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Renal > Rodriguez Notes > Flashcards

Rodriguez Notes Flashcards

1
Q

What are the two regions two the Kidney?

A

Outer Cortex
Inner Medulla

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2
Q

What does the Outer Cortex consist of?

A

Glomeruli and Proximal Distal Tubules

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3
Q

What does the Inner Medulla consist of?

A

Loops of Henle and Collecting Ducts

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4
Q

What forms the main size of the discriminant barrier in filtration?

A

Semipermeable Glomerular Basement Membrane

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5
Q

What is set up that is 3 times greater than the pressure in other capillaries?

A

A steep hydrostatic pressure difference

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6
Q

What charge does the basement membrane have?

A

A negative charge
Negatively charged proteins are repelled

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7
Q

What is the most metabolically active part of the Nephron?

A

The Proximal Tubule

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8
Q

What does Tubular Reabsorption require?

A

Active Transport (ATP)
Passive Transport (No ATP)

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9
Q

What is the function of the Distal Tubule?

A

Small adjustments to achieve electrolyte and Acid-Base homeostasis

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10
Q

What is the final site for concentration or diluting Urine?

A

Collecting Tube

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11
Q

What are the primary hormones produced by the kidneys?

A

Renin
Erythropoietin
Vitamin D3

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12
Q

What will patients not on Recombinant Erythropoietin likely develop?

A

Anemia
May need blood transfusions

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13
Q

What is often associated with Osteomalacia and Rickets?

A

Chronic Renal Insufficiency

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14
Q

What are some examples of secondary functions of the Kidneys?

A

Insulin
Aldosterone
ADH

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15
Q

Where is Aldosterone produced and what is it’s function?

A

Produced by the cortex of the Adrenal Glands
Sodium Reabsorption

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16
Q

What is the purpose of the Juxtaglomerular Apparatus (JGA)?

A

Maintaining blood pressure and sodium concentration

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17
Q

What is Angiotensin II?

A

Vasoconstrictor that increases blood pressure and causes Aldosterone to be released
Tells the JGA to stop

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18
Q

What do evaluations of renal function rely on to make measurements?

A

Waste products in the blood

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19
Q

What is Ammonia converted to in the Liver?

A

Urea

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20
Q

What happens to Urea during Water Reabsorption?

A

Freely filtered by Glomerulus
40%-60% reabsorbed in Collecting Ducts

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21
Q

What can impact the Central Nervous System?

A

Elevated Ammonia in the blood

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22
Q

How can we prevent Elevated Ammonia in the blood from becoming fatal?

A

Treating by Dialysis or Transplantation

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23
Q

What is the enzyme Urease responsible for?

A

Hydrolyzing Urea and the Ammonium ion is then quantified

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24
Q

What can we use to measure Urea levels?

A

Plasma, Serum, Urine
If plasma, Ammonium Heparin cannot be used

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25
Q

How does the Glomerulus treat Creatinine?

A

Readily filters it

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26
Q

What is used to determine Kidney function and monitor disease?

A

Creatinine

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27
Q

What is the method to measuring Creatinine?

A

Jaffe Reaction

28
Q

Describe the

A
29
Q

What have clinical laboratories been strongly recommended to report?

A

Estimated GFR
Does not require a timed urine collection

30
Q

Define the Kinetic Jaffe Method

A

Serum and Alkaline Picrate are mixed
Absorbance is measured
Positive interference by a-keto acids and Cephalosporins
Negative interference by Bilirubin and Hemoglobin

31
Q

What is the name of the alternative Jaffe Reaction?

A

Kinetic Jaffe Method

32
Q

What is the primary waste product of Purine metabolism?

A

Uric Acid

33
Q

What happens to Uric Acid as it goes through the Nephron?

A

Gets filtered but then 98% - 100% is reabsorbed
Secreted at the Distal tubule
Only 6%-12% Is finally excreted

34
Q

What are measurement of Uric Acid used to confirm/monitor?

A

Patients with Gout
Uric Acid Nephropathy
Kidney Dysfunction

35
Q

What is the role of Uricase?

A

Catalyze the oxidation of Uric Acid to Allantoin
Color produced is proportional to Uric Acid

36
Q

How do we collect a Uric Acid Specimen?

A

Heparinized plasma, Serum, Urine
Serum should be removed immediately
Serum refrigerated for 3-5 days
EDTA should not be used

37
Q

What have clinical laboratories been strongly recommended to report?

A

Estimated GFR
Does not require a timed urine collection

38
Q

What is the Gold Standard of infusion urinary clearance?

A

Inulin Clearance

39
Q

What is the most sensitive and specific measure of number of functioning Nephrons?

A

Glomerular Function Rate (GFR)

40
Q

What is present in all forms of progressive disease?

A

A decrease in GFR preceding Kidney Failure

41
Q

What is required for a specimen collection of Creatinine?

A

24 hour urine collection and Serum Creatinine value
Collected at the midpoint

42
Q

What must happen for a 24 hour urine collection?

A

Discarding of the first morning specimen of the first day

43
Q

What are sources of error regarding 24 hour collection?

A

Recording incorrect time
Loss of portions during urine
Vigorous exercise
Failure to properly hydrate
Incorrect values used

44
Q

What can be used to easily and rapidly measure Immunoassays?

A

Serum and Urine Myoglobin

45
Q

What is the normal pH range?

A

4.7 - 7.8

46
Q

What is the normal range for Urine SG?

A

1.003 - 1.035

47
Q

What is the method used to measure SG?

A

Refractometer

48
Q

What is more valid than measuring SG in assessing the concentrating abilities of the Kidneys?

A

Measuring Osmotic Concentration of Urine

49
Q

Which analyte test is specific for Albumin?

A

Protein

50
Q

Which Analyte detects presence of bacteria?

A

Nitrite

51
Q

How much bacteria needs to be present for it to be clinically significant?

A

20

52
Q

What is diagnostic for glomerular damage and inflammation that result in Hematuria?

A

RBC casts

53
Q

What is the value of GFR that is specific before kidney damage?

A

< 60mL/min/1.73^2

54
Q

What do abnormal lab findings usually include?

A

Rapid onset of Hematuria
Proteinuria
RBC casts

55
Q
A
56
Q

What does Nephrotic Syndrome almost always yield?

A

Massive Proteinuria ( > 3.5g/d)
Hypoalbuminemia

57
Q

What are other symptoms of Nephrotic Syndrome?

A

Hyperlipidemia and Lipiduria

58
Q

Hypoproteinemia stimulates protein synthesis in the Liver. What does this result in?

A

Overproduction of Lipoproteins and an increase in their filtration

59
Q

What is the presence of Renal Calculi or Kidney Stones known as?

A

Nephrolithiasis

60
Q

What are the clinical symptoms of Nephrolithiasis?

A

Hematuria
UTI’s
Nausea
Abdominal Pain

61
Q

What is SECOND to diabetes as a primary diagnosis of Chronic Renal Failure?

A

Renal Hypertension

62
Q

What are the forms of Dialysis/Filtration available for patients?

A

Hemodialysis
Hemodiafiltration
Peritoneal Dialysis

63
Q

What uses a synthetic membrane and filters from outside the body?

A

Traditional Hemodialysis

64
Q

What occurs inside the body using gravity to introduce and remove Dialysate?

A

Peritoneal Dialysis
Ambulatory and Continuous Cycling

65
Q

What does Kidney Transplantation offer?

A

The greatest chance for a full return to a healthy life

Renal (7 decks)

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