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MLT-MLS Spring 2022 > Body Fluids Exam 1 > Flashcards

Body Fluids Exam 1 Flashcards

1
Q

Kidney anatomy:

Where blood enters the glomerulus

A

Afferent arteriole

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2
Q

Kidney anatomy:

Where unfiltered blood exits the glomerulus

A

Efferent arteriole

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3
Q

Kidney anatomy:

This part of the nephron is where water and electrolyte exchange takes place

A

Loop of Henle

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4
Q

Kidney anatomy:

The microscopic structural and functional unit of the kidney

A

Nephron

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5
Q

Kidney anatomy:

Receives/filters blood

A

Glomerulus

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6
Q

Kidney anatomy:

Location of glomerulus

A

Bowman’s Capsule

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7
Q

Kidney anatomy:

Primary site of reabsorption of water and essential substances

A

Proximal convoluted tubule

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8
Q

Kidney anatomy:

Where concentration of urine begins in the nephron

A

Distal convoluted tubule

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9
Q

Kidney anatomy:

Where final concentration and secretion takes place in the nephron

A

Collecting ducts

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10
Q

Kidney anatomy:

Average amount of blood flowing through kidneys

A

1200 mL/min

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11
Q

Kidney anatomy:

Renal blood pressure/blood volume is controlled by

A

Renin-angiotensin-aldosterone system (RAA)

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12
Q

Kidney anatomy:

The glomerulus filters substances of what molecular weight?

A

< 70,000

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13
Q

Kidney anatomy:

The glomerulus creates a ______ free ultra-filtrate

A

Protein free

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14
Q

Kidney anatomy:

The glomerulus creates a protein free ultra-filtrate at what rate?

A

120 mL/min

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15
Q

Kidney anatomy:

What is not found in the glomerular ultra-filtrate?

A

Proteins

Protein-bound elements

Cells

Anything with a larger molecular weight than 70,000

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16
Q

Kidney anatomy:

What is the glomerular ultra-filtrate of 120 mL/min called?

A

GFR

Glomerular Filtration Rate

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17
Q

This is where the return of water and essential substances back into blood occurs

A

Proximal tubule of nephron

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18
Q

Where is renin released from?

A

Kidneys

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19
Q

What causes the RAA system to “turn on”

A

Decrease in Renal Blood Pressure/Volume

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20
Q

Where does aldosterone come from?

A

Adrenal glands

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21
Q

Glomerular Filtration Rate

A

120 mL/min

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22
Q

Repels molecules with a positive charge (such as proteins)

A

Shield of negativity

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23
Q

What makes it through glomerular filtration?

A

Glucose

Electrolytes

Water

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24
Q

What substance is reabsorbed in response to aldosterone?

A

Sodium

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25
Q

What causes sodium to be reabsorbed?

A

Aldosterone

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26
Q

Definition:

Substances go from tubule back into the bloodstream

A

Reabsorption

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27
Q

What is reabsorbed in to the bloodstream?

A

Mostly water

Glucose

Amino Acids

Other Essential electrolytes

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28
Q

Where does 60-85% of reabsorption occur in the nephron?

A

Proximal Convoluted Tubules

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29
Q

Definition:

Plasma concentration of a substance at which reabsorption stops and the substance begins to appear in urine

A

Renal Threshold

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30
Q

What is the range for Glucose Renal Threshold?

A

160 - 180 mg/dL

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31
Q

Removes large, unfilterable waste products from the blood in to the tubular filtrate

A

Tubular secretion

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32
Q

Tubular secretion excretes these for maintenance of blood acid-base balance

A

Hydrogen ions

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33
Q

Where does the final reabsorption of water occur in the nephron?

A

Distal Convoluted Tubules and the Collecting Ducts

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34
Q

Concentration is controlled by what hormone?

A

Anti-Diuretic Hormone (ADH)

AKA

Vasopressin

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35
Q

Another name for ADH

A

Vasopressin

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36
Q

What triggers ADH?

A

An increase in plasma concentration of sodium

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37
Q

Functions of kidneys (5)

A

Removal of waste products

Retention of nutrients and essential compounds

Acid-base balance

Water balance

Hormone synthesis (renin, erythropoiten, vitamin D)

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38
Q

Composition of urine

A

Urea (protein metabolism)

Uric acid (purine metabolism)

Creatinine (muscle cell breakdown)

Cl-, Na+, K+, H+ (electrolytes)

Few formed elements (squamous epis, possible crystals, bacteria, casts, WBCs, RBCs)

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39
Q

Average output of urine

A

600 - 2000 mL/24 hrs

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40
Q

Definition:

Decreased output of urine

A

Oliguria

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41
Q

Definition:

No output of urine

A

Anuria

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42
Q

Definition:

Increased output of urine

A

Polyuria

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43
Q

Definition:

Painful flow of urine

A

Dysuria

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44
Q

Definition:

Increased output of urine at night

A

Nocturia

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45
Q

What will average output of urine depend on?

