Renal and Liver Function Tests

Question 1

measures the amount of nitrogen contained in the urea. It is the end
product of protein metabolism

Answer 1

BUN test

Question 2

Produced entirely by the liver and eliminated by the kidneys

Answer 2

BUN

Question 3

T/F: BUN test may be a marker of renal function.

Answer 3

True

Question 4

High level BUN may indicate:
- _________ renal function
- _________ bleeding
- increased _______

Answer 4

• decreased
• upper GIT
• protein intake

Question 5

Low level BUN may indicate:
- increased _________ status
- end-stage _________ disease

Answer 5

• hydration
• liver

Question 6

With normal kidney function, the amount of __________ in the blood remains relatively constant and normal

Answer 6

creatinine

Question 7

It is a function of muscle mass,

Answer 7

Creatinine clearance

Question 8

It is filtered in glomerulus, but not re-absorbed or secreted

Answer 8

Creatinine clearance

Question 9

is an adequate reflection of glomerular filtration rate (GFR)

Answer 9

creatinine clearance

Question 10

most commonly used formula to
approximate renal function

Answer 10

Cockcroft and Gault formula

Question 11

Another means of approximating renal function is the

Answer 11

24-hour urine collection

Question 12

Comprised of seven most commonly ordered labs

Answer 12

Basic Metabolic Panel

Question 13

requires a blood sample to measure the amount of urea in the blood stream and two urine specimens, collected one hour apart, to determine the amount of urea that is filtered, or cleared, by the kidneys into the urine.

Answer 13

Urea clearance test:

Question 14

a measurement of the number of dissolved particles in urine. The test may be done on a urine sample collected first thing in the morning, on multiple time samples, or on a cumulative sample collected over a 24-hour period.

Answer 14

Urine osmolality test

Question 15

Found abundantly in heart and liver tissues

Answer 15

Aspartate Aminotransferase (AST)

Question 16

Used in clinical practice to:
- evaluate myocardial injury
- diagnoses and assess hepatocellular injury

Answer 16

Aspartate Aminotransferase (AST)

Question 17

Significant elevations of AST may be due to

Answer 17

viral hepatitis and acute exposure to hepatotoxins

Question 18

Moderate increase of AST may be due to

Answer 18

intrahepatic cholestasis or post-hepatic jaundice

Question 19

T/F: ALT is also found abundantly in heart and liver tissues like AST

Answer 19

True

Question 20

T/F: ALT is more abundant in liver than AST because it is more liver-specific enzyme

Answer 20

True

Question 21

AST>ALT in

Answer 21

cirrhosis

Question 22

AST»>ALT

Answer 22

myocardial injury

Question 23

increased due to intra-hepatic or post-hepatic biliary obstructio

Answer 23

Liver-derived Alkaline Phosphatase

Question 24

• increased due to Paget’s disease
• increased due to cancer bone metastasis

Answer 24

Bone-derived Alkaline Phosphatase is produced by osteoblast

Question 25

80% of serum colloid oncotic pressure

Answer 25

Albumin

Question 26

Hypoalbuminemia may occur due to

Answer 26

malnutrition,
hepatic insufficiency, or nephrosis

Question 27

Low albumin may lead to

Answer 27

edema or transudation of ECF

Question 28

Bilirubin clinical significance

Answer 28

Elevates (indirect): liver damage, hemolytic anemia
Elevated (direct): biliary obstruction

Question 29

Sum of conjugated and unconjugated forms

Answer 29

Total Bilirubin

Question 30

Originates as a breakdown product of hemoglobin degradation

Answer 30

Total Bilirubin

Question 31

Enters the blood from the RES primarily attached to serum albumin

Answer 31

Indirect Bilirubin

Question 32

Small fraction of bilirubin circulates thru the bloodstream in an unbound or free form

Answer 32

Indirect Bilirubin

Question 33

This free bilirubin is not water soluble

Answer 33

Indirect Bilirubin

Question 34

Upon arrival at the sinusoidal surface of the liver cells, the free bilirubin is rapidly taken up into the cell

Answer 34

Indirect Bilirubin

Question 35

Once it enters the liver, the free bilirubin undergoes conjugation thru a
process known as glucoronidation

Answer 35

Direct Bilirubin

Question 36

excretable

Answer 36

Direct Bilirubin

Question 37

Is excreted in bile

Answer 37

Direct Bilirubin

Question 38

May be excreted in urine if serum [DB] > 0.2 – 0.4 mg/dL

Answer 38

Direct Bilirubin

Question 39

Hyperbilirubinemia may be due to the increases in indirect bilirubin such as

Answer 39

hemolysis
- hepatocellular damage, due to an inability to conjugate

Question 40

Hyperbilirubinemia may be due to the increases in direct bilirubin such as

Answer 40

post-hepatic cholestasis