Quigley Lecture

Question 1

If you are dehydrated, what will your specific gravity usu be like?

Answer 1

High. Shows the conc’n of your urine.

Question 2

If you have protein in your urine…what does this indicate?

Answer 2

A lesion in your membrane in your nephrons.

Question 3

If you have protein & blood in your urine…where might the lesion in your nephron be located?

Answer 3

In the endothelial layer

Question 4

If you have protein only & no blood in your urine…where might the lesion in your nephron be located?

Answer 4

In the epithelial layer

Question 5

What does it mean if you see glucose in your urine?

Answer 5

Ahhh I have exceeded my transport maximum…glucose can’t be reabsorbed anymore. I may have Diabetes Mellitus or multiple myeloma.

Question 6

What do ketones in your urine indicate?

Answer 6

Your body is using fat, instead of carbs, for your energy. You see the breakdown of that as ketones.
Either you are malnourished or have Diabetes Mellitus & are prevented from using glucose as your energy source.

Question 7

What does blood in your urine indicate?

Answer 7

Damage to your nephron or to your ureter or something.

Question 8

What does the presence of bilirubin in your urine indicate?

Answer 8

This is formed from the breakdown of the heme of old red blood cells. Could indicate jaundice or liver damage.

Question 9

What could the presence of nitrates or leukocyte esterase indicate?

Answer 9

It could indicate bacteria.

Question 10

What could the presence of crystals in your urine indicate?

Answer 10

Kidney Stones.

Question 11

What are casts? What does it mean if you see a red cell cast in your urine? A white cell cast?

Answer 11

things that are stuck together in your kidney that break loose.
Red Cell Cast: endothelial damage
White Cell Cast: interstitial nephritis

Question 12

What is the most common organism to find in your urine?

Answer 12

E. Coli

Question 13

What is the significance of low urine sodium? What might help this?

Answer 13

Your body is reabsorbing all of your sodium. Trying to raise your BP…. 1L of water could help this by providing the proper blood volume.

Question 14

What is the significance of high urine sodium?

Answer 14

You can’t reabsorb any more sodium. Could indicate tubular damage in the kidney or something.

Question 15

What are the 2 most important things to get from a patient when you’re a nephrologist?

Answer 15

UA

Renal Ultrasound

Question 16

What are the 3 causes of acute renal failure?

Answer 16

Prerenal: decreases renal perfusion 80% cases
Renal: Intrinsic renal disease 10% cases
Postrenal: postrenal obstruction 10% cases

Question 17

How can a person who is overloaded with fluids have a low urine sodium conc’n? What might you do for them?

Answer 17

B/c their kidneys aren’t getting the blood flow. They might have a lot of edema. They probably need diuretics to manage their condition. This is similar to the situation w/ ppl w/ congestive heart failure.

Question 18

What are 5 indications for dialysis?

Answer 18

A: acidosis
E: electrolytes-->hyperkalemia
I: intoxication
O: fluid overload
U: uremic symptoms (happens when buildup of waste products in the blood--super low GFR)