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CLINICAL MICROSCOPY > RENAL FUNCTION > Flashcards

RENAL FUNCTION Flashcards

1
Q

this weighs approximately 150g and measures 12.5cm x 6cm x2.5 cm (length, width, depth)

A

kidney

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2
Q

ureter measure ____ long

A

25 cm

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3
Q

when approximately 150 mL urine accumulates

A

bladder

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4
Q

urethra is __ cm long in women and __ cm long in men

A

4 cm; 24 cm

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5
Q

fluid biopsy of the kidney

A

urine

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6
Q

basic structural and functional unit of the kidney

A

nephron

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7
Q

how many nephrons are there PER kidney

A

1 to 1.5 million

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8
Q

what are the two type of nephrons

A

cortical and juxtamedullary

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9
Q

nephrons consists of

A

glomerulus and renal tubules

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10
Q

what is the order of urine formation

A
  1. Glomerulus
  2. Proximal Convoluted Tubule
  3. Loop of Henle
  4. Distal Convoluted Tubule
  5. Collecting Duct
  6. Calyx
  7. Renal Pelvis -> Ureter -> Bladder -> Urethra
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11
Q

the kidney receive ____ of the total cardiac output

A

25%

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12
Q

what blood is present in Renal Artery

A

Unfiltered blood

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13
Q

what blood is present in renal vein

A

filtered blood

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14
Q

what is the order of renal blood flow

A
  1. renal artery
  2. afferent arteriole
  3. glomerulus
  4. efferent arteriole
  5. peritubular capillaries
  6. vasa recta
  7. renal vein
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15
Q

total renal blood flow of 2 kidneys

A

1, 200 mL/min

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16
Q

total renal plasma flow of two kidneys

A

600-700 mL/min

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17
Q

the “working portion” of the kidney

A

glomerulus

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18
Q

glomerulus has a coil of approximately _____ (capillary tuft) located w/in the Bowman’s capsule

A

8 capillary lobes

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19
Q

these are attached to the glomerular basement membrane

A

podocytes (epithelial cells)

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20
Q

this resembles a sieve

A

glomerulus

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21
Q

how many daltons are able to pass through the glomerulus

A

< 70, 000 Daltons

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22
Q

approximately __ of the filtered plasma volume is actually excreted as urine

A

1%

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23
Q

what is found between the podocytes of Bowman’s space

A

Filtration Diaphragm

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24
Q

how many daltons albumin is

A

69k daltons

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25
Q

why is albumin not able to pass through the glomerulus

A

because of the shield of negativity

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26
Q

what is the charge of albumin

A

negative

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27
Q

when is albumin positive charge

A

at 4.9 pH

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28
Q

1st function to be affected in renal disease

A

tubular reabsorption

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29
Q

plasma concentration at which active transport stops

A

renal threshold

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30
Q

renal threshold for glucose

A

160- 180 mg/dL

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31
Q

these alter the urine concentration

A

PCT, LH, DCT, & CD

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32
Q

major site (65%) of reabsorption of plasma substance

A

PCT

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33
Q

renal concentration begins in the ______

A

descending and ascending LH

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34
Q
  • Solute concentration is highest where
A

Loop of Henle (renal medulla)

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35
Q

true or false

the ascending loop of henle is highly permeable to water

A

false (highly impermeable)

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36
Q

Dam collects water, so does the _____

A

Descending loop of henle

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37
Q

Ascending loop of henle reabsorbs

a. Salt
b. Water

A

a. Salt (ASINding LH)

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38
Q

during the active transport, glucose, amino acids, and salts are located at the _____

A

PCT

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39
Q

location of sodium during active transport

A

PCT and DCT

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40
Q

location of water during passive transport

A

PCT, Descending LH, CD

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41
Q

Location of Urea during passive transport

A

PCT, ascending LH

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42
Q

location of sodium during passive transport

A

ascending LH

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43
Q

movement of molecules across a membrane by diffusion because of a physical gradient

A

passive transport

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44
Q

movement of a substance across cell membranes into the bloodstream by electrochemical energy

A

active transport

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45
Q

this regulates water reabsorption in the DCT and CD

A

Anti-diuretic hormone (ADH/Vasopressin)

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46
Q

ADH during increase of body hydration

A

decrease

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47
Q

Urine Volume during increase of body hydration

A

increase

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48
Q

ADH during decrease of body hydration

A

increase

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49
Q

Urine Volume during decrease of body hydration

A

decrease

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50
Q

ADH in Diabetes Insipidus

A

Decreased/Deficient (DI = Daming Ihi)

