Science Quiz / Medical Urology part 2

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Can you name the Medical Urology part 2

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The following properties describe an ________ concentration of crystallizable substance in urine?
Spontaneous crystal nucelation, maximal growth, maximal aggregation, no dissolution of crystals. 
Which of the following properties is NOT characteristic of a metastable or supersaturated urine concentration (crystallizable substances)?
a)heterogenous crystal nucleation b)minimal growth c)maximal aggregation d)no crystal dissolution e)all of the above are characteristic 
If urine shows no crystal aggregation, growth or nucleation, and crystals will dissolve, the urine is?
 
These two type of uroliths make up aprroximately 80-91% of all uroliths.
_____ and ____ _____ (Hint: the first is more common in female dogs, and younger animals, the second is more common in males) (There are also breed predispositions) 
The central layer of a compound urolith is called the ______, which is surrounded by stone, which is surrounded by shell, and finally there are ______ ______
 
 
True or false: a simple stone contains only one type of mineral?
 
Which of the following is not one of the major complaints associated with urinary calculi?
a)pollakiuria b)polyuria c)stranguria d)hematuria 
Which of the following is a test you might perform when you suspect urolithiasis?
a)pH urinalysis b)USG c)crystal urinalysis d)urine culture e)all of the above 
True or false: the presence of crystals= the presence of stones?
 
Which of the following types of urolith would you not associate with acidic pH?
a)cystine b)silicate c)calcium oxalate d)struvite e)acid uric 
Name a factor influencing the type of stones that have formed
 
Which of the following breeds would be predisposed to urate stones, rather than cystine?
a)dalmatians b)dachshunds c)basset hounds d)english bulldogs e)chihuahuas 
Which disease predisposes to ammonium urate stones?
a)renal disease b)pancreatic disease c)hepatic disease d)none of the above 
UTI tends to predispose to what type of stone?
a)cystine b)silicate c)calcium oxalate d)struvite 
If your patient was a female, with alkaline urine pH, a UTI, and big smooth stones in the bladder on rads, you would likely suspect _____, and try dissolution first.
 
If your patient was a MC schnauzer with acidic urine pH, small numerous stones on rads, it is likely _____ ______ and it needs to be removed and analyzed.
Removal options would include urohydropulsion (for stones small enough to pass through urethra), surgery or lithotripsy (minimally invasive procedure). 
True or false: size does NOT affect the success of attempted medical dissolution of stones?
 
True or false: medical dissolution is a viable method for nephroliths and ureteroliths?
 
Which is not characteristic of Hill's s/d diet for struvite uroliths?
a)takes 8-10 weeks to work b)has a high phosphorus content c)has a high salt content d)has a low calcium and magnesium content e)should be continued until over a month after calculi are no longer visible, and requires UTI to be cured. 
Which of the following is a contra-indication of medical dissolution diets?
a)pregnancy b)lactation c)young animals d)recent surgery e)all of the above 
What is your go-to antibiotic treatment for UTI in relation to medical management of urolithiasis?
Along with the s/d diet, you recheck after 1 week. 
True or false: Hill's s/d diet is required for life after urolithiasis for dogs?
 
The primary prevention of uroliths is?
 
True or false: urohydropulsion is indicated more in females?
 
True or false: intracorporeal lithotripsy is the most awesome choice, because you get to use LASERS.
 
True or false: lithotripsy cannot be performed in male dogs?
 
What is your post-op antibiotic of choice if surgical removal of uroliths becomes necessary?
 
This is a technique involving general anesthesia, a mini incision near the bladder apex, 3 stay sutures, and suctioning of uroliths.
 
Which stone is associated with the quickest recurrence time?
 
This drug forms soluble calcium citrate and alkalinizes the urine to increase CaOx stone dissolution.
 
What human fruit is one of the best treats to increase water intake?
 
True or false: about half of patients with calcium oxalate stones have recurrence in the first 3 years?
 
True or false: feline urologic syndrome (LUT clinical signs) make up 4-10% of all feline admissions?
 
