Path 1- Urinary 3

kelseyfmeyer's version from 2015-04-16 18:57

Lecture 5

Question Answer
*What are 2 out of the 5 developmental anomalies he mentioned that the key notes stresses we should know?renal dysplasia, and polycystic kidney. SO GO REVIEW THEM.
*What is going on in Primary renal glucosuria? WHO IS PRONE to this?reduced capacity of tubules to reabsorb glucose (no lesions, just a functional deficit, and needs to be distinguished from DM.) it is a inherited disorder of Norwegian elkhounds!!! (sporatic occurrence in other sp)
Basenji dog Fanconi syndrome--> what is happening here? what does it clinically cause?abnormal brush border membrane structure of the proximal tubular epithelium. clinically causes glucosuria, proteinuria, metabolic acidosis, and endocrine disorder
Most important cause of acute renal failure in animals?acute tubular necrosis
*clinical signs of Acute tubular necrosis??Clinical signs include oliguria or anuria with severe azotemia
what are the causes (main, and then list some others) of acute tubular necrosis?mostly ischemic or nephrotoxic injury, can also be from nephrotoxic pigments, heavy metals, pharmaceutical agents, fungal toxins, plant toxins, chemicals, vitamins and minerals, bacterial toxins, ischemia
Hemoglobinuric nephrosis--> what is this caused by? What does it result in?caused by increased serum concentration of hemoglobin which results in hemoglobinuria when the renal threshold for resorption is exceeded. high concentrations of hemoglobin in the glomerular filtrate //exacerbates ischemic injury of the renal tubules// (hemoglobin itself is not nephrotoxic)
**Hemoglobinuria occurs with hemolysis. NAME THE MOST COMMON CAUSE FOR SHEEP, CATTLE, DOG, AND HORSESheep: Copper toxicity. Cattle: Leptospirosis or babesiosis. Dog: Babesiosis or autoimmune hemolytic anemia. Horse: Red maple toxicity
Two mentioned nephrotoxic pigments which can cause acute tubular necrosis?myoglobin, Hemoglobin (not toxic in itself, but exacerbates ischemic injury of the renal tubules when there is hemolysis)
Myoglobinuric nephrosis--> what is this caused by? what does it result in?basically same as the Hb one (caused by increased serum concentration of hemoglobin which results in myoglobinuria when the renal threshold for resorption is exceeded.)
**Myoglobinuria occurs in what general situation? What are 3 specific situations this occurs in?occurs with extensive acute muscle necrosis and is seen with: (1) Exertional myopathy in horses (azoturia, tying-up) (2) Capture myopathy in wild animals (rhabdomyolysis) (3) Severe muscle trauma
What are some heavy metals which cause acute tubular necrosis? When is this important? What are common sources of lead?lead, mercury, cadmium, thallium, these are important in wildlife dz, and common sources of lead in animals include: used oil, grease, machine parts, old batteries, lead paint, linoleum, lead weights, lead shot, environmental contamination by smelting plants
how do you confirm a diagnosis of acute tubular necrosis from heavy metals?toxicology report
*What are the effects and histological changes which occur from heavy metal acute tubular necrosis?can cause direct injury to tubular epithelial cell membranes and mitochondria. histologic changes include tubular necrosis, degeneration, and //intranuclear inclusion bodies//
intranuclear inclusion bodies in the tubule cells might indicate what?heavy metal poisoning
**when do nephrotoxic drugs cause acute tubular necrosis? How does the damage happen?when they are administered at excessive doses or too frequently. cause direct tubular epithelial injury or cause hypoxic injury by /vasoconstriction/ and /reduced renal blood flow/ (nephrotoxin-associated ischemia)
what are some nephrotoxic drugs?antimicrobials drugs (Aminoglycosides: streptomycin, neomycin, gentamycin; tetracyclines; Amphotericin B), NSAIDs (aspirin, phenylbutazone, carprofen, flunixin, ibuprofen, naproxen), immunosuppressive drugs (cyclosporin), antineoplastic chemotherapeutics (cisplatin, carboplatin, cyclophosphamide, ifosfamide, mitomycin C, methotrexate, gemcitabine)
**what is the pathogenesis of NSAID toxicity?NSAIDs decrease the synthesis of renal prostaglandins which are responsible for maintaining normal renal blood flow--> the result is renal vasoconstriction that causes ischemic injury leading to tubular degeneration and necrosis, and acute renal failure. In addition to acute tubular necrosis, NSAIDS also cause renal papillary necrosis (covered later)
*What is a mycotoxoin which causes acute tubular necrosis? (what makes this mycotoxin?) how does the ingestion often take place? what kind of damage does this mycotoxin do?AFLATOXIN which comes from aspergillus and penicillium, is often a common feed contaminant. Aflatoxin causess tubular degeneration and necrosis (as well as hepatocellular necrosis and liver failure)
*what are 5 plants/plant toxins which cause acute tubular necrosis?Pigweed, oxalate-rich plants, grapes and raisins, lillies, oak
who does pigweed affect, in what way?pigweed can cause acute tubular necrosis and perirenal edema in pigs and cattle
what are some oxalate rich plants? what does consuming these cause?Halogeton, Sarcobatus, Rheum, Rumex, they cause oxalate nephrosis
**Explain oxalate nephrosisoxalate nephrosis occurs when calcium oxalates precipitate in the renal tubules which forms oxalate crystals with subsequent epithelial injury and renal failure
how, what, who, and why do grapes and raisins cause?ACUTE TUBULAR NECROSIS, ingestion by dogs can lead to acute renal failure and uremia. accompanied by vomiting, lethargy, anorexia, and diarrhea. Tannins susepcted as causitive agents.
