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Clinical Microscopy > Session 1: Kidneys & Urine > Flashcards

Session 1: Kidneys & Urine Flashcards

(95 cards)

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1
Q

Which part of the excretory system forms the urine?

A

Kidneys

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2
Q

Provides blood supply for the kidneys

A

Renal Artery

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3
Q

Provides blood drainage for the kidneys

A

Renal Vein

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4
Q

Each kidney contains how many Nephrons

A

1 - 1.5 million neohrons

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5
Q

Major type of Nephrons in the kidney

A

Cortical

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6
Q

Renal blood flow comes from?

A

25% of Cardiac output

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7
Q

Total Renal Blood Flow

A

1200 mL/min

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8
Q

Glomerulus filters out substances of what MW?

A

<70,000

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9
Q

Normal Glomerular filtration rate

A

120 mL/min

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10
Q

Specific gravity of ultrafiltrate

A

1.010

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11
Q

Ultrafiltrate same composition with plasma except for

A

Plasma protein, protein-bound substances, cells

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12
Q

The filtration barrier of the glomerulus is composed of

A

Fenestrated Endothelium
Basement membrane
Visceral epithelium

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13
Q

Fenestrated endothelium is also known as

A

Capillary endothelium

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14
Q

Basement membrane is also known as

A

Basal lamina

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15
Q

Visceral epithelium is also known as

A

Podocytes

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16
Q

This controls the regulation of blood flow to and within the glomerulus

A

Renin-Angiotensin-Aldosterone-System (RAAS)

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17
Q

What is the action of Angiotensin II

A

Vasodilation (Afferent art.)
Constriction (Efferent art.)

Reabsorption of Na

Release of Aldosterone & ADH

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18
Q

End effect of RAAS

A

Increase in systemic blood pressure

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19
Q

Example of substances that require active transport in tubular reabsorption

A

Glucose, amino acids, salts (PCT)
chloride (Asc. LOH)
sodium (DCT)

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20
Q

What substances are passively transported in tubular reabsorption

A

Water (All parts exc. Asc. LOH)
Urea (PCT, Acs. LOH)
Sodium (Asc. LOH)

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21
Q

Major site of reabsorption (Accounts for >65%)

A

Proximal Convoluted tubule

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22
Q

Glucose Renal threshold

A

160 - 180 mg/dL
8.88 - 9.99 mmol/L

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23
Q

What is the specific gravity of fluid leaving the PCT

A

1.010

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24
Q

Urine concentration begins where?

