Urinalysis Lab

Question 1

flow of blood through kidneys - filtrate/urine flow and blood flow

Answer 1

• filtrate/urine: renal artery –> afferent arterioles –> glomerulus –> renal tubule –> major and minor calicies –> ureter –> urine
• blood: renal artery –> afferent arterioles –> glomerulus –> efferent arteriole –> peritubular capillaries

Question 2

renal corpuscle 3 layers - just list them

Answer 2

• fenestrae
• basement membrane
• podocytes and slit diaphragm

Question 3

fenestrae

Answer 3

• holes in between endothelial cells that RBC, WBC, and platelets cannot go through

Question 4

basement membrane

Answer 4

• connective tissue layer of collagen, negatively charged to repel proteins which are also negatively charged

Question 5

slit diaphragm

Answer 5

• formed between podocytes

- also negatively charged to repel proteins

Question 6

renal tubule structure

Answer 6

• proximal convoluted tubule –> descending limb –> ascending limb –> distal convoluted tubule –> collecting duct

Question 7

renal clearance formula

Answer 7

renal clearance = (filtration + secretion) - reabsorption

Question 8

RPC = 0 meaning and example

Answer 8

• everything is reabsorbed or it is not filtered in the first place
• glucose, amino acids

Question 9

RPC < GFR meaning and example

Answer 9

• GFR = glomerular filtration rate
• more is reabsorbed then filtered or secreted
• urea so that it can make the renal medulla concentrated

Question 10

RPC > GFR meaning and example

Answer 10

• more is secreted than is reabsorbed

- drugs, xenobiotics so that drugs are eliminated faster

Question 11

RPC = GFR meaning and example

Answer 11

• no reabsorption or secretion

- creatinine which makes it a good measure of kidney function

Question 12

2 layers of the kidney and osmolality

Answer 12

• renal cortex on the outside - 300mOsm, isotonic to blood plasma
• renal medulla on the inside, 300mOsm to 1200mOsm in the center

Question 13

2 types of nephrons and and difference in function

Answer 13

• cortical nephron = 2/3 in cortex

- juxtamedullary nephron extends very far into renal medulla to create concentrated urine

Question 14

net filtration pressure

Answer 14

• very low, 10mmHg

Question 15

PCT reabsorption Na+, Cl-, water, glucose, and amino acids

Answer 15

• Na+ is the only one actively transported
• Cl- and water follow Na+
• glucose and amino acid are secondary cotransport

Question 16

reabsorption of water indifferent parts of kidney - list percentages

Answer 16

• 2/3 in PCT
• 20% in descending limb
• 15% in DCT and collecting duct which is controlled by ADH and aldosterone

Question 17

obligatory water loss amount

Answer 17

400mL about 1/2 a liter

Question 18

LEU meaning and abnormalities

Answer 18

leukocytes, presence indicates infection UTI, bladder, kidney, ureter

Question 19

NIT meaning and abnormalities

Answer 19

nitrates, made by bacteria and indicates UTI

Question 20

URO meaning and abnormalities

Answer 20

• urobilin, made by RBC disposal

- high level = liver disease, hemolysis, or gall bladder disease

Question 21

creation of urobilin and bilirubin

Answer 21

RBC –> porphoryin ring –> biliverdin –> bilirubin (toxic and insoluble) –> conjugated bilirubin –> bile secreted into duodenum as urobiliinogen and stercobilinogen

• • urobilinogen –> urobilin in urine
• • stercobilinogen –> stercobilin that gives stool its color

Question 22

PRO meaning and abnormalities

Answer 22

• protein, means glomerular dysfunction do to increased permeability to proteins

Question 23

pH normal range

Answer 23

5-7, <4.5 would cause burning as you pee

Question 24

BLO meaning and abnormalities

Answer 24

blood, whole RBC, aka hematuria

• glomerular disease that allows RBC to pass through
• or bleeding along urinary tract or bladder cancer

Question 25

SG meaning, normal range, and abnormalities

Answer 25

- specific gravity - water = 1.000 - urine = 1.005 to 1.030 - high = dehydration, low = water intoxication

Question 26

KET meaning, abnormalities, and how it is formed

Answer 26

- ketones - starvation, diabetes, low carb diet --> lipolysis --> lots of free fatty acids --> converted to ketone bodies in liver --> if not all used by the cells enters kidneys

Question 27

BIL meaning and abnormalities

Answer 27

bilirubin | - high = hemolysis, gall bladder disease, liver disease

Question 28

GLU meaning and abnormalities

Answer 28

glucose - high = glycosuria - could be diabetes or just eating a sugary meal - glucose transporters are saturated so not all glucose can be reabsorbed

Question 29

renal plasma threshold for glucose

Answer 29

180-200mg/dL, above this glycosuria occrus

Question 30

is glycosuria always a sign of diabetes?

Answer 30

no - can just be from eating a lot of sugar | - diabetes diagnosed by fasting blood glucose that is not in normal range of 70-100

Question 31

hematuria vs hemoglobinuira

Answer 31

- hematuria = complete RBC | - hemoglobinuria = hemoglobin in urine

Question 32

proteinuria vs albuminuria

Answer 32

- proteinuria = more severed | - albuminuria = less severe, sign of diabetic neuropathy

Question 33

3 urinary buffers

Answer 33

- ammonia, bicarbonate, phosphates

Question 34

how is ammonia made

Answer 34

- cuboidal cells that line PCT demaminate glutamate

Question 35

how is urea made

Answer 35

- ammonia in liver converted to urea

Question 36

how is uric acid made

Answer 36

DNA and RNA converted ot uric acid

Question 37

3 ketones

Answer 37

- beta hydroxy butyric acid - acetoacetic acid - acetone