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Clinical Chemistry 1 > 16. Renal > Flashcards

16. Renal Flashcards

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1
Q

Crystal found in urine

A

Uric acid

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2
Q

2 functions of peritubular capillaries

A

Reabsorption and secretion

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3
Q

3 causes of proteinuria

A
  • Renal disease
  • Post-strenuous exercise
  • Dehydration
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4
Q

Low MW proteins that are light chain Ig fragments

A

Bence Jones proteins

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5
Q

7 functions of kidney

A
  1. Urine formation
  2. Regulate fluid balance
  3. Regulate electrolyte balance
  4. Regulate acid/base balance
  5. Excrete waste products of metabolism
  6. Hormonal functions
  7. Protein conservation
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6
Q

Where is uromucoid produced

A

DCT, collecting duct

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7
Q

Cause of decreased serum uric acid

A

Fanconi’s disease

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8
Q

Acidic urine = formation of which calculi?

A
  • Uric acid calculi

- Cystine calculi (rare)

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9
Q

What gets converted to urea? Where?

A

Protein -> aa -> ammonia -> urea

Liver

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10
Q

3 principle nitrogenous waste compounds

A
  • Urea
  • Creatinine
  • Uric acid
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11
Q

When is uric acid soluble?

A

> pH 5.75 = sodium urate

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12
Q

Most common calculi

A

Calcium oxalate

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13
Q

Presence of waxy casts indicates?

A

End-stage renal disease

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14
Q

__________ rate of formation is constant per day and is proportional to one’s muscle mass

A

Creatinine

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15
Q

Cause of Type II RTA

A

Fanconi’s syndrome

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16
Q

Creatinine is made in the liver from these 3 compounds

A
  • Arginine
  • Glycine
  • Methionine
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17
Q

Part of nephron that is permeable to ions (active and passive) but not to water

A

Ascending loop of Henle

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18
Q

Glomerular filtrate formation due to 2 things

A
  • Pressure

- Selectivity by charge and size

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19
Q

Enzyme that catalyzes hydrolysis of urea to ammonia and CO2

A

Urease

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20
Q

Alkaline urine = formation of which calculi?

A
  • Calcium phosphate

- Magnesium ammonium phosphate calculi (struvite)

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21
Q

Inborn error of metabolism associated w/ overproduction of uric acid resulting in arthritis, nephropathy, nephrolithiasis

A

Gout

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22
Q

Cause of type IV RTA

A

Diabetic nephropathy

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23
Q

Name of test that is starting to replace microalbumin

A

Albumin/creatinine ratio (ACR)

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24
Q

How to differentiate upper/lower UTI in terms of casts?

A

Lower - no casts

Upper - WBC casts

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25
Q

Pre-renal, renal- post-renal causes of increased serum BUN

A

Pre-renal = congestive heart failure, hemorrhage, dehydration, increased production in liver

Renal = kidney failure

Post-renal = urinary tract obstruction

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26
Q

Crystal found in pseudo-gout

A

Calcium pyrophosphate

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27
Q

4 hormones produced by kidneys

A
  • Renin
  • Vitamin D
  • EPO
  • Prostaglandins
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28
Q

ADH regulates final urine concentration by controlling?

A

Tubular permeability

29
Q

Which renal tubular acidosis type? Basic urine pH

A

Type I (distal/classical RTA)

30
Q

Part of nephron that is permeable to water by passive transport but not to ions

A

Descending loop of Henle

31
Q

Effect of prostaglandins produced by kidneys?

A

Increase renal flow, sodium and water excretion, renin release

32
Q

Formed when creatine loses a water molecule

A

Creatinine

33
Q

Reabsorption of Na+ in DCT is under the control of?

A

Aldosterone

34
Q

RBC casts indicates..?

A

Acute glomerulonephritis

35
Q

Steps in production of creatinine

A

Creatine (liver) -> creatine phosphate via creatine kinase -> CP loses phosphoric acid and water => creatinine which diffuses into plasma

36
Q

RI for creatinine clearance?

A

1.20 - 2.60 mL/sec/1.73m^2

37
Q

High serum creatinine = ____ urine creatinine = _____ GFR

A

Low urine CR

Low GFR

38
Q

Glomerular basement membrane cut-off size

A

68 kDa (size of albumin)

39
Q

Countercurrent mechanism takes place in the?

A

Juxtaglomerular nephrons

40
Q

Varying pH urine = formation of which calculi?

A

Calcium oxalate calculi

41
Q

What to look for in Type I, II, and IV RTA?

A

I - renal STONES
II - BONE demineralization
IV - low ALDOSTERONE

42
Q

Small amounts of urea can be excreted through these 2 places

A

GI

Skin

43
Q

The selective reabsorption process in the loop of Henle is called the _______________ and serves to maintain the osmotic gradient of the medulla

A

countercurrent multiplier system

44
Q

Constituent of hyaline casts

A

Uromucoid (Tamm-Horsfall mucoprotein)

45
Q

Which renal tubular acidosis type? Acidic urine pH

A

Type IV (generalized distal RTA)

46
Q

Formula for urine formation

A

Glomerular filtration - tubular reabsorption + tubular secretion = excretion/urine

47
Q

What is oliguria

A

Diminished urine secretion in relation to fluid intake (<400 mL/day)

48
Q

3 physiological functions of nephron

A
  • Glomerular filtration
  • Tubular reabsorption
  • Tubular secretion
49
Q

Crystal found in gout

A

Monosodium urate

50
Q

Name of calculi that has multiple small calculi with varying size

A

Staghorn calculi

51
Q

What form of uric acid causes urolithiasis and gout

A

pH <5.75

52
Q

What is azotemia

A

Excess of urea/creatinine/other nitrogenous end products in blood

53
Q

Type of nephron responsible for renal concentration

A

Juxtaglomerular

54
Q

Function of aldosterone

A

Stimulates Na+ reabsorption, K+ and H+ secretion at DCT

55
Q

Hormone that stimulates water reabsorption in DCT

A

ADH (DCT normally impermeable to water but ADH makes it permeable)

56
Q

Where and what controls the production of aldosterone

A

Adrenal cortex

RAAS - decreased blood flow/BP in renal arteriole or decreased blood Na+

57
Q

An increase in urea and BUN

A

Uremia

58
Q

Which renal tubular acidosis type? Variable to <5.3 urine pH

A

Type II (proximal RTA)

59
Q

What is another word for uremia

A

Azotemia

60
Q

Word for complete suppression of urine formation and excretion (acute renal failure) <100 mL/day

A

Anuria

61
Q

Cause of type I RTA

A
  • Drugs

- Autoimmune

62
Q

Enzyme that produces creatine when creatine phosphate loses a phosphoric acid

A

Creatinase

63
Q

Waste product of purine metabolism

A

Uric acid

64
Q

After kidneys, blood returns to venous system via _________ to the ________

A

via RENAL VEIN to the IVC

65
Q

What is polyuria

A

Excessive excretion of urine (e.g. DM) >3 L/day

66
Q

3 hormones that control tubular reabsorption

A
  • ADH/vasopressin
  • Aldosterone
  • PTH
67
Q

3 mechanisms of pathologic proteinuria

A
  • Glomerular defect
  • Tubular defects
  • Overflow proteinuria
68
Q

Renin secreted by nephron in response to..?

A

Low systemic BP

69
Q

May interfere with creatinine measurements

A
  • Bilirubin

- Ammonia

Clinical Chemistry 1 (13 decks)

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