wk 6 - Renal function II Flashcards
1
Q
______ blood pressure is a sign of pre-renal uraemia.
A
Low blood pressure is a sign of pre-renal uraemia.
2
Q
The estimated glomerular filtration rate (eGFR) doesn’t take into account the ______ sample.
A
The estimated glomerular filtration rate (eGFR) doesn’t take into account the urine sample.
3
Q
_____ blood pressure is a sign of post-renal obstruction.
A
High blood pressure is a sign of post-renal obstruction.
4
Q
why are plasma creatinine & urea (UCE) tests done together?
A
urea and creatinine both have differing limitations as markers of GFR - so both are tested to eliminate these
5
Q
_____________ is the inflammation and damage of the filtration system of the kidneys, which can cause kidney failure.
A
Glomerulonephritis is the inflammation and damage of the filtration system of the kidneys, which can cause kidney failure.
6
Q
Patients with ———————————— could have metabolic acidosis blood, whereas their urine is alkaline, pH > 7.
A
Patients with Renal tubular acidosis could have metabolic acidosis blood, whereas their urine is alkaline, pH > 7.
7
Q
During acute renal failure, sodium appears in low concentration in the blood due to ________________.
A
During acute renal failure, sodium appears in low concentration in the blood due to pseudohyponatremia.
8
Q
In the kidney, drugs are moved by active transport from the blood into the ————- to urine
A
In the kidney, drugs are moved by active transport from the blood into the Distal convoluted tubule to urine
9
Q
Renal Tubular Acidosis patients could have metabolic acidosis ______ , whereas their ______ is alkaline.
A
Renal Tubular Acidosis patients could have metabolic acidosis blood, whereas their urine is alkaline.
10
Q
Brittle hair, thin nails, and white/yellow crystals of urate on skin are symptoms of
a) Acute renal failure
b) Chronic renal failure
A
b) Chronic renal failure
11
Q
- decreased protein intake
- pregnancy
- severe liver disease
- severe vomitting
- diarrhoea
are all causes of ___________ BUN/blood urea concentration
A
- decreased protein intake
- pregnancy
- severe liver disease
- severe vomitting
- diarrhoea
are all causes of decreased BUN/blood urea concentration
12
Q
a high BUN/plasma urea (ref range: 3.2 - 7.1) indicates a _____ GFR
A
a high BUN/plasma urea (ref range: 3.2 - 7.1) indicates a low GFR
13
Q
Using analgesics over a long period of time may cause ————— disease.
A
Using analgesics over a long period of time may cause chronic kidney disease.
14
Q
Glomerulonephritis is the most common cause for ________ syndrome in adults.
A
Glomerulonephritis is the most common cause for nephrotic syndrome in adults.
15
Q
A useful test for detecting risk of diabetic nephropathy is:
a) Albumin creatinine ratio
b) Creatinine
c) HbA1C
A
a) Albumin creatinine ratio
16
Q
Analgesics are safe to use. However, using analgesics over a long period of time may cause _________
a) Cough
b) Cancer
c) Chronic kidney disease
d) Diarrhoea
A
c) Chronic kidney disease
17
Q
During acute renal failure, the kidney goes from _______ phase to ________ phase.
A
During acute renal failure, the kidney goes from oliguric phase to diuretic phase.
18
Q
What is the gold standard for GFR?
A
inulin
19
Q
___________ is a test highly recommended to assess tubular function specifically for renal transplant patients.
A
beta 2-microglobilin is a test highly recommended to assess tubular function specifically for renal transplant patients.
20
Q
plasma BUN reference range is?
A
- 2 - 7.1
- high BUN = low GFR = renal failure
21
Q
renal tubular acidosis is a syndrome due to either a defect in proximal tubule ___________ reabsorption, or a defect in distal tubule ___________ secretion, or both.
A
RTA is a syndrome due to either a defect in proximal tubule bicarbonate reabsorption, or a defect in distal tubule hydrogen ion secretion, or both.