A

Descending & Ascending Loop of Henle

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25
This is a selective process which serves to maintain the osmotic gradient of the medulla
Countercurrent mechanism
26
Explain what happens during the countercurrent mechanism
Water is removed via osmosis in the DESCENDING LOOP OF HENLE (Inc. SG) Sodium & Chloride are reabsorbed in the ASCENDING LOOP OF HENLE (Dec. SG)
27
Final concentration begins where?
Late distal convoluted tubule and continues in the collecting duct
28
Reabsorption of water & sodium in the Distal Convoluted tubule and Collecting ducts is controlled by what?
Hormones (Aldosterone & ADH)
29
Aldosterone hormone responds to the body’s need for?
Sodium
30
Aldosterone is secreted & produced by?
Adrenal cortex
31
Action of Adrenal hormone
Sodium reabsorption Potassium secretion
32
ADH/AVP hormone responds to the body’s need for?
Hydration (Water)
33
ADH/AVP is produced by?
Hypothalamus
34
ADH/AVP is secreted by?
Posterior pituitary gland
35
Action of ADH/AVP
Makes the walls of the DCT & CD (collecting duct) permeable or impermeable to water
36
Refers to the passage of substance from the blood to the filtrate for excretion
Tubular secretion
37
Major site of secretion
Proximal convoluted tubule
38
Purpose of tubular secretion
Elimination of products not filtered by the glomerulus Regulation of the acid-base balance thru secretion of hydrogen ions
39
Variables used in computing eGFR using the Cockroft & Gault formula, except: (Age, Sex, Weight, BUN)
BUN
40
PAH Test is a test for?
Tubular secretion & Renal Blood Flow
41
Greatest source of error in any clearance procedure
Improperly timed urine specimen
42
Specimen of choice for clearance test
24 hour urine
43
Standard test used to measure the filtering capacity of the glomeruli
Clearance test
44
Originally used as the reference method for GFR
Inulin Clearance
45
Routinely used for screening of GFR
Creatinine clearance
46
Normal GFR
120 mL/min
47
Provide estimates of GFR based on the serum creatinine without urine creatinine
Calculated Glomerular Filtration Est8mates
48
Most frequently used formula for calculated glomerular filtration estimates
Cockroft & Gault (5th ed) MDRD (6th ed)
49
Cockroft & Gault variables includes
Age, Sex, Body Weight
50
Additional variables for MDRD
Blood urea nitrogen, Ethnicity, Serum Albumin
51
Specific Gravity & Osmolarity tests are used for assessing
Tubular reabsorption tests/ Concentration tests
52
Fishberg & Mosenthal are examples of?
Water deprivation tests
53
Normal value for water deprivation test
Urine SG: 1.025 Urine osmolarity: 800 mOsm
54
Quantitative measurement of renal concentrating ability
Osmometry
55
1 mol (1000 mOsm’ will lower the freezing point by?
1.86 deg C
56
What are the 2 types of osmometers in the lab
Freezing point osmometer & Vapor pressure osmometer
57
Lipemic serum affects
Vapor & Freezing point osmometer
58
Lactic acid affects
Both vapor & freezing point osmometer
59
Volatile substances (ethanol) affects
Freezing point osmometer
60
Major organic component of the urine
Urea
61
Urine pH in RTA
Consistently alkaline
62
Major inorganic component in the urine
Chloride
63
Principal salt in the urine
Sodium Chloride
64
<0.8 g/d creatinine in the urine may mean
Improperly collected specimen
65
Urine preservative used for transporting urine specimen for culture
Boric Acid
66
Capacity for urine specimen container
50 mL
67
Labels on urine specimens must be placed
On the container and not the lid
68
After collection, specimens must be sent to the laboratory and tested within?
2 hours
69
Most routinely used method for preservation
Refrigeration at 2-8 deg c
70
Boric acid is bacteriostatic at?
18g/L
71
Excellent sediment preservative used for addis count
Formalin
72
This fixative used for cytology
Saccomano fixative
73
This method of preservation do not interfere with chemical tests
Refrigeration
74
This preservative is used for steroid & hormone analysis
Acids(HCl, glacial acetic acid)
75
Most commonly received specimen used for routine screening tests
Random urine
76
Ideal screening specimen and preferred specimen for pregnancy test
First-morning urine test
77
Preferred specimen for evaluating orthostatic proteinuria
First-morning urine
78
Preferred specimen for nitrite testing
First-morning urine
79
Also known as 2nd morning urine
Fasting urine
80
Preferred specimen for monitoring insulin therapy
2H - post-prandial urine
81
Addition of urine formed before the start of collection for 24 hour urine collection may lead to
Falsely elevated results
82
Failure to include urine produced at the end of collection period for 24 hr urine collection may lead to
Falsely decreased results
83
Specimen of choice for urobilinogen determination
Early afternoon specimen
84
12hr urine is used for
Addis count
85
Second specimen for Three-Glass Collection is used as
Control for bladder & kidney infection
86
In prostatic infection, the 3rd specimen will have
WBC/HPO count & a bacterial count of 10x that of the first specimen
87
This is a variation of three glass collection
Stamey-Mears Four-Glass collection
88
Expressed prostatic secretion for Stamey Meats collection is abnormal if
>10 - 20 WBCs/HPF
89
In Pre-and Post-massage test bacteruiria is positive if
Post massage specimen is >10x the pre-massage count
90
This refers to the process that provides documentation of proper sample identification from the time of collection to the receipt of laboratory results
Chain of Custody (COC)
91
Who are the signatories of COC
collector, courier, laboratory, medical review officer, employer
92
Volume of urine specimen for Drug Specimen collection
30-45 mL
93
Temp of urine for drug specimen collection
32.5 to 37.7
94
Blueing agent is added to the ____________ to prevent specimen adulteration in drug specimen collection
Toilet reservoir
95
SG of urine specimen in drug specimen collection
1.002 - 1.035

Clinical Microscopy (4 decks)

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