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Renal > Kidney Biochem > Flashcards

Kidney Biochem Flashcards

1
Q

Different part of a nephron

A 
Glomerulus 
Proximal tubule 
Descending limb 
Loop of henle 
Ascending limb 
Distal tube 
Collecting duct
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2
Q

Excretory function of kidney

A

Remove waste product from bloodstream

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3
Q

Type of waste eliminated by kidney

A 
Urea 
Uric acid
Creatinine
Urobilina
Acids, drugs
Excess Na, K, Cl, Ca, HPO4, Mg, S, HCO3
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4
Q

Homeostatic role of kidney

A 
Blood pressure , blood volume regulation
Water balance 
Blood ph maintenance 
Electrolytes balance
Regulation of red blood cells
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5
Q

Reabsorptive function of kidney

A

Reabsorption of glucose , aa, electrolytes, proteins

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6
Q

Metabolic function of kidney

A

Synthesis of gluthatione, glycogen, ammonia

Breaking of hormones and cytokines

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7
Q

Endocrine functin of kidney

A

Synthesis of erythropoitein
Vitamin D activation
Renin release

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8
Q

Urinary ph norm

A

4.5-5

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9
Q

3 general causes to acute renal failure

A

Prerenal causes
Renal causes
Post renal causes

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10
Q

Renal causes to acute renal failure

A

Vascular disorders
Glomerulonephritis
Interstitial nephritis
Tubular necrosis

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11
Q

Tubular necrosis causes

A

Ischemia
Toxins
Pigments

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12
Q

Main cause of acute renal failure

A

Prerenal causes , renal perfusion disorders - 55%

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13
Q

2nd main cause of acute renal failure

A

Disease of renal parenchyma - 40 %

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14
Q

Is ARF reversible

A

Yes most of the time

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15
Q

What is prerenal azotemia

A

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

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16
Q

Majors causes of prerenal ARF

A

Hypovolemia

Low CO
Increased renal systemic vascular resistance ratio

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17
Q

Diseases of renal azotemia causing ARF

A

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

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18
Q

Postrenal azotemia causes

A

Ureteric (calculi ,blood clots ,cancer )

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

urethra stricture

19
Q

What is the mechanism of post Renal disease leading to ARF

A

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

20
Q

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

A

Glomerulonephritis
diabetes mellitus
hypertension
tubulo interstitial nephritis

21
Q

What is GFR

A

sensitive index of overall renal excretory function

22
Q

What is the consequence of decreased GF our

A

Retention and accumulation of the excreted substances in the body fluids

23
Q

What does uremia indicates

A

Profound loss of renal function

24
Q

What impact the severity of the signs and symptoms of uremia

A

The magnitude of reduction in functioning renal mass

the rapidity with which renal function is lost

25
Q

Urea clinical abnormalities

A

Anorexia
malaise
Vomiting
headache

26
Q

Consequences of excessive salt ingestion

A

Congestive heart failure
hypertension
Ascites
edema

27
Q

Excessive water ingestion can lead to

A

Hyponatremia

Weight gain

28
Q

How is potassium level in chronic renal failure

A

Stable until final stages of uremia

29
Q

Why could there be metabolic acidosis in chronic renal failure

A

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

30
Q

Why is there hypocalcemia in chronic renal failure

A

Due to impaired ability of kidney to synthesize active vitamin D

31
Q

What can cause hyperphosphatemia in chronic renal failure

A

Due to decreased GFR

32
Q

Why is there renal and metabolic osteodystrophy

A

Increased PTH
Disordered vitamin D metabolism
Chronic metabolic acidosis

33
Q

HDL level and tryglycerides and cholesterol level in uremia

A

Hypertriglyceridemia
Decreased HDL
Normal cholesterol

34
Q

Level of lipoprotien lipase in uremia

A

Decreased which explains high triglycerides

35
Q

Signs and symptoms of renal failure

A 
Uremia symptoms ( nausea, vomiting, lethargy)
Micturation disorders
Urine volume disoderds
Urine composition alteration
Pain
Edema
36
Q

When to do renal function

A 
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
37
Q

Renal function tests

A 
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 )
38
Q

First step in kidney function test

A

Simple inexpensive screenig test of random urine sample

39
Q

`anuria

A

Less tha 100ml/24h

40
Q

Causes of anuria

A

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

41
Q

Oliguria

A

Less than 400 ml/day

42
Q

Causes of oliguria

A 
Dehydration
Vomit
Diarrhea
Sweating 
Ascites
Hypoperfusion
Edema
AKI
Terminal CKD
Glomerulonephritis
43
Q

Polyuria

A

More than 3000 ml / day

44
Q

Causes of polyuria

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

Renal (16 decks)

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