Which of the following does not predispose to feline urologic syndrome?
a)obesity b)over 7 years old c)indoor cats d)winter and spring timeframe e)dry food 
Which of the following would NOT form part of your diagnostic approach to partial or no obstruction on feline urologic syndrome?
a)urinalysis b)urine culture c)radiography d)biochemistry e)none of the above 
Several sources of fresh water, several litter boxes, and a canned diet can be helpful in managing the ________ feline urinary patient.
 
You'd do _ months of Hill's s/d diet for idiopathic cystitis with struvite and alkaline urine pH?
 
True or false: over 7 classes of drugs have been tried for idiopathic cystitis, with variable success, but placebos work over 70% of the time.
 
On the 3rd relapse of a urethral obstruction in cats, you should do this procedure?
 
What kills cats in urethral obstruction cases?
 
True or false: 3/4 of spayed females with urethral incompetence (UI) become incontinent within a year after surgery.
 
True or false: castration for males does not increase the chances of urethral incompetence?
 
What therapy woudl you recommend fro a middle aged to older spayed female dog with incontinence when asleep or relaxed?
 
What treatment is effective in males and females with UI?
Can be combined with hormone replacement for the appropriate gender if a severe case. 
What is the major disadvantage of phenylpropanolamine?
a)cardiac side effects b)poor efficacy c)anorexia d)expense e)none of the above apply 
This drug can be administered concurrently with phenylpropanolamine for synergistic effect. It increass alpha adrenergic receptors in urethral smooth muscle, as well as responsiven
Female dogs only. Alternative to low dose daily estrogen. Side effects include estrus like signs, myelosuppression, endocrine alopecia. 
True or false: testosterone treatment in neutered males for UI can cause recurrence of benign prostatic hypertrophy, perianal adenoma or behavioural disorders?
 
Name an option to increase urethral resistance for refractory UI patients who don't respond to the above drugs?
 
True or false: surgery to relocate the bladder neck from intrapelvic to intraabdominal causes resolution in over half of cases, with sustained improvement?
 
Which of the following is a possible complication of surgical correction of UI?
a)post-op stranguria b)recurrence of incompetence c)dysuria d)diazepam responsive dyssynergia e)all of the above 
True or false: the prognosis for UI is guarded?
 
True or false: ectopic ureters are more common in male cats and female dogs?
 
Name a condition which is congenital (aside from ectopic ureters) and associated with incontinence?
 
This radiograph technique involves IV injection of contrast agents, but you may confuse extramural ureters with intramural.
 
This gold standard diagnostic test invovles expensive equipment and an experienced operator...
 
This condition will present as constant/intermittent dribbling of urine since birth or weaning?
You'll also likely see perivulvar dermatitis inf emales, and incontinence is worse in lateral recumbency 
This diagnostic technique involves endoscopic visualisation of urethra and bladder.
 
True or false: you can effectively gurantee continence after surgical reimplantation of ectopic ureters?
 
Active contraction of the detrussor without relaxation of internal or extenral urethral sphincters is termed?
Occurs more often in larger breed male dogs, due to spinal cord autonomic ganglia problems. 
Name one of the three nerves that detects bladder stretching?
 
True or false: Reflex dyssynergia is characterized by inability to urinate?
 
Which of the following is NOT a treatment option for reflex dyssynergia?
a) intermittent urinary catheterization b)phenoxybenzamine c)maropitant d)diazepam e)betanechol 
The last resort for refractory cases of reflex dyssynergia for middle to long term management is?
RIsk of dehiscience, bladder tumors and urinary tract infections. 
This term refers to the presence of all urine constituents in the blood. May be renal failure or postrenal disorders.
 
Encephalopathy, GE, acidosis, pneumonitis, osteodystrophy are all signs of this syndrome associated with chronic renal failure?
 
Which of the following is not characteristic of chronic renal failure (instead of acute)?
a)stable weight b)progressive onset c)irreversible damage d)none of the above 
______ will only be present with renal failure, whereas both renal failure and insufficiency will have ___ ___
 
 
Name a potential cause of chronic renal failure?
 
If my creatinine levels were 150, regardless of whether I am a dog or cat, I am stage _ on the IRIS scale.
 
