Kidney

Question 1

Kidney funct tests used for

Answer 1

assess function
water balance
acid base balance

Question 2

3 process of kidney
g
t
t

Answer 2

golmerulor filtration
tube reabsorbtion
tube secretion

Question 3

NH3

Answer 3

filtered and secreted
not reabsorbed

Question 4

Glucose

Answer 4

filtered and partically reabsorbed

Question 5

AA

Answer 5

filtered and completly reabsorbed

Question 6

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

Answer 6

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

Question 7

Proximal tube

Answer 7

waste products/valuble products
tubular reabsorb/secretion

Question 8

Loop of henly

Answer 8

hyperosmolality
concurrent flow

Question 9

Distal tubule
filtrate similar to?
balance?

what is secreted in response to increased osmolality?
stims?

makes what?

Answer 9

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

Question 10

Aldosterone
where is it located?
system?

Answer 10

adrenal cortex
RAAS

Na absorb

K/H excretion

Question 11

Collecting duct

Answer 11

final site
AVP/Aldosterone
Cl/urea
highly permeable

Question 12

NPN elimination
synth?
readily filt by?

Answer 12

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

UREA MOST
synth in liver
readily filtered by golm

Question 13

Creatinine
how much becomes waste?

Answer 13

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

Question 14

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

Answer 14

purine metabolism
filt by glom
6-12% excreted

Question 15

Water balance
reg by
dehydration
excess hydration

Answer 15

reg by AVP
dehydration - tubes reabs h20 until osmol 1200

Excess H20- excretion of large diluted urine 50 osmol

Question 16

Sodium

Answer 16

prim extracell cation
controlled by excretion
RAAS mechanism

Question 17

K+

Answer 17

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

Question 18

Cl

Answer 18

extracellular anion
extracell fluid balance
passively reabs

Question 19

Phosphate

Answer 19

higher intra than extra
controlled by PTH

Question 20

Calcium

Answer 20

2nd most dom intracell cation

Question 21

Endocrine functions

what hormones?

Answer 21

primary: produce hormones
2nd: target for hormones

Renin, EPO, 1,25 D, prostaglands

Question 22

1,25(OH)sD
what balance?

Answer 22

active Vit D
phosphate/calcium balance

Question 23

Prostoglands
increase
oppose
a/n

Answer 23

increase renal blood flow
oppose vasoconstriction
angiotensin/norepinephrine

Question 24

Analytic procedures
creatinine clearance

Answer 24

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

Question 25

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

Answer 25

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

Question 26

Cockcroft-Gaut formula

Answer 26

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

Question 27

Mod of diet in renal disease

Answer 27

no weight or body surface area measured

Question 28

CKD-EPI

Answer 28

still uses race, less weight bias

Question 29

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

Answer 29

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

Question 30

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

Answer 30

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

Question 31

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

rhabdomyelosis -

early

Answer 31

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

Rhabdomyelosis - acute renal failure

early diagn/treament required

Question 32

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

what is preformed?
what ratio?

Answer 32

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

24hr urine preformed
ALB/creatinine ratio

Question 33

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

Answer 33

lesions
decreased GFR
rbc casts
B heme strep infections

Question 34

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

Answer 34

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

Question 35

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

Answer 35

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

Question 36

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

Answer 36

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

Question 37

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

upper?

Answer 37

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

Upper: const lesions below collecting duct

Question 38

Renal calculi

whats most common?
reduced?

Answer 38

kidney stones crystal substance

Calcium oxolate most common
reduced urine flow/saturation

Question 39

AKI
sharp decline in….. due to
common?

prerenal aki:
aki:
post renal:

Answer 39

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

Question 40

CKD
grad…
leading cause?
renal…

how many stages?
describe stages
what is being added?

Answer 40

gradual decline >3mos
diabetes leading cause
renal hypertension

5 stgs
A1-opt/mild
A2
A3 severe increase

alburmia being added

Question 41

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

irreversable damage only?

Answer 41

kidney unable to sec waste products
hemodyalsis
CAPD
hemofiltrate

irreversable damage
dialysis/transplantation only