22
Q
80% of patients with Nephrolithiasis have ________ stones.
A
80% of patients with Nephrolithiasis have calcium stones.
23
Q
plasma osmolarity reference range?
A
285 ~10 mOSm/L
24
Q
During post-renal obstruction, GFR is initially normal but will eventually lead to _______ renal damage where GFR is ________ and tubular function is impaired.
A
During post-renal obstruction, GFR is initially normal but will eventually lead to intinsic/intra renal damage where GFR is reduced and tubular function is impaired.
25
Nephrotic syndrome is characterised by how much albumin in urine / day?
\>3.5 grams
26
Anti-diuretic analogue is also termed --------
desmopressin
27
------------is when you have blood in urine.
Hematuria
28
The following are expected to be seen in a healthy person’s urine, however, in case of glomerulonephritis, we are more likely to see _________ in urine.
a) Blood and protein
b) Water and sodium
c) Calcium and potassium
d) Creatinine and urea
a) Blood and protein
29
A __________ is a condition that has a known cause, a fairly consistent set of symptoms, and a quantifiable alteration of a person’s anatomy.
A **disease** is a condition that has a known cause, a fairly consistent set of symptoms, and a quantifiable alteration of a person’s anatomy.
30
Normal blood pH is ----------------, whereas normal urine pH is -----------------.
Normal blood pH is **7.35 - 7.45,** whereas normal urine pH is **6.**
31
In chronic renal failure, the patient smells like \_\_\_\_\_\_\_\_\_\_
a) Blood
b) Citric acid
c) Glucose
d) Urine/ammonia
d) Urine/ammonia
32
What is the most common cause for nephrotic syndrome in adults?
glomerulonephritis
33
Which test is highly recommended to assess tubular functions?
a) β2-microglobulin
b) Creatinine
c) Myoglobin
d) Microalbuminuria
a) β2-microglobulin
34
Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the _________________ of the glomerulus. The most common cause in adults is glomerulonephritis.
Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the **basement membrane** of the glomerulus. The most common cause in adults is glomerulonephritis.
35
\_\_\_\_\_\_\_\_\_\_\_ is due to muscle damage, as a result myoglobin in the muscle cells is released into the bloodstream and it beaks down to toxic compounds that can damage the kidney.
**rhabdomyolysis** is due to muscle damage, as a result myoglobin in the muscle cells is released into the bloodstream and it beaks down to toxic compounds that can damage the kidney.
36
How many liters of blood do the kidneys filtrate a day?
180L
37
The inflammation and damage of the filtration system of the kidneys due to problem in the immune system is termed ---------.
glomerulonephritis
38
Glomerulonephritis is the damage and inflammation of the filtration system of the kidneys and that can cause
a) Acute kidney failure
b) Acute/chronic kidney failure
c) Chronic kidney failure
b) Acute/chronic kidney failure
39
Normal GFR is ____ mL/min/1.73m2
However, it is usually written as ≥ \_\_\_\_
(reference range = 80 - 140)
Normal GFR is **100 mL/min/1.73m2**
However, it is usually written as **≥ 90**
(reference range = 80 - 140)
40
Glomerulonephritis is due to the damage of the \_\_\_\_\_\_\_\_\_, this causes blood and proteins to pass into the urine
Glomerulonephritis is due to the damage of the **glomeruli,** this causes blood and proteins to pass into the urine
41
A __________ is a condition where there are a set of signs and symptoms that often go together, but the cause is unknown.
A **syndrome** is a condition where there are a set of signs and symptoms that often go together, but the cause is unknown.
42
X-ray can be used to detect patients with renal ________ stones, but it can’t detect patient with uric stones.
X-ray can be used to detect patients with renal **calcium stones**, but it can’t detect patient with uric stones.
