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Clinical Chemistry 1 > 16. Renal > Flashcards

16. Renal Flashcards

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1
Q

Crystal found in urine

A

Uric acid

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2
Q

2 functions of peritubular capillaries

A

Reabsorption and secretion

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3
Q

3 causes of proteinuria

A
  • Renal disease
  • Post-strenuous exercise
  • Dehydration
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4
Q

Low MW proteins that are light chain Ig fragments

A

Bence Jones proteins

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5
Q

7 functions of kidney

A
  1. Urine formation
  2. Regulate fluid balance
  3. Regulate electrolyte balance
  4. Regulate acid/base balance
  5. Excrete waste products of metabolism
  6. Hormonal functions
  7. Protein conservation
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6
Q

Where is uromucoid produced

A

DCT, collecting duct

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7
Q

Cause of decreased serum uric acid

A

Fanconi’s disease

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8
Q

Acidic urine = formation of which calculi?

A
  • Uric acid calculi

- Cystine calculi (rare)

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9
Q

What gets converted to urea? Where?

A

Protein -> aa -> ammonia -> urea

Liver

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10
Q

3 principle nitrogenous waste compounds

A
  • Urea
  • Creatinine
  • Uric acid
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11
Q

When is uric acid soluble?

A

> pH 5.75 = sodium urate

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12
Q

Most common calculi

A

Calcium oxalate

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13
Q

Presence of waxy casts indicates?

A

End-stage renal disease

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14
Q

__________ rate of formation is constant per day and is proportional to one’s muscle mass

A

Creatinine

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15
Q

Cause of Type II RTA

A

Fanconi’s syndrome

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16
Q

Creatinine is made in the liver from these 3 compounds

A
  • Arginine
  • Glycine
  • Methionine
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17
Q

Part of nephron that is permeable to ions (active and passive) but not to water

A

Ascending loop of Henle

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18
Q

Glomerular filtrate formation due to 2 things

A
  • Pressure

- Selectivity by charge and size

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19
Q

Enzyme that catalyzes hydrolysis of urea to ammonia and CO2

A

Urease

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20
Q

Alkaline urine = formation of which calculi?

A
  • Calcium phosphate

- Magnesium ammonium phosphate calculi (struvite)

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21
Q

Inborn error of metabolism associated w/ overproduction of uric acid resulting in arthritis, nephropathy, nephrolithiasis

A

Gout

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22
Q

Cause of type IV RTA

A

Diabetic nephropathy

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23
Q

Name of test that is starting to replace microalbumin

A

Albumin/creatinine ratio (ACR)

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24
Q

How to differentiate upper/lower UTI in terms of casts?

A

Lower - no casts

Upper - WBC casts

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25
Pre-renal, renal- post-renal causes of increased serum BUN
Pre-renal = congestive heart failure, hemorrhage, dehydration, increased production in liver Renal = kidney failure Post-renal = urinary tract obstruction
26
Crystal found in pseudo-gout
Calcium pyrophosphate
27
4 hormones produced by kidneys
- Renin - Vitamin D - EPO - Prostaglandins
28
ADH regulates final urine concentration by controlling?
Tubular permeability
29
Which renal tubular acidosis type? Basic urine pH
Type I (distal/classical RTA)
30
Part of nephron that is permeable to water by passive transport but not to ions
Descending loop of Henle
31
Effect of prostaglandins produced by kidneys?
Increase renal flow, sodium and water excretion, renin release
32
Formed when creatine loses a water molecule
Creatinine
33
Reabsorption of Na+ in DCT is under the control of?
Aldosterone
34
RBC casts indicates..?
Acute glomerulonephritis
35
Steps in production of creatinine
Creatine (liver) -> creatine phosphate via creatine kinase -> CP loses phosphoric acid and water => creatinine which diffuses into plasma
36
RI for creatinine clearance?
1.20 - 2.60 mL/sec/1.73m^2
37
High serum creatinine = ____ urine creatinine = _____ GFR
Low urine CR | Low GFR
38
Glomerular basement membrane cut-off size
68 kDa (size of albumin)
39
Countercurrent mechanism takes place in the?
Juxtaglomerular nephrons
40
Varying pH urine = formation of which calculi?
Calcium oxalate calculi
41
What to look for in Type I, II, and IV RTA?
I - renal STONES II - BONE demineralization IV - low ALDOSTERONE
42
Small amounts of urea can be excreted through these 2 places
GI | Skin
43
The selective reabsorption process in the loop of Henle is called the _______________ and serves to maintain the osmotic gradient of the medulla
countercurrent multiplier system
44
Constituent of hyaline casts
Uromucoid (Tamm-Horsfall mucoprotein)
45
Which renal tubular acidosis type? Acidic urine pH
Type IV (generalized distal RTA)
46
Formula for urine formation
Glomerular filtration - tubular reabsorption + tubular secretion = excretion/urine
47
What is oliguria
Diminished urine secretion in relation to fluid intake (<400 mL/day)
48
3 physiological functions of nephron
- Glomerular filtration - Tubular reabsorption - Tubular secretion
49
Crystal found in gout
Monosodium urate
50
Name of calculi that has multiple small calculi with varying size
Staghorn calculi
51
What form of uric acid causes urolithiasis and gout
pH <5.75
52
What is azotemia
Excess of urea/creatinine/other nitrogenous end products in blood
53
Type of nephron responsible for renal concentration
Juxtaglomerular
54
Function of aldosterone
Stimulates Na+ reabsorption, K+ and H+ secretion at DCT
55
Hormone that stimulates water reabsorption in DCT
ADH (DCT normally impermeable to water but ADH makes it permeable)
56
Where and what controls the production of aldosterone
Adrenal cortex RAAS - decreased blood flow/BP in renal arteriole or decreased blood Na+
57
An increase in urea and BUN
Uremia
58
Which renal tubular acidosis type? Variable to <5.3 urine pH
Type II (proximal RTA)
59
What is another word for uremia
Azotemia
60
Word for complete suppression of urine formation and excretion (acute renal failure) <100 mL/day
Anuria
61
Cause of type I RTA
- Drugs | - Autoimmune
62
Enzyme that produces creatine when creatine phosphate loses a phosphoric acid
Creatinase
63
Waste product of purine metabolism
Uric acid
64
After kidneys, blood returns to venous system via _________ to the ________
via RENAL VEIN to the IVC
65
What is polyuria
Excessive excretion of urine (e.g. DM) >3 L/day
66
3 hormones that control tubular reabsorption
- ADH/vasopressin - Aldosterone - PTH
67
3 mechanisms of pathologic proteinuria
- Glomerular defect - Tubular defects - Overflow proteinuria
68
Renin secreted by nephron in response to..?
Low systemic BP
69
May interfere with creatinine measurements
- Bilirubin | - Ammonia

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