lilies cause what in who? how?cause acute renal failure when cats ingest them. unknown cause.
who does oak harm? how?causes toxicity in ruminants and horses, by ingestion, tannins suspected
**what are three chemicals which can cause acute kidney failure?Ethylene glycol (antifreeze), melamine, and cyanuric acid
*how does ethylene glycol (antifreeze) cause acute tubular necrosis?dogs and cats often drink it because of its sweet taste. The chemical then has many NEPHROTOXIC METABOLITES (including oxalate and glycolic acid). These metabolites cause causes oxalate nephrosis and renal failure
*what are two pet food contaminants which cause acute tubular necrosis? what do they do?Melamine and Cyanuric Acid (were used to artificially elevate protein levels), causes distal tubular necrosis with characteristic irregular brown birefringent crystals
which vitamin can cause acute tubular necrosis?Vitamin D
How might a dog or cat get vitamin D toxicosis? Ruminant?DOG/CAT: usually from excessive dose of vit D, or ingestion of calciferol-containing rodenticides. RUMINANT: ingestion of calcinogenic plants (Cestrum diurnum (USA), Solanum sp., Trisetum sp
**what is the PATHOGENISIS of vitamin D toxicosis?Leads to HYPERCALCEMIA and causes METASTATIC mineralization of tubular and glomerular basement membranes followed by degeneration, necrosis, fibrosis, and loss of fxn
**WHAT CAUSES PULPY KIDNEY? IN WHO?~BACTERIAL TOXINS IN SMALL RUMINANTS, USUALLY. SPECIFICALLY: enteric proliferation of Clostridium perfringens type D with production of **epsilon exotoxin**
**epsilon exotoxin is from what, causes what, with what lesions?causes PULPY KIDNEY (usually in sm rumis), and is a toxin from clostridium perfringens D which is growing enterically. causes bilateral acute tubular degeneration and necrosis, with interstitial edema and hemorrhage
*What is Hydronephrosis?dilation of the renal pelvis due to obstruction of urine outflow
if there is a bilateral blockage of of the renal pelvis causing hydronephrosis, what will happen?DEATH FROM UREMIA AND HYPERKALEMIA
**What is Pyelonephritis? is it usually unilateral or bilateral? What are the gross lesions? Microscopic lesions?~Ascending bacterial infection leads to infection of the renal pelvis with extension to the renal tubules. Usually bilateral. Gross lesions: expansion of the renal pelvis by purulent exudate (pus). Microscopic lesions: suppurative inflammation of pelvis and medulla with necrotic transitional epithelium
*Papillary necrosis Happens when?ISCHEMIC INJURY CAUSED BY NSAIDs. Most frequent in HORSES (phenylbutazone, flunixin meglumine), can also happen in dogs and cats with accidental ingestion or wrongful usage (ibuprofen, aspirin, acetaminophen)
Granulomatous nephritis--> Bacteria--> which?mycobacteriosis
Granulomatous nephritis--> fungi--> which?aspergillosis, histoplasmosis, blastomycosis, encephalitozoonosis, etc
Granulomatous nephritis--> viruses--> which?FIP, porcine circovirus
Granulomatous nephritis--> toxins--> which?hairy vetch toxicosis in cattle
Granulomatous nephritis--> parasites--> which?toxacara canis
Xanthogranulomas--> what part of the kidney does this affect? Who does this usually affect, and what happens?DZ OF THE RENAL INTERSTITIUM! cats with inherited hyperlipoproteinemia have xanthogranuloma formation in various tissues including the kidney. similar lesions are observed in dogs with hypothyroidism and severe atherosclerosis
Renal interstitial amyloidosis--> who does this usually occur in?it's especially in Abyssinian cats with medullary interstitial fibrosis (otherwise, usually it's GLOM deposition, not intersititum)
**WHAT IS THE most common primary renal neoplasm of the kidney?? when do they usually occur in?Renal carcinoma (adenomas are usually rare and asymptomatic). occur frequently in older dogs
**what is the notable species thing about renal CARCINOMAS?German shepherd - renal carcinoma is associated with nodular dermatofibrosis
*which urinary system tumor has VERY HIGH METASTATIC POTENTIAL?Transitional cell carcinoma
*what are the epithelial tumors of the urinary system? where do they usually occur?Transitional cell papilloma and carcinoma they are most common in the urinary bladder but may also occur in ureters and renal pelvis
how common are mesenchymal tumors in the kidney? what are the ones that occur in the kidney?rare, but they are fibromas, fibrosarcomas, or hemangiosarcomas
what is the Embryonal tumor which occurs in the kidney? Who does it affect?Nephroblastoma. common in pigs, chickens, some fish. Less frequent in dogs and cattle
what is the most common metastasized tumor to end up in the kidney?renal lymphoma is a common neoplasm that may be primary or metastatic, may be nodular or diffuse
what are two Malignant adrenal tumors in close proximity to kidney, which become invasive into the kidney?pheochromocytoma, adrenocortical carcinoma
*focus on the two diseases of the tubules that are Inherited abnormalities of tubular function, and Acute tubular necrosis (nephrotoxic and ischemic)key concepts
*know Pathogenesis of NSAID nephrotoxicitykey concepts
*know Oxalate nephrosis (ethylene glycol and oxalate-rich plants)key concepts
*know the 3 Diseases of the renal pelvis: Hydronephrosis, pyelonephritis, renal papillary necrosis (NSAIDS)key concepts
*know the 3 Diseases of the interstitium: Granulomatous nephritis, xanthgranuloma, amyloidosiskey concepts

