Kidney Biochem

Question 1

Different part of a nephron

Answer 1

Glomerulus 
Proximal tubule 
Descending limb 
Loop of henle 
Ascending limb 
Distal tube 
Collecting duct

Question 2

Excretory function of kidney

Answer 2

Remove waste product from bloodstream

Question 3

Type of waste eliminated by kidney

Answer 3

Urea 
Uric acid
Creatinine
Urobilina
Acids, drugs
Excess Na, K, Cl, Ca, HPO4, Mg, S, HCO3

Question 4

Homeostatic role of kidney

Answer 4

Blood pressure , blood volume regulation
Water balance 
Blood ph maintenance 
Electrolytes balance
Regulation of red blood cells

Question 5

Reabsorptive function of kidney

Answer 5

Reabsorption of glucose , aa, electrolytes, proteins

Question 6

Metabolic function of kidney

Answer 6

Synthesis of gluthatione, glycogen, ammonia

Breaking of hormones and cytokines

Question 7

Endocrine functin of kidney

Answer 7

Synthesis of erythropoitein
Vitamin D activation
Renin release

Question 8

Urinary ph norm

Answer 8

4.5-5

Question 9

3 general causes to acute renal failure

Answer 9

Prerenal causes
Renal causes
Post renal causes

Question 10

Renal causes to acute renal failure

Answer 10

Vascular disorders
Glomerulonephritis
Interstitial nephritis
Tubular necrosis

Question 11

Tubular necrosis causes

Answer 11

Ischemia
Toxins
Pigments

Question 12

Main cause of acute renal failure

Answer 12

Prerenal causes , renal perfusion disorders - 55%

Question 13

2nd main cause of acute renal failure

Answer 13

Disease of renal parenchyma - 40 %

Question 14

Is ARF reversible

Answer 14

Yes most of the time

Question 15

What is prerenal azotemia

Answer 15

Renal hypoperfusion which is rapidly reversible but can lead to ischemic renal renal parenchyma injury and intrinsic renal azotemia if prolonged

Question 16

Majors causes of prerenal ARF

Answer 16

Hypovolemia

Low CO
Increased renal systemic vascular resistance ratio

Question 17

Diseases of renal azotemia causing ARF

Answer 17

Renovascular obstruction
Disease of glomeruli
Acute tubular necrosis ( ischemia, toxins)
Interstitial nephritis ( allergy, infection, infiltration , idiopathic)

Question 18

Postrenal azotemia causes

Answer 18

Ureteric (calculi ,blood clots ,cancer )

bladder neck (neurogenic bladder ,prostatic hyperplasia , calculi , blood clot, cancer )

urethra stricture

Question 19

What is the mechanism of post Renal disease leading to ARF

Answer 19

Glomerular filtration continues in early stage of obstruction
increased intraluminal pressure upstream to the obstruction
gradual distention of proximal ureter ,renal pelvis and calyces
fall in GFR

Question 20

What are some Renal injury that can lead to chronic renal failure

Answer 20

Glomerulonephritis
diabetes mellitus
hypertension
tubulo interstitial nephritis

Question 21

What is GFR

Answer 21

sensitive index of overall renal excretory function

Question 22

What is the consequence of decreased GF our

Answer 22

Retention and accumulation of the excreted substances in the body fluids

Question 23

What does uremia indicates

Answer 23

Profound loss of renal function

Question 24

What impact the severity of the signs and symptoms of uremia

Answer 24

The magnitude of reduction in functioning renal mass

the rapidity with which renal function is lost

Question 25

Urea clinical abnormalities

Answer 25

Anorexia malaise Vomiting headache

Question 26

Consequences of excessive salt ingestion

Answer 26

Congestive heart failure hypertension Ascites edema

Question 27

Excessive water ingestion can lead to

Answer 27

Hyponatremia | Weight gain

Question 28

How is potassium level in chronic renal failure

Answer 28

Stable until final stages of uremia

Question 29

Why could there be metabolic acidosis in chronic renal failure

Answer 29

Because of reduction in Reno mess limiting amount of ammonia and bicarbonate that can be generated

Question 30

Why is there hypocalcemia in chronic renal failure

Answer 30

Due to impaired ability of kidney to synthesize active vitamin D

Question 31

What can cause hyperphosphatemia in chronic renal failure

Answer 31

Due to decreased GFR

Question 32

Why is there renal and metabolic osteodystrophy

Answer 32

Increased PTH Disordered vitamin D metabolism Chronic metabolic acidosis

Question 33

HDL level and tryglycerides and cholesterol level in uremia

Answer 33

Hypertriglyceridemia Decreased HDL Normal cholesterol

Question 34

Level of lipoprotien lipase in uremia

Answer 34

Decreased which explains high triglycerides

Question 35

Signs and symptoms of renal failure

Answer 35

``` Uremia symptoms ( nausea, vomiting, lethargy) Micturation disorders Urine volume disoderds Urine composition alteration Pain Edema ```

Question 36

When to do renal function

Answer 36

``` Older age Family history of CDK Decreased renal mass Low birth weight diabetes mellitus Hypertension Autoimmune disease Systemic infections UTI Nephrolithiasis Obstruction to lower urinary tract Drug toxicity ```

Question 37

Renal function tests

Answer 37

``` GFR measurements ( clearance test, plasma creatinine, urea, uric acid, B2 microglobulin) Renal tubular function test ( osmolality measurements, proteinuria, glycosuria, aminoaciduria ) Urinalysis ( appearance, gravity, osmolality, pH, glucose, protein, urinary sediments ) ```

Question 38

First step in kidney function test

Answer 38

Simple inexpensive screenig test of random urine sample

Question 39

`anuria

Answer 39

Less tha 100ml/24h

Question 40

Causes of anuria

Answer 40

Urinary tract obstruction (Prostatic hyperplasia ,Tumors ) Heart failure , severe hypotension ( renal ischemia ) Glomerular nephritis (acute, subacute, chronic ) Hemolitic rxn with blood transfusion

Question 41

Oliguria

Answer 41

Less than 400 ml/day

Question 42

Causes of oliguria

Answer 42

``` Dehydration Vomit Diarrhea Sweating Ascites Hypoperfusion Edema AKI Terminal CKD Glomerulonephritis ```

Question 43

Polyuria

Answer 43

More than 3000 ml / day

Question 44

Causes of polyuria

Answer 44

``` Polydipsia Extreme protein intake Caffein Alcohol Diuretic DM, DI Deficit ADH ```