RENAL FUNCTION Flashcards
(140 cards)
1
Q
this weighs approximately 150g and measures 12.5cm x 6cm x2.5 cm (length, width, depth)
A
kidney
2
Q
ureter measure ____ long
A
25 cm
3
Q
when approximately 150 mL urine accumulates
A
bladder
4
Q
urethra is __ cm long in women and __ cm long in men
A
4 cm; 24 cm
5
Q
fluid biopsy of the kidney
A
urine
6
Q
basic structural and functional unit of the kidney
A
nephron
7
Q
how many nephrons are there PER kidney
A
1 to 1.5 million
8
Q
what are the two type of nephrons
A
cortical and juxtamedullary
9
Q
nephrons consists of
A
glomerulus and renal tubules
10
Q
what is the order of urine formation
A
- Glomerulus
- Proximal Convoluted Tubule
- Loop of Henle
- Distal Convoluted Tubule
- Collecting Duct
- Calyx
- Renal Pelvis -> Ureter -> Bladder -> Urethra
11
Q
the kidney receive ____ of the total cardiac output
A
25%
12
Q
what blood is present in Renal Artery
A
Unfiltered blood
13
Q
what blood is present in renal vein
A
filtered blood
14
Q
what is the order of renal blood flow
A
- renal artery
- afferent arteriole
- glomerulus
- efferent arteriole
- peritubular capillaries
- vasa recta
- renal vein
15
Q
total renal blood flow of 2 kidneys
A
1, 200 mL/min
16
Q
total renal plasma flow of two kidneys
A
600-700 mL/min
17
Q
the “working portion” of the kidney
A
glomerulus
18
Q
glomerulus has a coil of approximately _____ (capillary tuft) located w/in the Bowman’s capsule
A
8 capillary lobes
19
Q
these are attached to the glomerular basement membrane
A
podocytes (epithelial cells)
20
Q
this resembles a sieve
A
glomerulus
21
Q
how many daltons are able to pass through the glomerulus
A
< 70, 000 Daltons
22
Q
approximately __ of the filtered plasma volume is actually excreted as urine
A
1%
23
Q
what is found between the podocytes of Bowman’s space
A
Filtration Diaphragm
24
Q
how many daltons albumin is
A
69k daltons
25
why is albumin not able to pass through the glomerulus
because of the shield of negativity
26
what is the charge of albumin
negative
27
when is albumin positive charge
at 4.9 pH
28
1st function to be affected in renal disease
tubular reabsorption
29
plasma concentration at which active transport stops
renal threshold
30
renal threshold for glucose
160- 180 mg/dL
31
these alter the urine concentration
PCT, LH, DCT, & CD
32
major site (65%) of reabsorption of plasma substance
PCT
33
renal concentration begins in the ______
descending and ascending LH
34
* Solute concentration is highest where
Loop of Henle (renal medulla)
35
true or false
the ascending loop of henle is highly permeable to water
false (highly impermeable)
36
Dam collects water, so does the _____
Descending loop of henle
37
Ascending loop of henle reabsorbs
a. Salt
b. Water
a. Salt (ASINding LH)
38
during the active transport, glucose, amino acids, and salts are located at the _____
PCT
39
location of sodium during active transport
PCT and DCT
40
location of water during passive transport
PCT, Descending LH, CD
41
Location of Urea during passive transport
PCT, ascending LH
42
location of sodium during passive transport
ascending LH
43
movement of molecules across a membrane by diffusion because of a physical gradient
passive transport
44
movement of a substance across cell membranes into the bloodstream by electrochemical energy
active transport
45
this regulates water reabsorption in the DCT and CD
Anti-diuretic hormone (ADH/Vasopressin)
46
ADH during increase of body hydration
decrease
47
Urine Volume during increase of body hydration
increase
48
ADH during decrease of body hydration
increase
49
Urine Volume during decrease of body hydration
decrease
50
ADH in Diabetes Insipidus
Decreased/Deficient (DI = Daming Ihi)
51
ADH in Syndrome of Inappropriate ADH secretion
ADH excess
52
regulates sodium reabsorption in the DCT
Aldosterone
53
Effects of Angiotensin II
- Release of Aldosterone and ADH
- Vasoconstriction
- Corrects renal blood flow
54
sodium and water reabsorption during the releasing of Aldosterone and ADH
INCREASE OR DECREASE
INCREASE
55
