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Clinical Microscopy > Session 1: Kidneys & Urine > Flashcards

Session 1: Kidneys & Urine Flashcards

1
Q

Which part of the excretory system forms the urine?

A

Kidneys

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2
Q

Provides blood supply for the kidneys

A

Renal Artery

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3
Q

Provides blood drainage for the kidneys

A

Renal Vein

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4
Q

Each kidney contains how many Nephrons

A

1 - 1.5 million neohrons

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5
Q

Major type of Nephrons in the kidney

A

Cortical

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6
Q

Renal blood flow comes from?

A

25% of Cardiac output

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7
Q

Total Renal Blood Flow

A

1200 mL/min

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8
Q

Glomerulus filters out substances of what MW?

A

<70,000

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9
Q

Normal Glomerular filtration rate

A

120 mL/min

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10
Q

Specific gravity of ultrafiltrate

A

1.010

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11
Q

Ultrafiltrate same composition with plasma except for

A

Plasma protein, protein-bound substances, cells

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12
Q

The filtration barrier of the glomerulus is composed of

A

Fenestrated Endothelium
Basement membrane
Visceral epithelium

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13
Q

Fenestrated endothelium is also known as

A

Capillary endothelium

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14
Q

Basement membrane is also known as

A

Basal lamina

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15
Q

Visceral epithelium is also known as

A

Podocytes

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16
Q

This controls the regulation of blood flow to and within the glomerulus

A

Renin-Angiotensin-Aldosterone-System (RAAS)

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17
Q

What is the action of Angiotensin II

A

Vasodilation (Afferent art.)
Constriction (Efferent art.)

Reabsorption of Na

Release of Aldosterone & ADH

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18
Q

End effect of RAAS

A

Increase in systemic blood pressure

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19
Q

Example of substances that require active transport in tubular reabsorption

A

Glucose, amino acids, salts (PCT)
chloride (Asc. LOH)
sodium (DCT)

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20
Q

What substances are passively transported in tubular reabsorption

A

Water (All parts exc. Asc. LOH)
Urea (PCT, Acs. LOH)
Sodium (Asc. LOH)

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21
Q

Major site of reabsorption (Accounts for >65%)

A

Proximal Convoluted tubule

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22
Q

Glucose Renal threshold

A

160 - 180 mg/dL
8.88 - 9.99 mmol/L

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23
Q

What is the specific gravity of fluid leaving the PCT

A

1.010

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24
Q

Urine concentration begins where?

A

Descending & Ascending Loop of Henle

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25
Q

This is a selective process which serves to maintain the osmotic gradient of the medulla

A

Countercurrent mechanism

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26
Q

Explain what happens during the countercurrent mechanism

A

Water is removed via osmosis in the DESCENDING LOOP OF HENLE (Inc. SG)

Sodium & Chloride are reabsorbed in the ASCENDING LOOP OF HENLE (Dec. SG)

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27
Q

Final concentration begins where?

A

Late distal convoluted tubule and continues in the collecting duct

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28
Q

Reabsorption of water & sodium in the Distal Convoluted tubule and Collecting ducts is controlled by what?

A

Hormones (Aldosterone & ADH)

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29
Q

Aldosterone hormone responds to the body’s need for?

A

Sodium

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30
Q

Aldosterone is secreted & produced by?

A

Adrenal cortex

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31
Q

Action of Adrenal hormone

A

Sodium reabsorption
Potassium secretion

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32
Q

ADH/AVP hormone responds to the body’s need for?

A

Hydration (Water)

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33
Q

ADH/AVP is produced by?

A

Hypothalamus

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34
Q

ADH/AVP is secreted by?

A

Posterior pituitary gland

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35
Q

Action of ADH/AVP

A

Makes the walls of the DCT & CD (collecting duct) permeable or impermeable to water

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36
Q

Refers to the passage of substance from the blood to the filtrate for excretion

A

Tubular secretion

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37
Q

Major site of secretion

A

Proximal convoluted tubule

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38
Q

Purpose of tubular secretion

A

Elimination of products not filtered by the glomerulus

Regulation of the acid-base balance thru secretion of hydrogen ions

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39
Q

Variables used in computing eGFR using the Cockroft & Gault formula, except: (Age, Sex, Weight, BUN)

A

BUN

40
Q

PAH Test is a test for?

