10- Indices of the Kidney Flashcards
What are examples of qualitative tests
Scans and Endoscopic procedures
What are examples of quantitive results
Haematology and biochemistry results
What are common specimens that are analysed
whole blood
serum
urine
cerebrospinal fluid
What are factors affecting biochemistry test results
The way a specimen is collected, transported, stored and processed.
Patients position
Several blood constituents can fluctuate throughout the day.
State of nutrition
The age of the patient
Patients rate of physical activity.
What analytes are found in blood
Urea and Electrolytes (U and Es)
Liver function tests (LFTs)
Glucose
Lipids
Endocrinology
What is found in purple collection tubes
FBC, blood film, ESR, HbA1c
What is found in pink collection tubes
Group and save crossmatch
What is found in blue collection tubes
coagulation screen, INR and D-dimer
What is found in yellow collection tubes
U+E, CRP, LFTs, amylase, calcium, phosphate, magnesium, TFTs, lipid profile, troponins
what is found in green collection tubes
glucose
lactate
How is sodium in the body controlled
Renin is produced in the kidneys in response to decreased blood flow(due usually to a decreased intravascular volume) and converts angiotensinogen to angiotensin I
Angiotensin I converted in the lungs by angiotensin converting enzyme (ACE) to angiotensin II
Stimulates adrenal cortex to produce aldosterone peripheral vasoconstriction
Activates pump in in the distal renal tubule leading to reabsorption of Na+ and water from the urine in exchange for K+ and H+ ions
How is water controlled in the body.
Controlled mainly by sodium concentration
An increased plasma concentration causes thirst release of antidiuretic hormone (ADH) from the posterior pituitary increases the passive water reabsorption from renal collecting ducts
So, lots of ion transport going on in body – coordinated with exchange/movement at other sites/locations e.g. previous identification of regulation of acid secretion
Where does ion transport go on
Acid secretion; stomach
Adsorption in GIT (as per previous examples); small intestine – e.g. monosaccharides
Muscle function; skeletal vs. smooth muscle
Different forms of E-C coupling : Ca2+ movement
Neuronal function
Renal-hepatic systems
What is the symptoms of low body sodium
cellular over hydration, confusion, fits
What are symptoms of water excess
Hypertension, cardiac failure, oedema, anorexia, nausea, muscle weakness, haemodilution
What are symptoms of increased body sodium
cellular dehydration; thirst, confusion, coma
What are symptoms of water deficiency
hypotension, low pulse volume, decreased skin turgour, peripheral vasoconstriction, tachycardia, raised plasma protein, uraemia
What is needed to measure creatinine clearance
Collect urine over 24h
Empty bladder just before start
Take sample for plasma creati§nine once during 24h
What are symptoms of low GFR (classic acute renal failure)
Raised: urea, creatnine, K+, H+, urate, phsophate
Lowered: calcium and bicarbonate
What are symptoms of tubular dysfunction
Lowered: K+, phosphate, urate, bicarbonate
Urea and creatinine are normal
What are causes of tubular dysfunction
hypercalcaemia, hyperuricaemia, myeloma, hypokalaemia, pyelonephritis (bacterial infection), poisoning
Symptoms of Chronic Renal Failure
Raised: creatinine, urea, phosphate, urate, potassium
Decreased: bicarbonate and Hb
What GFR indicates the start of decrease in renal function
89 or under
