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Clin Med II - Exam 4 > Schoenwald - Renal Labs > Flashcards

Schoenwald - Renal Labs Flashcards

1
Q

components of the nephron (5)

A

glomerulus

proximal tubule

loop of henle

distal tubule

collecting duct

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2
Q

fxn of the nephron

A

filtration

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3
Q

blood enters nephron via the __,

into the __,

and exits via the __

A

renal artery

afferent arteriole

efferent arteriole

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4
Q

substances up to __ can pass thru renal capillaries

A

40 k

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5
Q

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

A

glucose

uric acid

Na

Cl

HCO3

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6
Q

loop of henle further reabsorbs (3)

A

Na

Cl

H2O

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7
Q

fxn of distal tubule

A

excretion into collecting duct

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8
Q

what substances does the distal tubule secrete (4)

A

Na

K

HCO3

H

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9
Q

fxn of collecting duct

A

regulation of amt of water in urine

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10
Q

what hormone affects fxn of collecting duct

A

antidiuretic hormone (adh)

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11
Q

renal fxn tests (3)

A

BUN

Cr

urinalysis

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12
Q

BUN measures

A

concentration of nitrogen (urea) in serum

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13
Q

BUN reflects

A

protein metabolism

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14
Q

3 conditions that cause elevated BUN

A

renal failure

CHF

acidosis

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15
Q

creatinine is a catabolic product of

A

creatinine phosphate → skeletal m contraction

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16
Q

daily Cr level is dependent on

A

muscle mass

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17
Q

how is Cr excreted

A

entirely by kidney → directly related to renal fxn

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18
Q

doubling of Cr =

A

50% decrease in renal fxn

directly related to severity of renal dz

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19
Q

2 pt populations w. naturally lower Cr

A

women

quadriplegic

less muscle mass

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20
Q

GFR is assessed most accurately by

A

inulin filtration rate

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21
Q

__ is an approximation of GFR

and is used more often in clinical setting

A

CrCl

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22
Q

in kidney dysfxn __ is increased

and __ is decreased

A

Cr

GFR

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23
Q

CrCl is used to evaluate (3)

A

kidney fxn in acute/chronic renal failure

effectiveness/monitoring of drugs

determining dosage

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24
Q

how do you measure CrCl

A

24 hr urine

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25
Q

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

A

24

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26
Q

CrCl equation

A

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

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27
Q

estimated GFR calculation is based on __

and does not require __

A

SCr

24 hr urine collection

→ quicker

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28
Q

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

A

cockcroft-gault

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29
Q

cockcroft-gault is used for

A

renal dosing

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30
Q

cockroft-gault equation

A

CrCl = (140-age) x wt / (Cr x 72)

multiply by 0.85 for women

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31
Q

what equation incorporates age, sex, and ethnicity

A

MDRD (modification of diet in renal dz)

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32
Q

GFR 90 or higher

A

ckd 1

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33
Q

GFR 89-60

A

ckd 2 → mild loss

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34
Q

GFR 59-45

A

ckd 3a → mild to moderate

35
Q

GFR 44-30

A

ckd 3b → moderate to severe

36
Q

GFR 29-15

A

ckd 4 → severe

37
Q

GFR < 15

A

ckd 5 → failure

38
Q

GFR approximates

A

% of kidney fxn

39
Q

2 types of UA

A

dipstick

microscopic

40
Q

components of UA report

A

color

clarity

41
Q

UA strips measure (9)

A

specific gravity

pH

glucose

protein

ketones

blood

bilirubin

nitrite

leukocyte esterase

42
Q

normal pH of urine

A

4.5 - 8.0

43
Q

urine must be __ to be reliable

A

freshly voided

44
Q

acidic urine inhibits

A

bacterial growth

45
Q

alkaline urine can indicate (2)

A

UTI

renal tubular defects

46
Q

specific gravity measures

A

concentration of particles in urine

47
Q

elevated specific gravity suggests

A

concentrated urine → dehydration

48
Q

low specific gravity indicates (3)

A

dilute urine

renal failure

hydration

49
Q

specific gravity correlates w.

A

osmolality

50
Q

main component of specific gravity

A

Na

51
Q

ketones measure

A

aetoacetic acid

52
Q

ketones may be (+) in (4)

A

uncontrolled dm

ketoacidosis

high protein diet

excessive vomiting/dehydration

53
Q

positive urine glucose reflects

A

amt of plasma hyperglycemia

54
Q

renal glucose threshold

A

over 300 mg/dl

55
Q

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

A

t!

56
Q

protein in urine indicates __ damage

A

glomerular membrane

57
Q

indications of nephrotic syndrome (2)

A

proteinuria

edema

58
Q

6 conditions that might cause proteinuria

A

mm

pyelonephritis

diabetic neuropathy

glomerulonephritis

chf

lupus

59
Q

nl for bilirubin and urobilinogen

A

negative

60
Q

(+) bilirubin and urobilinogen indicates (2)

A

liver damage

obstruction of bile duct

61
Q

dipstick blood urine might not match microscopic bc

A

dipstick does not detect lysed cells

62
Q

what might cause a false positive blood urine

A

myoglobin

63
Q

what might cause false negative blood urine

A

high vitamin c intake

64
Q

painless hematuria plus hx smoking

A

bladder ca until proven otherwise

65
Q

RBCs on UA usually correlate w.

A

proteinuria

66
Q

what lab is 90% accurate in detecting WBCs in urine

A

leukocyte esterase

67
Q

(+) leukocyte esterase indicates

A

UTI

68
Q

gram negative bacteria produce __,

which converts __

to __

A

reductase

nitrate

nitrite

69
Q

(+) urine nitrite indicates

A

UTI

70
Q

__ can interfere w. nitrite test

A

color of urine

71
Q

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

A

wbc

rbc

epithelial ells

casts

72
Q

wbc on microscopic ua indicate

A

infxn → pyelonephritis

73
Q

what does sterile pyuria make you think of

A

tb

74
Q

rbc on microscopic ua indicate (2)

A

infxn

renal calculi

75
Q

eosins on microscopic ua indicate

A

interstitial nephritis

76
Q

where do casts form

A

distal and collecting tubules

77
Q

hyaline casts indicate (2)

A

post exercise

chronic renal faioure

78
Q

red cell casts indicate (2)

A

glomerulonephritis

SBE (subacute bacterial endocarditis)

79
Q

white cell casts indicate

A

pyelonephritis

80
Q

epithelial casts indicate

A

tubular necrosis

81
Q

granular casts indicate (3)

A

nephrotic syndrome

lead toxicity

glomerulonephritis

82
Q

waxy casts indicate (2)

A

renal failure

acute tubular necrosis

83
Q

crystals in urine can be normal or an indication of

A

stones

84
Q

mc type of renal stone

A

calcium oxalate

Clin Med II - Exam 4 (20 decks)

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