43
Low urine \< 100 mL / 24 hour is termed ---------
Anuria
44
Nephrotic syndrome means less albumin in _______ and more albumin in \_\_\_\_\_\_\_
Nephrotic syndrome means less albumin in **blood** and more albumin in **urine**
45
\_\_\_\_\_\_\_\_\_\_\_ is the excess of urea and other nitrogenous wastes in the blood and it is the end stage of renal disease (ESRD).
**Fatal uremia** is the excess of urea and other nitrogenous wastes in the blood and it is the end stage of renal disease (ESRD).
46
Measurement of the urine sodium concentration (FENa) provides information on the integrity of tubular \_\_\_\_\_\_\_\_\_\_\_
Measurement of the urine sodium concentration (FENa) provides information on the integrity of **tubular reabsorption**
47
The decrease in blood volume in the body is termed -----.
Hypovolemia
48
in Acute renal failure - **vomiting, diarrhoea, haemorrhage** are considered to be due to:
a) Pre-renal uraemia
b) Intrinsic renal damage
c) Post-renal obstruction
a) Pre-renal uraemia
49
The use of analgesics such as acetaminophen and ibuprofen regularly over long durations of time can cause ----------
**chronic kidney disease**
50
In chronic renal failure, the end stage of renal disease (ESRD) requires:
a) Dialysis or transplant
b) Increase fluid
c) IV sodium
d) IV potassium
a) Dialysis or transplant
51
To differentiate between kidney problem or lack of ADH when there is low osmolarity, patients are given an ____ analogue.
To differentiate between kidney problem or lack of ADH when there is low osmolarity, patients are given an **ADH analogue.**
## Footnote
**- desmopressin**
52
80% of patients with Nephrolithiasis have ________ stones.
a) Calcium
b) Magnesium
c) Phosphorous
d) Uric acid
a) Calcium
53
During pre-renal uremia, GFR \_\_\_\_\_\_\_\_\_\_.
During pre-renal uremia, GFR **decreases**.
54
Normal GFR is usually written as ------ mL/min/1.73m2
Normal GFR is usually written as **80 - 140mL/min/1.73m2**
55
Albumin creatinine ratio is a useful test for detecting risk of -------------------------.
Albumin creatinine ratio is a useful test for detecting risk of **diabetic nephropathy**
56
Fractional excretion of sodium is about the relation between sodium in ______ and \_\_\_\_\_\_\_\_.
Fractional excretion of sodium is about the relation between sodium in **urine and plasma.**
57
although _________ is completely filtered by the glomerulus, about half is reabsorbed when there is decreased blood flow
although **urea** is completely filtered by the glomerulus, about half is reabsorbed when there is decreased blood flow
58
The typical pH of urine is about --------, whereas that of blood is -----------
The typical pH of urine is about **6**, whereas that of blood is **7.35 - 7.45**
59
A typical situation where RTA would be suspected is if urine pH is greater than ____ despite the presence of a metabolic \_\_\_\_\_\_\_\_\_\_.
A typical situation where RTA would be suspected is if urine pH is greater than **7.0** despite the presence of a metabolic **acidosis.**
(alkaline urine due to hyperchloraemia)
60
\_\_\_\_\_\_\_\_\_ is not reabsorbed in the proximal tubules and it is also termed a tubular fluid / golden standard for kidney function tests.
inulin is not reabsorbed in the proximal tubules and it is also termed a tubular fluid / golden standard for kidney function tests.
61
Which test is highly recommended to assess tubular function specifically for renal transplant patients as it is relatively intact molecule?
a) β2-microglobulin
b) Creatinine
c) Myoglobin
d) Microalbuminuria
a) β2-microglobulin
62
Fractional excretion of sodium helps determine if the drop in urine production is due to reduced blood flow (hypovolemia) to the kidney (\_\_\_\_\_\_\_\_) or to kidney damage itself (\_\_\_\_\_\_\_\_)
Fractional excretion of sodium helps determine if the drop in urine production is due to reduced blood flow (hypovolemia) to the kidney **(pre-renal)** or to kidney damage itself **(renal).**
63
T/F
Acute renal failure can be reversible?
