Urinary3- Inflammatory Dz

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Mawad
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311575
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Urinary3- Inflammatory Dz
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2015-11-18 10:49:54
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vetmed urinary3
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vetmed urinary3
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  1. What is the most common signalment/ animals at higher risk for perinephric pseudocysts?
    cats >16 yrs
  2. Clinical signs of perinephric pseudocysts.
    lumps on abdomen/palpate very large kidneys, usually no other signs
  3. Describe the fluid within perinephric pseudocysts.
    pure or modified transudate
  4. Describe txt of perinephric pseudocysts.
    periodic drainage as cat demonstrates discomfort/decline in renal function [+/- capsulectomy for rapidly accumulating cases]
  5. What is the prognosis of perinephric pseudocysts?
    related to degree of CKD/ discomfort (CKD is not thought to be directly related...kinda unknown)
  6. What is the most common signalment for polycystic kidney disease (PKD)?
    PERSIANS, himalayans, DLH cats; avg. 7 yrs old (when they get CKD and show signs)
  7. How is PKD inherited?
    autosomal dominant
  8. What are PKD cysts filled with?
    ultrafiltrate
  9. What often accompanies PKD?
    liver cysts
  10. How do you diagnose PKD?
    ultrasonography- honeycomb/swiss cheese appearance
  11. How do you treat PKD?
    no known treatment, non-specific therapy for renal failure
  12. What are renal worms? (3)
    Dictophyma renale, Capillaria plica, Capillaria felis-cati
  13. How is D. renale contracted?
    dog or cat drinks water from ponds/lakes containing mudworm hosts
  14. Describe the pathogenesis of D. renale.
    worm lodges in renal pelvis, leads to hydronephrosis, and obliterates the renal tubules
  15. Clinical signs of D. renale. (3)
    hematuria, uremia, palpable abdominal mass
  16. How do you diagnose D. renale? (2)
    look for ova in urine (urine sediment), may see worms in renal pelvis on US
  17. How do you treat renal worms?
    [unilateral] nephrectomy, [bilateral] nephrotomy and removal of worms
  18. How do you prevent D. renale? (2)
    don't feed raw fish/fish viscera, don't let animals drink from potentially infected water
  19. What are the essential hosts of C. plica and C. felis-cati?
    earthworms
  20. How do you diagnose Capillaria spp.?
    eggs in urine
  21. How do you treat Capillaria spp.?
    may be self-limiting, Ivermectin
  22. What is polyploid cystitis caused by?
    result of chronic bacterial infections/inflammation or stones [epithelial hyperplasia secondary to bacterial invasion of bladder mucosa]
  23. Polyploid cystitis causes ________ in the patient.
    pain
  24. What is the treatment for polyploid cystitis? (2)
    extended course antibiotic, +/- surgical removal
  25. How can you tell the difference b/w TCC and polyploid cystitis?
    polyploid cystitis occurs at apex of bladder and TCC usually occurs at trigone....BUT to definitively rule out TCC, must take surgical biopsy
  26. Signs of proliferative urethritis. (3)
    straining, hematuria, neuts/ lymphoplasmacytic inflammation
  27. How do you differentiate proliferative urethritis from TCC?
    biopsy
  28. What causes proliferative urethritis?
    can be due to infectious causes or immune-mediated
  29. How do you treat proliferative urethritis? (3)
    antibiotics, NSAIDs, steroids
  30. What is the prognosis for proliferative urethritis?
    good
  31. The most common form of UTI.
    bacterial cystitis
  32. History commonly associated with cystitis. (5)
    pollakiuria, hematuria, stranguria, malodorous urine, inappropriate urination
  33. UA findings associated with cystitis. (3)
    bacteriuria, pyuria, proteinuria
  34. Prevalence of bacterial UTI is more common in which sex?
    females
  35. Natural defense mechanisms against UTI. (5)
    urethral length (longer in males), sphincters, flushing via urine flow, chemical composition of urine is inhospitable to microbes (osmolality, urea conc), local innate immunity