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51
Q

ADH in Syndrome of Inappropriate ADH secretion

A

ADH excess

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52
Q

regulates sodium reabsorption in the DCT

A

Aldosterone

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53
Q

Effects of Angiotensin II

A
  • Release of Aldosterone and ADH
  • Vasoconstriction
  • Corrects renal blood flow
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54
Q

sodium and water reabsorption during the releasing of Aldosterone and ADH

INCREASE OR DECREASE

A

INCREASE

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55
Q

Blood Pressure during the increase of Sodium and water reabsorption

A

Increased

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56
Q

juxtaglomerular apparatus consists of the _____ in the afferent arteriole

A

JG cells

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57
Q

JG cells produce what

A

renin

58
Q

this detects the decrease in Blood Pressure

A

Macula Densa

59
Q

RAAS ____ the afferent arteriole and _____ the efferent arteriole

A

dilates; constricts

60
Q

RAAS stimulates the sodium reabsorption in the
a. DCT
b. PCT

A

b. PCT

61
Q

RAAS triggers the adrenal to release _____ to cause sodium reabsorption & potassium excretion in the DCT and CD

A

aldosterone

62
Q

RAAS triggers the release of anti-diuretic hormone by the ______ to stimulate water reabsorption in the CD

A

Hypothalamus

63
Q

2 major functions of tubular secretion

A
  1. regulation of the acid-base balance in the body through secretion of hydrogen ions (in the form of ammonium & dihydrogen phosphate
  2. elimination of waster products not filtered by the glomerulus
64
Q

major site for removal of nonfiltered substances

A

Proximal Convoluted Tubule

65
Q

_______ are secreted in exchange for sodium ions which are reabsorbed with bicarbonate into the plasma in the PCT

A

Hydrogen ions

66
Q

failure to produce an acid urine due to inability to secrete hydrogens ions

A

Renal Tubular Acidosis (RTA)

67
Q

blood pH during RTA

A

acidic (decreased)

68
Q

Urine pH during RTA

A

alkaline (increased)

69
Q

used to evaluate glomerular filtration

A

clearance test

70
Q

clearance test measure the rate at which the kidneys are able to ________ from the blood

A

remove a filterable substance

71
Q

clearance test is used for measuring what substances

A
  1. Urea
  2. Creatinine
  3. Inulin
  4. Beta2-microglobulin
  5. Radioisotopes
  6. Cystatin
72
Q

what is the most common/routinely performed test creatinine

A

clearance test

73
Q

specimen for creatinine clearance

A

24-hour urine

74
Q

Reference range of creatinine clearance for male

A

107-139 mL/min

75
Q

Reference range of creatinine clearance for female

A

87-107 mL/min

76
Q

variables for cockgroft and gault

A

age, sex, & body weight in kg

77
Q

variables for modification of diet in renal disease (MDRD) system formula

A

ethnicity, BUN, and Serum Albumin

78
Q

used to evaluate tubular reabsorption

A

concentration tests

79
Q

obsolete test that deprived the patient of fluid for up to 24 hrs

A

Fishberg test

80
Q

Urine SG after 12 hr restricted fluid diet is about ____ or more

A

1.022

81
Q

Urine SG after 24 hr restricted fluid diet is about ____ or more

A

1.026

82
Q

obsolete test wherein the patient is deprived of fluid for up to 24 hrs

A

mesonthal test

83
Q

it is influenced by the number & density of particles in a solution

A

Specific Gravity

84
Q

influence by the number of particles in a solutiion

A

osmolality

85
Q

it is more accurate and preferred than SG determination

A

Osmolality

86
Q

most commonly used and reference method for tubular secretion & renal blood flow

A

p-aminohippuric acid (PAH) test

87
Q

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

A

Phenolsulfonphtalein (PSP) test

88
Q

hindu physicians that this attracted ants

A

honey urine

89
Q

this is used by the Babylonians and Egyptians to detect diabetes

A

taste test

90
Q

urine is composed of

A

95-97% water
3-5% solids

91
Q

total solids are composed of

A

35 grams organic
25 grams inorganic

92
Q

major constituent of organic total solids

A

urea

93
Q

2nd major constituent of organic total solids

A

creatinine

94
Q

other components of organic total solids

A

hippurate, uric acid, CHO, pigments, fatty acid, mucins, enzymes, hormones

95
Q

major constituent of inorganic total solids

A

chloride

96
Q

other inorganic total solids

A

chloride > sodium > potassium

sulfate. phosphate, ammonium, magnesium, calcium

97
Q

principal salt of inorganic total solids

A

NaCl

98
Q

urine spx that is used for routine screening tests and qualitative urinalysis

A

random /occasional/single urine

98
Q

true or false

random urine sample is ideal for cytology studies

A

true BUT patient must have prior hydration & exercise 5 mins before collection

99
Q

ideal specimen for routine screening/urinalysis and pregnancy testing (hCG)

