Bryan - Clin Path - Test 3 - Winter 2Nd Year - Urinary System

Front 1

What is the approximate specific gravity of plasma?

Back 1

1.007 to 1.017

Front 2

T or F:
Isothenuria alone is pathologic.

Back 2

False!
It is NOT pathologic by itself

Front 3

Where is most of the ultrafiltrate reabsorbed?
a) Bowman's Capsule
b) PCT
c) Loop of Henle
d) DCT
e) Macula Densa

Back 3

b) PCT

Front 4

What materials are secreted by the kidney tubules?

Back 4

H+, NH3, and K+

Front 5

What is the most common cause of hypernatremia?

Back 5

Dehydration!

Front 6

A(n) _______________ of Na+ concentration stimulates the release of ADH.

Back 6

increased Na+ stimulates ADH release

Front 7

Increased BUN or Creatinine =

Back 7

Azotemia

Front 8

T or F:
If BUN is increased but not Creatinine, this is not azotemia.

Back 8

False! It's still azotemia!

Front 9

Choose pre, post, or renal azotemia...
...concentrated urine specific gravity.

Back 9

Pre and post renal azotemia

Front 10

Choose pre, post, or renal azotemia...
...associated with obstructed outflow.

Back 10

Post renal

Front 11

Choose pre, post, or renal azotemia...
...associated with decreased GFR due to decreased perfusion.

Back 11

Pre-renal azotemia
(GFR is also reduced in renal due to kidney disease and in post renal due to obstruction)

Front 12

Choose pre, post, or renal azotemia...
...isothenuric specific gravity.

Back 12

Renal azotemia

Front 13

T or F:
Decreased GFR can be due to issues pre-renal, post-renal, or within the kidney.

Back 13

True!
Decreased perfusion, renal disease, or obstruction can cause decreased GFR

Front 14

Are GFR and BUN directly or inversely proportional?

Back 14

Inversely (low GFR = high BUN)

Front 15

BUN doesn't increase until _____ of kidney function is lost. Kidney concentration ability is not lost until ________ of kidney function is lost.

Back 15

3/4 kidney fxn --> increased BUN
2/3 kidney fxn --> can't concentrate

Front 16

Which has better urine concentrating ability, cats or dogs?

Back 16

Cats!

Front 17

T or F:
Cats can have high BUN and still concentrate urine.

Back 17

True

Front 18

What are some causes of increased BUN but normal Creatinine?

Back 18

High protein diet
Digested blood (GI bleeding)

Front 19

What are some causes of decreased BUN?

Back 19

Low protein diet
Liver failure

Front 20

Why is BUN not a sensitive indicator of renal function in bovids?

Back 20

Urea is used in the rumen for protein syntheisis

Front 21

Are GFR and Creatinine inversely or directly proportional?

Back 21

Inversely

Front 22

T or F:
An increase in BUN but not creatinine indicates a decreased GFR.

Back 22

False!
This shows that the issue is not GFR related

Front 23

Choose BUN, Creatinine, or Inulin...
...consistent on a daily basis for a given animal.

Back 23

Creatinine

Front 24

Choose BUN, Creatinine, or Inulin...
...ONLY affected by GFR in renal clearance.

Back 24

Inulin

Front 25

Choose BUN, Creatinine, or Inulin...
...muscle mass impacts values.

Back 25

Creatinine

Front 26

Choose BUN, Creatinine, or Inulin...
...low GFR causes increase.

Back 26

BUN, Creatinine

Front 27

Choose BUN, Creatinine, or Inulin...
...the "gold standard" for GFR evaluation.

Back 27

Inulin

Front 28

Which test helps to determine the cause of decreased GFR?

Back 28

Urine Specific Gravity

Front 29

What SG range constitutes isothenuria?

Back 29

1.007 to 1.017

Front 30

High SG, high BUN and high Creatinine = which type of azotemia?

Back 30

pre-renal

Front 31

High BUN, Creatinine, and isothenuria = which type of azotemia?

Back 31

Renal azotemia

Front 32

Which test challenges the kidneys ability to concentrate urine?

Back 32

Water deprivation test

Front 33

What are the four "stop points" for the water deprivation test?

Back 33

1) Azotemia occurs
2) USG is 1.03 or 1.035 (cats)
3) 5% body wt. is lost
4) clinical dehydration occurs

Front 34

What are the two non-renal failure possibilities describing a lack of USG increase in a water deprivation test?

Back 34

Primary (pituitary) D. insipidus;
Nephrogenic D. insipidus

Front 35

Which test differentiates the types of diabetes insipidus? What would the results of this test be in an animal with nephrogenic D. insipidus?

Back 35

ADH response test;
Would have no response in nephrogenic D. insipidus

Front 36

Which test measures electrolyte clearance?

Back 36

Fractional excretion

Front 37

T or F:
Increased fractional excretion denotes tubular failure.

