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Clinical Chem II spring > Kidney > Flashcards

Kidney Flashcards

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1
Q

Kidney funct tests used for

A

assess function
water balance
acid base balance

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2
Q

3 process of kidney
g
t
t

A

golmerulor filtration
tube reabsorbtion
tube secretion

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3
Q

NH3

A

filtered and secreted
not reabsorbed

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4
Q

Glucose

A

filtered and partically reabsorbed

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5
Q

AA

A

filtered and completly reabsorbed

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6
Q

Golmerular filtration
first part of?
filters?
based on?
blood filtered per min is?

A

first part of nephron
filters incoming blood
based on BP/membrane
blood filtered per min = GFR

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7
Q

Proximal tube

A

waste products/valuble products
tubular reabsorb/secretion

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8
Q

Loop of henly

A

hyperosmolality
concurrent flow

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9
Q

Distal tubule
filtrate similar to?
balance?

what is secreted in response to increased osmolality?
stims?

makes what?

A

filtrate similar to final compound
electrolyte/acid base balance

AVP sec by posterior pituitary in response to inc osmolality
stims H20 reabs

makes distal tubes permeable to water

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10
Q

Aldosterone
where is it located?
system?

A

adrenal cortex
RAAS

Na absorb

K/H excretion

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11
Q

Collecting duct

A

final site
AVP/Aldosterone
Cl/urea
highly permeable

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12
Q

NPN elimination
synth?
readily filt by?

A

waste products from body
3 princ compounds
urea/creatininine/uric acid

UREA MOST
synth in liver
readily filtered by golm

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13
Q

Creatinine
how much becomes waste?

A

creatin phosphate muscle fuel
20% muscle creatinine becomes waste
levels tied to muscle mass
not reabsorbed

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14
Q

Uric acid
what kind of metabolism
filtered by?
how much is excreted?

A

purine metabolism
filt by glom
6-12% excreted

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15
Q

Water balance
reg by
dehydration
excess hydration

A

reg by AVP
dehydration - tubes reabs h20 until osmol 1200

Excess H20- excretion of large diluted urine 50 osmol

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16
Q

Sodium

A

prim extracell cation
controlled by excretion
RAAS mechanism

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17
Q

K+

A

major intracell cation
H ions in exchange for Na
filtered and reabsorbed

18
Q

Cl

A

extracellular anion
extracell fluid balance
passively reabs

19
Q

Phosphate

A

higher intra than extra
controlled by PTH

20
Q

Calcium

A

2nd most dom intracell cation

21
Q

Endocrine functions

what hormones?

A

primary: produce hormones
2nd: target for hormones

Renin, EPO, 1,25 D, prostaglands

22
Q

1,25(OH)sD
what balance?

A

active Vit D
phosphate/calcium balance

23
Q

Prostoglands
increase
oppose
a/n

A

increase renal blood flow
oppose vasoconstriction
angiotensin/norepinephrine

24
Q

Analytic procedures
creatinine clearance

A

creatininine clearance
ideal substance to measure
constant rate
cleared only by glom filt
correlate w muscle mass

25
Q

Estimated GFR
reported with….
based on…
what is not required?
should pick up?

A

reported w serum creatinine level
based on serum creatinine, age, body, size gender
no 24hr test required
should pick up CKD impairment

26
Q

Cockcroft-Gaut formula

A

was 1st
didnt correct for body surface area and women having low creatininie

27
Q

Mod of diet in renal disease

A

no weight or body surface area measured

28
Q

CKD-EPI

A

still uses race, less weight bias

29
Q

Cystatin C
what kind of protein
rises faster than… in AKI?
uneffected by?
rise seen before….
bio?
better for?

A

LWM protein
levels rise faster than creatinine in AKI
uneffected by diet/age
rise seen before GFR/creatinine
bio variation
better for minor imparement

30
Q

B2 macroglobulin
what is shed at constant rate?
filt?
increased levels =
assesses?

A

plasma membrane shed at constant rate
filt by glom
incease levels increase cell turn over
asses renal tube function

31
Q

Myoglobulin
what kind of protein
acute…
binds/trans…..

rhabdomyelosis -

early

A

LWM protein
acute skeletal/caridac injury
bind/trans oxy from plasma to mitochondria

Rhabdomyelosis - acute renal failure

early diagn/treament required

32
Q

Albuninuria
important for?
if found early?
decrease to prevent?

what is preformed?
what ratio?

A

microalbumin
important for pt w diabetes
if found early - rapid glucose control
decrease hypertension to prevent kidney fail

24hr urine preformed
ALB/creatinine ratio

33
Q

Acute glomerulonephritis
what is present
decreased
casts?
what kind of infections?

A

lesions
decreased GFR
rbc casts
B heme strep infections

34
Q

Chronic glomerulo
what kind of damage?
s
loss of?
minor decrease in?

A

length inflammation
scarring
loss of nephron function
minor dec in renal function

35
Q

Nephrotic syndrome
caused by?
increased perm?
massive?
e
hyper

A

injury
increase permeablility of golm basement membrane
massive proteinuria/hypoalb
edema
hyperlipidemia

36
Q

Tubular diseases
occurs in progress….
RTA clinically important….
affects
what cant keep up pH
what decrease bicarb reabsorption?

A

occur in progress of all renal disease as GFR fails
RTA clinically important affects acid base balance

Distal tubes cant keep up pH
proximal tubes decrease bicarb reabs

37
Q

UTI
called what in the kidney?
what is diagnostic
whats it called in bladder/urinary?
what increases pressure?

upper?

A

pyeloneph in kidney
wbc casts diagnostic
cystitis - bladder/urinary
obstruction increases pressure

Upper: const lesions below collecting duct

38
Q

Renal calculi

whats most common?
reduced?

A

kidney stones crystal substance

Calcium oxolate most common
reduced urine flow/saturation

39
Q

AKI
sharp decline in….. due to
common?

prerenal aki:
aki:
post renal:

A

sharp decline in renal function due to acute toxic/hypoxic
common and serious

Prerenal AKI: cardiovasc sysmtem failure/hypovolermia
AKI: tube necrosis, vascular obstruction
Post renal: lower fraction

40
Q

CKD
grad…
leading cause?
renal…

how many stages?
describe stages
what is being added?

A

gradual decline >3mos
diabetes leading cause
renal hypertension

5 stgs
A1-opt/mild
A2
A3 severe increase

alburmia being added

41
Q

Therapy for AKI
kidney unable to..
methods?
h
c
h

irreversable damage only?

A

kidney unable to sec waste products
hemodyalsis
CAPD
hemofiltrate

irreversable damage
dialysis/transplantation only

Clinical Chem II spring (16 decks)

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