Blood Pressure during the increase of Sodium and water reabsorption
Increased
56
juxtaglomerular apparatus consists of the _____ in the afferent arteriole
JG cells
57
JG cells produce what
renin
58
this detects the decrease in Blood Pressure
Macula Densa
59
RAAS ____ the afferent arteriole and _____ the efferent arteriole
dilates; constricts
60
RAAS stimulates the sodium reabsorption in the
a. DCT
b. PCT
b. PCT
61
RAAS triggers the adrenal to release _____ to cause sodium reabsorption & potassium excretion in the DCT and CD
aldosterone
62
RAAS triggers the release of anti-diuretic hormone by the ______ to stimulate water reabsorption in the CD
Hypothalamus
63
2 major functions of tubular secretion
1. regulation of the acid-base balance in the body through secretion of hydrogen ions (in the form of ammonium & dihydrogen phosphate
2. elimination of waster products not filtered by the glomerulus
64
major site for removal of nonfiltered substances
Proximal Convoluted Tubule
65
_______ are secreted in exchange for sodium ions which are reabsorbed with bicarbonate into the plasma in the PCT
Hydrogen ions
66
failure to produce an acid urine due to inability to secrete hydrogens ions
Renal Tubular Acidosis (RTA)
67
blood pH during RTA
acidic (decreased)
68
Urine pH during RTA
alkaline (increased)
69
used to evaluate glomerular filtration
clearance test
70
clearance test measure the rate at which the kidneys are able to ________ from the blood
remove a filterable substance
71
clearance test is used for measuring what substances
1. Urea
2. Creatinine
3. Inulin
4. Beta2-microglobulin
5. Radioisotopes
6. Cystatin
72
what is the most common/routinely performed test creatinine
clearance test
73
specimen for creatinine clearance
24-hour urine
74
Reference range of creatinine clearance for male
107-139 mL/min
75
Reference range of creatinine clearance for female
87-107 mL/min
76
variables for cockgroft and gault
age, sex, & body weight in kg
77
variables for modification of diet in renal disease (MDRD) system formula
ethnicity, BUN, and Serum Albumin
78
used to evaluate tubular reabsorption
concentration tests
79
obsolete test that deprived the patient of fluid for up to 24 hrs
Fishberg test
80
Urine SG after 12 hr restricted fluid diet is about ____ or more
1.022
81
Urine SG after 24 hr restricted fluid diet is about ____ or more
1.026
82
obsolete test wherein the patient is deprived of fluid for up to 24 hrs
mesonthal test
83
it is influenced by the number & density of particles in a solution
Specific Gravity
84
influence by the number of particles in a solutiion
osmolality
85
it is more accurate and preferred than SG determination
Osmolality
86
most commonly used and reference method for tubular secretion & renal blood flow
p-aminohippuric acid (PAH) test
87
obsolete test for tubular secretion & renal blood flow because the results are hard to interpret
Phenolsulfonphtalein (PSP) test
88
hindu physicians that this attracted ants
honey urine
89
this is used by the Babylonians and Egyptians to detect diabetes
taste test
90
urine is composed of
95-97% water
3-5% solids
91
total solids are composed of
35 grams organic
25 grams inorganic
92
major constituent of organic total solids
urea
93
2nd major constituent of organic total solids
creatinine
94
other components of organic total solids
hippurate, uric acid, CHO, pigments, fatty acid, mucins, enzymes, hormones
95
major constituent of inorganic total solids
chloride
96
other inorganic total solids
chloride > sodium > potassium
sulfate. phosphate, ammonium, magnesium, calcium
97
principal salt of inorganic total solids
NaCl
98
urine spx that is used for routine screening tests and qualitative urinalysis
random /occasional/single urine
98
true or false
random urine sample is ideal for cytology studies
true BUT patient must have prior hydration & exercise 5 mins before collection
99
ideal specimen for routine screening/urinalysis and pregnancy testing (hCG)
First Morning Urine
100
true or false
