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CLIN CHEM LEC > RENAL FUNCTION > Flashcards

RENAL FUNCTION Flashcards

1
Q

Paired, bean-shaped organs found retroperitoneally in
either side of the spinal column

A

Kidney

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2
Q

kidney size About the size of a fist

A

10-12 cm)

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3
Q

are important organs in the body because they
excrete the waste products of the body’s metabolism

A

Kidney

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4
Q
  • at the back
A

retro

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5
Q

abdomen

A

Peritoneal cavity

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6
Q

kidney is in Between

A

T12 - L3

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7
Q

○ Outside part of the kidney

A

renal cortex

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8
Q

○ Heart-shaped
- contains 8-12 renal pyramids which contain of 1 million of nephrons

A

Renal medulla

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9
Q
  • central region of the kidney
    -located in the renal sinuses

The urine will go to the renal medulla and will
be collected in the renal pelvis and will go to the
ureters then bladder

A

renal pelvis

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10
Q

are made up of nephrons

A

Kidneys

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11
Q

kidneys Functional unit:

A

Nephrons

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12
Q

Can’t be seen in the naked eye

A

nephrons

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13
Q
  • filter the substances needed to be filtered)
A

Glomerulus

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14
Q

Made up of tuft of capillaries and covered by
the Bowman’s capsule and the space inside it
is called __________

A

Bowman’s space

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15
Q

Approaching the glomerulus

A

afferent

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16
Q

Exiting the glomerulus

A

efferent

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17
Q

2 types of nephrons in the body

A

cortical nephrons and juxtamedullary nephron

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18
Q

known for short nephron loop
glomerulus further from the cortex medulla junction
efferent arterioles supplies peritubular capillaries

A

cortical nephrons

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19
Q

known for long nephron loop
glomerulus closer from the cortex medulla junction
efferent arterioles supplies peritubular vasa recta

A

juxtamedullary nephrons

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20
Q

U turn

A

loop of henle

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21
Q

three loop of henle

A

○ Thin Descending LoH
○ Thin Ascending LoH
○ Thick Ascending LoH

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22
Q

what percent made up of cortical nephrons?

A

85%

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23
Q

what percent made up of juxtamedullary nephrons?

A

15%

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24
Q

how many nephrons in a kidney?

A

1 million

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25
Q

in glomerular filtrate there are ____ liters per a day filtrate and _______ of urine each day

A

180 liters an 1-2 litres of urine each day

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26
Q

is the movement of of substances outside of the tubules

A

reabsorption

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27
Q

Most important function
○ Filters unwanted substances in the body

A

● Urine formation

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28
Q

○ Kidneys secretes and reabsorbs water

A

● Fluid and electrolyte balance

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29
Q

Kidneys can also secrete acids (hydrogen) or
base (bicarbonate)

A

● Regulation of acid-base balance

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30
Q

Reabsorbs rom the tubules to the capillaries
back to the blood (back to the circulation)

A

● Tubular Absorption

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31
Q

Give me the renal basic process

A

Renal blood flow
Glomerular filtration
Tubular reabsorption
Tubular secretion

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32
Q

What are the factors that make the glomerulus the best site for
filtration?

A

High pressure in the glomerulus
Semi-permeability of the glomerulus
negatively charged basement membrane

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33
Q

what is the cut off value of the molecular size that is able to pass through glomerulus?

A

66,000 or 66kDA

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34
Q

the glomerular filtrate is around ___________

A

130-150 mL/min

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35
Q

volume of blood filtered per minute

A

Glomerular filtration rate

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36
Q

renal blood flow ml/L

A

1,200-1,500 ml/L

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37
Q

(6) can pass through glomerulus

A

water
electrocytes
glucose
amino acid
urea
creatinine

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38
Q

(3) cannot pass through glomerulus

A

plasma proteins
Cellular elements
protein bound molecules

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39
Q

Happens when the substances from the tubular lumen
are moved to the peritubular capillary plasma

A

tubular reabsorption

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40
Q

Tubular reabsorption Happens mostly at the _________

A

PROXIMAL CONVOLUTED
TUBULE (90%)

