URR 42 Flashcards
(100 cards)
1
Q
Higher sodium levels with increase water retention by:
A
reducing urine output
2
Q
Higher sodium levels increase ___ and ___
A
blood volume
blood pressure
3
Q
Elevated aldosterone levels =
A
increased blood volume and pressure
4
Q
Reduced aldosterone levels =
A
decreased blood volume and pressure
5
Q
refers to when renin is produced by the kidneys to prompt the release of angiotensin to caused vasoconstriction
A
autoregulation of systemic blood pressure
6
Q
Vasoconstriction =
A
increased systemic blood pressure
7
Q
When the systemic blood pressure increases, glomerular filtration rate ____
A
increases
8
Q
Normal glomerular filtration rate
A
90 mL/min +
9
Q
fluid is forced across a membrane into the nephron; increases with increased blood pressure; decreased with kidney disease
A
glomerular filtration
10
Q
When the fluid is within the renal tubules, it can be resorbed according to the body’s needs; electrolytes and components of the fluid are selectively resorbed to allow for excretion of intended waste products
A
tubular resorption
11
Q
selective process of disposing of the waste products and pH regulation
A
tubular secretion
12
Q
BUN is produced by the:
A
liver
13
Q
BUN is excreted by the:
A
kidney
14
Q
BUN stands for:
A
blood urea nitrogen
15
Q
BUN increases with ___, ___, ____, ___
A
decreased renal function
dehydration
starvation
congestive heart failure
16
Q
BUN decreased with ____, ____, ____
A
liver failure
pregnancy
overhydration
17
Q
Creatinine is produced when:
A
skeletal muscle is broken downCrea
18
Q
Creatinine increases with ___, ____, ___, ____, ____
A
decreased renal function
urinary tract obstruction
acute tubular necrosis
glomerulonephritis
nephritis
19
Q
Creatinine decreases with ___, ____, ____
A
hyperthyroidism
starvation
muscular dystrophy
20
Q
Uric acid increases with ___, ___, ____, ___, ___, ___
A
renal failure
arthritis
hypothyroidism
metastatic cancer
alcoholism
chemotherapy
21
Q
Uric acid decreases with ___, ___
A
Wilson disease
liver atrophy
22
Q
White blood cell count increases with ____
A
infection
23
Q
White blood cell count decreases with ___ or ___
A
chemotherapy
radiation therapy
24
Q
Red blood cell count increases with ____ and ____
A
hypernephroma
renal cysts
25
Aldosterone increases with ____, ___
decreased urinary output
dehydration
26
Lactate Dehydrogenase increases with ___ and ___
renal disease
renal infarction
27
Increased hematocrit means:
the percentage of red blood cells is above the upper limits of normal
28
Increased hematocrit causes include ___ and ___
dehydration
polycythemia vera
29
A low hematocrit means:
percentage of red blood cells is below the lower limits of normal
30
Causes of low hematocrit include ___, ____, and ____
internal bleeding (varices)
red blood cell destruction (anemia)
malnutrition
31
estimates how much blood passes through the glomeruli each minute
glomerular filtration rate
32
Glomerular filtration rate normally varies with ___, ___, ___, ___, ___
age
ethnicity
gender
height
weight
33
Normal glomerular filtration rate
90 tp 120 mL.min
34
< Glomerular filtration rate <60 mL/min for 3 or more months indicates:
chronic kidney diseaes
35
Glomerular filtration rate <15 mL/min indicates
kidney failure
36
Uric acid ___ with renal disease
decreases
37
Hematuria is identified with ___, ___, ____
infection
renal calculi
renal tumors
38
Patients with gross hematuria have a higher risk of ____ than those with microscopic hematuria
malignancy
39
Proteinuria increases with ___, ___, ___, ___
glomerulonephritis
nephrotic syndrome
lupus
renal venous congestion
40
pH-alkalinity indicates ___ or ___
renal tubular acidosis
infection
41
Glucose levels are increased with ____ and ___
diabetes mellitus
renal tubule dysfunction
42
ability of kidneys to concentrate urine
specific gravity
43
Specific gravity increases with ___
dehydration
44
Specific gravity decreases with ___ and ___
renal failure
pyelonephritis
45
Substances NOT normal found in urine include:
glucose
red/white blood cells
protein
acid ketones
46
Conjugated bilirubin detected on urinalysis indicates ___ or ___
biliary obstruction
liver disease
47
Risk factors for renal disease
over age 40 years
smoking
history of urinary tract infections
history of exposure to toxic chemicals/dyes
48
Symptoms of renal issues
flank pain
palpable flank mass
gross hematuria
microscopic hematuria
abnormal lab values
flank trauma
urinary frequency
decreased urine output
burning with urination
fever
49
indications for renal ultrasound
allergy to contrast media
evaluate renal size
evaluate for obstruction
evaluation of a renal allograft
unexplained HTN
50
radiographic exam that uses iodinated dye that is injected into the blood stream and filtered from the blood by the kidneys, used to evaluate the collecting system of the kidneys
intravenous pyelogram
51
used to detect renal artery stenosis
arteriography
52
test used to evaluate renal structure and blood flow
CT scan
53
Test that evaluates kidney structure and vasculature; may require the use of gadolinium contrast
MRI/MRA
54
Prep for renal us
full bladder, no fasting
55
Adult renal exam transducer
3-5 MHz
56
Children and renal transplant patients transducer renal exam
5-7.5 MHz
57
Where is the best visualization of the right kidney?
patient supine or LLD position using liver as a window
58
Where is the best visualization of the left kidney?
