RENAL FUNCTION

Question 1

Basic structural & functional unit of the kidney

Answer 1

Nephron

Question 2

there are approximately __ to ____ nephrons per kidney

Answer 2

1 to 1.5 million nephrons per kidney

Question 3

2 types of nephrons

Answer 3

Cortical nephrons
Juxtamedullary nephrons

Question 4

Order of urine formation

Answer 4

1. Glomerulus
2. Proximal convoluted tubule (PCT)
3. Loop of Henle (LH)
4. Distal convoluted tubule (DCT)
5. ## Collecting ducts (CD)
6. Calyx
7. Renal pelvis –> Ureter –> Bladder –> Urethra

Question 5

The kidneys receive ___% of the total cardiac output

Answer 5

25% of the total cardiac output

Question 6

Total Renal Blood Flow:

Answer 6

1,200 mL/minute

Question 7

Total Renal Plasma Flow:

Answer 7

600 - 700 mL/minute

Question 8

Renal Blood Flow order:

Answer 8

1. Renal artery (blood in)
2. Afferent arteriole
3. Glomerulus (sieve)
4. Efferent arteriole
5. peritubular capilliaries
6. vasa recta
7. Renal vein (blood out)

Question 9

The working portion of the kidney; resembles a sieve; coil of approximately 8 capillary lobes located within the Bowman’s capsule:

Answer 9

Glomerulus

Question 10

The glomerulus is a non-selective filter of plasma substances with MW of __________

Answer 10

<70,000 Da

Question 11

it repels negatively charged substances even if they are small enough to pass

Answer 11

Shield of negativity

Question 12

First function to be affected in renal disease

Answer 12

Tubular reabsorption

Question 13

Renal threshold for glucose:

Answer 13

160-180 mg/dL

Question 14

substances that are reabsorbed in the PCT via active transport

Answer 14

Glucose
Amino acids
Salts

Question 15

substance/s that are/is reabsorbed in the PCT and DCT via active transport

Answer 15

Sodium

Question 16

substance/s that are/is reabsorbed in the Ascending LH via active transport

Answer 16

Chloride

Question 17

substance/s that are/is reabsorbed in the PCT, descending LH, CD via passive transport

Answer 17

Water

Question 18

substance/s that are/is reabsorbed in the PCT, ascending LH via passive transport

Answer 18

Urea

Question 19

substance/s that are/is reabsorbed in the Ascending LH via passive transport

Answer 19

Sodium

Question 20

3 glomerular filtration barrier:

Answer 20

1. capillary endothelium
2. trilayer basement membrane
3. filtration diaphragm

Question 21

glomerular filtration barrier that has large open pores:

Answer 21

Capillary endothelium

Question 22

glomerular filtration barrier that consist of the lamina rara interna, lamina densa, and lamina raraexterna

Answer 22

Trilayer basement membrane

Question 23

glomerular filtration barrier that is found between the podocytes of the bowman’s capsule

Answer 23

filtration diaphragm

Question 24

the RAAS system is activated when there is ____ blood pressure

Answer 24

low blood pressure

Question 25

the RAAS system ______ the blood pressure

Answer 25

increases the blood pressure

Question 26

In cases of Diabetes Insipidus, ADH is:

Answer 26

Deficient

Question 27

In cases of Syndrome of inappropriate ADH secretion (SIADH), ADH is:

Answer 27

Excess/Increased

Question 28

Body hydration increased ADH decreased Urine volume = ?

Answer 28

Increased

Question 29

Body hydration decreased ADH increased Urine volume =?

Answer 29

Decreased

Question 30

Aldosterone regulates ____ reabsorption in the DCT

Answer 30

Sodium (Na) reabsorption

Question 31

Major functions of tubular secretion:

Answer 31

1. Regulation of the acid-base balance in the body through secretion of hydrogen ions 2. Elimination of waste products not filtered by the glomerulus

Question 32

Major site for removal of non-filtered substances

Answer 32

PCT

Question 33

Failure to produce acid urine due to the inability to secrete hydrogen ions

Answer 33

Renal Tubular Acidosis

Question 34

In RTA, urine pH is _______

Answer 34

alkaline

Question 35

to maintain the normal blood pH, what ion is secreted into the urine?

Answer 35

Hydrogen ion (H+)

Question 36

In renal tubular acidosis, the blood pH is:

Answer 36

Acidic

Question 37

used to evaluate glomerular filtration; measures the rate at which the kidneys are able to remove a filterable substance from the blood

Answer 37

Clearance test

Question 38

most common clearance test:

Answer 38

Creatinine clearance test

Question 39

Gold standard/reference method clearance test

Answer 39

Inulin

Question 40

Creatinine clearance formula:

Answer 40

Ccr (mL/min) = UV/P x 1.73m^2/A

Question 41

In the creatinine clearance formula, the 'U' represents:

Answer 41

U = urine creatinine (mg/dL)

Question 42

In the creatinine clearance formula, the 'A' represents:

Answer 42

A = Body surface area

Question 43

In the creatinine clearance formula, the 'P' represents:

Answer 43

Plasma creatinine

Question 44

Reference range or creatinine clearance test: Male: Female:

Answer 44

Male: 107 - 139 mL/min Female: 87 - 107 mL/min

Question 45

What are the variables included in the Estimated GFR formula developed by COCKGROFT & GAULT

Answer 45

Variables: 1. Age 2. Sex 3. Body weight in kg

Question 46

What are the variables included in the Modification of Diet in Renal Disease (MDRD) system formula?

Answer 46

Variables: 1. Ethnicity 2. BUN 3. Serum albumin

Question 47

Used to evaluate tubular reabsorption:

Answer 47

Concentration test

Question 48

concentration test where the patient is deprived of fluid for up to 24 hours

Answer 48

Fishberg test (obsolete)

Question 49

concentration test where the patient maintains a normal diet and fluid intake, and compares day & night urine in terms of volume & Specific gravity

Answer 49

Mosenthal test (obsolete)

Question 50

Influenced by the number & density of particles in a solution

Answer 50

Specific gravity

Question 51

Influenced by the number of particles in a solution; more accurate and preferred than S.G. determination

Answer 51

Osmolality

Question 52

Most commonly used test and the reference method for tubular secretion & renal blood flow:

Answer 52

p-aminohippuric acid (PAH) test

Question 53

test for tubular secretion & renal blood flow; obsolete test; results are hard to interpret

Answer 53

Phenolsulfonphthalein (PSP) test