Renal Function Test 4

Question 1

What are the 3 main functions of the kidneys?

Answer 1

1-Excrection
2-Regulation
3-Hormone production

Question 2

3 principle components of excretion?

Answer 2

1-Urea
2-Creatinine
3-Uric Acid

Question 3

What is water regulated by?

Answer 3

osmolality and ADH

Question 4

Electrolytes are regulated by what?

Answer 4

Aldosterone and Renin

Question 5

What does renin respond to?

Answer 5

changes in fluid volume, blood volume, BP, hyponatremia

Question 6

Erythropoetin (EPO) responds to?

Answer 6

changes in blood volume

Question 7

What is 1,25 Dihydroxy vitamin D3 and what does it control?

Answer 7

active form of vitamin D and it controls Phosphate and Calcium balance and bone calcification

Question 8

Cyclic fatty acids that increase renal blood flow, Control renin release and oppose renal vasoconstriction?

Answer 8

Prostaglandins

Question 9

Incoming blood is filtered through?

Answer 9

Glomerulus

Question 10

Basic Renal Process (3 steps)

Answer 10

1-Filtration-incoming blood filtered through glomerulus
2-Tubular reabsorption- returns valuable substance back to body out of glomerular filtrate
3-Tubular Secretion- substances not needed transferred back to filtrate for excretion in urine

Question 11

Testing of Renal Function (5)

Answer 11

1-BUN
2-Craetinine
3-Uric Acid
4-Ammonia
5-Creat clear and GFR

Question 12

BUN

Answer 12

– Urea is 75% of all NPN – metabolic waste of protein metabolism
Urea is filtered and excreted, only a small amount is reabsorbed

Question 13

Plasma BUN will be ______ in renal disease and is _____ to changes in renal function but is not _______ to the kidney
Is influenced by diet

Answer 13

increased
sensitive
specific

Question 14

Creatine is converted to ________ in _______, and is produced at a _______ rate.

Answer 14

Creatine converted to creatinine in muscle. Produced at constant rate

Question 15

Plasma BUN will be increased or decreased in renal disease?

Answer 15

increased

Question 16

TRUE/FALSE
Creatinine is not as senstive to changes in renal function – up to 50% loss in function before elevations seen
Is more specific

Answer 16

True

Question 17

A waste product of purine metabolism?

Answer 17

Uric acid

* at low pH, excess is deposited as Crystals (GOUT)

Question 18

A waste product of metabolism?

Answer 18

Ammonia

* will be increased in kidney disease

Question 19

Creatinine clearance will decrease by ____ for each ______ of life?

Answer 19

6.5ml/min

10 years

Question 20

Creatinine clearance

Formula?
Corrected formula?

Answer 20

(U)*(V)/P

(U)*(V)/P X 1.73/SA

Question 21

Estimated GFR

Formula?

Answer 21

EST GFR= (140-age)*Mass (kg)
—————————
72 * Serum Creatine
*multiply by 0.85 if female (correction factor for gender)

Question 22

Protein/Microalbumin

1-used to monitor?
2-early sign of?
3-get through glomerulus?

Answer 22

1-diabetics and cardiac disease
2-kidney damage (early marker)
3-no

Question 23

Cystatin-C

1-Cleared by the kidney?
2-affected by age, gender, or mass?
3-best marker for renal disease?

Answer 23

1-small protein normal cleared by the kidney but in renal disease it is not
2-not affected
3-yes, better marker than creatine for renal disease
* can be elevated before decrease in GFR or increase in creatinine

Question 24

B2 Microglobulin

1-Stable B2 seen in?
2-Increased B2 seen in?
3-used to assess?
4-Increased B2 usually indicates?

Answer 24

1-healty individuals
2-conditions of increased cell turnover, inflammation, renal failure
3-used to assess renal tubular function in renal transplant patients
4-increased- organ rejection

Question 25

TRUE/FALSE Myoglobin gives a false + for blood on a dipstick?

Answer 25

TRUE

Question 26

A low molecular weight protein associated with skeletal and cardia muscle injury?

Answer 26

Myoglobin *Rhabdomyelosis

Question 27

Can distinguish acute glomerular neuropathy and tubular proteinuria?

Answer 27

Phoresis

Question 28

Can differentiate proteinuria due to abnormal monoclonal or polyclonal?

Answer 28

Phoresis

Question 29

Acute Glomerulonephritis ``` 1-Urinalysis 2-GFR will be? 3-BUN and CREAT? 4-Na and H2O? 5-RBC morphology ```

Answer 29

``` 1-protein and Hematuria 2-decreased 3-increased 4-increased (causes edema) 5-RBC casts ```

Question 30

Often related to group A beta-hemolytic-Strep, auto-immune disease or drug mediated?

Answer 30

Acute Glomerulonephritis

Question 31

What is Nephrotic syndrome?

Answer 31

several different disease/conditions that injury and increase permeability of glomerular basement membrane.

Question 32

Key findings of Nephrotic syndrome?

Answer 32

Proteinuria, hematuria | hyperlipidemia

Question 33

Nephrotic Syndrome SPE 1-Albumin? 2-Alpha 2? 3-Beta? 4-Gamma?

Answer 33

1-decreased 2-increased 3-increased 4-may see a decrease

Question 34

Renal Tubular Disease 1-influenced by? 2-most important manifestation? 3-key findings (3)?

Answer 34

``` 1-influenced by the changes in GFR 2-cannot regulate electrolytes and pH 3-Decrease reabsorption/secretion -Decrease GFR, loss of Na balance -WBC casts on UA ```

Question 35

Acute Renal failure Pre-renal Renal Post-renal

Answer 35

sharp, sudden loss of renal function

Question 36

Chronic renal failure

Answer 36

Gradual loss of function over time

Question 37

Treatment with dialysis 1-Traditional hemodialysis? 2-Peritoneal dialysis? 3-Hemofiltration?

Answer 37

1-removal of waste via synthetic membrane outside body 2-Peritoneal wall is used as membrane-can do it at home-takes longer 3-critically ill patients in ICU/CCU, membrane outside body