True
64
Most of the blood acids are coming from --------------
Most of the blood acids are coming from CO2
65
During acute renal failure, all the following are correct EXCEPT
a) Metabolic alkalosis
b) Hyperkalemia
c) Increase in waste products
d) Hypervolemia
e) Hyponatremia
a) Metabolic alkalosis
66
Glomerulonephritis is the damage of the _________ system in the kidneys.
Glomerulonephritis is the damage of the **filtration** system in the kidneys.
67
Nephrotic syndrome is more likely accompanied by\_\_\_\_\_\_ plasma TG, _____ plasma cholesterol and _____ plasma albumin.
Nephrotic syndrome is more likely accompanied by **high plasma TG, high plasma cholesterol** and **low plasma albumin.**
68
\_\_\_\_\_\_\_\_\_\_\_\_\_ tests are sensitive for detecting small decreases in GFR and are useful when monitoring monitoring __________ or assessing ______ doses
**clearance** tests are sensitive for detecting small decreases in GFR and are useful when monitoring monitoring **toxicity** or assessing **drug doses.**
69
The principal of GFR is that some substances when filtered by the kidney enter the tubules, are not reabsorbed and so GFR = ----------%
The principal of GFR is that some substances when filtered by the kidney enter the tubules, are not reabsorbed and so **GFR = 100%**
70
In the kidney, the --------------- are in charge of the reabsorption and secretion process.
In the kidney, the **Proximal convoluted tubules** are in charge of the reabsorption and secretion process.
71
A typical situation where renal tubular acidosis (RTA) would be suspected is if urine pH is greater than -------- despite the presence of a metabolic ------------.
A typical situation where renal tubular acidosis (RTA) would be suspected is if urine pH is greater than **7**, despite the presence of a **metabolic acdosis.**
72
What is the gold standard for GFR?
inulin clearance
- 100% in healthy individuials
73
During acute renal failure, calcium concentration decreases in blood due to \_\_\_\_\_\_\_\_\_\_\_\_\_, which is necessary to reabsorb calcium from the kidney:
a) Lack of sodium
b) Lack of potassium
c) Lack of 25(OH)Vit D3
d) Lack of 1,25(OH)Vit D3
c) Lack of 25(OH)Vit D3
| (inactive Vit D)
74
In cases of renal disease, glomerular filtration rate decreases. So urea and creatinine do not get filtered as they normally would and they both are elevated in blood, BUN:Cr
In cases of renal disease, glomerular filtration rate decreases. So urea and creatinine do not get filtered as they normally would and they both are elevated in blood, **BUN:Cr \< 15.**
75
Low urine volume \< 400 mL / 24 hour is termed ---------
Oliguria
76
Glomerulonephritis is the inflammation and damage of the filtration system of the kidneys, and it may be caused by specific problems with the body's \_\_\_\_\_\_\_\_\_\_\_\_\_\_, often the precise cause is unknown
Glomerulonephritis is the inflammation and damage of the filtration system of the kidneys, and it may be caused by specific problems with the body's **immune system,** often the precise cause is unknown
77
Fractional excretion of sodium helps determine if the drop in urine production is due to pre-renal due to reduced blood flow (hypovolemia), where FENa is ------- and urine osmolality is ------ or due to kidney damage itself (renal) where urine osmolality is ------- and FENa is -----.
a) \<1%
b) \>1%
c) Higher than plasma
d) Similar to plasma
Fractional excretion of sodium helps determine if the drop in urine production is due to pre-renal due to reduced blood flow (hypovolemia), where FENa is **\<1%** and urine osmolality is **higher than plasma** to kidney damage itself (renal) where urine osmolality is **lower than plasma** and FENa is **\>1%**
78
How many times per day does the blood gets filtered by the kidneys?
25 - 30 times per day
| (180L per day / ~6L total blood volume)
79
---------- is the percentage of the sodium filtered by the kidney and is excreted in the urine.
