators by mesangial cells
  • filtration barrier compromised => Protein loss
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15
Q

Types glomerulonephritis

A
  • Membranous GN
    • thickened glomerular basement membranes => too much pink stuff in glomerulus
  • Proliferative GN
    • inc numbers of mesangial cells
  • Membranoproliferative GN
    • combo of both above
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16
Q

Conditions associated with GN

A
  • Chronic inflammatory stimuli
    • viral dz
    • chronic bact infecitons
    • parasitic and protozoal diseases
    • neoplasms
  • initial inciting cause often not determined
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17
Q

Glomerulosclerosis

A
  • shrunken end stage glomerulus
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18
Q

Dz with same end result as glomerular nephritis

A

Glomerular amyloidosis

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19
Q

Glomerular amyloidosis

A
  • often reactive systemic amyloidosis
    • acute phase protein, chronic inflammation
  • familial condition
    • shar pei
    • abyssinian
  • loss of glomerular function => progressive renal insufficiency, protein loss
  • Lugol’s iodine to fresh tissue: amyloid stains dark brown
  • Congo red: stains for amyloidin histo sections
  • causes proximal tubule damage

*grossly look pale

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20
Q

Embolic nephritis/glomerulitis

A
  • bact lodge in glomerular and peritubular capillaries
  • Horses
    • actinobaccillus equuli
  • Pigs
    • Erysipelothrix rhusiopathiae
  • Cattle
    • trueperella pyogenes (arcanobacterium)
    • from vavularendocarditis

*micro abcesses in cortex (glomeruli), tan colored, blue on histo stain

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21
Q

Acute tubular necrosis - ischemic

A
  • shock or hypotension
  • proximal tubules (higher metabolic rate)
  • disruption of basement membrane
    • no scaffold, therefore no regeneration
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22
Q

Acute tubular necrosis - toxic

Study These Flashcards
A
  • tubules susceptible to toxins
  • proximal tubules
  • histo: ext necrosis prox tubules
  • basement membranes preserved
23
Q

Nephrosis

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A
  • pale swollen kidney
24
Q

Tubular degeneration

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A
  • vacuolar degeneration tubular epithelium
  • Don’t confuse with normal cat kidney cause they fat
25
Tubular necrosis Features
* Loss of cellular detail * Nuclear Karyorrhexis (nucleus breaking up), karyolysis (nucleus fading out), pyknosis (small and dark) * Increased cytoplasmic eosinophilial * sloughing epithelial cells (looks vaculed on histo)
26
Tubular regeneration Features
* increased cytoplasmic basophilia * piling/crowding epithel cells * nuclei with open chromiatin pattern and prominant nucleoli * mitotic figures
27
Interstitial (tubulointerstitial nephritis)
* most common cause chronic renal failure in old cats * acute cases * edema * leukocyte infiltration * focal tubular necrosis * chronic cases * leukocytic (often plasmocytic) infiltrate * interstial fibrosis * tubular atrophy \*lumpy bumpy irregular ligth pink kidney grossly \*lepto pig pic
28
Pyelonephritis
* inflammation of **renal pelvis and parenchyma** * Usually results from ascending infection from LUT * concurrent ureteritis and cystitis * Vesicoureteral reflux: retrograde flow up ureters during micturation * infections agents similar to those causing UTIs * radiating pattern grossly \*Edge of pelvis irregular, discoloration \*chronic cow case lighter pink
29
Stephanurus dentatus
* parasitic renal dz swine * eggs passed in urine
30
Dioctophyma renale
* giant kidney worm in mammals * adults live in renal pelvis * progressive destruction of renal parenchyma * fish eaters \*disgusting big worm
31
Renal neoplasia
* Adenoma * small, benign, incidental (looks like fat glob) * Adenocarcinoma * sheep, cattle dogs (looks like a white alien) * well-demarcated, compress renal parenchyma, located at one pole of kidney * Nephroblastoma * pigs, chicken, fish * younger animals, kidney looks primitive * metastises * lymphoma most common (multiple nodular masses thruout)
32
Non-urinary lesions assoc with renal failure
* gastric ulcers/uremic gastritis * ulcerative glossitis/tomatitis * mineralization intercostal pleura (uremic frosting) * uremic pneumonitis * parathyroid hyperplasia * phosphate retention from dec GFR - dec plasma ionized Ca++ - stimulates PTH rel * bilat dz indicates metabolic dz, not cancer * Anemia * dec erythropoietin, hemolysis from factors in uremic plasma * GI hemorrhage
33
Ectopic ureter
* ureters can empty into weird places * congenital * unilateral or bilateral * certain breeds predisposed
34
Patent urachus
* failures of closure of urachal lumen * results in driblling urine from urachus * most common in foals
35
Urolithiasis
* calculi in urinary passages * predisposing factors * urine pH (precipitation) * Hereditary (dalmations) * Dietary factors * UTIs
36
Cystitis
* ascending infection from rectal flora * predisposing factors * loss normal voiding * loss acidic urine pH (carnivores) * Glucosuria * Proteinuria * Mucosal trauma * Degress inflammation doesn't correlate to histological inflammation * Females predisposed
37
Emphysematous cystitis
* gas in bladder * bacterial fermentation of urinary glucose to CO2 * diabetics
38
Enzootic hematuria
* ruminants * bracken fern ingestion * toxic substances and carcinogens, alkylates DNA * Neoplasms * TCC * SCC * Papilloma * fibroma/sarcoma * hemangioma/sarcoma * leiomyosarcoma
39
Neoplasia of lower urinary tract
* Papilloma (look for features of malignancy) * covered by well-differentiated transitional epithelium * may undergo malignant transformation to TCC in dogs * TCC * **most often in bladder neck/trigone** * 50% met * Botryoid rhabdomyosarcoma (stem cells) * young (\<18 mo) large/giant breed dogs
40
UTI abx
* clavamox for 14 days
41
Relapse
same infection coming back
42
recurrent infections
new infections
43
Causes of recurrent UTIs
* tumor * diabetes * Cushings (immunosuppression) * pyelonephritis (if org changed probs not) * ectopic ureters * neuro * bladder stones
44
Piroxicam
COX 2 inhibitor
45
Oral ulcers from
azotemia (uremia)
46
Synechiae
* adhesion of glomerulus to side of nephron
47
Distiguishing acute from chronic renal failure Acute
* Acute * good body cond * smooth, enlarged kidneys (+/- pain) * Severe clnical signs related to BW * PCV N-inc * K+ N-inc * more severe metabolic acidosis
48
Distiguishing acute from chronic renal failure Chronic
* Poor body condition * Small irregular kidneys on palpation * relatively mild CS related to BW (HIGH BUN) * nonregenerative anemia * K+ N-dec * less severe metabolic acidosis * Longstanding PU/PD
49
Oxalates
Ethylene glycol poisoning
50
Ethylene glycol toxicosis
* Histopath * tubular necrosis * intratubular birefringent crystals
51
Gout
* Deposition of urates in tissues * visceral gout: depostion on serosal surfaces of organs * synovial gout: deposition in joints
52
High levels uric acid predispose to
* Tissue deposition * Renal dysfunction * dehydration * high protein diet
53
Birds with renal tumors can present with
* lameness * disrupt sciatic nerves
54
Renal pelvic inflammation
Pyelitis
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