  36. Uncomplicated cystitis is uncommon in _________ and never occurs in _________; it is extremely common in __________.
    dogs; cats; humans
  37. Predisposing causes of cystitis. (4)
    interference with normal micturition, anatomic defects, changes to urothelium, metabolic/endocrine disease
  38. What predisposing factors interfere with normal micturition? (2)
    obstruction, incomplete emptying
  39. Anatomic defects that predispose to cystitis. (4)
    urachal diverticula, ectopic ureters, juvenile vulvar conformation (hidden hoohoo), surgical relocation of the urethral meatus
  40. What changes to the urothelium can cause complicated cystitis? (4)
    traumatic catheterization, trauma, neoplasia, urolithiasis
  41. What metabolic/immune causes can contribute to complicated cystitis? (5)
    anything that causes dilute urine, DM, corticosteroids, hyperadrencorticism, congenital immunodeficiency
  42. Common bacterial agents in small animals. (6)
    • [Gram -] E. coli, Klebsiella, Enterobacter, Proteus
    • [Gram+] Coag+ staph (staph aureus, staph pseudointermedius), Enterococcus
  43. UPEC refers to a subset of __________ that are...
    E. coli; adapted to the urinary tract.
  44. What are the key virulence factors of UPEC? (2)
    P fimbrae (help organism stick to urothelium), α-hemolysin
  45. What changes on the UA are often associated with bacterial infection? (4)
    alkaline urine, struvite crystals, bacteria, WBCs
  46. How do you usually culture urine? (2)
    aerobic culture, susceptibility testing
  47. Urease-producing bacteria, making them well-adapted to the bladder/urine. (4)
    staph, proteus, enterobacter, klebsiella
  48. Urease-producing bacteria often cause _____________.
    struvite urolithiasis
  49. What is the gold standard for urine collection?
    cystocentesis
  50. Bacterial culture of urine must be ___________ to interpret.
    quantitative
  51. Which drugs reach the urine (and thus can be used to treat bacterial UTI)? (7)
    penicillins, cephalosporins, fluoroquinolones, trimethoprim-silfamethoxazole, tetracyclines, aminoglycosides, nitrofurantoin
  52. Treatment based on clinical diagnosis (abnormal UA).
    empirical therapy
  53. Treatment on the basis of significant result and antimicrobial susceptibility profile.
    targeted therapy
  54. When is empirical therapy reasonable for treatment of bacterial cystitis?
    first time with clinical signs
  55. When should you use targeted therapy for cystitis? (2)
    hospital-acquired infection, multiple infections
  56. Define recurrent infection.
    3+ episodes within 12 months
  57. Define reinfection.
    infection within 6 months with a new bacterial species
  58. Define relapse.
    re-presentation within 6 months with the same bacterial species
  59. Define refractory.
    persistent infection despite appropriate treatment
  60. Common empirical choices for treatment of bacterial cystitis. (2)
    beta-lactam (amoxicillin, clavamox), cephalexin
  61. How long should you treat uncomplicated (suspected uncomplicated) cystitis?
    10-14 days
  62. If the antimicrobial therapy for cystitis is working, you should see improvement of clinical signs within ________.
    48hr
  63. Describe prevention of infectious cystitis. (3)
    address anatomic defects, treat primary causes (metabolic), good indwelling catheter management
  64. What is the theory behind using cranberry supplements to prevent bacterial cystitis?
    prevents p fimbriae from binding to urothelia, reduces uncomplicated UTI in humans, prevents UPEC infections
  65. What is asymptomatic bacteriuria?
    recover bacteria from urine but no UTI; if they don't have urinary signs.... don't treat them!
  66. Describe clinical signs associated with acute prostatitis in dogs. (6)
    fever, depression, +/- urethral d/c, +/- stiff gate, defecation avoidance, pain on palpation
  67. With prostatitis (acute and chronic), is the prostate enlarged?
    only if there is concurrent BPH
  68. Clinical signs of chronic prostatitis in dogs. (3)
    often silent infection, recurrent UTI, usually non-painful palpation
  69. How do you treat prostatitis?
    surgical is abscess, antimicrobials (enrofloxacin, clindamycin if staph, chloramphenicol)
  70. ___________ will increase the cure rate of prostatitis.
    Castration of intact dogs
  71. The prostate has a very __________ pH; therefore, only ___________ drugs are useful.
    acidic; lipophilic/weak base

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