**FENa (fractional excretion of sodium)** is the percentage of the sodium filtered by the kidney and is excreted in the urine.
(\<1% in healthy individuals)
80
In chronic renal failure, the patient smells like ------
urine / ammonia
81
In **Acute renal failure**, renal stones and enlarged prostate are considered:
a) Pre-renal uraemia
b) Intrinsic renal damage
c) Post-renal obstruction
c) Post-renal obstruction
82
Renal calculi is also called \_\_\_\_\_\_\_\_\_\_\_
a) Kidney functions
b) Kidney stones
c) Liver functions
d) Prostate stones
b) Kidney stones
83
GFR reference range?
80 - 140
84
White/yellow crystals of urate on skin is called
a) Hyperkalemia
b) Metabolic acidosis
c) Uremic frost
d) Uremia
c) Uremic frost
85
The right equation to measure the estimated glomerular filtration rate (eGFR) if you don’t know your body weight is —-----
MDRD equation
(modified diet on renal disease)
**ethnicity - age - sex**
86
Uremia is usually happening in case of
a) Acute renal failure
b) Chronic renal failure
b) Chronic renal failure
87
What is the best terminology to describe the abnormalities here? Ref Interval
* Sodium 140 mmol/L 135-145
* Potassium 6.0 mmol/L 3.0-5.0
* Bicarbonate 16 mmol/L 22-32
* Urea 40 mmol/L 3-8
* Creatinine 400 µmol/L 50-120
a) Dehydration and acidosis
b) Dehydration and alkalosis
c) Renal failure and acidosis
d) Renal failure and alkalosis
c) Renal failure and acidosis
88
Patients with renal ________ stones can be detected using **x-ray,** whereas _________ stones can’t..
Patients with renal **calcium** stones can be detected using x-ray, whereas **uric acid** stones can’t..
89
Normally, low MW proteins (e.g. Cystatin C) are filtered by the GFR, reabsorbed by the kidney tubular cells and been catabolized. Whereas, high MW proteins (e.g. blood cells) won’t be filtered and they will remain in the blood too.
In case of kidney diseases, we will find proteins in urine, which are probably due to the following EXCEPT:
a) Glomerulus dysfunction, thus high MW proteins, e.g. albumin, were filtered.
b) Renal tubular cells dysfunction, thus can’t reabsorb low MW proteins and thus they were excreted in urine.
c) Overflow or excessive filtration rate exceeded reabsorption capacity (Bence-Jones)
d) Overflow or excessive reabsorption rate exceeded filtration capacity
d) Overflow or excessive reabsorption rate exceeded filtration capacity
90
The Reference range for GFR is ----------- mL/min
The Reference range for GFR is **80 - 140 mL/min**
91
Creatinine is a breakdown product of creatine phosphate in which organ?
muscle
92
What is the responsible hormone for concentrating urine and increasing osmolality / osmolarity?
ADH
93
a **BUN:Cr ratio \< 15** indicates:
## Footnote
a) prerenal uremia (decreased bloodflow to kidneys)
b) renal uremia (acute renal failure, glomerulonephritis, acute tubular necrosis)
c) post renal uremia (urinary tract obstruction)
b) renal uremia (acute renal failure, glomerulonephritis, acute tubular necrosis)
94
In the kidney, the ------------ is in charge of filtering the blood.
In the kidney, the **glomerulus** is in charge of filtering the blood.
95
a **BUN:Cr ratio \> 20** indicates:
## Footnote
a) prerenal uremia (decreased bloodflow to kidneys)
b) renal uremia (acute renal failure, glomerulonephritis, acute tubular necrosis)
c) post renal uremia (urinary tract obstruction)
a) prerenal uremia (decreased bloodflow to kidneys)
96
\_\_\_\_\_\_ renal failure develops over hours or days versus years for _______ renal failure
**Acute** renal failure: develops over hrs or days versus years for **chronic** renal failure
97
Among the symptoms of chronic renal failure, patient breath smells like ---------
ammonia (urine)
## Footnote
**- called uremic fetor/uremic halitosis**
98
How many times a day, do the kidneys filtrate the blood?
