Renal

Question 1

Where are the kidneys located?

Answer 1

Posterior abdominal wall

Question 2

What is the function of the kidneys?

Answer 2

Filters the blood and excrete excess water and waste products in the form of urine

Question 3

What is reabsorbed in selective reabsorption?

Answer 3

Sodium, amino acids and glucose are reabsorbed from the filtrate into the blood.

Question 4

How many nephrons does a healthy adult have in each kidney?

Answer 4

0.8 to 1.5 million

Question 5

What do the kidneys eliminate?

Answer 5

Drugs, water and H+ ions

Question 6

What do the kidneys retain?

Answer 6

Plasma proteins and blood cells

Question 7

What do the kidneys secrete?

Answer 7

Distal convoluted tubules
H+ and Ammonia

Question 8

What is reabsorbed by the kidneys?

Answer 8

Distal convoluted tubules
Sodium
Chloride
Water
biocarbonate (HCO3)
glucose
organic substrate

Question 9

Name all the renal function tests.

Answer 9

Blood urea
Creatinine
Proteinuria
Albumin creatinine ratio
Serum electrolyte
Blood in the urine
Glomerular filtration rate (GFR)

Question 10

Renal function tests - blood urea

Answer 10

normal blood level = 7-21 mg/dl

raised in renal failure

Question 11

Renal function tests - creatinine

Answer 11

normal blood level = 0.6 to 1.2 mg/dl

Levels are increased when there is reduced glomerular filtration

Question 12

Renal function tests - Proteinuria

Answer 12

Normally protein is not found in urine when a routine dipstick test is performed.
Albumin presence is a sign of renal failure

Question 13

Renal function tests - albumin creatinine ratio

Answer 13

200mg/g of creatinine

Greater the ratio, more albumin in the urine

Question 14

Renal function tests - serum electrolyte

Answer 14

Abnormal levels may be due to kidney problems

Question 15

What is blood in the urine a sign of?

Answer 15

Renal disease

Question 16

Renal function tests - GFR

Answer 16

The GFR test measures how well your kidneys are filtering the blood.

Normal range - 90-120 mL/min/1.74 m2

Older people will have lower than normal GFR levels - GFR decreases with age
Levels below 60 for 3 or more months are a sign of chronic kidney disease

A GFR lower than 15 is a sign of kidney failure

Question 17

What is the Normal Urinary Output for an Adult?

Answer 17

400 to 2,000 mL of urine daily.

Question 18

What are the types of acute renal failure?

Answer 18

Prerenal
Intrarenal
postrenal

Question 19

Prerenal failure

Answer 19

A sudden and severe drop in blood pressure or interruption of blood flow to the kidneys from severe injury/illness

Question 20

Intrarenal failure

Answer 20

Direct damage to the kidneys by inflammation, toxins, drugs infection or reduced blood supply

Question 21

Postrenal failure

Answer 21

sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor or injury

Question 22

Oliguria

Answer 22

Excretion of less than 300 ml of urine/day

Question 23

Uremia

Answer 23

Urea, creatinine, and other waste products are retained in the blood, along with symptoms such as loss of appetite, nausea, vomiting , pericarditis. Symptoms like lethargy, confusion, coma indicate a progression to the final stages of uremia

Question 24

Dysuria

Answer 24

Pain, burning, difficulty, or discomfort related to urination. Causes include stone and/or infection in the urinary tract

Question 25

Renal colic

Answer 25

Severe pain that can present suddenly and without warning. It is usually caused by stones in the kidney, renal pelvis or ureter. The pain is caused by dilatation, stretching and spasm of the ureter

Question 26

Oedema

Answer 26

It is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body.

Question 27

What are the factors contributing to oedema?

Answer 27

increased hydrostatic pressure of blood reduced oncotic pressure of blood increased blood vessel wall permeability as in inflammation. obstruction of fluid clearance via the lymphatics

Question 28

Azotemia

Answer 28

abnormally high levels of nitrogen-containing compounds, such as urea and creatinine.

Question 29

Prerenal azotemia

Answer 29

caused by a decrease in cardiac output, resulting in inadequate blood supply to the kidneys.

Question 30

Renal azotemia (acute renal failure)

Answer 30

It is intrinsic disease of the kidney, generally the result of renal parenchymal damage.

Question 31

Postrenal azotemia

Answer 31

Blockage of urine flow in an area below the kidneys results in postrenal azotemia.

Question 32

Polyuria

Answer 32

Persistent large increase in urine output. It may be due to excess intake of water, or increased excretion of solute, as in hyperglycemia and glycosuria or defective renal concentration ability.

Question 33

Proteinuria

Answer 33

It is the most common sign of renal disease. Most reagent strips can detect 20mg/dl or more in urine. These tests primarily detect albumin and are insensitive to globulin.

Question 34

Haematuria

Answer 34

It is the presence of red blood cells (erythrocytes) in the urine. it can be a sign that there is a kidney stone or a tumor in the urinary tract.

Question 35

Pathology of glomerular diseases

Answer 35

1. Cellular proliferation of: - visceral epithelial - endothelium - parietal epithelium - mesangial cells 2. Deposition of immune complexes: - subepithelial - subendothelium - mesangial

Question 36

What are the diseases of the glomerulus?

Answer 36

Nephrotic syndrome Acute nephritic syndrome Mixed

Question 37

Nephritic syndrome - manifestations and pathology

Answer 37

Manifestations: Hematuria Variable proteinuria Impaired renal function Hypertension Edema Pathology: Endothelial damage and inflammation of glomerulus

Question 38

Nephrotic syndrome

Answer 38

Insidious onset Manifestations: 1) Massive proteinuria 2) Hypoalbuminemia 3) Generalized edema 4) Hyperlipidemia Pathology: 1) Shortening and fusion of foot processes of podocytes 2) damage to basement membrane due to accumulation of membrane like material, as in diabetes mellitus

Question 39

Nephrotic syndrome

Answer 39

Insidious onset Manifestations: 1) Massive proteinuria 2) Hypoalbuminemia 3) Generalized edema 4) Hyperlipidemia Pathology: 1) Shortening and fusion of foot processes of podocytes 2) damage to basement membrane due to accumulation of membrane like material, as in diabetes mellitus

Question 40

Focal Segmental Glomerulosclerosis

Answer 40

Focal—only some of the glomeruli are involved segmental—only part of an entire glomerulus is involved glomerulosclerosis—refers to scarring of the glomerulus

Question 41

What is minimum change disease?