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RRPA Clinical Med II > Renal System Part 1 (Exam 4) > Flashcards

Renal System Part 1 (Exam 4) Flashcards

1
Q

The functional unit of the kidney is the _____

A

nephron

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2
Q

How many nephrons per kidney?

A

1 million

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3
Q

A nephron is composed of:

A

Glomerulus Proximal Tubule Loop of Henle Distal tubule Collecting duct

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4
Q

The proximal tubule absorbs large amount of?

A

H2O, Glucose, uric acid, Na, Cl, HCO3

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5
Q

Loop of Henle absorbs?

A

Na, Cl, H2O

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6
Q

Distal tubule controls excretion of?

A

Na, K, HCO3, H

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7
Q

Collecting duct regulates?

A

Amount of water in urine

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8
Q

What 3 labs are tests of renal function?

A

BUN Creatinine Urinalysis

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9
Q

What is BUN? What is its normal range?

A

Blood urea nitrogen 8-20mg/dl

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10
Q

BUN is a marker of?

A

Protein metabolism

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11
Q

Creatinine is a product of?

A

Skeletal muscle contraction

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12
Q

Daily production of Cr depends on?

A

Muscle mass

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13
Q

Normal range for Cr?

A

0.5-1.1

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14
Q

A doubling of Cr corresponds to a ___ decrease in renal function

A

50%

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15
Q

What two groups would you expect to see lower creatinine levels assuming no renal disease?

A

Females Spinal cord injuries

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16
Q

What is the most accurate test of glomerular filtration rate?

A

Inulin filtration rate

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17
Q

What test is ordered most often to for glomerular filtration rate?

A

CrCl (creatinine clearance)

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18
Q

Normal CrCl?

A

90-140ml/min

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19
Q

What tests are required to detect CrCl?

A

24 hour urine and serum creatinine drawn within 24 hours of urine collection

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20
Q

If your patient refuses a 24 hour urine, what can you use to estimate a CrCl?

A

Cockroft-Gault or MDRD equations

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21
Q

To calculate a Cockroft-Gault, what measurements do you need?

A

Age, weight, and serum Cr

22
Q

To calculate an MDRD, what measurements are neccessary?

A

Age, sex, ethnicity, plasma Cr (PCr)

23
Q

What is measured in a unrinalysis?

A

Specific gravity, pH, glucose, protein, ketones, blood, bilirubin, nitrite, and leukocyte esterase

24
Q

Normal urine pH?

A

4.5-8

25
Q

Alkalinic urine can be a sign of?

A

UTI or renal tubular defects

26
Q

Normal specific gravity?

A

1.010-1.025

27
Q

A high specific gravity can indicate _____, while a low specific gravity can indicate _____.

A

Concentrated (dehydration) Dilute (renal failure, over hydration)

28
Q

What ion is the main contributor to specific gravity?

A

Na

29
Q

Normal urine ketones measure as _____

A

negative

30
Q

Name a few populations that may have ketonuria?

A
  • Uncontrolled diabetics
  • Ketoacidosis patients
  • High protein diets
  • Patients with excessive vomiting and dehydration
31
Q

Urine glucose is normally negative unless plasma glucose is above ____

A

250-300

32
Q

Suspect ______ ______ in a patient with proteinuria and edema

A

Nephrotic syndrome

33
Q

Bilirubin and urobilinogen would be elevated in what conditions?

A
  • Liver damage
  • Obstruction of bile duct
34
Q

Name 1 thing that could cause a false negative for blood in urine

A

High doses of Vit C

35
Q

What S/S should make you think of bladder carcinoma?

A

Painless hematuria with history of smoking

36
Q

When suspicious of a UTI, what value will likely detect presence of WBCs?

A

Leukocyte esterase

37
Q

How does urine nitrate help in diagnosis of UTIs?

A

Bacteria produce nitrate reductase, which converts nitrate to nitrite.

38
Q

What type of bacteria commonly produce reductase?

A

Gram negative organisms

39
Q

A patient taking pyrimidine presents for UTI symptoms. Her UA is + for nitrite. Is this enough to diagnose a UTI?

A

No, the color of urine interferes with the nitrite test. Pyrimidine (Azo) is a drug that interferes with urine color.

40
Q

Sterile pyruia should make you think of?

A

TB

41
Q

UA with RBCs should make you think of?

A

Infection, renal calculi

42
Q

UA with eosinophils should make you think of?

A

interstitial nephritis.

43
Q

Urinary casts are formed in the _____

A

Distal and collecting tubules

44
Q

Casts present after exercise or chronic renal failure?

A

Hyaline

45
Q

Casts present during glomerulonephritis or SBE(subacute bacterial endocarditis??)?

A

Red cell casts

46
Q

What casts would you expect to be present during pyelonephritis?

A

White cell casts

47
Q

What cell casts would you expect to be present during tubular necrosis?

A

Epithelial cell casts

48
Q

What cell casts would you expect to be present during nephrotic syndrome, lead toxicity, or glomerulonephritis?

A

Granular cell casts

49
Q

What cell casts would you expect to be present during renal failure/acute tubular necrosis?

A

Waxy cell casts

50
Q

Crystal in urine should make you suspicious for?

A

Stones

51
Q

Name 1 thing that could cause a false positive for blood in urine

A

Myoglobin

RRPA Clinical Med II (45 decks)

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