Urine protein/creatinine ratios of over 0.4 in cats or over ___ in dogs predict shorter survival, more likely progression of CRF.
 
If you have performed urine culture to rule out pyelonephritis, but suspect false result, your next test would be?
 
True or false: dehydration and azotemia contraindicate intravenous urograms?
 
CRF usually presents with smaller kidneys than normal, except with?
 
Renal biopsy should only go in one side of the kidney, sampling ____ only?
 
Name something that should be lower in a diet for a CRF patient?
 
If my creatinine levels are under 120 for a dog or 140 micromol/L for a cat, what stage on IRIS classification is it?
 
Renal diet would be recommended at IRIS stage _ for cats, and _ for dogs.
_, _ 
The nutritional supplement epakitin is good for CRF patients because it contains?
 
Omega 3s are an example of ________ _____ ____ that may extend longevity and prevent progression of CRF?
 
Decreased gastrin elimination, metabolic acidosis may contribute to this condition seen in over 60% of CRF dogs?
 
Which of the following drugs would you not give an anorexic CRF dog?
a)cyproheptadine b)oxazepam c)metarzapin d)maropitant 
Metoclopramide, chlorpromazine, and ondensetron are all ______ _____ antiemetics
 
ACE inhibitors will _____ the GFR and treat ________
______, _______ (Examples of ACEIs include benazepril and enalapril) 
At what urine protein creatinine ratio would I begin monitoring a nonazotemic patient?
Recall it's over 0.4 for cats and over 0.5 in dogs that requires treatment if they have azotemia. 
After you get a plateau and cessation of clinical signs, recurrent dehydration at home may be treated with long term _____ ____ therapy.
 
Decreases in this hormone may result in anemia due to CKD?
You may also see blood loss through the GI as a result of uremic gastropathy, and reduced erythropoiesis due to uremic toxins. 
This anabolic steroid has a questionable benefit for anemic animals, but risks hepatotoxicity in cats.
 
Anemai that is severe with PCV under 20% and symptoms should be treated with this?
You risk antibody formation in around 35% of cases, and may see hypertension, seizures or iron deficiency as side effects. 
Name a risk factor for worse prognosis with CRF?
 
Name a drug that may be used for upper urinary tract stones, together with IV fluids?
 
Dry lithotriptor is better in ___, and wet for ___ when performing extracorporeal lithotripsy?
___s, ___s 
What is a SUB, in the context of treating upper urinary calculi?
 
Aside from SUB and extracorporeal lithotripsy, the other minimally invasive treatment for upper urinary tract stones is?
 
_____ contains beneficial bacteria that flush out uremic toxins diffused into the bowel, to slow toxin buildu p in blood and prevent further damge to kidneys.
great for first signs of azotemia from acute or CRF. 
A condition of secondary __________ may result from phosphorus retention and impaired production of calcitriol with CRF?
Treating with oral calcitriol may cause hypercalcemia and renal injury. 
Immune complexes in the capillary walls can cause damage to the ______ and cause proteinuria.
 
What is the most common cause of glomerulopathy?
 
The hallmark of glomerulopathy is the loss of ______ in the urine.
Protein is not specific enough. 
______ may result form severe protein loss with glomerulopathies.
 
True or false: pulmonary thromboembolism is a potential complication of glomerulonephritis?
 
True or false: There will be abnormalities in the sediment of glomerulopathy patients in most cases?
 
Hemorrhage or infalmmation of urogenital tract, lack of tubular reabsorption are all _______ DDx for proteinuria.
 
84% of glomerular disease patients have this complication which may cause blindness.
 
The loss of anti-thrombin in the urine, along with altered fibrinolysis can lead to ______ and ______ in glomerular disease.
name one or the other, get both. 
Name an underlying disease the antigens of which may be associated with glomerular issues?
thing -osis. think blood parasites. 
Which drug does not belong on this list of treatments for glomerulopathy?
a)spirolactone, furosemide b)DMSO, colchicine c)aspirine d)melphalan e)all of the above are legit 
Renal amyloidosis has a ____ prognosis, wheras Immune complex glomerulopathy is fair to guarded.
 

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