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Chemistry 2.0 > Renal > Flashcards

Renal Flashcards

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1
Q

How is Urea produced in the body?

A

Through the urea cycle which converts ammonia into urea

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2
Q

How is ammonia produced in the body?

A

Through protein metabolism

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3
Q

How is fluids and electrolyte balanced?

A

Through absorption and reabsorption through the kidneys

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4
Q

How is protein metabolism waste removed from the body. and in what form is it in?

A

Ammonia is converted into Urea and is excreted through the kidney into urine.

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5
Q

What does Renin do?

A

Maintains water balance

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6
Q

What does EPO do?

A

Stimulates the maturation & proliferation of RBC

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7
Q

What is 1,25 dihydroxyvitamin D3?

A

Aids in bone metabolism and effects Magnesium, calcium and phosphorus.

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8
Q

What does the presence of ammonia in urine indicate?

A

There’s an issue with the liver and it’s no longer converting ammonia into urea.

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9
Q

What is the purpose of testing urea?

A

Helps evaluate
- renal function
- hydration
- dialysis
- tubules working

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10
Q

what samples can urea be tested for?

A

Urine / plasma

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11
Q

What tubes can’t be used for the collection of plasma urea?

A
  • sodium fluoride
  • sodium citrate
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12
Q

what is the difference between Azotremia and uremia?

A

Azotremia: high urea
Uremia: high urea and renal dysfunction

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13
Q

What are the three stages associated with high urea? and what are their reference ranges?

A

Pre-renal: >80
renal: 50-80
Post-renal: <50

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14
Q

How do you measure the urea/creatinine?

A

Urea over creatinine = ratio
** ensure to convert to the same units **

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15
Q

When should a urea:creatinine ratio be used?

A

When both are elevated

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16
Q

What is the reference range for urea?

A

2.0-7.0 mmol/L

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17
Q

How is uric acid produced?

A

Through the metabolism of purine nucleic acids

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18
Q

What is the clinical purpose of measuring uric acid? and why?

A
  • Monitors/ confirms gout because uric aid deposits in the joints and tissue.
  • calculi diagnosis
  • prevent neuropathy during chemotherapy
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19
Q

What is the reference range for uric acid?

A

210-430 mcmol/L

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20
Q

What samples can uric acid be tested in?

A
  • plasma
  • serum
  • urine
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21
Q

What tubes should not be used for the collection of plasma/ serum uric acid levels?

A
  • EDTA
  • sodium fluoride
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22
Q

What interferences can cause false uric acid results?

A
  • high protein
  • Lipemia
    • Bilirubin (False -)
  • Hemolysis (False -)
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23
Q

What inference is associated with false urea results?

A
  • Bacterial decomposition
24
Q

What is the pathophysiology of a patient in pre-renal disease?

A

Reduced renal blood flow

25
Q

What is the pathophysiology of a patient in renal disease?

A

Acute and chronic renal failure

26
Q

What is the pathophysiology of a patient in post-renal disease?

A

Obstruction of urine flow

27
Q

How is creatinine produced?

A

synthesis of creatine in muscles.

28
Q

Why is creatinine better than measuring urea?

A

Because creatinine is excreted into plasma at a constant rate and is related to muscle mass (relatively consistent)

29
Q

What clinical purpose does measuring creatinine serve?

A
  • asses renal filtration function because inversely related to GFR
30
Q

In what samples can creatinine be measured?

A
  • Plasma
  • Urine
31
Q

What is the purpose of measuring clearance creatinine?

A

Measures amount of creatinine eliminated from the body by the kidneys per unit of time

32
Q

What is the difference between an eGFR and creatinine.

A

eGFR measures the glomerular filtration rate, creatinine must be measured to do an eGFR.

33
Q

What kind of interference affects creatinine?

A
  • icteric
  • hemolysis
  • Ascorbates
  • Bili
  • drugs
34
Q

What is kinetic measuring?

A

Multiple measurements

35
Q

What is the reference3 range for creatinine?

A

50-100 mcmol/L

36
Q

What is the equation for measuring creatinine clearance?

A

Urine creatinine over plasma creatinine multiplied by the volume over time in minutes.

37
Q

How do collect an ammonia level?

A

EDTA / Heparin - place on ice immediately

38
Q

Which tube is best for ammonia testing and why?

A

PST - because the gel separator gets it off the cells quickly.

39
Q

How is an ammonia specimen prepared for testing?

A
  • centrifuged cold at 4DC within 20 mins
  • or froze if not immediately testing.
40
Q

What interferences must be avoided when testing/collecting ammonia levels?

A
  • hemolysis
  • smoking
  • cleaners
41
Q

Why does hemolysis effect ammonia levels?

A

RBC contains 2-3x more ammonia then plasma

42
Q

Why serum sample not a good sample to test ammonia?

A

bc ammonia is unstable in serum samples

43
Q

What is the clinical significance of testing ammonia?

A
  • hepatic failure
  • Reyes syndrome (children)
  • deficiency of urea cycle enzyme
44
Q

What is the reference range of ammonia?

A

11-35 mcmol/L

45
Q

Which diseases are related to increased protein loss?

A
  • Acute Glomerulonephritis
  • nephrotic syndrome
  • infections
  • obstructions
46
Q

Which renal disease is #1 for the loss of protein?

A

Nephrotic syndrome

47
Q

Which renal disease is #2 for the loss of protein?

A

Acute Glomerulonephrititis

48
Q

What significant findings are associated with acute glomerulonephritis

A
  • Hematuria
  • proteinuria >3g/day
  • low GFR
  • RBC casts
  • Recently sick with Grp A beta- hemolytic strep
49
Q

What significant findings are associated with nephrotic syndrome?

A
  • proteinuria >3.5g/day
  • hyperlipidemia
  • oval fat bodies
50
Q

What significant findings are associated with infections?

A
  • Presence of bacteria
  • hematuria
  • pyuria
  • WBC casts
51
Q

What are two kinds of kidney infections?

A
  • Kidney pyelonephritis
  • Bladder cystitis
52
Q

What are common obstructions of the kidneys?

A
  • tumors
  • calculi
  • Calcium oxalate
53
Q

What is the purpose of using dialysis?

A

Filter out the bodies waste which is likely decreased in renal disease.

54
Q

What are two ways dialysis can be done?

A
  • hemodialysis
  • peritoneal dialysis
55
Q

Which crystal do you commonly see in alkaline urines?

A

Amorph phosphates
Calcium carbonate
triple phosphates
ammonium biurate

56
Q

Which crystal do you commonly see in acidic urines?

A

calcium oxalate
amorphous urates
uric acids
cholesterol
cystine

57
Q

which crystals are pathological?

A
  • Leucine
  • Tyrosine
  • Cystine
  • sulfonamides
  • cholesterol

Chemistry 2.0 (5 decks)

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