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Chem Path Flashcards

1
Q

What renal function tests are used to screen for kidney disease?

A
  • Complete urine analysis
  • Plasma urea and creatinine
  • Plasma electrolytes
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2
Q

What are the tests used to assess glomerular function?

A
  • Glomerular Filtration rate - Clearance tests.
  • Glomerular permeability - Proteinurea
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3
Q

What are the tests used to assess tubular function ?

A
  • Specific gravity
  • Reabsorption and Secretion tests
  • Concentration & Dilution tetsts
  • Renal acidification
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4
Q

Which test is used for Endogenous substances used for clearance test?

A

Creatinine

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5
Q

Which test is used for Exogenous substance used for clearance test ?

A

Inulin

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6
Q

What tool is used for a measurement of specific gravity ?

A

Urinometer

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7
Q

Which test can be used to detect Diabetic and Hypertensive nephropathy?

A

Microalbumin

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8
Q

The renal tubular function tests asses what clinical aspects?

A
  • Specific gravity
  • Concentration test
  • Urine volume
  • Osmolality
  • Dilution test
  • Acidification
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9
Q

What are the different clearance tests used for a measurement of GFR for Creatinine clearance ?

A
  • Serum creatinine.
  • Serum urea.
  • Urine creatinine.
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10
Q

What is the Glomerular Filtration Rate?

A

The GFR is the rate in millilitres per minute that substances are cleared from the circulation through the kidney’s glomeruli.

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11
Q

True or False? The GFR gives an estimate degree of renal impairment .

A

TRUE!!

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12
Q

True or False? After After age 40, GFR decreases progressively with age, by about 0.4 mL/min to 1.2 mL/min per year.

A

TRUE!!

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13
Q

What are the different characteristics that make a substance a suitable marker for clearance studies?

A
  • freely filterable at the glomerular barrier,
  • not reabsorbed by the tubules
  • not secreted by the tubules,
  • present at a stable plasma concentration.
  • if exogenous – non toxic,
  • reliable assay procedure.
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14
Q

Give examples of compounds that are used as EXOGENOUS markers to determine GFR.

A
  • Inulin (Sinsitrin),
  • Iohexol,
  • 51Cr-EDTA (isotopic),
  • 99mTc-DTPA (99mTechnetium - isotopic).
  • 125 - iodothalamate
  • Idoacetate
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15
Q

What is the definition of Clearance ?

A

Clearance is defined as the hypothetical quantity of blood or plasma completely cleared of a substance per unit of time.

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16
Q

True or False?The volume of blood from which Inulin is cleared in one minute is known as the Inulin clearance and is equal to the GFR.

A

TRUE !!!

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17
Q

Where is Inulin completely filtered ?

A

At the glomerulus

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18
Q

Which substance can be determined as a highly accurate measure of the GFR?

A

Inulin ( Sinistrin)

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19
Q

What is the Gold standard used to measure the GFR?

A

Inulin( Sinistrin) clearance

20
Q

What are compounds that are used as ENDOGENOUS markers to measure GFR ?

A
  • Creatinine
  • Urea
  • Cystatin C
  • β2-microglobulin
  • Retinol Binding protein
  • Alpha - w microglobulin
21
Q

What is Creatinine Clearance ?

A

Creatinine clearance rate (CrCl) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR.

22
Q

What is the normal value of Creatinine measurement ?

A

9 – 18 mol/24h

23
Q

What is the normal creatinine clearance for Males?

A

85 – 125 mL/min

24
Q

What is the normal creatinine clearance for Females?

A

75 – 115 mL/min

25
What is a commonly used surrogate marker for the estimate of creatinine clearance ?
Cockcroft-Gault (CG) formula
26
Where is Creatinine synthesised?
In the liver , kidneys and pancreas
27
Fill in the blanks. " Creatinine is an end product of _________."
Nitrogen metabolism
28
What are some non- renal causes of increased serum creatinine?
* a high meat intake, * vigorous exercise, * some analytical methods are not specific for creatinine, * some drugs (e.g. salicylates, cimetidine) can reduce tubular secretion of creatinine and cause elevation of serum [creatinine].
29
True or False? An increase in Serum creatinine means there is a Decrease in GFR.
TRUE!!
30
What are the Renal causes of Increased serum creatinine?
* Impaired renal perfusion (e.g. reduce blood pressure, fluid depletion, renal artery stenosis), * Loss of functioning nephrons (e.g. acute and chronic glomerulonephritis), and * Diseases where pressure is increased on the tubular side of the nephron (e.g. urinary tract obstruction due to prostatic enlargement).
31
What is the most reliable simple routine biochemical test ?
Serum creatinine
32
Where is high serum urea observed in?
* Prerenal uraemia due to impaired renal perfusion (e.g. ECF losses, cardiac failure, and hypoproteinaemia). * Renal uraemia (acute or chronic renal failure - reduction in glomerular filtrate). * Outflow obstruction - postrenal uraemia due to renal stones, genitourinary cancer.
33
When is a decreased serum urea seen?
low protein intake (starvation, malabsorption), chronic liver disease, renal dialysis, water retention associated with inappropriate vasopressin secretion or dilution of plasma with intravenous fluids.
34
What kind of cells produce Cystatin C?
All nucleated cells
35
Fill in the blanks. " Cystatin C is reabsorbed and metabolised by __________."
Renal tubular cells and it does NOT appear in urine.
36
What are the causes of Distal Tubular Acidosis?
Sjrogen's syndrome Rheumatoid arthritis SLE Sickle cell anaemia Hyperparathyroidism Hyperthyroidism Chronic active hepatitis Primary Biliary cirrhosis
37
Fill in the blanks. " Thirst is stimulated by _________ and inhibited by ______________."
Stimulated by ADH and inhibited by ANP.
38
What is the primary regulator of water intake?
Thirst
39
What is the regulator of water output?
ADH
40
What is the unit of measurement for Osmorality?
Mosmol/L
41
What is the unit of measurement of Osmolality?
Mosmol/Kg
42
Fill in the blanks." The hypothalamic thirst centre is stimulated by _______."
* Increases in plasma osmolality of 1–2%. * A decline in plasma volume of 10%–15% * JGA: RAAS input
43
Where is ADH formed?
In the supraoptic nucleus & Paraventricular nucleus of the Hypothalamus
44
What are renal excretion of Na+, K+ & Cl - controlled by?
* Renal sympathetics: increase Na+ reabsorption. * Aldosterone: increases Na+ reabsorption, increase K+ secretion/excretion. * ANP: decreases Na+ reabsorption
45

Urogenital System (12 decks)

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