Back 37

True

Front 38

Which of the following are common lab abnormalities in canine renal disease?
a) non-regenerative anemia
b) Hypophosphatemia
c) hypokalemia
d) secretional metabolic acidosis
e) increased amylase

Back 38

a) non-regenerative anemia
b) Hypophosphatemia (NO - in horses maybe)
c) hypokalemia
d) secretional metabolic acidosis (NO - titrational though)
e) increased amylase

Front 39

What type of crystals may be seen in EG toxicity? Which one is the bad one?

Back 39

Calcium oxalate monohydrate and dihydrate; monohydrate is BAD NEWS

Front 40

Of the following signs, which is associated with chronic or acute (or both) renal failure?
a) PU/PD
b) anuria/oliguria
c) azotemia
d) isothenuria
e) anemia

Back 40

a) PU/PD (chronic)
b) anuria/oliguria (acute)
c) azotemia (both)
d) isothenuria (both)
e) anemia (chronic)

Front 41

Which method of urine collection is best for culturing bacteria?

Back 41

Cystocentesis

Front 42

What does cloudy urine indicate?

Back 42

Formed elements (cells, casts, crystals, bacteria)

Front 43

What tests can be performed using a urine dipstick that are of veterinary importance? (hint - there are 6)

Back 43

pH, ketones, glucose, bilirubin, blood, protein

Front 44

What can cause false negative glucose values in a dipstick urine test?

Back 44

Ascorbic acid (vit C)

Front 45

T or F:
Bilirubinuria is always significant in cats.

Back 45

True! Indicative of cholestasis or hemolysis

Front 46

What are some causes of ketonuria?

Back 46

Starvation, B-cell tumor, diabetic ketoacidosis, high fat/low carb diet, persistent hypoglycemia

Front 47

T or F:
Ketonuria is only detectable after ketonemia has exceeded the urinary threshold.

Back 47

False! Ketonuria is often detected before ketonemia.

Front 48

What is the most common cause of bilirubinuria?

Back 48

Cholestasis

Front 49

What three things can show a positive blood test in a urinalysis dipstick?

Back 49

Free hemoglobin,
Free myoblobin,
RBCs

Front 50

Which proteins will urinalysis dipsticks not commonly detect?

Back 50

Globulins
Bence-Jones Proteins
Hemoglobin
Mucoprotein

Front 51

Which test is used to semi-quantify proteinuria?

Back 51

Sulfosalycylic Acid Precipitation test

Front 52

What are some common reasons for proteinuria?

Back 52

Inflammation
hemorrhage
infection

Front 53

What test is used when there is no obvious explanation for proteinuria? How is this test interpreted?

Back 53

Protein:Creatinine
(ratio >1 = significant protein loss)

Front 54

What can cause false protein positives in a urinalysis dipstick?

Back 54

high pH

Front 55

How many RBCs per high-power field are normal in a urinalysis? What is unique about the RBC morphology in urine?

Back 55

up to 5/hpf;
RBCs are crenated

Front 56

How many WBCs per high-power field are normal in a urinalysis? What is it called when this level is exceeded?

Back 56

up to 5/hpf; greater than this = pyuria

Front 57

Name these cells found in a urinalysis? Which is common in a free-catch sample?

Back 57

A - Squamous cell (common in free catch)
B- Transitional

Front 58

T or F:
In a urine sample, rod bacteria are easier to see than cocci.

Back 58

True

Front 59

What two conditions should accompany the findings of bacteria in the urine?

Back 59

Proteinuria
Pyuria

Front 60

What do you think if you see fungal hyphae in urine?

Back 60

Craptamination!

Front 61

Name that urine sediment!

Back 61

Capillarria plica

Front 62

T or F:
Crystals in the urine generally implies urinary stones.

Back 62

False

Front 63

Name that urine sediment! In which species are these most common?

Back 63

Struvite crystals (MgNH4PO4); common in dogs

Front 64

What crystal is indicated by A? By B? In which species are these common?

Back 64

Both are CaCO3 crystals; common in horses

Front 65

What crystal is indicated by A? By B? What is associated with A?

Back 65

A - Ca-oxalate monohydrate (EG poisoning)
B - Ca-oxalate dihydrate

Front 66

Which urine crystals have no clinical significance?

Back 66

CaCO3;
Cholesterol

Front 67

Which urine crystals are associated with alkaline urine?

Back 67

Struvite (neutral/alkaline)
CaCO3
Ammonium biurate (acid to alkaline)
Ca-oxalate (acid to alkaline)

Front 68

Name these crystals! What disease(s) are associated with these?

Back 68

Ammonium biurate;
Assoc w/hepatic dz (portosystemic shunt)

Front 69

Name that crystal! What causes this?

Back 69

Bilirubin crystal;
Same causes as bilirubinuria

Front 70

How many casts may be seen in normal concentrated urine?

Back 70

1-2 per lpf

Front 71

Which type of cast is the worst:
a) hyaline cast
b) waxy cast
c) granular cast
d) erythrocyte cast

Back 71

Waxy is worst --> it is advanced stage of granular cast (indicates chronic tubular degeneration)