A

State of hydration

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46
Q

Possible causes of oliguria

(3)

A

Dehydration

Diabetes

UTI

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47
Q

Possible causes of anuria

(3)

A

Kidney failure

Kidney damage

Decreased blood flow

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48
Q

Possible causes of polyuria

(4)

A

Diabetes insipidus (Na+ issue)

Diabetes mellitus (glucose issue)

Caffeine

Alcohol

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49
Q

Possible causes of dysuria

(5)

A

UTI

Kidney stones

Enlarged prostate

STD/STI

Yeast infection

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50
Q

Possible causes for nocturia

(2)

A

Pregnancy

Elderly

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51
Q

Rate at which blood enters the kidneys

A

1200 mL/min

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52
Q

Rate at which the kidneys filter blood

A

120 mL/min

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53
Q

Hormone that controls final reabsorption of water

A

Anti-diuretic hormone (ADH)

AKA

Vasopressin

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54
Q

Term used to describe the point where reabsorption of a substance stops

A

Renal threshold

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55
Q

Included in physical examination of urine

(3)

A

Color

Clarity

Specific gravity

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56
Q

Normal color of urine is due to

A

Urochrome

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57
Q

Cause of clear, yellow urine

A

Normal

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58
Q

Cause of colorless, pale, or straw colored urine

A

Diluted urine

Diabetes

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59
Q

Causes of dark yellow or amber colored urine

A

Concentrated urine

Dehydration

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60
Q

Cause of amber/brownish-orange urine

A

Icteric- presence of bilirubin

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61
Q

Cause of orange colored urine

A

UTI drugs (pyridium)

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62
Q

UTI drug that is known for causing urine to turn orange

A

Pyridium

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63
Q

Cause of blue or green colored urine

A

Drugs (such as birth control)

or Dyes

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64
Q

Cause of brown urine

A

Old bloody urine

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65
Q

Cause for red, cloudy urine

A

Intact RBCs (hematuria)

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66
Q

Cause for red, clear urine

A

Hemoglobin (hemoglobinuria)

Myoglobin (myoglobinuria)

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67
Q

Cause for red-purple urine

A

Porphyrins

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68
Q

Cause for black urine

A

Melanin

or

Homogentisic acid

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69
Q

What affects the color of urine? (4)

A

Metabolism

Ingested materials

Diseases

Physical activity

70
Q

Clarity of urine:

Transparent; no visible particulates

71
Q

Clarity of urine:

Few particulates

72
Q

Clarity of urine:

Print is blurred through the urine

73
Q

Clarity of urine:

Print not seen

74
Q

Clarity of urine:

May precipitate or clot

75
Q

Causes for milky urine

A

Increased lipids

Increased proteins

76
Q

Nonpathologic causes of hazy, slightly cloudy, cloudy, or turbid urine

(7)

A

Mucus

Talc

Cream

Fecal contamination

Sperm

Squamous epithelial cells

Certian crystals (ammonium biurate, triple phosphate uric)

77
Q

Pathologic causes for hazy, slightly cloudy, cloudy, or turbid urine

(8)

A

RBCs

WBCs (infection, STD/STI)

Crystals (bilirubin, leucine)

Bacteria, yeast, Trichomonas (UTI, genital contamination)

Renal epithelial cells (deterioration in kidneys)

Lipids (milky urine)

78
Q

Definition:

A measure of dissolved substances present in a solution. Primarily reflects the patient’s state of hydration

A

Specific Gravity

79
Q

Term used for the presence of intact red cells in the urine

80
Q

Term used for presence of lysed red cells or free hemoglobin in the urine

A

Hemoglobinuria

81
Q

Assesses the kidney’s ability to reabsorb water

A

Specific Gravity

82
Q

What influences specific gravity?

A

Size and number of particles

83
Q

Normal urine specific gravity

A

1.003 - 1.035

84
Q

TRUE or FALSE

Urine can have a specific gravity of 1.000

A

FALSE

Pure water has this SG

85
Q

Specific gravity of glomerular filtrate

86
Q

What does having a fixed SG of 1.010 from multiple samples indicate?

A

Renal dysfunction

87
Q

Correlation between volume of urine and specific gravity

A

As volume increases, specific gravity decreases (hydrated)

As volume decreases, specific gravity increases (dehydrated)

88
Q

TRUE or FALSE

Diseased kidneys lose the ability to concentrate/dilute urine causing the specific gravity to become fixed at 1.035

A

FALSE

Specific gravity becomes fixed at 1.010 due to glomerular filtration working but nothing else.