25 - 30 times
## Footnote
**(180L per day / ~6L per person)**
99
Plasma _________ concentrations are directly related to muscle mass, and plasma levels increase when the GFR decreases by 50-60% making the test insensitive. but still useful for everyday purposes
Plasma **creatinine** concentrations are directly related to muscle mass, and plasma levels increase when the GFR decreases by 50-60% making the test insensitive. but still useful for everyday purposes
100
a **BUN:Cr ratio \> 15** indicates:
## Footnote
a) prerenal uremia (decreased bloodflow to kidneys)
b) renal uremia (acute renal failure, glomerulonephritis, acute tubular necrosis)
c) post renal uremia (urinary tract obstruction)
c) post renal uremia (urinary tract obstruction)
101
In the kidneys, inulin is not -------- in the proximal tubules and it goes directly to the urine.
In the kidneys, inulin is not **reabsorbed** in the proximal tubules and it goes directly to the urine.
102
plasma creatinine reference range is?
80 - 120
103
Renal Tubular Acidosis is a syndrome due to either a defect in proximal tubule __________ or a defect in distal tubule ___________ As a result there is \_\_\_\_\_\_\_\_\_\_\_
a) Bicarbonate reabsorption
b) Hydrogen ion secretion
c) Metabolic acidosis
d) Respiratory acidosis
Renal Tubular Acidosis is a syndrome due to either a defect in proximal tubule **Bicarbonate reabsorption** or a defect in distal tubule **Hydrogen ion secretion.** As a result there is **Metabolic acidosis.**
104
Rhabdomyolysis is the breakdown of
a) Brain fibers
b) Kidney fibers
c) Liver fibers
d) Muscle fibers
d) Muscle fibers
105
\_\_\_\_\_\_\_\_ test is a measure of the amount of nitrogen in the blood in the form of urea, and a measurement of renal function.
**BUN test** is a measure of the amount of nitrogen in the blood in the form of urea, and a measurement of renal function.
## Footnote
**(Blood Urea Nitrogen)**
106
Measurement of the urine -------- concentration provides information on the integrity of tubular reabsorptive function
Measurement of the urine **creatinine concentration** provides information on the integrity of tubular reabsorptive function
107
measurement of __________ is subject to interference by numerous endogenous (e.g. acetoacetate) substances and some drugs.
measurement of **creatinine** is subject to interference by numerous endogenous (e.g. acetoacetate) substances and some drugs.
108
urine osmolarity reference range is?
300 - 900 mOsm/L
109
Infertility and reduced sperm motility are symptoms of
a) Acute renal failure
b) Chronic renal failure
b) Chronic renal failure
110
FENa is the percentage of the sodium filtered by the kidney and is excreted in the urine. This can determine whether the patient's low urine volume can be attributed to either **prerenal or renal** damage
**If the FENa is ________ than 1%** - the kidneys are filtering ok and the cause must be prerenal (hypovolemia)
**if the FENa is _________ than 1% -** the kidneys are not filtering ok and the cause must be renal (acute glomerulonephritis, acute blood loss)
FENa is the percentage of the sodium filtered by the kidney and is excreted in the urine. This can determine whether the patient's low urine volume can be attributed to either prerenal or renal damage
If the FENa is **less than 1%** - the kidneys are filtering ok and the cause must be prerenal (hypovolemia)
if the FENa is **greater than 1%** - the kidneys are not filtering ok and the cause must be renal (acute glomerulonephritis, acute blood loss)
111
renal tubular acidosis results in a hyperchloraemic metabolic acidosis with normal to moderately __________ GFR.
This results in a hyperchloraemic metabolic acidosis with normal to moderately **decreased** GFR.
