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Year 2 Renal > Introduction to renal testing > Flashcards

Introduction to renal testing Flashcards

1
Q

what are the essential functions of the nephron?

A
  • maintain constant extracellular environment
  • secrete enzymes and hormones
  • catabolize peptide hormones
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2
Q

what does BUN measure? what is it related to?

A
  • amount of nitrogen in the blood in the form of urea

- related to the metabolic function of liver and excretory function of kidney

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3
Q

what organ is responsible for excretion of urea?

A

liver

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4
Q

is azotemia related to an decreased or increased BUN? what are causes of azotemia?

A
  • high BUN
  • dehydration
  • hypovolemia
  • shock
  • CHF
  • MI
  • GI bleed
  • protein supplementation
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5
Q

what are causes of a decreased BUN?

A
  • liver failure
  • overhydration
  • negative nitrogen balance (malnutrition / malabsorption)
  • pregnancy
  • nephrotic syndrome
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6
Q

can GFR be measured directly? what are the filtration markers?

A
  • cannot be measured directly
  • creatinine
  • cystatin C
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7
Q

creatinine is a catabolic product of __________

A

creatinine phosphate

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8
Q

what causes increased creatinine levels?

A

diseases affecting renal function

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9
Q

what causes decreased creatinine?

A

decreased muscle mass

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10
Q

what is a normal (postrenal) BUN : creatinine level? prerenal? renal?

A
  • postrenal (normal): 10-20 : 1
  • prerenal: over 20 : 1
  • renal: under 10 : 1
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11
Q

creatinine clearance is proportional to _________

A

GFR

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12
Q

what is the normal pH of urine?

A
  • normal: 4.5 - 8.0

- usually: 5.0 - 6.5

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13
Q

does dehydration cause a high or low specific gravity?

A

high

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14
Q

if you get a false positive for blood in the urine, what is the follow up test?

A

microscopy

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15
Q

urine microalbumin is ordered for patients with what conditions?

A

DM, HTN

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16
Q

if you have 3 abnormal urine dipstick tests, what is performed next?

A

24 hr urine collection

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17
Q

what is the cause of glomerular proteinuria?

A

increased filtration of macromolecules across glomerular capillary wall (usually albumin)

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18
Q

what is the cause of tubular proteinuria?

A

malfunctioning tubule cells no longer metabolize or resorb normally filtered proteins (poor function)

19
Q

what is the cause of overflow proteinuria?

A

protein overwhelms the ability of the tubules to resorb filtered proteins

20
Q

most cases of high proteinuria are due to which type?

A

glomerular

21
Q

definition: pyuria

A

over 4 WBC/HPF in a clean voided specimen

22
Q

definition: hematuria

A

over 3 RBC/HPF on 2/3 urine samples

23
Q
  • hematurie
  • proteinuria
  • RBC casts
  • dysmorphic RBCs

what is the source of the blood?

A

glomerular hematuria

24
Q
  • hematuria
  • proteinuria

what is the source of the blood?

A

renal (tubular, interstitial, vascular)

25
what is the source of the blood in a patient with only hematuria (no proteinuria, etc)?
urologic hematuria - tumors, calculi, infection
26
what type of epithelial cells in the urine are the only type of importance?
tubular
27
definition: casts
clumps of material or cells that form in the renal distal and collecting tubules
28
RBC casts - diagnosis?
glomerulonephritis
29
WBC casts - ddx?
- pyelonephritis - glomerulonephritis - interstitial nephritis - tubular epithelial acute tubular necrosis - interstitial nephritis - eclampsia - glomerulonephritis
30
fatty casts - ddx?
- nephrotic syndrome | - hypothyroidism
31
waxy / broad casts - ddx?
advanced renal failure
32
cystine crystals are seen in what disease? what is the inheritance pattern?
cystinuria - autosomal recessive
33
what is the most common type of stone?
calcium oxalate
34
what type of stone is seen in ehtylene glycol poisoning?
calcium oxalate
35
calcium oxalate crystals are seen in what conditions?
- ethylene glycol poisoning | - acute renal failure
36
struvite stone are seen in infection from what organism?
proteus
37
proteus infection causes what type of stone?
struvite
38
what is the most common intrinsic cause of acute renal failure in the hospitalized patient?
ATN
39
what is the standard test for diagnosis of UTI?
quantitative urine culture
40
what type of casts are seen in nephritic syndrome?
RBC
41
- high CK - high Mb - UA blood - neg RBCs diagnosis?
rhabdomyolysis
42
UA+ for eosinophils - diagnosis?
(allergic) interstitial nephritis
43
what are the major indications for renal biopsy (4)?
- isolated glomerular hematuria with proteinuria - nephrotic syndrome - acute nephritic syndrome - unexplained acute or rapidly progressive renal failure

Year 2 Renal (38 decks)

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