89
Q

3 ways to measure specific gravity (SG)

A

Dipstick

Harmonic oscillation

Refractometer

90
Q

Method of measuring Specific Gravity:

The frequency of sound waves will change in proportion to the density

A

Harmonic oscillation densitometry

91
Q

Compares the velocity of light in air with the velocity of light in a solution

A

Refractive index

92
Q

Method of measuring Specific Gravity:

The density of dissolved particles present in the sample will determine the angle at which light passes through a solution

A

Refractometer

93
Q

What “fixed” SG value is associated with kidney problems?

94
Q

Generally, as urine volume increases, specific gravity _______

95
Q

Steps to follow if SG is off the scale

A

Dilute 1:2

Rerun

Multiply result by dilution factor

96
Q

Causes for Abnormal Specific Gravity Using a Refractometer

Low

(dilute or hypotonic)

A

Diabetes insipidus (impaired ADH, increased plasma Na+, Increased thirst)

High water intake

97
Q

Causes for Abnormal Specific Gravity Using a Refractometer

High

(concentrated, hypertonic)

A

Protein

Diabetes mellitus (defective insulin, increased plasma/urine glucose)

Dehydration

Radiographic dyes

Some IV fluids

98
Q

Causes for Abnormal Specific Gravity Using a Refractometer

Fixed 1.010

A

Renal disorder

99
Q

This causes a vivd yellow foam

100
Q

This causes an abundant amount of white foam

101
Q

TRUE or FALSE

A small amount of white foam is normal when urine is shaken

102
Q

Urine Odor:

Normal

A

Faintly aromatic

103
Q

Urine odor:

Strong unpleasant ammonia-like odor, foul

A

Bacterial infection

104
Q

Urine Odor:

Sweet or fruity due to the presences of ketones

105
Q

Urine Odor:

Syrup, sulfur, mousey

A

Metabolic defects

106
Q

Automated method for chemical analysis of urine

A

Reflectance photometry

(As color increases, reflectance of light decreases)

107
Q

TRUE or FALSE

Reagent strips should always be protected from moisture, light, heat, volatile chemicals, and should be refrigerated.

A

FALSE

Reagent strips should always be protected from moisture, light, heat, and volatile chemicals but should NOT be refrigerated.

108
Q

Normal urine pH

109
Q

Causes of acidic pH

(4)

A

H+

Ketones - due to starvatin or Type 1 Diabetes mellitus

Dehydration

Cranberry juice

110
Q

Causes of alkaline pH

(2)

A

Certain UTIs (bacteria create ammonia)

Old urine (normal flora reproduce creating ammonia)

111
Q

Principle for testing pH

A

Double indicator system

112
Q

Are there any interfering factors for pH?

113
Q

What is the best indicator of renal disease?

114
Q

Normal result for protein in urine

A

Negative or Trace

115
Q

What is the only protein detected by dipstick?

116
Q

Causes of Pre-renal proteinuria

A

Excessive blood protein levels

-Hemoglobin

-Myoglobin

-Bence Jones proteins

117
Q

Functional causes of Renal proteinuria

(4)

A

-Seizures

-Fever

-Excessive stress/exercise

-Hypertension

118
Q

Pathologic causes of Renal proteinuria

(3)

A

-Glomerular

-Tubular

-Interstitial

119
Q

Causes of Post-renal proteinuria

(3)

A

Disease of renal pelvis onwards

-Infection

-Urolithiasis

-Neoplasia

120
Q

Protein associated with Multiple Myeloma

A

Bence Jones proteins

121
Q

Glomerular disorders or damage by toxins will cause what type of proteinuria?

A

Renal proteinuria

122
Q

Pressure on the renal vein causing a positive protein result when standing upright but a negative protein result after lying down

A

Orthostatic or Postural proteinuria

123
Q

Principle for testing protein

A

Protein error of indicators

124
Q

Interfering factors for a false positive protein

A

Alkaline urine - check pH

125
Q

Interfering factors for a false negative protein result

A

Protein other than albumin (Ex. BJ protein)

Microalbuminuria (not enough albumin to trigger threshold)

126
Q

Confirmatory test for positive protein dipstick

A

Sulfosalicylic Acid Precipitation (SSA)

127
Q

Causes of false positive SSA result

A

Radiographic Dyes

Drug Crystals

128
Q

Most frequent chemical test performed on urine

129
Q

Normal Renal threshold for glucose

A

160 - 180 mg/dL

130
Q

When the blood level of gluvose becomes so elevated that tubular reabsorption can’t keep up, glucose will appear in urine.

