Renal Function Pt 2

Question 1

T/F tubular secretion is based off Acid base balance

Answer 1

t

Question 2

List the 3 major mechanisms in the kidney to maintain pH homeostasis

Answer 2

excretion of H+ ions in exchange for reabsorb of bicarb
excretion of H+ ions in combined w/ phosphate
excretion of H+ ions bound to ammoia to produce ammonium ions

Question 3

T/f Tubular secretion substance moves from blood, peritubular to tubular filtrate

Answer 3

T

Question 4

Waste products not filtered by golmerulous

Answer 4

Medications/foregin substances
bound to carrier proteins
high affinity for cells in proximal tubule

Question 5

Normal pH of blood

Answer 5

7.35-7.45

Question 6

T/F body needs bicarb buffer and it is readily filtered by the golmerulous

Answer 6

t

Question 7

What is the pH of urine?

Answer 7

4.6-8.0
avg 6.0
>9.0 reject
no abnormal ranges due to different levels of hydration

Question 8

What are some golmerulor filtration tests?

Answer 8

inulin clearance
creatinine
calculated GF

Question 9

Tubular reabsorbtion tests?

Answer 9

osmolarity
free water clearance

Question 10

Describe GFT
rk…sb
measure what kind of substance

Answer 10

clearance test: filtering capacity
rate kidney can remove substance from blood
measure a substance that can not be reabsorbed/sec by tubular

Question 11

Types of GFT
Exogenous
Endogenous

Answer 11

types: urea,inulin,B-Macro

Exogenous: infused
Endogenous: naturally present in body

Question 12

Describe Exogenous

Answer 12

inulin
polymer of fructose
not naturally found in body or eaten

Question 13

Describe Endogenous
example
results affected by
used for?

Answer 13

GFR
creatinine clearance
result affected by functional nephrons/capacity
Not used to detect renal disease but to monitor

Question 14

Disadvantages of GFR/Creatinine clearance
Some
medications
RT
diets
not reliable if?

Answer 14

some secreted by tubules
medications can cause false low serum levels
specimen RT breakdown creatinine/bacteria
meat diets
NOT RELIABLE IF PT HAS WASTING DISEASE

Question 15

C=UV/P

Answer 15

C= ml plasma
V = vol of urine ml/min
U= creat urine
P= plasma creat

Question 16

T/F we use serum creatinine to measure now or eGFR calculations

Answer 16

true

Question 17

What other things can you used now instead of creatinine clearance?

Answer 17

Cystatin C
small protein not secr
Beta-Macrogolb
MLA

Question 18

Describe tubular reabsorption tests
indicator of
used to
urine conc dep

Answer 18

indicator of early renal disease
(loss of tubular reab 1st stage)
used to determ. ability of tubes to reab salts/H2O
urine concent determ by hydration

Question 19

Describe specific gravity

Answer 19

particles/density measurement

Question 20

Describe osmolarity

Answer 20

particles dissolved
normal ratio 1:1 urine: serum
controlled fluid intake 3:1

Question 21

Clinical sign of osmolarity
eval
monitor
monitor
diff diag
eval

Answer 21

eval renal conc of tubules
monitor renal disease
monitor fluid therapy
diff. diag in sodium levels
eval ADH response

Question 22

Describe Diabetes Insipidous and its two mech

Answer 22

inability to conserve water
Dec ADH production
inability of renal tubules to respond to ADH

Question 23

How do you differentite the mech is Diab insipidus

Answer 23

inject pt with ADH, control fluid intake 12-14 hr (should be 3:1)

not 3:1 = tubules do not have func ADH receptors
3:1= dec ADH prod