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Flashcards in Renal Function Tests Deck (45):
1

Enumerate purposes of measuring GFR in established disease

targeting treatment
monitoring progression
predicting req for renal replacement therapy

2

Cystatin: low MW protease inhibitor and produced at constant rate by all nuc cells.
What is false about it?
A.plasma level decreases when GFR increases
B.increase may indicate diabetic nephropathy
C.assesses GFR @ pedia, elderly, renal transplant
D.increases more rapidly than creatinine @ early stages of GFR impairment

(A - directly proportional sila)

3

Enumerate 3 pre-req for reliable urine collection

urine flow must be adequate
collection period > 4 hours
complete bladder emptying

4

false about urea clearance
A.reabsorption bulk @ proximal tubule
B.in normal renal func:10% of creatinine clearance
C.there is intrarenal recycling of urea

(B - 50% dapat)

5

false about urea clearance
A.volume depletion decreases it
B.in advanced renal failure, it approaches unity with creatinine clearance
C.BOTA
D.NOTA

(B: GFR dapat)

6

gold standard for measuring GFR
A.inulin clearance
B.I-iothalamate and TC-DTPA (radioactive)
C. iohexol and Cr-EDTA
D.nonradiolabeled iothalamate

(A)

7

Does not require urine collection
A.inulin clearance
B.I-iothalamate and TC-DTPA (radioactive)
C. iohexol and Cr-EDTA
D.nonradiolabeled iothalamate

(C)

8

gold standard for assessing renal function. give also ref range. :)
A. Serum Creatinine
B. Serum Amylase
C. Urea Clearance
D. Glomerular Filtration Rate

(D - 80 to 120 mL/min)

9

Which is false about creatinine?
A. creatinine partially secreted by proximal tubule
B. derived from dietary meat
C. clearance affected by muscle and age
D. production same for men and women

D

10

not a cause of increased creatinine clearance
A.high cardiac output
B.pregnancy
C.dehydration
D.CO poisoning

C

11

not a cause of decreased creatinine clearance
A.burns
B.congestive heart failure
C.dehydration

A

12

___ increases Na reabsorption
A.aldostrone
B.anti-diuretic hormone
C.atrial natiruetic peptide

A

13

___increases water reabsorption
A.aldostrone
B.anti-diuretic hormone
C.atrial natiruetic peptide

B

14

___inhibits release of renin and ADH, to increase urine prod
A.aldostrone
B.cortisol
C.atrial natiruetic peptide

(C)

15

Not a selection criteria of the glomerular membrane
A. pressure
B. temperature
C. molecular weight
D. charge

B

16

True about proximal convoluted tubule
A. most metabolically active part of the nephron
B. secretes electrolytes
C. reabsorbs hydrogen ion

(A. B and C - baliktad)

17

A. What is renal plasma threshold (RPT)?
B. If you go beyond your RPT, is there still reabsorption?

A.limit to amount of analyte that is completely reabsored from the glomerular filtrate
B.No

18

Enumerate 2 functions of the distal convoluted tubule

final reabsorption of sodium
removal of excess acid

19

A.T/F Ascending Loop of Henle concentrates, while descending Loop of Henle dilutes
B. The collecting duct is the site of final conc for urine. It is formed from __ distal tubules.

A.F, baliktad
B.6

20

False about Beta-2-microglobulin
A.plasma level increases in renal failure
B.needed for production of CD4 cells
C.component of MHC-I

B - CD8 dapat

21

Why does Beta Trace Protein level increase in patients with renal disease?

reduced filtration in the presence of constant production

22

Which renal function marker does not use urine as specimen?
A.alpha-1 microglobulin
B.alpha-2 macroglobulin
C.cystacin C
D.microalbumin

C

23

Which renal function marker is useful in monitoring diabetic nephropathy?
A.alpha-1 microglobulin
B.alpha-2 macroglobulin
C.cystacin C
D.microalbumin

D

24

Which renal function marker is marker of membrane permeability in serum
A.alpha-1 microglobulin
B.alpha-2 macroglobulin
C.cystacin C
D.microalbumin

B

25

Enumerate 3 reasons why creainine is the most widely used marker for GFR

1. endogenous substance with fairly constant rate of prod
2. freely filtered by glomerulus
3. not reabsorbed by renal tubules

26

A. 1.2-1.4 mg/dL
B. 1.5-1.7 mg/dL
C.1.6-1.9 mg/dL
Which is the upper limit of serum creatinine before removing noncreatinine chromogens?

(C. A - after removal)

27

Does not falsely increase serum creatinine conc
A.ketones
B.fructose & glucose
C.urea
D.pyridoxal phosphate
E.ascorbic acid

D

28

A.most widely used method to measure creatinine @ serum -
B.in (A), creatinine reacts with ___ -

A.Direct Jaffe
B.picric acid

29

[Serum Creatinine]
A.color of end product of Direct Jaffe Method
B.to eliminate interferences, what step is added?

A.red
B.acidification

30

Does not cause serum creatinine increase
A. impaired renal function
B. pregnancy
C. chronic nephritis
D. congestive heart failure

(B)

31

Does not cause serum creatinine decrease
A. impaired renal function
B. pregnancy
C. decreased muscle mass
D. inadequate dietary func

A

32

A.Enumerate two ways on how blood urea nitrogen is reabsorbed.
B.What is azotemia?

A.2 ways:
1.passive thru lipid membrane @ proximal convoluted tubule
2.mediated by urea transporters @ inner medullary collecting duct
B.elevated plasma levels of urea and creatinine in blood

33

false about blood urea nitrogen
A.first to elevate at kidney disease
B.drop in severe liver disease
C.kidney is in-charge of generating urea fr ammonia

C - liver dapat

34

The ff are enzymatic methods for measuring blood urea nitrogen except
A.hydrolysis of urea
B.coupled urease/glutamate dehydrogenase method
C.isotope dilution mass spectrometry
D.diacetyl monoxime method

D - direct/chemical method

35

not a limitation of BUN measurement methods
A.protein metab
B.hydration state
C.infectious disease
D.use of steroids

(C)

36

BUN is increased in all except
A.burns
B.chronic renal disease
C.poor nutrition
D.dehydration

C

37

BUN is decreased in all except
A.impaired absorption
B.high protein diet
C.poor nutrition
D.pregnancy

B

38

disease not connected w/elevated uric acid
A.renal disease
B.gout
C.tuberculosis
D.NOTA

C

39

Uric acid may be measured in all except
A.plasma
B.stool
C.serum
D.urine

B

40

Not reference values for uric acid
A.2.6-6.0 mg/dL
B.0.5-7.2 mg/dL
C.8-23 mg/dL
D.0-27 mmol/L

C & D

A - uric acid ref range, female
B - uric acid ref range, male
C - this is for BUN.
D - ammonia

41

ammonia is a useful marker for the ff except
A.Reye syndrome
B.Urea cycle enzyme deficiency
C.Hepatic failure
D.Respiratory acidosis

D

42

false about ammonia measurement
A.heparin and EDTA are suitable anticoagulants
B.ion selective electrodes measures pH change
C.enzymatic assay uses malate dehydrogenase

C - glutamate dehydrogenase dapat

43

poor perfusion at kidneys
A.pre-renal azotemia
B.renal azotemia
C.post-renal azotemia

A

44

any type of obstruction in which urea is reabsorbed into the circulation
A.pre-renal azotemia
B.renal azotemia
C.post-renal azotemia

C

45

main diff bet pre-renal azotemia & renal azotemia

renal azotemia c/o acute or chronic renal disease
pre-renal azotemia c/o dehydration, low blood volum, congestive heart failure, increased protein breakdown