first morning urine is not preferred for cytology studies/cytodiagnostic urine testing
First Morning Urine
101
it is the most concentrated and most acidic urine specimen that allows well preservation of cells and casts
First Morning Urine
102
why is first morning urine acidic
because we hypoventilate while sleeping (steady and slow breathing)
103
first morning urine is used for evaluation of
Orthostatic Proteinuria
104
it is the 2nd voided urine after a period of fasting
2nd morning urine/fasting
104
urine specimens for glucose determination
2-hour post prandial
Glucose tolerance
fractional specimen
104
glucose tolerance test is optional to be test with
blood samples
104
urine spx for diabetic screening and monitoring; preferred for glucose testing
2-hour post prandial
105
2nd morning urine is used for
glucose determination (but not recommended)
106
bladder urine for anaerobic bacterial culture and urine cytology wherein the abdominal wall is punctured, and urine is directly aspirated from the bladder
suprapubic aspiration
106
for routine screening and bacterial culture (OPD)
Midstream clean catch
106
urine spx used for bacterial culture (may urethral or ureteral)
catheterized
107
used in diagnosis of diabetes wherein series of blood and urine samples are collected at specific time intervals to compare concentration of a substance in urine with its concentration in the blood
fractional specimen
108
urines in three glass technique
1. first portion of voided urine
2. middle portion of voided urine
3. urine after prostatic
massage
108
type of urine collection that uses soft, clear, plastic bag with adhesive
pediatric spx
108
3 glass technique result for prostatitis
1. WBC bacteria
2. Clear
3. 10x greater WBC bacteria compared to 1st
108
3 glass technique result for healthy prostate
1. WBC bacteria
2. Clear
3. Clear
108
control for bladder and kidney infection
2nd specimen
108
3 glass technique result for UTI
1. WBC bacteria
2. WBC bacteria
3. WBC bacteria
109
the four glass method that consists of bacterial cultures of the initial voided urine (VB1), midstream urine (VB2), expressed prostatic secretions (EPS) and a post prostatic massage urine specimen (VB3)
Stamey-Meares Test for Prostatitis
109
process for 24 hour urine
at the start time, the patient will empty their bladder and the rest of the urine throughout the day will be collected (ex. 8AM to 8AM)
109
12 hr urine is used for
addis count (quantitation of formed elements)
110
4hr urine is used for
nitrite determination
111
why is 4hr urine used for nitrite determination
in the bladder, the bacteria will convert nitrate to nitrite (mas matagal mas maganda)
111
afternoon (2-4pm) urine is used for
Urobilinogen determination
111
process providing documentation of proper sample ID from the time of collection to the receipt of laboratory results
Chain of Custody (COC)
112
required urine volume for drug test
30-45 mL
112
container capacity for drug test specimen
60 mL (pinapapuno ng ibang lab kaya nagiging 60mL 'yung required volume)
112
temperature of urine for drug test
32.5 - 37.7 ℃ (checked within 4 minutes)
112
added to the toilet water reservoir to prevent specimen adulteration
Blueing agent
112
following collection, urine specimens should be delivered to the laboratory promptly and tested within ____
2 hrs (ideally is within 30 mins)
113
increased in unpreserved urine
1. pH
2. Bacteria
3. Odor
4. Nitrite
113
Decreased in Unpreserved Urine
1. Clarity
2. Glucose
3. Ketones
4. Bilirubin (CB)
5. Urobilinogen
6. RBC/WBC/Casts
7. Trichomonas
114
reason for increase in pH
Urea-----(Urease) -----> Ammonia; loss of CO2
115
reason for increase of nitrite
bacterial multiplication
116
darkened/modified urine is due to _____
oxidation or reduction of metabolites (increase of urobilin)
117
decrease of clarity is due to ____
bacterial multiplication; precipitation of amorphous material
118
decrease of ketones is due to ____
volatilization and bacterial metabolism
119
bacterial metabolism is due to ____
evaporation when the specimen is left uncapped
120
