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CLS 304 > CH. 5 > Flashcards

CH. 5 Flashcards

1
Q

Which of the following solutes are present in the

largest molar amounts in urine?

A

urea
chloride
sodium

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2
Q

Renal excretion is not involved in the elimination of

A

normal by-products of fat metabolism.

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3
Q

The concentration of which substances provides the
best means of distinguishing urine from other body
fluids?

A

creatinine and urea

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4
Q

What is the definition of the osmolality of a solution?

A

The number of solute particles per kilogram of

solvent

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5
Q

The osmolality of a solution containing 1.0 mole of

urea is equal to that of a solution containing

A

0.5 mole of NaCl.

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6
Q

The maximum osmolality that urine can achieve is

determined by the

A

osmolality of the medullary interstitium.

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7
Q

Serum osmolality remains relatively constant,

whereas the urine osmolality ranges from

A

one to three times that of serum.

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8
Q

Another name for excessive thirst is

A

polydipsia.

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9
Q

Specific gravity measurements are not affected by

A

solute charge

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10
Q

Which of the following solutes, if added to pure
water, affects the specific gravity more than it affects
its osmolality?

A

Glucose

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11
Q

Occasionally the specific gravity of a urine specimen
exceeds that physiologically possible (i.e., >1.040).
Which of the following substances when found in
urine could account for such a high value?

A

mannitol

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12
Q

The excretion of large volumes of urine (>3 L/day)

is called

A

polyuria

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13
Q

The daily volume of urine excreted normally ranges

from

A

500 to 1800 mL/day.

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14
Q

When the body is dehydrated, the kidneys

A

excrete solutes in as small a volume of urine as

possible.

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15
Q

The excretion of less than 400 mL of urine per day

is called

A

oliguria

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16
Q

The ultrafiltrate in the urinary space of the glomerulus has a specific gravity of 1.010 and the same as

A

the blood plasma.

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17
Q

conditions that may produce nocturia

A

pregnancy
chronic renal disease
fluid intake at night

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18
Q

Which renal function is assessed using specific

gravity and osmolality measurements?

A

Concentrating ability

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19
Q

A fluid deprivation test is used to

A

assess renal concentrating ability.

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20
Q

A fluid deprivation test involves the measurement of

serum and urine

A

osmolality

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21
Q

The volume of plasma cleared per minute in
excess of that required for solute elimination is
called the

A

free-water clearance

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22
Q

A free-water clearance value of −1.2 would be

expected from a patient experiencing

A

dehydration

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23
Q

Which of the following is an endogenous substance

used to measure glomerular filtration rate?

A

creatinine

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24
Q

Renal clearance is defined as the volume of

A

plasma cleared of a substance in a time interval.

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25
Q

Creatinine is a good substance to use for a renal

clearance test because it

A

has a constant plasma concentration.

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26
Q

Which of the following groups would be expected to

have the greatest 24-hour excretion of creatinine?

A

men

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27
Q

Creatinine clearance results are “normalized” using
an individual’s body surface area to account for
variations in the individual’s

A

muscle mass

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28
Q

A 24-hour urine collection is preferred for determination of creatinine clearance because of diurnal variation in the

A

GFR

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29
Q

Which of the following situations results in an erroneous creatinine clearance measurement?

A

A 24-hour urine collection maintained at room

temperature throughout the collection

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30
Q

The glomerular filtration rate is controlled by

A

renal blood flow

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31
Q

For measurement of renal plasma flow,
p-aminohippurate is an ideal substance to use
because it

A

is secreted completely in its first pass through the

kidneys.

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32
Q

What percentage of the total cardiac output is

received by the kidneys?

A

25%

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33
Q

Measuring the quantity of hydrogen ion excreted as

titratable acids and ammonium salts in urine provides a measure of

A

tubular secretory function.

