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Analysis of Urine and Other Body Fluids > Chapter 2 - Renal Function > Flashcards

Chapter 2 - Renal Function Flashcards

1
Q

Basic structural & functional unit of the kidney

A

Nephron

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2
Q

How many nephrons are there per kidney?

A

1 to 1.5 million

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3
Q

Nephron consists of?

A

Glomerulus, renal tubules

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4
Q

Renal functions

A

renal blood flow, glomerular filtration, tubular reabsorption, tubular secretion

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5
Q

Renal artery carries:
A. Unfiltered blood
B. Filtered blood

A

A. Unfiltered blood

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6
Q

Blood entering the glomerulus comes from:

A. Efferent arteriole
B. Afferent arteriole

A

B. Afferent arteriole

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7
Q

Blood exiting the glomerulus goes to:
A. Efferent arteriole
B. Afferent arteriole

A

A. Efferent arteriole

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8
Q

Total renal plasma flow

A

600-700 mL/min

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9
Q

Total renal blood flow

A

1200 mL/min

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10
Q

Part of nephron that resembles a sieve

A

Glomerulus

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11
Q

Glomerulus is
A. Nonselective
B. Selective

A

Nonselective

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12
Q

Glomerulus is a coil of approximately 8 capillary lobes (capillary tuft) located within _____.

A

Bowman’s capsule

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13
Q

Glomerulus filter plasma substances with MW of _____.

A

<70 000 Da / <70 KDa

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14
Q

Why is albumin not filtered by the glomerulus?

A

Shield of negativity repels the negatively charged albumin

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15
Q

The specific gravity of glomerular filtration

A

1.010

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16
Q

The specific gravity of plasma

A

1.010

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17
Q

5 main substances that pass through the glomerulus?

A

Salt, water, amino acid, glucose, urea

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18
Q

What is the MW of albumin and its charge in the body?

A

6.9 KDa, negative

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19
Q

When does albumin become positive?

A

At pH 4.9

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20
Q

First function to be affected in renal disease

A

Tubular reabsorption

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21
Q

Renal threshold for glucose

A

160-180 mg/dL

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22
Q

Major site (65%) of reabsorption of plasma substances

A

Proximal convoluted tubule

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23
Q

Which of the following is the main action of aldosterone?

A. Return sodium back to blood
B. Promote excretion of sodium
C. Return water back to blood
D. Promote water excretion

A

A. Return sodium back to blood

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24
Q

What happens when ADH is decreased?

A. More salt is excreted
B. More water is excreted
C. Less salt is excreted
D. Less water is excreted

A

B. More water is excreted

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25
Q

What happens when aldosterone is decreased?

A. More salt is excreted
B. More water is excreted
C. Less salt is excreted
D. Less water is excreted

A

A. More salt is excreted

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26
Q

What happens when aldosterone is increased?

A. More salt is excreted
B. More water is excreted
C. Less salt is excreted
D. Less water is excreted

A

C. Less salt is excreted

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27
Q

What happens when ADH is increased?

A. More salt is excreted
B. More water is excreted
C. Less salt is excreted
D. Less water is excreted

A

D. Less water is excreted

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28
Q

How much amino acid is reabsorbed and how much is excreted?

A

100% is reabsorbed, 0% is excreted

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29
Q

How much urea is reabsorbed and how much is excreted?

A

40% is reabsorbed, 60% is excreted

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30
Q

What happens when vasopressin is decreased?

A. More salt is excreted
B. More water is excreted
C. Less salt is excreted
D. Less water is excreted

A

B. More water is excreted

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31
Q

The ADH / vasopressin regulates water reabsorption in which part/s of the kidneys?

A

DCT and collecting duct

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32
Q

Expected level of ADH and urine volume when there is increased body hydration

A

Decreased ADH, increased increased urine volume

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33
Q

What causes DI?

A

ADH deficiency

34
Q

Urine volume for patients with DI. (Increased / decreased)

A

Increased

35
Q

Cause of SIADH

A

ADH excess

36
Q

Expected urine volume for patients with SIADH. (Increased / decreased)

A

Decreased

37
Q

What hormone regulates water reabsorption?

A

ADH / vasopressin

38
Q

What hormone regulates sodium reabsorption?

A

Aldosterone

39
Q

When will RAAS be activated?

A

When there is low blood pressure

40
Q

Effects of RAAS in aldosterone and ADH

A

Increased ADH and vasopressin

41
Q

Effects of angiotensin II

A

Sodium and water reabsorption, vasoconstriction, corrects renal blood flow

42
Q

What produces renin?

