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Year 2 Renal > Introduction to renal testing > Flashcards

Introduction to renal testing Flashcards

1
Q

what are the essential functions of the nephron?

A
  • maintain constant extracellular environment
  • secrete enzymes and hormones
  • catabolize peptide hormones
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2
Q

what does BUN measure? what is it related to?

A
  • amount of nitrogen in the blood in the form of urea

- related to the metabolic function of liver and excretory function of kidney

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3
Q

what organ is responsible for excretion of urea?

A

liver

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4
Q

is azotemia related to an decreased or increased BUN? what are causes of azotemia?

A
  • high BUN
  • dehydration
  • hypovolemia
  • shock
  • CHF
  • MI
  • GI bleed
  • protein supplementation
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5
Q

what are causes of a decreased BUN?

A
  • liver failure
  • overhydration
  • negative nitrogen balance (malnutrition / malabsorption)
  • pregnancy
  • nephrotic syndrome
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6
Q

can GFR be measured directly? what are the filtration markers?

A
  • cannot be measured directly
  • creatinine
  • cystatin C
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7
Q

creatinine is a catabolic product of __________

A

creatinine phosphate

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8
Q

what causes increased creatinine levels?

A

diseases affecting renal function

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9
Q

what causes decreased creatinine?

A

decreased muscle mass

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10
Q

what is a normal (postrenal) BUN : creatinine level? prerenal? renal?

A
  • postrenal (normal): 10-20 : 1
  • prerenal: over 20 : 1
  • renal: under 10 : 1
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11
Q

creatinine clearance is proportional to _________

A

GFR

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12
Q

what is the normal pH of urine?

A
  • normal: 4.5 - 8.0

- usually: 5.0 - 6.5

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13
Q

does dehydration cause a high or low specific gravity?

A

high

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14
Q

if you get a false positive for blood in the urine, what is the follow up test?

A

microscopy

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15
Q

urine microalbumin is ordered for patients with what conditions?

A

DM, HTN

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16
Q

if you have 3 abnormal urine dipstick tests, what is performed next?

A

24 hr urine collection

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17
Q

what is the cause of glomerular proteinuria?

A

increased filtration of macromolecules across glomerular capillary wall (usually albumin)

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18
Q

what is the cause of tubular proteinuria?

A

malfunctioning tubule cells no longer metabolize or resorb normally filtered proteins (poor function)

19
Q

what is the cause of overflow proteinuria?

A

protein overwhelms the ability of the tubules to resorb filtered proteins

20
Q

most cases of high proteinuria are due to which type?

A

glomerular

21
Q

definition: pyuria

A

over 4 WBC/HPF in a clean voided specimen

22
Q

definition: hematuria

A

over 3 RBC/HPF on 2/3 urine samples

23
Q
  • hematurie
  • proteinuria
  • RBC casts
  • dysmorphic RBCs

what is the source of the blood?

A

glomerular hematuria

24
Q
  • hematuria
  • proteinuria

what is the source of the blood?

A

renal (tubular, interstitial, vascular)

25
Q

what is the source of the blood in a patient with only hematuria (no proteinuria, etc)?

A

urologic hematuria - tumors, calculi, infection

26
Q

what type of epithelial cells in the urine are the only type of importance?

A

tubular

27
Q

definition: casts

A

clumps of material or cells that form in the renal distal and collecting tubules

28
Q

RBC casts - diagnosis?

A

glomerulonephritis

29
Q

WBC casts - ddx?

A
  • pyelonephritis
  • glomerulonephritis
  • interstitial nephritis
  • tubular epithelial acute tubular necrosis
  • interstitial nephritis
  • eclampsia
  • glomerulonephritis
30
Q

fatty casts - ddx?

A
  • nephrotic syndrome

- hypothyroidism

31
Q

waxy / broad casts - ddx?

A

advanced renal failure

32
Q

cystine crystals are seen in what disease? what is the inheritance pattern?

A

cystinuria - autosomal recessive

33
Q

what is the most common type of stone?

A

calcium oxalate

34
Q

what type of stone is seen in ehtylene glycol poisoning?

A

calcium oxalate

35
Q

calcium oxalate crystals are seen in what conditions?

A
  • ethylene glycol poisoning

- acute renal failure

36
Q

struvite stone are seen in infection from what organism?

A

proteus

37
Q

proteus infection causes what type of stone?

A

struvite

38
Q

what is the most common intrinsic cause of acute renal failure in the hospitalized patient?

A

ATN

39
Q

what is the standard test for diagnosis of UTI?

A

quantitative urine culture

40
Q

what type of casts are seen in nephritic syndrome?

A

RBC

41
Q
  • high CK
  • high Mb
  • UA blood
  • neg RBCs

diagnosis?

A

rhabdomyolysis

42
Q

UA+ for eosinophils - diagnosis?

A

(allergic) interstitial nephritis

43
Q

what are the major indications for renal biopsy (4)?

A
  • isolated glomerular hematuria with proteinuria
  • nephrotic syndrome
  • acute nephritic syndrome
  • unexplained acute or rapidly progressive renal failure

Year 2 Renal (38 decks)

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