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41
Q

in tubular reabsorption are 75% ________

A

75% of the sodium, chloride, water

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42
Q

TUBULAR REABSORPTION
_______of the glucose

A

100%

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43
Q

TUBULAR REABSORPTION

__________of uric acid is reabsorbed, only to be secreted
at the DCT

A

98-100%

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44
Q

Variable amounts of urea, uric acid, ions (Ca, Mg, K,
HCO3

A

TUBULAR REABSORPTION

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45
Q

mg/dl of renal threshold

A

160-180 mg/dl

46
Q

uses energy, transport mechanisms, carriers,
proteins to transport the substance from the
tubules back to the capillaries

A

● Active transport

47
Q

○ Freely flowing

A

● Passive transport

48
Q

○ Excess of aldosterone
○ If there will be excess of aldosterone, sodium
will be reabsorbed.

A

● Conn Syndrome?

49
Q

Conn syndrome
sodium in urine = _______
sodium in blood = _______

A

decreased
increased

50
Q

Deficiency of aldosterone
○ Sodium will not be reabsorbed

A

● Addison’s Disease?

51
Q

● Addison’s Disease?
sodium in urine = __________
sodium in blood = ________

A

increased
decreased

52
Q

Decrease in ADH
○ Water will be freely flowing and will not be
reabsorbed
○ Water in the urine will increase
■ Urine will be more dilute
○ Water in blood will decrease

A

● Diabetes Insipidus?

53
Q

Excess in ADH
○ Water will be reabsorbed from the tubule to the
blood
○ Water in the urine will be decreased
○ Urine will be more concentrated
○ Water in the blood will increase

A

● Syndrome of Inappropriate ADH secretion (SIADH)?

54
Q

Movement of the substances from the peritubular
capillary plasma to the tubular lumen
○ From the blood to the tubules
○ Baliktad ng tubular reabsorption
● Tubular cells secrete products of their own cellular
metabolism to the filtrate in the tubular lumen
● The tubules are made up of cells and these cells have
metabolic wastes
● Secrete waste products na hindi kaya ifliter ng
glomerulus
● Can contribute to acid base balance, fluid balance, and
electrolyte balance

A

tubular secretion

55
Q

Some of the solute is filtered and most are
secreted to the urine

A

● Substance A

56
Q

○ Substance is filtered but reabsorbed

A

● Substance B

57
Q

A lot of the substance is filtered in the
glomerulus and all of the substance is
reabsorbed

A

● Substance C

58
Q

● Tests that determine of the kidneys are functioning well

A

RENAL FUNCTION TESTS

59
Q

● These rely on the measurement of the waste products in
the blood (usually urea and creatinine) which accumulate
when the kidneys begin to fail

A

renal function tests

60
Q

__________ are waste products of the
blood

A

Urea and creatinine

61
Q

increase in urea
and creatinine in the bloof\d

A

kidney problems

62
Q

There should be _________ of the nephrons still
functioning (advanced renal failure) before concentration
of these product begin to accumulate in the blood

A

20-30%

63
Q

_______-of the nephrons ang masisira before
these product accumulate
○ Not sensitive markers to test for renal failure,
but if it is vast, it can accumulate in the blood
and diagnosed as having kidney failure

A

70%-80%

64
Q

Standard test used to measure the filtering capacity of
the glomerul

A

Clearance Tests

65
Q

Measures the rate at which the kidneys are able to
remove a filterable substance from the blood

A

Clearance Tests

66
Q
  • measures the “concentration”
    of analytes in the urine
A

Osmolality and osmolarity

67
Q

measures the amount of
solute-free water excreted in the kidney

A

Free water clearance

68
Q
  • 24 hours fluid deprivation
A

Fishberg Test

69
Q

Day vs Night concentration
function

A

Mosenthal Test

70
Q

To measure the exact amount of blood flowing through
the kidney, it is necessary to use a substance that is:

A

Tubular Secretion and Renal Blood Flow Tests

71
Q

How to measure the blood flowing to the
kidney

A

Use a substance that is completely
removed from the blood (peritubular
capillaries) rather than being removed
when the blood reaches the
glomerulus