A

Juxtaglomerular cells

43
Q

What converts angiotensinogen to angiotensin I?

A

Renin

44
Q

What converts angiotensin I to angiotensin II?

A

ACE

45
Q

What organ produces ACE?

A

Lungs

46
Q

Active form of angiotensinogen

A

Angiotensin II

47
Q

Identify the ff whether they are transported active or passively:

  1. Water
  2. Glucose
  3. Sodium
  4. Salts
  5. Urea
  6. Amino acids
  7. Chloride
A
  1. Passive
  2. Active
  3. Passive at PCT and DCT, active at Ascending LH
  4. Active
  5. Passive
  6. Active
  7. Active
48
Q

Identify the locations where the ff can be reabsorbed:

  1. Glucose
  2. Amino acids
  3. Chloride
  4. Salts
  5. Sodium
  6. Urea
  7. Water
A
  1. PCT
  2. PCT
  3. Ascending LH
  4. PCT
  5. PCT DCT ascending LH
  6. PCT Ascending LH
  7. PCT descending LH CD
49
Q

Major site for removal of nonfiltered substances

A

PCT

50
Q

Inability to produce acidic urine

A

Renal tubular acidosis

51
Q

What is the urine pH for px with renal tubular acidosis?

A

Alkaline

52
Q

What is the blood pH for px with renal tubular acidosis?

A

Acidic

53
Q

What is the problem for px with renal tubular acidosis?

A. Tubular reabsorption
B. Tubular secretion
C. Glomerular filtration
D. Renal blood flow

A

B. Tubular secretion

54
Q

Average normal blood pH

A

7.40

55
Q

What is the normal pH of urine?

A

Slightly acidic

56
Q

Test used to evaluate GFR

A

Clearance test

57
Q

What is commonly measured in a clearance test?

A

Creatinine

58
Q

What is measured in the gold standard/reference method for clearance test?

A

Inulin

59
Q

Formula for clearance test (give the units as well for the result and each given)

A

(UV/P)x(1.73/body surface area)

Creatinine clearance in mL/min
Urine and plasma creatinine in mg/dL
Urine volume in mL/min
Body surface area in m^2

60
Q

Variables of MDRD system formula

A

Ethnicity, BUN, serum albumin

61
Q

Variables present in calculating using Cockgroft & Gault (give the units as well if necessary)

A

Age, sex, body weight in kg

62
Q

What is the formula in computing glomerular filtration estimate? Give units as well

A

([140-age] [body weight in kg]) / 72 x serum creatinine in mg dL

63
Q

What will you multiply in your Cockgroft & Gault result if the px is female?

A

0.85

64
Q

Recommended computation for GFR by the NKDEP

A

MDSD-IDMS Traceable Formula

65
Q

What does MDRD-IDMS stands for?

A

Modification of Diet in Renal Disease - Isotope Dilution Mass Spectrophotometry

66
Q

Used to evaluate tubular secretion & renal blood flow

A

Dilution

67
Q

Used to evaluate tubular reabsorption

A

Comcentration

68
Q

Enumerate the commonly used concentration tests

A

Specific gravity, osmolarity

69
Q

Enumerate the obsolete tests for concentration tests

A

Fishberg, Mosenthal

70
Q

What concentration test deprives px of fluid for 24 hours?

A

Fishberg

71
Q

What concentration test compares day and night urine in terms of volume & SG?

A

Mosenthal test

72
Q

Differentiate SG and osmolarity

A

SG is influenced by the number & density of particles while osmolarity is only influenced by number of particles in solution

73
Q

Enumerate the tests for tubular secretion and renal blood flow.

A

PAH, PSP

74
Q

Which dilution test is already obsolete?

A

PSP (phenolsulfonpthalein)

75
Q

The plasma concentration at which active transport stops.

A

Renal threshold

76
Q

Renal concentration begins in which part pf the kidney?

A

Ascending and descending loop of Henle

77
Q

The greatest source of error in any clearance procedure utilizing urine is?

A

The use of improperly timed urine specimens

78
Q

Type of specimen used for measuring GFR

A

24 hour urine collection

79
Q

True or False: large molecular weight molecules such as glucose and urea DO NOT contribute to the evaluation of renal concentration.

A

True

80
Q

PAH stands for?

A

Para-aminohippuric acid

Analysis of Urine and Other Body Fluids (18 decks)

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