Lecture 6

Question Answer
what are the 5 developmental anomalies of the lower urinary tract?aplasia, hypoplasia, ectopic ureters, patent urachus, urinary bladder diverticulum
lower tract--> aplasia--> whats going on here?lack of formation of a recognizable ureter. rare, may occur in conjunction with renal aplasia
lower tract--> hypoplasia--> whats going on here?smaller than normal ureter with reduced diameter
what are ectopic ureters?ureters empty in the wrong place such as urethra, vagina, neck of bladder, ductus deferens, prostate, etc.
**WHAT IS the most common malformation of the urinary bladder??patent urachus!!!!
**Explain patent urachus. whos most affected?**the most common malformation of the urinary bladder**! the fetal urachus fails to close and involute completely which forms a channel between the bladder’s apex and the umbilicus--> allows urine to dribble from the umbilicus. frequently observed with neonatal omphalitis and abscess formation. FOALS most commonly affected
what's going on in a urinary bladder diverticulum?outpocketing of the bladder wall, can be congenital or acquired (acquired diverticulae are associated with obstructive disease). can predispose to cystitis and calculi formation due to urine stasis, and predispose to rupture
Hydroureter and Hydrourethra--> what is this? what might occur concurrently? clinical signs?dilation of the ureter and urethra caused by urine outflow obstruction. may occur concurrently with hydronephrosis. clinical signs consistent with urinary obstruction (post renal azotemia, pain, hyperkalemia)
what is Urolithiasis?a syndrome that occurs when familial, congenital, and/or pathophysiological factors increase the precipitation of stone-forming salts resulting in urinary calculi formation (uroliths). Most common in the bladder, but can be anywhere, and can affect any sp
list some factors (many) which are associated with urolithiasis?genetic factors, diet composition, metabolism and liver function, urine pH, urine temperature, dehydration, bacterial infection, urinary obstruction, anatomic abnormalities, drug excretion
**What is the absolutely necessary occurrence to form uroliths?Supersaturation of urine is the essential precursor to initiation of crystal formation and urolith formation--> supersaturation of **mineral salts //and// protein**
*how are crystals and calculi related? which is more common?crystals are more common. Crystals are only PARITALLY responsible for calculogenesus
what are the 5 most common urine crystals?struvite, bilirubin, calcium carbonate, amorphous, calcium oxalate //dihydrate// crystals
struvite crystals: how common? what are they usually related with?MOST common type in cats and dogs (rectangle-y looking ones). usually known as "infection calculi" because Urinary tract infection with urease-positive bacteria can promote struvite crystalluria (and urolithiasis) by raising urine pH and increasing free ammonia
*"infectious calculi" are aka for what crystal?struvite

Recent badges