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34
Q

The oral ammonium chloride test evaluates the

ability of the tubules to secrete

A

ammonia and hydrogen

35
Q

what are the factors that change urine volume and solute composition

A

diet
physical activity
health

36
Q

what organ regulates body fluid composition

A

kidneys

37
Q

what kind of excretion is primary elimination route of soluble metabolic waste

A

renal excretion

38
Q

what waste can be used to asses kidney function

A

creatinine and urea

39
Q

polyphagia

A

excessive eating

40
Q

what condition do diabetes mellitius patients have

A

polyuria

41
Q

what 2 urine volume conditions are related

A

polyuria and nocturia

42
Q

what causes oliguria

A

schelrosis

43
Q

condition where there is no urine

A

anuria

44
Q

normal osmolality range

A

275-1000

45
Q

what determines the finial osmolality

A

distal and collecting tubles with ADH is present

46
Q

what does specific gravity depend on

A

density and mass

47
Q

normal range of specific gravity

A

1.002 to 1.035

48
Q

what measure of urine concentration is more accurate reflection of kidney’s conc ability

A

osmolality

49
Q

what happens to specific gravity or osmolality over time with patients with chronic renal diseases

A

concentrating ability slowly diminishes until they are unchanging

50
Q

neurogenic

A

ADH decreased

51
Q

nephrogenic

A

lack of renal response to ADH

52
Q

increased body hydration = ____ ADH= ____ urine volume

A

decreased

increased

53
Q

decreased body hydration = ____ ADH= ___ urine volume

A

increased

decreased

54
Q

GFR

A

amount of plasma filtered through the glomerous

55
Q

waste product of muscles

A

creatinine

56
Q

true or false; creatinine is produced at a constant rate

A

true

57
Q

what kind of sample collection is creatinine and serum creatinine for a creatinine clearance test

A

timed

58
Q

what is the problem with creatinine

A

a small amount of creatinine is secreted by tubules resulting in an increased urine conc of creatinine

59
Q

normal range of plasma creatinine

A

0.5 to 1.5 mg/dL

60
Q

average BSA for adults

A

1.73

61
Q

nonogram

A

charts to calculate BSA

62
Q

low molecular weight protein found on surface of nucleated cells and shed into plasma

A

beta2-microglobulin

63
Q

what is an advantage of beta2-microglobulin

A

99.9% is reabsorbed by proximal tubules

64
Q

what is the marker of reduced tubular function

A

beta2-microglobulin

65
Q

an increase in cystatin C in blood, _____ GFR

A

decreases

66
Q

low-molecular-weight protein that has potential as a marker for long-term monitoring of renal function

A

cystatin C

67
Q

what filters cystatin C

A

glomerulus

68
Q

normal amount of albuminuria

A

5 mg

69
Q

what protein would you expect to see in patients with early diabetic nephropathy

A

albuminuria

70
Q

normal range of microalbuminuria

A

40-50 mg

71
Q

what is the most important change associated with glomerular proteinuria

A

hyperglycemia

72
Q

exogenous nontoxic weak acid secreted almost exclusively by proximal tubules, used as indicator of renal tubular secretory function

A

p-aminohippurate clearance

73
Q

true or false: titratable acids are not constant

A

false

74
Q

assess tubular function for removing acids

A

measurement of titratable acid versus urinary ammonia

75
Q

what test are patients given ammonium chloride and measure series of urine pH and plasma bicarbonate

A

oral ammonium chloride test

76
Q

what test diagnoses renal tubular acidosis

A

oral ammonium chloride test

77
Q

what test checks how much plasma is being filtered and is an assessment of GFR

A

creatinine clearance

78
Q

what test sees how well kidneys are able to conc urine

A

urine osmolality

79
Q

what test uses electrophoresis to evaluate glomerular permeability to plasma proteins in urine

A

urine protein

80
Q

what test looks at renal function

A

plasma creatinine

81
Q

what proteins are apart of the acute phase reactant

A

alpha I

alpha II

82
Q

what kind of gamma peak would you expect from monoclonal

A

sharp

83
Q

what kind of gamma peak would you expect from multiple clonal

A

shallow

CLS 304 (21 decks)

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