clin chem t3

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clin chem t3
2012-07-19 01:07:05

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  1. Casts
    • #/lpf form in lumen of distal renal tubules when the RT cells secrete protein called tamm-horsfall
    • degenerate (alkaline urine) urine must be fresh to see
    • rare in herbavors
  2. Hyaline casts
    • 1-2/lpf=norm
    • colorless parallel sides cylinder shape ez to miss
    • increased #'s w/ fever, stenuous exercise, mild renal irritation
  3. Granular casts
    • 1-2/lph=norm
    • look like hyaline only with granules that can be small and fine or big and course
    • more common than hyaline
    • may indicate nephritis
    • tapioca in jello
  4. Cellular casts
    never normal
  5. erythrocyte cast
    • rbcs incorporated into tamm-horsfall protein
    • deep yellow to orange
    • indicate bleeding in kidney i.e trauma or may be pathological
    • look like cherrys in jello
  6. leukocyte casts
    • wbc in T-H protein
    • disorganized arrangements
    • granular appearance or marshmellows in jello
    • indicate inflammation and commonly due to pyelonephritis
  7. Epithelial cell casts
    • contain renal tubular ep. cells
    • more organized arrangement of granules than wbc casts
    • indicate renal tubular damage
  8. fatty acid casts
    • contain fat drops in the T-H protein
    • round and refractile seen in DM or high fatty diets
    • seen more often in cats
  9. Waxy casts
    • Rare broader square ends
    • consistency of hyaline casts but more opaque look brittle
    • indicate cronic sever degeneration of the renal tubules
  10. urolithiasis
    • stone or calculi in the urinary tract
    • composedof various minerals
  11. 4things needed for stones to form
    • increased concentration of minerals
    • adequate pH
    • adequate time in urinary tract
    • +/-nidus-something upon which a stone can form on
    • i.e bacteria crystals and suture material
  12. things you can do to decrease likely hood of stones
    • alter diet-feed cats low ash food=low minerals
    • increase animals access to water
    • change pH of urine w/ diet
  13. struvites
    • crystal phosphate or A.M.P.S
    • most commonly seen in Dogs and cats
    • alkaline urine (bacterial infec. like due to urease + bacteria)
    • stones 2ndary to infection
    • urease converts urea to ammonia which increases the ph
    • Tx: acidify the urine w/ diet
  14. Uric acid stone
    • urate/ammonium urate
    • common in dalmations due  to they excrete a lot of uric acid
    • haed to prevend
    • can also be seen with portosystemic shunt
    • restricting protein from diet may help
  15. Calcium oxalate stone
    • hard stone w/ sharp protrusions
    • can damage the bladder
    • from in acidic urine
    • tx: change diet to make more alkaline
    • Will not dissolve
  16. U/A
    usg-evaluates renal tubular function (how well they respond to adh)
  17. BUN/Craetinine
    • Non-protein nitrogenous waste in blood
    • measure glomerular filtration
    • used to diagnose azotemia which is an ^ in non-protein nitrogenous waste in Blood
  18. BUN
    • protein-->ammonia-->urea-->urine
    • urea is filtered by glomerulus
    • bun measure lvl or urea in the blood thus measuring glomerular filtration
  19. normal bun in dogs
    7-27 mg/dl
  20. Norm bun in cats
    16-36 mg/dl
  21. reasons for increased BUN
    azotemia, ^ protein diet, ^ breakdown of bodys protein (fever, streniois exercise, infection, necrosis)
  22. reasons for decreased BUN
    • liver dz (unable to convert ammonia to urea) ,
    • young animals (anabolic state drink alot of water)
    • diuresis (pd, IV)
    • starvation (decreased protein, malnutriton, anorexia)
  23. creatinine
    • by product of nrorm muscle cell metabolism
    • filtered by glomerulus
    • excreted by muscles cell constantly regarless
    • measures lxl of creatinine in blood and glomerular filtration
  24. norm creatinine k9
  25. norm creatinine feline
    0.8-2.4 mg/dl
  26. why do you do a BUN w/ Creatinine
    because creatinine is slower to ^ than BUN
  27. reasons for increased creatinine
    • I: azotemia
    • D:Diuresis (pupd, Iv fluids)
  28. what three test are used to dx azotemia
    creatinine, USG, BUN
  29. pre-renal azotemia
    • prob is b4 the kidney
    • ^bun
    • ^usg
    • ^creat
    • urine is concentrated thus the kidney is fxing norm
  30. causes of pre-renal azotemia
    • poor renal perfusion-inadequate circulation to the kidney thus decreasing glom. filtration and waste isnt getting filtered.
    • poor ciculation can be caused by
    • shock, hypotension (syst should be >80mmHg) CHF, hypovolemia
  31. primnary renal azotemia
    • problem is the kidney itself
    • ^BUN
    • ^Creat
    • FIXED Usg (1.008-1.012 1.015cats)
    • dilute urine 1/3-3/4nephrons are non-functional
    • Glom filtration and R.tubular function do not work
  32. causes of primary renal azotemia
    age, nephrotoxins, lead and arcinic, drugs, snake venom
  33. what drugs may cause Primary renal azotemia
    aminoglycosides and anitfungals
  34. post-renal azotemia
    • prob is after the kids
    • ^BUN ^Create ^USG
    • concentrated urine kid. fx is okay
    • laws of diffusion are broke
    • emergency due to if untreated it may back up causing primary renal azotemia
    • if you also have ^PCY ^TP and v/d you then have pre-renal azotemia must have all 3
  35. causes of Post-renal azotemia
    urinary obstruction-blocked tom (straining to piss) urinatry tract rupture