A

First Morning Urine

100
Q

true or false

first morning urine is not preferred for cytology studies/cytodiagnostic urine testing

A

First Morning Urine

101
Q

it is the most concentrated and most acidic urine specimen that allows well preservation of cells and casts

A

First Morning Urine

102
Q

why is first morning urine acidic

A

because we hypoventilate while sleeping (steady and slow breathing)

103
Q

first morning urine is used for evaluation of

A

Orthostatic Proteinuria

104
Q

it is the 2nd voided urine after a period of fasting

A

2nd morning urine/fasting

104
Q

urine specimens for glucose determination

A

2-hour post prandial
Glucose tolerance
fractional specimen

104
Q

glucose tolerance test is optional to be test with

A

blood samples

104
Q

urine spx for diabetic screening and monitoring; preferred for glucose testing

A

2-hour post prandial

105
Q

2nd morning urine is used for

A

glucose determination (but not recommended)

106
Q

bladder urine for anaerobic bacterial culture and urine cytology wherein the abdominal wall is punctured, and urine is directly aspirated from the bladder

A

suprapubic aspiration

106
Q

for routine screening and bacterial culture (OPD)

A

Midstream clean catch

106
Q

urine spx used for bacterial culture (may urethral or ureteral)

A

catheterized

107
Q

used in diagnosis of diabetes wherein series of blood and urine samples are collected at specific time intervals to compare concentration of a substance in urine with its concentration in the blood

A

fractional specimen

108
Q

urines in three glass technique

A
  1. first portion of voided urine
  2. middle portion of voided urine
  3. urine after prostatic
    massage
108
Q

type of urine collection that uses soft, clear, plastic bag with adhesive

A

pediatric spx

108
Q

3 glass technique result for prostatitis

A
  1. WBC bacteria
  2. Clear
  3. 10x greater WBC bacteria compared to 1st
108
Q

3 glass technique result for healthy prostate

A
  1. WBC bacteria
  2. Clear
  3. Clear
108
Q

control for bladder and kidney infection

A

2nd specimen

108
Q

3 glass technique result for UTI

A
  1. WBC bacteria
  2. WBC bacteria
  3. WBC bacteria
109
Q

the four glass method that consists of bacterial cultures of the initial voided urine (VB1), midstream urine (VB2), expressed prostatic secretions (EPS) and a post prostatic massage urine specimen (VB3)

A

Stamey-Meares Test for Prostatitis

109
Q

process for 24 hour urine

A

at the start time, the patient will empty their bladder and the rest of the urine throughout the day will be collected (ex. 8AM to 8AM)

109
Q

12 hr urine is used for

A

addis count (quantitation of formed elements)

110
Q

4hr urine is used for

A

nitrite determination

111
Q

why is 4hr urine used for nitrite determination

A

in the bladder, the bacteria will convert nitrate to nitrite (mas matagal mas maganda)

111
Q

afternoon (2-4pm) urine is used for

A

Urobilinogen determination

111
Q

process providing documentation of proper sample ID from the time of collection to the receipt of laboratory results

A

Chain of Custody (COC)

112
Q

required urine volume for drug test

A

30-45 mL

112
Q

container capacity for drug test specimen

A

60 mL (pinapapuno ng ibang lab kaya nagiging 60mL ‘yung required volume)

112
Q

temperature of urine for drug test

A

32.5 - 37.7 ℃ (checked within 4 minutes)

112
Q

added to the toilet water reservoir to prevent specimen adulteration

A

Blueing agent

112
Q

following collection, urine specimens should be delivered to the laboratory promptly and tested within ____

A

2 hrs (ideally is within 30 mins)

113
Q

increased in unpreserved urine

A
  1. pH
  2. Bacteria
  3. Odor
  4. Nitrite
113
Q

Decreased in Unpreserved Urine

A
  1. Clarity
  2. Glucose
  3. Ketones
  4. Bilirubin (CB)
  5. Urobilinogen
  6. RBC/WBC/Casts
  7. Trichomonas
114
Q

reason for increase in pH

A

Urea—–(Urease) —–> Ammonia; loss of CO2

115
Q

reason for increase of nitrite

A

bacterial multiplication

116
Q

darkened/modified urine is due to _____

A

oxidation or reduction of metabolites (increase of urobilin)

117
Q

decrease of clarity is due to ____

A

bacterial multiplication; precipitation of amorphous material

118
Q

decrease of ketones is due to ____

A

volatilization and bacterial metabolism

119
Q

bacterial metabolism is due to ____

A

evaporation when the specimen is left uncapped

120
Q
A

CLINICAL MICROSCOPY (2 decks)

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