Schoenwald - Renal Labs Flashcards by Alice Richards

components of the nephron (5)

glomerulus

proximal tubule

loop of henle

distal tubule

collecting duct

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fxn of the nephron

filtration

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blood enters nephron via the __,

into the __,

and exits via the __

renal artery

afferent arteriole

efferent arteriole

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substances up to __ can pass thru renal capillaries

40 k

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proximal tubule reabsorbs large quantities of water along w. (5)

glucose

uric acid

HCO3

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loop of henle further reabsorbs (3)

H2O

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fxn of distal tubule

excretion into collecting duct

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what substances does the distal tubule secrete (4)

HCO3

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fxn of collecting duct

regulation of amt of water in urine

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what hormone affects fxn of collecting duct

antidiuretic hormone (adh)

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renal fxn tests (3)

BUN

urinalysis

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BUN measures

concentration of nitrogen (urea) in serum

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BUN reflects

protein metabolism

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3 conditions that cause elevated BUN

renal failure

CHF

acidosis

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creatinine is a catabolic product of

creatinine phosphate → skeletal m contraction

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daily Cr level is dependent on

muscle mass

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how is Cr excreted

entirely by kidney → directly related to renal fxn

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doubling of Cr =

50% decrease in renal fxn

directly related to severity of renal dz

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2 pt populations w. naturally lower Cr

women

quadriplegic

less muscle mass

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GFR is assessed most accurately by

inulin filtration rate

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__ is an approximation of GFR

and is used more often in clinical setting

CrCl

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in kidney dysfxn __ is increased

and __ is decreased

GFR

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CrCl is used to evaluate (3)

kidney fxn in acute/chronic renal failure

effectiveness/monitoring of drugs

determining dosage

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how do you measure CrCl

24 hr urine

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serum Cr is drawn w.in __ hours of urine collection

CrCl equation

(UCr mg/dl x urine volume ml/min) / (PCr mg/dl)

estimated GFR calculation is based on \_\_ and does not require \_\_

SCr 24 hr urine collection → *quicker*

what equation is used to estimate CrCl w.o 24 hr urine collection

cockcroft-gault

cockcroft-gault is used for

renal dosing

cockroft-gault equation

CrCl = (140-age) x wt / (Cr x 72) *multiply by 0.85 for women*

what equation incorporates age, sex, and ethnicity

MDRD (modification of diet in renal dz)

GFR 90 or higher

ckd 1

GFR 89-60

ckd 2 → mild loss

GFR 59-45

ckd 3a → mild to moderate

GFR 44-30

ckd 3b → moderate to severe

GFR 29-15

ckd 4 → severe

GFR \< 15

ckd 5 → failure

GFR approximates

% of kidney fxn

2 types of UA

dipstick microscopic

components of UA report

color clarity

UA strips measure (9)

specific gravity pH glucose protein ketones blood bilirubin nitrite leukocyte esterase

normal pH of urine

4.5 - 8.0

urine must be __ to be reliable

freshly voided

acidic urine inhibits

bacterial growth

alkaline urine can indicate (2)

UTI renal tubular defects

specific gravity measures

concentration of particles in urine

elevated specific gravity suggests

concentrated urine → dehydration

low specific gravity indicates (3)

dilute urine renal failure hydration

specific gravity correlates w.

osmolality

main component of specific gravity

ketones measure

aetoacetic acid

ketones may be (+) in (4)

uncontrolled dm ketoacidosis high protein diet excessive vomiting/dehydration

positive urine glucose reflects

amt of plasma hyperglycemia

renal glucose threshold

over 300 mg/dl

t/f: protein is a sensitive indicator of renal fxn

protein in urine indicates __ damage

glomerular membrane

indications of nephrotic syndrome (2)

proteinuria edema

6 conditions that might cause proteinuria

mm pyelonephritis diabetic neuropathy glomerulonephritis chf lupus

nl for bilirubin and urobilinogen

negative

(+) bilirubin and urobilinogen indicates (2)

liver damage obstruction of bile duct

dipstick blood urine might not match microscopic bc

dipstick does not detect lysed cells

what might cause a false positive blood urine

myoglobin

what might cause false negative blood urine

high vitamin c intake

painless hematuria plus hx smoking

bladder ca until proven otherwise

RBCs on UA usually correlate w.

proteinuria

what lab is 90% accurate in detecting WBCs in urine

leukocyte esterase

(+) leukocyte esterase indicates

UTI

gram negative bacteria produce \_\_, which converts \_\_ to \_\_

reductase nitrate nitrite

(+) urine nitrite indicates

UTI

\_\_ can interfere w. nitrite test

color of urine

in a normal UA, you will not see (4)

wbc rbc epithelial ells casts

wbc on microscopic ua indicate

infxn → pyelonephritis

what does sterile pyuria make you think of

rbc on microscopic ua indicate (2)

infxn renal calculi

eosins on microscopic ua indicate

interstitial nephritis

where do casts form

distal and collecting tubules

hyaline casts indicate (2)

post exercise chronic renal faioure

red cell casts indicate (2)

glomerulonephritis SBE (subacute bacterial endocarditis)

white cell casts indicate

pyelonephritis

epithelial casts indicate

tubular necrosis

granular casts indicate (3)

nephrotic syndrome lead toxicity glomerulonephritis

waxy casts indicate (2)

renal failure acute tubular necrosis

crystals in urine can be normal or an indication of

stones

mc type of renal stone

calcium oxalate