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Shae Cards > Renal labs > Flashcards

Renal labs Flashcards

1
Q

Name the renal function tests

A

BUN
Creatinine
Urinalysis

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2
Q

BUN stands for and measures what

A

blood urea nitrogen

measures concentration of nitrogen (urea) in serum

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3
Q

Normal BUN

A

8-20mg/dl

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4
Q

What is the BUN a marker of?

A

Protein metabolism

  • –Kidney failure
  • –CHF, acidosis
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5
Q

Creatinine is a catabolic product of _____

A

creatine (important in skeletal muscle contraction)

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6
Q

Daily production of creatinine depends on ______ _____

A

muscle mass

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7
Q

Creatinine is entirely excreted by______

A

Kidneys

Directly related to renal function

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8
Q

T/F: a person with increased muscle mass can have higher creatinine values

A

True

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9
Q

NL value for creatinine

A

0.5-1.1 mg /dl

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10
Q

Elevation of creatinine suggests?

A

Chronicity of renal disease

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11
Q

A doubling of creatinine equals a ______% decrease in renal function.

A

50%

1.0 - 2.0 is doubling

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12
Q

2 groups that may have lower levels of creatinine

A

females

debilitated c muscle wasting

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13
Q

NL creatinine clearance? males vs female

A

90-140 ml/min

Males: 107-140
Females: 90-107

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14
Q

Why is GFR important.

A

Proper dosing and treatment decisions

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15
Q

What test most accurately assesses GFR?

A

inulin filtration rate

not available clinically

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16
Q

What is CrCl used for?

A

assessing kidney fx
Monitor drug therapy
monitor therapetuic drugs and determine doses

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17
Q

CrCl requires 2 things:

A

24 hr urine

serum drawn w/in 24 hrs of urine collection

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18
Q

Estimated Glomerular filtration rate (EGFR) has what advantages over CrCl?

A
  • no need for 24hr urine collection

- quick, from BMP

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19
Q

What equation estimates crcl without 24hr urine study?

A

Cockcroft-Gault equation

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20
Q

MDRD stands for?

A

Modification of diet in renal disease

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21
Q

MDRD equations incorporates what into the equation?

A

age
Sex
ethnicity

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22
Q

Stage 1 CKD

A

GFR 90 or higher

NL

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23
Q

Stage 2 CKD

A

GFR 60-89

Mild loss

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24
Q

Stage 3a CKD

A

GFR 45-59

mild to mod

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25
Q

Stage 3b CKD

A

30-44

Mod to severe loss

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26
Q

Stage 4 CKD

A

GFR 15-29

Severe loss

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27
Q

Stage 5 CKD

A

GFR<15

Kidney failure

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28
Q

Urinalysis consists of what 2 tests?

A

Dipstick

Microscopic analysis

29
Q

Dipstick strips measure what 9 things?

A 
Specific gravity
pH
Glucose
Protein
Ketones
blood
bilirubin
nitrite 
leukocyte esterase
30
Q

NL pH of urine?

31
Q

What time frame is a urine sample usable?

A

with in 24 hrs

32
Q

NL specific gravity of urine?

A

1.010 - 1.025

33
Q

High specific gravity indicates.

A

concentrated urine

dehydration

34
Q

Low specific gravity indicates.

A

dilute urine
renal failure
over hydration

35
Q

What ion is the main contributor to SG?

36
Q

NL ketones in urine?

37
Q

Strips testing urine will pick up which ketones type?

A

Acetoacetic acid

38
Q

T/F: excessive vomiting and dehydration would not cause ketones in the urine?

A

False.

This causes the body to break down muscle and urine would be + for ketones

39
Q

T/F: glucose is normally found in urine

A

false

Glucose is usually negative in urine

40
Q

What is the renal threshold for glucose spillage into urine?

A

250-300mg/dl

41
Q

NL protein in urine?

42
Q

If ______ _____ is injured, protein will be elevated in the urine.

A

Glomerular membrane

43
Q

Proteinuria + edema =

A

nephrotic syndrome

44
Q

What is a sensitive indicator of kidney function?

A

Protein in urine

45
Q

T/F: you can have trace amounts of protein in urine after exercise

46
Q

NL bilirubin and urobolinogen

47
Q

bilirubin and urobolinogen are elevated when?

A

Liver dmg

obstruction of bile duct

48
Q

Which is more sensitive for detecting blood in urine? Dipstick or microscopic analysis?

A

Dipstick - can pick up lysed cells

49
Q

What condition can cause false positive for blood in urine?

A

Crush injury - myoglobin

50
Q

what can cause a false negative for blood in urine?

A

high levels of Vit c

51
Q

what condition should you highly suspect with painless hematuria?

A

bladder ca

52
Q

What condition is leukocyte esterase postive in?

53
Q

Leukocyte esterase is ____% accurate in detecting WBCs in urine?

54
Q

Nitrite is positive in which condition?

55
Q

____ of urine can interfere with test of nitrite

A

Color of urine

Would give false+

56
Q

Gram ( ) bacteria produce_____ which converts nitrate to nitrite

A

Gram - (but some gram + can as well)

Reductase

57
Q

Microscopic UA looks for what?

A

WBC
RBC
epithelial cells
casts

58
Q

WBC on microscopic UA =

59
Q

If you find sterile pyuria (WBC in urine) what condition should you think

60
Q

RBC on microscopic UA =

A

infection

renal calculi

61
Q

Eosins on microscopic UA =

A

interstitial nephritis

62
Q

Hyaline casts

A

NL after exercise

Chronic renal failure

63
Q

RBC casts

A

glomerulonephritis

Subacute bacterial endocarditis

64
Q

WBC casts

A

pyelonephritis

65
Q

Epithelial Casts

A

tubular necrosis

66
Q

Granular casts

A

nephrotic syndrome

lead toxicity

67
Q

Waxy casts

A

renal failure

acute tubular necrosis

68
Q

Where do casts form

A

distal and collecting tubules

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