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Mercy CLS 3: Urinalysis > 5. Renal Function > Flashcards

5. Renal Function Flashcards

1
Q

nephrons in kidney

A

1-1.5 million

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2
Q

—- minor calyces join to form —- major calyces, which drain into the…

A

12
2-3
renal pelvis

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3
Q

medullary rays

A

striations in renal pyramids which connect the cortex with the medulla

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4
Q

urethra length

A

males 24 cm
females 4 cm

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5
Q

capillary lobes in glomerulus

A

8

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6
Q

3 layers of glomerular filtration barrier

A

capillary endothelials, basement membrane, visceral epithelium of Bowman’s capsule

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7
Q

shield of negativity function

A

prevents passage of + molecules
including albumin

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8
Q

——% of filtrate is reabsorbed in the PCT

A

60-80%

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9
Q

—% Na+ is reabsorbed in the PCT

A

67%

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10
Q

pars recta

A

thick descending limb of loop of Henle

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11
Q

vasa recta

A

capillaries adjacent to loops of Henle
major exchange of salt and water
maintain osmotic gradient

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12
Q

renal artery receives –% of blood from heart

A

25%

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13
Q

glomerular filtration rate

A

volume of plasma that is filtered by the glomerulus in a specified time

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14
Q

juxtaglomerular apparatus

A

autoregulatory mechanism that maintains glomerular BP at a relatively constant rate regardless of fluctuation of systemic BP

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15
Q

RAAS responds to…

A

↓ BP
↓ Na+ concentration

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16
Q
A
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17
Q
A
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18
Q
A
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19
Q

renin

A

secreted by juxtaglomerular cells in response to ↓ BP and ↓ Na+

forms angiotensin

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20
Q

5 effects of angiotensin II

A

afferent vasodilation
efferent constriction
stimulates reabsorption of Na+ and water in PCT
↑ K+ excretion
triggers aldosterone release

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21
Q

Na+ retaining hormone

A

aldosterone

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22
Q

3 functions of ADH

A

decreased urine production
decreased sweating
increased BP

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23
Q
A
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24
Q

defect in NH3 production

A

renal tubular acidosis
inability to produce acid urine

25
Q

tests used to detect an acid-base imbalance

A
  • pH
  • titratable acidity
  • urinary ammonia
26
Q

important characteristics of substance for clearance test (5)

A

neither be reabsorbed nor secreted; stability over time; plasma consistency; availability to the body; ability to analyze substance

27
Q

substances used in clearance tests

A

creatinine
cystatin C
B2-microglobulin
radioisotopes
inulin (gold standard but invasive)

28
Q

eGFR used with —— clearance test

A

creatinine

29
Q

clearance test reported in…

A

mL/min

30
Q

creatinine clearance AKA ——

A

GFR

31
Q

clearance calculation and variable definitions

A

C = UV/P = mL/min

C = GFR
U = urine concentration in mg/dL
V = volume urine in mL/min
P = plasma concentration in mg/dL

32
Q

24 hr = —- min

A

1440

33
Q

concentration =
(units?)

A

Conc = UV = g/24 hours

34
Q

normal creatinine reference range

A

0.5-1.5 mg/dL

35
Q

corrected creatinine clearance calculation

A

Corrected CrCl = (UV/P)(1.73/A)

A = BSA score from nomogram
1.73 = average body surface area in m^2

36
Q

traditional vs current eGFR systems

A

traditional: MDRD-IDMS; considered sex and ethnicity
current: CKD-EPI 2021; no longer considers ethnicity

37
Q

clearance test

produced by all nucleated cells at constant rate
serum levels directly reflect GFR
for pediatrics, diabetics, elderly, critically ill

A

cystatin C

38
Q

clearance test

dissociates from human leukocyte antigens at constant rate
measured by immunoassay
unreliable in those with immune disorders/malignancies

A

B2-microglobulin

39
Q

clearance test that does not require urine collection and can measure viability of transplanted kidney

A

radionucleotide
125I iothalamate

40
Q

normal osmolality after fluid deprivation

A

> 800 mOsm/kg
3:1 urine:serum ratio

41
Q

is osmolality is abnormal after fluid deprivation…

A

testing continues for 2 more hours

if it’s still abnormal, move on to ADH challenge

42
Q

osmolality

A

number of osmoles per kilogram of solvent

43
Q

isosmotic

A

osmolality of initial filtrate = that of plasma
1.010 SG

44
Q

normal osmolality ranges for urine and serum

A

urine: 50-1400 mOsm/kg
serum: 275-300 mOsm/kg

45
Q

3 substances that can cause false results in osmolality readings

A

lipemic serum
lactic acid
ethanol

46
Q

free water clearance

A

volume of water cleared by the kidneys per minute in excess of that necessary to remove solutes

47
Q

ADH levels vs free water clearance

A

low ADH, (+) CH2O
high ADH, (-) CH2O

48
Q

osmolar clearance calculation

A

Cosm = UosmV/Posm

49
Q

free water clearance calculation

A

CH2O = V - (UosmV/Posm)

50
Q

2 parts of water in free water clearance

A
  1. solute-free H2O (cleared)
  2. H2O with solute
51
Q

reference range for normal renal plasma flow

A

600-700 mL/min

52
Q

measures renal plasma flow

A

PAH

53
Q

normal person excretes — mEq/day of acid

A

70

54
Q

forms of acid in the urine

A

H+
H2PO4-
NH4+

55
Q

alkaline tides

A

shortly after arising
postprandially 2pm
postprandially 8pm

56
Q

lowest urine pH time

A

night

57
Q

evaluates ability of tubules to secrete ammonium and hydrogen

A

oral ammonium chloride test

58
Q

acid load of oral ammonium chloride
speciments collected at — hour intervals
—-, —-, and —– are measured
ammonium concentration =

A

2 hour
pH, titratable acidity, and urinary ammonia
ammonium concentration = titratable acidity - total acidity

59
Q

normal BUN

A

7-20 mg/dL

Mercy CLS 3: Urinalysis (10 decks)

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