Clin Path- Renal Evaluation.txt

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Clin Path- Renal Evaluation.txt
2014-11-24 20:47:22
clin path renal

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  1. 5 functions of the kidneys.
    excretion of waste products, retention/reabsorption, water and electrolyte balance, urine concentration, hormone production
  2. What waste products are secreted by the kidneys? (2)
    urea and creatinine
  3. What do the kidneys retain/ resorb? (2)
    amino acids, glucose
  4. How do the 3 methods of urine collection potentially affect the UA results?
    • Free catch- may contain cells, protein, and bacteria
    • Catheterization- increased numbers of epithelial cells and erythrocytes
    • Cystocentesis- may produce iatrogenic RBC contaimination
  5. The color of urine may suggest:
    Dark brown-
    Yellow brown to green-
    • red- hematuria,hemoglobinuria, myoglobinuria
    • dark brown- methemoglobinuria
    • ellow brown to green- bilirrubinuria
  6. Adequate concentrating ability in dogs, cats, and large animals are what SGs?
    • dogs- >1.030
    • cats- >1.035
    • large animals- >1.025
  7. In the dehydrated animal, urine should be __________, and if it is not, it can be associated with ____________.
    concentrated; renal failure/insufficiency
  8. Reduced ability to concentrate urine can occur with... (4)
    renal failure/ insufficiency, medullary washout, osmotic diauresis, dysfunction of ADH pathway
  9. Isosthenuria implies that...
    no concentrating or dilution has been performed by the tubules of the nephron
  10. Increased RBCs in the urine.
  11. increased numbers of WBCs in the urine.
  12. Pyuria is typically associated with... (2)
    urinary tract inflammation, contamination of the sample from the distal urinary tract
  13. Epithelial cells in the urine sample typically represent...
  14. Structures formed in renal tubular lumens and are composed or mucoprotein secreted by tubular cells plus accumulated cellular material; high amounts in urine may indicate renal disease.
  15. The presence of bacteria in a urine sample without WBCs suggests...
  16. The observation of crystals in urine sediment depends on... (5)
    extent of saturation with crystal precursors, urine pH, specific gravity, time b/w collection and analysis, refrigeration of sample
  17. Acidic urine is associated with... (3)
    meat-based diet, drugs, acidotic states
  18. Basic urine is associated with... (5)
    herbivorous diet, bacteria (infection/old urine), postprandial alkaline tide, drugs, alkalotic states
  19. Normal urine is ______ for glucose.
  20. Glucosuria may occurs with... (3)
    diabetes, epinephrine response, treatment
  21. Ketones may be present in the urine in concurrence with... (3)
    diabetes mellitus, starvation, ketosis in cattle
  22. Only _________ bilirubin is water soluble and will pass into urine.
  23. How do you decide if reddening of urine is caused by hematuria, hemoglobinuria, or myoglobinuria?
    • hematuria- urine clears when centrifuged
    • hemoglobinuria- urine does not clear and erythrocytes are seen in sediment (caused by intravascular hemolysis)
    • myoglobinuria- urine does not clear and no erythrocytes are seen in sediment (muscle disease)
  24. Urine protein should be interpreted in light of the ___________.
    specific gravity
  25. 4 reasons for proteinuria.
    hemorrhage (positive occult blood), inflammation (leukocytes in urine), renal disease, pre-renal
  26. The functional unit of the kidney.
  27. What are the components of the nephron?
    glomerulus, tubules (PCT, loop of henle, DCT, collecting duct)
  28. What are the 2 functions of the glomerulus?
    filters fluids, retains proteins and cells
  29. What are the 3 functions of the tubules of the nephron?
    reabsorption, secretion, concentration of urine
  30. Loss of nephron function.
    renal failure/ insufficiency
  31. BUN is a marker of ________________.
    glomerular filtration
  32. If the GFR is reduced, less is ________, and BUN concentration _______.
    filtered; increases
  33. Creatine is synthesized in the _______ and the analyte creatinine is derived from _____________.
    liver; energy use in muscle
  34. Bun is a more sensitive indicator of ________, and creatinine is a more accurate measure of ________.
    dehydration; GFR
  35. Decrease BUN is seen with... (3)
    decreased liver ( end stage liver failure, liver shunts, massive necrosis)
  36. With renal insufficiency/ failure, there is a decreased __________, meaning...
    GFR; those things normally filtered by the kidney (BUN, creatinine, phosphorous) are increased
  37. Increased nitrogenous products in the blood.
  38. GFR us dependent on _______, thus with dehydration, there will be less _____________ and less filtration.
    blood flow; blood to the kidneys
  39. Increased BUN and creatinine that induce clinical disease.
  40. With pre-renal azotemia, less _______ is filtered through the kidney due to _______ or _______; urine SG is typically _______.
    blood volume; dehydration; shock; high
  41. Renal azotemia can be due to...(3)
    inflammatory, neoplastic, toxic, or other reasons
  42. Acute kidney disease is associated with ______ or _______ and overlaps with post-renal and renal azotemia.
    oliguria; anuria
  43. Chronic kidney disease is associated with _________ (SG), ________ BUN/creatinine, and _________.
    isosthenuria; increased; anemia
  44. Post-renal azotemia is usually due to... (3)
    obstruction, rupture, acute kidney disease
  45. When urine is formed by the kidney but not removed from the body.
    post-renal azotemia
  46. Hyperphosphatemia, low to normal calcium, normocytic, normochromic non-regenerative anemia, and renal azotemia point to...
    chronic kidney disease
  47. Horses with chronic kidney disease are often _______-calcemic due to decreased renal clearance.
  48. With acute kidney disease, body condition is _______, potassium is _______, urine is __________, and there is/is not anemia?
    good; increased; anuric/olignuric; no anemia
  49. With chronic kidney disease, body condition is ______, potassium is ____________, urine is ________, and anemia is/is not present?
    poor; normal to low; polyuric; anemia is present and non-regenerative
  50. When BUN is increased and creatinine is normal, consider... (2)
    GI hemorrhage or high-protein diets
  51. With uroabdomen, you will see... (6)
    post-renal azotemia, hyperkalemia, hyponatremia, hypochloremia, usually no urine, distended abdomen
  52. Differentials for azotemia with hyperkalemia, hyponatermia, and hypochloremia?
    urinary tract rupture/obstruction, acute kidney disease, addisons' disease
  53. The medullary gradient is partially responsible for...
    the kidney's ability to concentrate urine
  54. Diseases that reduce urea or sodium, aka medullary washout, can reduce ______.
    urine SG
  55. 6 causes of medullary washout.
    polyuria, steroids, diabetes mellitus, polydipsia/ fluid therapy, hyponatremia, low BUN (end stage liver or shunt)