72
Q

● NPN with the highest concentration in the blood
● Major excretory product of protein metabolism

A

Blood urea nitrogen

73
Q

BUN →

A

Blood urea nitrogen

74
Q

Has 2 amino groups and 1 carboxyl
group

A

UREA

75
Q

is formed in the liver from CO2 and ammonia (from
the deamination of proteins)

A

Urea

76
Q

The major waste product of protein metabolism

A

Urea

77
Q

3 under azotemia

A

pre renal
renal
post renal

78
Q

_______ are excreted in the GI tract and skin

A

<10%

79
Q

_________ excretion and appears in the urine

A

○ 90%

80
Q

azotemia + renal failure = ________

A

Uremia

81
Q

■ Before the kidney

A

○ Prerenal

82
Q

○ kidney

A

○ Renal

83
Q

■ After kidney

A

post-renal

84
Q

○ Elevation of urea with renal failure

A

uremia

85
Q

elevation of urea in the blood

A

azotemia

86
Q

● Concentration of urea in the blood is affected by

A

protein content of the diet
rate of protein catabolism
renal function and perfusion

PRR

87
Q

Formed from creatine and creatine phosphate in the
muscle

A

Creatinine

88
Q

_____________is synthesized in the liver from arginine, glycine,
and methionine

AGM

A

Creatine

89
Q

3 muscle diseases in creatine

A

○ Muscular dystrophy
○ Poliomyelitis
○ Trauma

90
Q
  • increased in uric acid
A

Gout

91
Q

Purine nucleic acid

A

guanine and adenosine

92
Q

of filtered uric acid is reabsorbed in the PCT

A

98%-100%

93
Q

excreted in the kidneys, others excreted in the GI
tract

A

70%

94
Q

Most uric acid in the plasma is in the form of

A

monosodium urate

95
Q

At concentrations >6.8 mg/dL, the plasma is saturated forming __________

A

urate crystals

96
Q

___________ (pH <5.75), uric acid predominates and
is seen as uric acid crystals

A

acidic urine

97
Q

Gout Found primarily in men (______ years old)

A

30-50 years old

98
Q

https://www.youtube.com/watch?v=NaDVEY4_aE4

A

file:///C:/Users/USER/Downloads/CLIN%20CHEM%20LEC%20FINAL%20(1).pdf

99
Q

Increased levels of urea because of
protein metabolism from the muscles

A

○ Rate of protein metabolism

100
Q

When there is a failure of renal
function, the urea will not be excreted
from the urine and will accumulate in
the blood lading to increased levels

A

○ Renal function and perfusion

101
Q

■ Product of protein
metabolism/catabolism

A

○ Protein content of the diet

102
Q
  • elevation of urea in the blood
A

Azotemia

103
Q

_____________
- afferent arteriole - tuft of capillaries - efferent of arteriole
- bowman’s capsule and space
_________
__________
- thin descending
-thin and thick ascending
___________
__________

A

Glomerulus
proximal convoluted tubule
loop of henle
distal convoluted tubule
collecting ducts

104
Q

____________ in the glomerulus
____________ of the glomerulus
__________ charged basement membrane
Glomerular filtrate = ___________

A

high-pressure
semi-permiability
130-150 ml/L

105
Q

Remember: If a substance’s concentration exceeds the renal threshold for tubular reabsorption, it will appear in the urine

A

Renal Threshold

106
Q

The patient will just be sleeping, very confused, or in
coma (in severe cases)

A

Hepatic Encephalopathy

107
Q

X-linked genetic disorder caused by the
complete deficiency of HGPRT (hypoxanthine
guanine phosphoribsyl transferase)

A

● Lesch-Nyhan Syndrome

108
Q

If bigger muscle mass = more creatine and
creatine phosphate =

A

more creatinine

109
Q

Protein-bound molecules can pass through the glomerulus
because they are negatively charged.

TRUE OR FALSE

A

FALSE

110
Q

Creatinine is formed from phosphocreatine in the muscles.

A

TRUE

111
Q

Creatine - water = __________

A

creatinine

112
Q

Phosphocreatine - phosphoric acid =

A

creatinine

CLIN CHEM LEC (13 decks)

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