A

Tubular secretion & Renal Blood Flow

41
Q

Greatest source of error in any clearance procedure

A

Improperly timed urine specimen

42
Q

Specimen of choice for clearance test

A

24 hour urine

43
Q

Standard test used to measure the filtering capacity of the glomeruli

A

Clearance test

44
Q

Originally used as the reference method for GFR

A

Inulin Clearance

45
Q

Routinely used for screening of GFR

A

Creatinine clearance

46
Q

Normal GFR

A

120 mL/min

47
Q

Provide estimates of GFR based on the serum creatinine without urine creatinine

A

Calculated Glomerular Filtration Est8mates

48
Q

Most frequently used formula for calculated glomerular filtration estimates

A

Cockroft & Gault (5th ed)

MDRD (6th ed)

49
Q

Cockroft & Gault variables includes

A

Age, Sex, Body Weight

50
Q

Additional variables for MDRD

A

Blood urea nitrogen, Ethnicity, Serum Albumin

51
Q

Specific Gravity & Osmolarity tests are used for assessing

A

Tubular reabsorption tests/ Concentration tests

52
Q

Fishberg & Mosenthal are examples of?

A

Water deprivation tests

53
Q

Normal value for water deprivation test

A

Urine SG: 1.025
Urine osmolarity: 800 mOsm

54
Q

Quantitative measurement of renal concentrating ability

A

Osmometry

55
Q

1 mol (1000 mOsm’ will lower the freezing point by?

A

1.86 deg C

56
Q

What are the 2 types of osmometers in the lab

A

Freezing point osmometer & Vapor pressure osmometer

57
Q

Lipemic serum affects

A

Vapor & Freezing point osmometer

58
Q

Lactic acid affects

A

Both vapor & freezing point osmometer

59
Q

Volatile substances (ethanol) affects

A

Freezing point osmometer

60
Q

Major organic component of the urine

A

Urea

61
Q

Urine pH in RTA

A

Consistently alkaline

62
Q

Major inorganic component in the urine

A

Chloride

63
Q

Principal salt in the urine

A

Sodium Chloride

64
Q

<0.8 g/d creatinine in the urine may mean

A

Improperly collected specimen

65
Q

Urine preservative used for transporting urine specimen for culture

A

Boric Acid

66
Q

Capacity for urine specimen container

A

50 mL

67
Q

Labels on urine specimens must be placed

A

On the container and not the lid

68
Q

After collection, specimens must be sent to the laboratory and tested within?

A

2 hours

69
Q

Most routinely used method for preservation

A

Refrigeration at 2-8 deg c

70
Q

Boric acid is bacteriostatic at?

A

18g/L

71
Q

Excellent sediment preservative used for addis count

A

Formalin

72
Q

This fixative used for cytology

A

Saccomano fixative

73
Q

This method of preservation do not interfere with chemical tests

A

Refrigeration

74
Q

This preservative is used for steroid & hormone analysis

A

Acids(HCl, glacial acetic acid)

75
Q

Most commonly received specimen used for routine screening tests

A

Random urine

76
Q

Ideal screening specimen and preferred specimen for pregnancy test

A

First-morning urine test

77
Q

Preferred specimen for evaluating orthostatic proteinuria

A

First-morning urine

78
Q

Preferred specimen for nitrite testing

A

First-morning urine

79
Q

Also known as 2nd morning urine

A

Fasting urine

80
Q

Preferred specimen for monitoring insulin therapy

A

2H - post-prandial urine

81
Q

Addition of urine formed before the start of collection for 24 hour urine collection may lead to

A

Falsely elevated results

82
Q

Failure to include urine produced at the end of collection period for 24 hr urine collection may lead to

A

Falsely decreased results

83
Q

Specimen of choice for urobilinogen determination

A

Early afternoon specimen

84
Q

12hr urine is used for

A

Addis count

85
Q

Second specimen for Three-Glass Collection is used as

A

Control for bladder & kidney infection

86
Q

In prostatic infection, the 3rd specimen will have

A

WBC/HPO count & a bacterial count of 10x that of the first specimen

87
Q

This is a variation of three glass collection

A

Stamey-Mears Four-Glass collection

88
Q

Expressed prostatic secretion for Stamey Meats collection is abnormal if

A

> 10 - 20 WBCs/HPF

89
Q

In Pre-and Post-massage test bacteruiria is positive if

A

Post massage specimen is >10x the pre-massage count

90
Q

This refers to the process that provides documentation of proper sample identification from the time of collection to the receipt of laboratory results

A

Chain of Custody (COC)

91
Q

Who are the signatories of COC

A

collector, courier, laboratory, medical review officer, employer

92
Q

Volume of urine specimen for Drug Specimen collection

A

30-45 mL

93
Q

Temp of urine for drug specimen collection

A

32.5 to 37.7

94
Q

Blueing agent is added to the ____________ to prevent specimen adulteration in drug specimen collection

A

Toilet reservoir

95
Q

SG of urine specimen in drug specimen collection

A

1.002 - 1.035

Clinical Microscopy (4 decks)

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