- hyperchloraemic = high chloride levels in urine = alkaline urine (pH \>7)
112
Myoglobin is attached to oxygen to provide extra oxygen to the _________ to maintain high level of activity for a longer period of time. When _________ is damaged, Rhabdomyolysis, myoglobin in the ________ cells is released into the bloodstream. Large amounts of myoglobin can damage the __________ as it breaks down to \_\_\_\_\_\_\_\_\_\_
a) Muscle
b) Kidney
c) Toxic compounds
Myoglobin is attached to oxygen to provide extra oxygen to the **muscle** to maintain high level of activity for a longer period of time. When **muscle** is damaged, Rhabdomyolysis, myoglobin in the **muscle** cells is released into the bloodstream. Large amounts of myoglobin can damage the **kidneys** as it breaks down to **toxic compounds**
113
In intrinsic renal damage, FeNa is usually \>\_\_\_\_
\>1%
## Footnote
**(\<1% in healthy individuals)**
114
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ was replaced by 'moderately increased albuminuria'.
**Microalbuminuria** was replaced by 'moderately increased albuminuria'.
115
the test used to measure GFR more directly compared to a plasma UCE test, by measuring the volume of blood which can be completely cleared of a substance per unit time (mL/min or mL/sec) is called the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
creatinine clearance test
116
Nephrotic syndrome is more likely accompanied by _______ albumin in urine.
a) \> 1 g / day
b) \< 1 g / day
c) 2 g / day
d) \> 3.5 g / day
e) \< 3.5 g / day
d) \> 3.5 g / day
117
In case of pre-renal uremia due to hypovolemia, the kidney is functioning correctly, the response to decreased GFR is to increase ___________ rates.
The increased reabsorption of Na leads to increased _______ and _______ reabsorption from the proximal tubules of the kidney back into the blood.
In contrast, creatinine is actually secreted in the proximal tubule. This generally leads to a BUN:Cr ratio \>\_\_\_\_\_.
In case of pre-renal uremia due to hypovolemia, the kidney is functioning correctly, the response to decreased GFR is to increase **reabsorption** rates.
The increased reabsorption of Na leads to increased **water and urea** reabsorption from the proximal tubules of the kidney back into the blood.
In contrast, creatinine is actually secreted in the proximal tubule. This generally leads to a **BUN:Cr ratio \> 15**
118
electrolytes are measured by using an \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
This involves using an electrochemical cell to measure the final potential given by the sodium/potassium ions in the sample. This potential is directly proportionate to the concentraion of sodium/potassium
electrolytes are measured by using an **Ion-sensitive electrode**
This involves using an electrochemical cell to measure the final potential given by the sodium/potassium ions in the sample. This potential is directly proportionate to the concentraion of sodium/potassium
119
in alkaline conditions, creatinine reacts with _______ acid to form a red chromogen. This reaction is known as the Jaffe reaction.
This reaction is not specific to creatinine as ______ acid also reacts with proteins, acetoacetate, glucose and ascorbic acid, producing similar coloured complexes.
To increase specificity, aluminum silicate (\_\_\_\_\_\_\_ reagent) can be added to the plasma to bind the creatine and isolate it from the interferences.
in alkaline conditions, creatinine reacts with **picric acid** to form a red chromogen. This reaction is known as the Jaffe reaction.
This reaction is not specific to creatinine as **picric acid** also reacts with proteins, acetoacetate, glucose and ascorbic acid, producing similar coloured complexes.
To increase specificity, aluminum silicate **(Lloyds reagent)** can be added to the plasma to bind the creatine and isolate it from the interferences.
120
an alternative to using Lloyds reagent (aluminum silicate) to bind creatinine prior to isolation via the Jaffe reaction, is to use ___________ acid solution to precipitate the serum proteins first.
an alternative to using Lloyds reagent (aluminum silicate) to bind creatinine prior to isolation via the Jaffe reaction, is to use **tungstic acid** solution to precipitate the serum proteins first.
121
increased aldosterone and/or cotisol is a result of what disease?
cushings disease
