CH. 5

Question 1

Which of the following solutes are present in the

largest molar amounts in urine?

Answer 1

urea
chloride
sodium

Question 2

Renal excretion is not involved in the elimination of

Answer 2

normal by-products of fat metabolism.

Question 3

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

Answer 3

creatinine and urea

Question 4

What is the definition of the osmolality of a solution?

Answer 4

The number of solute particles per kilogram of

solvent

Question 5

The osmolality of a solution containing 1.0 mole of

urea is equal to that of a solution containing

Answer 5

0.5 mole of NaCl.

Question 6

The maximum osmolality that urine can achieve is

determined by the

Answer 6

osmolality of the medullary interstitium.

Question 7

Serum osmolality remains relatively constant,

whereas the urine osmolality ranges from

Answer 7

one to three times that of serum.

Question 8

Another name for excessive thirst is

Answer 8

polydipsia.

Question 9

Specific gravity measurements are not affected by

Answer 9

solute charge

Question 10

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

Answer 10

Glucose

Question 11

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?

Answer 11

mannitol

Question 12

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

is called

Answer 12

polyuria

Question 13

The daily volume of urine excreted normally ranges

from

Answer 13

500 to 1800 mL/day.

Question 14

When the body is dehydrated, the kidneys

Answer 14

excrete solutes in as small a volume of urine as

possible.

Question 15

The excretion of less than 400 mL of urine per day

is called

Answer 15

oliguria

Question 16

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

Answer 16

the blood plasma.

Question 17

conditions that may produce nocturia

Answer 17

pregnancy
chronic renal disease
fluid intake at night

Question 18

Which renal function is assessed using specific

gravity and osmolality measurements?

Answer 18

Concentrating ability

Question 19

A fluid deprivation test is used to

Answer 19

assess renal concentrating ability.

Question 20

A fluid deprivation test involves the measurement of

serum and urine

Answer 20

osmolality

Question 21

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

Answer 21

free-water clearance

Question 22

A free-water clearance value of −1.2 would be

expected from a patient experiencing

Answer 22

dehydration

Question 23

Which of the following is an endogenous substance

used to measure glomerular filtration rate?

Answer 23

creatinine

Question 24

Renal clearance is defined as the volume of

Answer 24

plasma cleared of a substance in a time interval.

Question 25

Creatinine is a good substance to use for a renal | clearance test because it

Answer 25

has a constant plasma concentration.

Question 26

Which of the following groups would be expected to | have the greatest 24-hour excretion of creatinine?

Answer 26

men

Question 27

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

Answer 27

muscle mass

Question 28

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

Answer 28

GFR

Question 29

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

Answer 29

A 24-hour urine collection maintained at room | temperature throughout the collection

Question 30

The glomerular filtration rate is controlled by

Answer 30

renal blood flow

Question 31

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

Answer 31

is secreted completely in its first pass through the | kidneys.

Question 32

What percentage of the total cardiac output is | received by the kidneys?

Answer 32

25%

Question 33

Measuring the quantity of hydrogen ion excreted as | titratable acids and ammonium salts in urine provides a measure of

Answer 33

tubular secretory function.

Question 34

The oral ammonium chloride test evaluates the | ability of the tubules to secrete

Answer 34

ammonia and hydrogen

Question 35

what are the factors that change urine volume and solute composition

Answer 35

diet physical activity health

Question 36

what organ regulates body fluid composition

Answer 36

kidneys

Question 37

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

Answer 37

renal excretion

Question 38

what waste can be used to asses kidney function

Answer 38

creatinine and urea

Question 39

polyphagia

Answer 39

excessive eating

Question 40

what condition do diabetes mellitius patients have

Answer 40

polyuria

Question 41

what 2 urine volume conditions are related

Answer 41

polyuria and nocturia

Question 42

what causes oliguria

Answer 42

schelrosis

Question 43

condition where there is no urine

Answer 43

anuria

Question 44

normal osmolality range

Answer 44

275-1000

Question 45

what determines the finial osmolality

Answer 45

distal and collecting tubles with ADH is present

Question 46

what does specific gravity depend on

Answer 46

density and mass

Question 47

normal range of specific gravity

Answer 47

1.002 to 1.035

Question 48

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

Answer 48

osmolality

Question 49

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

Answer 49

concentrating ability slowly diminishes until they are unchanging

Question 50

neurogenic

Answer 50

ADH decreased

Question 51

nephrogenic

Answer 51

lack of renal response to ADH

Question 52

increased body hydration = ____ ADH= ____ urine volume

Answer 52

decreased | increased

Question 53

decreased body hydration = ____ ADH= ___ urine volume

Answer 53

increased | decreased

Question 54

GFR

Answer 54

amount of plasma filtered through the glomerous

Question 55

waste product of muscles

Answer 55

creatinine

Question 56

true or false; creatinine is produced at a constant rate

Answer 56

true

Question 57

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

Answer 57

timed

Question 58

what is the problem with creatinine

Answer 58

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

Question 59

normal range of plasma creatinine

Answer 59

0.5 to 1.5 mg/dL

Question 60

average BSA for adults

Answer 60

1.73

Question 61

nonogram

Answer 61

charts to calculate BSA

Question 62

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

Answer 62

beta2-microglobulin

Question 63

what is an advantage of beta2-microglobulin

Answer 63

99.9% is reabsorbed by proximal tubules

Question 64

what is the marker of reduced tubular function

Answer 64

beta2-microglobulin

Question 65

an increase in cystatin C in blood, _____ GFR

Answer 65

decreases

Question 66

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

Answer 66

cystatin C

Question 67

what filters cystatin C

Answer 67

glomerulus

Question 68

normal amount of albuminuria

Answer 68

5 mg

Question 69

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

Answer 69

albuminuria

Question 70

normal range of microalbuminuria

Answer 70

40-50 mg

Question 71

what is the most important change associated with glomerular proteinuria

Answer 71

hyperglycemia

Question 72

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

Answer 72

p-aminohippurate clearance

Question 73

true or false: titratable acids are not constant

Answer 73

false

Question 74

assess tubular function for removing acids

Answer 74

measurement of titratable acid versus urinary ammonia

Question 75

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

Answer 75

oral ammonium chloride test

Question 76

what test diagnoses renal tubular acidosis

Answer 76

oral ammonium chloride test

Question 77

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

Answer 77

creatinine clearance

Question 78

what test sees how well kidneys are able to conc urine

Answer 78

urine osmolality

Question 79

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

Answer 79

urine protein

Question 80

what test looks at renal function

Answer 80

plasma creatinine

Question 81

what proteins are apart of the acute phase reactant

Answer 81

alpha I | alpha II

Question 82

what kind of gamma peak would you expect from monoclonal

Answer 82

sharp

Question 83

what kind of gamma peak would you expect from multiple clonal

Answer 83

shallow