A

Renal Threshold

131
Q

Major cause of glucose in urine

132
Q

Term for glucose in urine

A

Glycosuria

AKA

Glucosuria

133
Q

Principle of the reaction for glucose

A

Double sequential enzyme specific for glucose

134
Q

Interfering factors for a false negative glucose on urine dipstick

A

Acorbic acid (vitamin C)

High SG

Unpreserved specimens (glycolysis from bacteria and normal flora digesting glucose until its gone or too low)

135
Q

Confirmation test for positive dipstick glucose

A

Copper Reduction Test

AKA

Clinitest

136
Q

TRUE or FALSE

The Copper Reduction Test reacts with ALL reducing sugars

137
Q

Reducing sugars convert copper sulfate to cuprous oxide in the presence of heat and alkali

A

Copper Reduction Test

AKA

Clinitest

138
Q

Positive Glucose dipstick

+

Positive Clinitest

=

A

Glucose present

139
Q

Trace - 1+ Glucose Dipstick

+

Negative Clinitest

=

A

Small glucose

140
Q

2+ - 4+ Glucose dipstick result

+

Negative Clinitest result

=

A

Interference or testing error

141
Q

Negative Glucose dipstick

+

Positive Clinitest result

=

A

Other reducing sugars

*Galactose* - congenital enzyme defect; failure to thrive, retardation,

screen kids < 2 years old

142
Q

3 by-products of fat metabolism

143
Q

What are the by-products of fat metabolism?

(3)

A

-Acetone

-Acetoacetic acid

-Beta-hydroxybutyric acid

144
Q

Clinical significance of ketones

A

-Diabetes mellitus

-Starvation

-Carb-free diets

-Vomiting

-Malabsorption

145
Q

Term for ketones in urine

146
Q

What does Diabetes mellitus with insufficient insulin control cause?

(5)

A

-Glucosuria

-Ketonuria

-Acid pH

-Positive serum glucose/ketone

-Risk of diabetic keto-acidosis (DKA)

147
Q

Principle of the Reaction for ketones

A

Sodium nitroprusside reaction

148
Q

Interfering factors for a false negative ketone dipstick result

A

-Evaporation

-Improper storage of specimen

149
Q

Interfering factors for a false positive ketone dipstick

A

-Drugs

-Medication

-Dyes (radioactive)

150
Q

Confirmatory test for ketones

151
Q

Test that is the best indicator for renal disease

A

Protein - testing for albumin, specifically

152
Q

Test that will most likely be positive if a patient is starving

153
Q

Substance that can cause a false negative glucose result

A

Ascorbic acid

AKA

Vitamin C

154
Q

3 causes for a dipstick to result as positive for blood

A

-Hematuria

-Hemoglobinuria

-Myoglobinuria

155
Q
  • Presence of intact red cells in urine
  • Urine usually appears red and hazy or cloudy
  • Sometimes not visible
  • Trauma or injury; toxins; tumors
  • Kidney stones
  • Glomerulonephritis/ Pyelonephritis
  • Menstruation
156
Q
  • Presence of free hemoglobin
  • Urine appears clear, reddish-brown
  • Intravascular hemolysis (transfusion reactions, hemolyic anemias, burns)
A

Hemoglobinuria

157
Q
  • Presence of muscle protein
  • Appears clear, reddish-brown
  • Muscle crush or muscle-wasting disease (rhabdomyolysis)
  • AMI
  • Strenuous exercise in an untrained person
  • Confirmed with special testing
A

Myoglobinuria

158
Q

Principle of reaction for blood on dipstick

A

Pseudoperoxidase activity of hemoglobin

159
Q

Free hemoglobin or myoglobin will cause what type of reaction on the dipstick?

A

uniform color reaction

160
Q

Intact red cells will cause what type of reaction on the dipstick?

A

Speckled pattern

Sensitive to as few as 5-10 cells/uL

161
Q

Interfering factors for false positive blood result on dipstick

A

Menstrual contamination

162
Q

Interfering factor for false negative for blood on dipstick

A

High SG (may crenate cells)

163
Q

Degradation product of hemoglobin that is normally metabolized in the liver

164
Q

Causes a vivd yellow foam on urine

165
Q

What could cause direct (unconjugated) bilirubin in the urine?

A

Hepatitis

Cirrhosis and other liver disorders

Biliary obstruction (gallstones, tumor, etc)

166
Q

Principle of reaction for bilirubin on dipstick

A

Diazo reaction

167
Q

Interfering factor for false positive for bilirubin on dipstick

A

Pigments from dyes or drugs

168
Q

Interfering factor for a false negative bilirubin dipstick result

A

Exposure to light

169
Q

Confirmatory test for bilirubin

170
Q
  • Normal by-product of RBC degradation
  • Formed from thereduction of bilirubin by bacterial enzymes in the intestines
  • Excreted in both feces and urine
A

Urobilinogen

MLT-MLS Spring 2022 (14 decks)

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