9.2- Kidney Tests

Question 1

What are the 1st line kindey tests (3 categories)

Answer 1

1. Serum (creatine, urea, electrolytes)
2. Urinalysis
3. Creatine clearence

Question 2

2nd line kidney tests if first idicate a problem (3)

Answer 2

1. Serum (calcium, albumin)
2. Urine pro
3. Osmolarity

Question 3

of those w known kidney disease 72% didnt have these 2 known risk factors

Answer 3

• High blood pressure

- Diabetes mellitus

Question 4

What are the major symptoms of kindey disease(4)

Answer 4

-changes in urine volume, color, smell

• Pain in abdomen or on micturition
• oedema, heart failure etc
• itching, skin chanegs etc

Question 5

What is serum creatine used for and when does it become abnormal

Answer 5

Glomerular filtration test

becomes abnormal when 80% of function is lost

Question 6

Creatine clearence test

Answer 6

• becoming obsolete

- tests for amount of blood cleared of creatine in unit tim (GFR meaurment)

Question 7

serum creatine vs creatine clearence

Answer 7

Creatine clearence more sensitive

-clearence is simlpler

Question 8

If serum creatine clearence is low but pt is well what could that mean (2)

Answer 8

• Preg

- Reduced mm mass

Question 9

If serum creatine is high but pt is well what could that mean

Answer 9

-Acute or chronic reduction in GFR

false pos = creatine sups

Question 10

What is the best test to test for early kidney disease

Answer 10

Serum creatinine

Question 11

What is the back up test to serum creatinine and what does it test forq

Answer 11

serum urea
(asseses kidney function)

Question 12

What could low serum urea suggest

Answer 12

Low pro

Question 13

What could high serum urea suggest (3)

Answer 13

1. High pro diet
2. Gastrointestinal hemorrhage
3. Pro catabolism

Question 14

What are the commonly tested electrolytes in kidney tests (4)

Answer 14

sodi
pot
chl
bicarbonate

Question 15

What are the 2 electros in cell and 2 out

Answer 15

in- pot, magnesium

out- sodium, calcium

Question 16

Comparing sodium in serum and urine gives an assesment of what

Answer 16

kidney proximal tubular function

Question 17

If sodium and cholride change in the same direction what could that indicate (2)

Answer 17

1. retention/loss of water

2. excress/ loss of NaCl

Question 18

What is bicarbonate abnormal in (3)

Answer 18

1. metabolic diseases
2. Kidney diseases
3. Lung diseases

Question 19

What is anion gap and what does a increased anion gap mean

Answer 19

(na + k)- (cl + bicarb)

-increased when another abnormal anion is present (usually due to metabolic diseases

Question 20

What could calcium and magnesium changes indicate in kidney diseases

Answer 20

Specifically for issues w distal tubule

Question 21

What do high levels (>50g/l) mean for serum albumin

Answer 21

dehydration

Question 22

What is serum phosphate changed in (2)

Answer 22

reciprocal of serum calc (if calc low then phosphate high)

-will be low w low vit d

Question 23

Why would serum albumin be low (<35g/l)

Answer 23

• liver diseases
• kidney diseases
• chronic starvation

(will have obvious oedema)

Question 24

How should u sample urine

Answer 24

<4hrs old
-most conc sample overnight

-for metabolic diseases (diabetes) sample taken 2 hrs after meal

Question 25

what could anuria and oliguria suggest (2, 1)

Answer 25

anuria- kidney failure, obstruction oliguria- kidney ischemia

Question 26

What does deep yellow, red, black urine suggest

Answer 26

deep yellow- riboflavin red0 haemoglobin black- old blood, bleeding in kidney

Question 27

What could a small amount constant pro, and large, false pos amount suggest

Answer 27

small constant- early kidney failure large- nephrotic syndrome false- Quaternary amonia, chlorohexidine

Question 28

What could a small amount constant pro, and large, false pos amount suggest

Answer 28

small constant- early kidney failure large- nephrotic syndrome false- Quaternary amonia, chlorohexidine

Question 29

What could cause glucose overload (2) and flase neg

Answer 29

Diabetes, preg false neg- Vit C

Question 30

What could keytones present suggest (2)

Answer 30

Diabetes, preg

Question 31

What could hypersthenuria suggest (>1.010), (2)

Answer 31

-Dehydration, diabetes

Question 32

What would cause bilirubin/urobilinogen to be present

Answer 32

Liver disease

Question 33

What would pos nitrates sigest

Answer 33

Uti from bacteria such as e coli (mc)

Question 34

if nitrites, leucocytes, blood are present on dipstick

Answer 34

94%

Question 35

What could casts of tubules suggest in microscopy

Answer 35

Dehydration UTI red cell casts= infection in kidnet

Question 36

what could crystals in microscopy suggest

Answer 36

Metabolic UTI stones

Question 37

What could epithelia suggest

Answer 37

tubular disease

Question 38

Pos PSA result suggest prostate cancer what % of the time

Answer 38

50% of the time