RLD position using the spleen or fluid filled stomach as a window
59
Medial and lateral borders of the kidneys are better visualized in the ____ position
decubitus
60
Normal adult renal cortex is ___ echogenic than the adjacent liver or spleen in adults
less
61
Normal neonatal cortex is normally ____ when compared to the adjacent liver or spleen
isoechoic
hyperechoic
62
The ___ of the kidney are normally visualized only in neonatal and pediatric kidneys
pyramids
63
small anechoic spaces within the renal parenchyma
pyramids
64
Cortical thickness should be measured in the ____ view of the kidney
long axis
65
Where are the calipers placed when measuring the cortical thickness>
on the base of the pyramid to the outer edge of the parenchyma
66
normal cortical thickness
>1.0 cm
67
The center of the kidney contains ___, ___, and ___
sinus fat
calices
major vessels
68
Normally the central sinus is ____ as a result of fat and multiple tissue interfaces
highly echogenic
69
The ___ is evaluated for hydronephrosis
renal sinus
70
In the presence of a solid renal mass, evaluation of ___, ___, and ___ must be performed to evaluate for local tumor invasion and metastasis
renal vein
IVC
liver
71
The renal volume can be estimated using:
3D imaging
72
The right renal artery is located ___ to the IVC
posterior
73
The left renal artery is located ____ to the left renal vein
posterior
74
Measurements of arcuate and interlobular arteries
RI
acceleration time
75
Normal findings of intrarenal vessels
low resistance flow, increased diastolic flow
76
Normal renal artery waveforms will demonstrate ____ systolic peak
early
77
Patient must be NPO ___ hours prior to the evaluation of the native kidneys for perfusion and/or stenosis
8-12
78
Most common site of stenosis, most important site to evaluate
origin of renal arteries
79
Kidneys develop in the ___ and migrate into the ___.
a. paracolic gutters, Morison pouch
b. pelvic cavity, abdominal cavity
c. chest cavity, abdominal cavity
d. peritoneal cavity, retroperitoneal cavity
b
80
The ___ muscles lies posterior medial to the kidney, while the ____ muscle lies directly posterior to the kidney.
a. rectus abdominis, psoas
b. quadratus lumborum, psoas
c. psoas, quadratus lumborum
d. quadratus lumborum, rectus abdominis
c
81
The renal cortex extends from the:
a. capsule to the base of the pyramids
b. renal pelvis to the base of the pyramids
c. minor calyces to the major calyces
d. medulla to the renal pelvis
a
82
What is the most posterior structure at the renal hilum?
a. renal artery
b. renal vein
c. ureter
d. adrenal gland
c
83
List the structures involved in urine production from blood filtration to the ureter
Glomerulus
Bowman Capsule
proximal convoluted tubule
loop of Henle
distal convoluted tubule
collecting duct
pyramid
minor calyces
major calyces
renal pelvis
ureter
84
The renal arteries are transverse branches of the aorta that originate:
a. 1 cm below the level of the celiac axis origin
b. at the level of the SMA origin
c. 3cm above the iliac bifurcation
d. 2-3 cm below the origin of the SMA
d
85
Identifying accessory renal arteries is most important for patients:
a. with malignant HTN
b. scheduled for transplant surgery
c. with hydronephrosis
d. diagnosed with adrenal malignancy
b
86
What patient position is best for evaluating the length of the left renal artery?
a. supine
b. prone
c. left lateral decubitus
d. right lateral decubitus
d
87
An RI value over 0.7 in the renal parenchymal arteries indicates ___, while an RI value less than 0.5 in the renal parenchymal arteries indicates ____.
a. renal artery stenosis, severe hydronephrosis
b. normal flow, renal artery stenosis
c. parenchymal dysfunction, renal artery stenosis
d. parenchymal dysfunction, normal flow
c
88
Parenchymal dysfunction, renal artery stenosis
a. left renal artery
b. left renal vein
c. right renal artery
d. right renal vein
c
89
Which renal vessel is normally identified coursing between the aorta and SMA?
a. left renal artery
b. left renal vein
c. right renal artery
d. right renal vein
b
90
List the renal arterial circulation path from origin to the renal parenchyma
aorta
main renal artery
segmental arteries
interlobar arteries
arcuate arteries
interlobular arteries
afferent arterioles
91
Which of the following are preferred to directly assess parenchymal resistance in the kidneys?
a. arcuate or interlobular
b. main and segmental
c. interlobar or interlobular
d. segmental and arcuate
a
92
Which of the following is secreted by the pituitary gland to help regulate fluid levels through changes in water permeability?
a. BUN
b. creatinine
c. aldosterone
d. antidiuretic hormone
d
93
Aldosterone levels affect:
a. blood volume and pressure
b. urine viscosity
c. urine pH
d. venous outflow
a
94
Renin is produced by the ___ to aid in autoregulation of the systemic blood pressure.
a. pituitary gland
b. adrenal gland
c. liver
d. kidneys
d
95
Which of the following serum levels increase with reduced renal function?
a. uric acid
b. creatinine
c. blood urea nitrogen
d. all the above
d
96
Which of the following serum levels increases with dehydration?
a. BUN
b. aldosterone
c. hematocrit
d. all the above
d
97
Which of the following Glomerular Filtration Rates indicates kidney failure?
a. 100 mL/min
b. 60 mL/min
c. 40 mL/min
d. 10 mL/min
d
98
Abnormal glucose levels in the urine are related to ___, while abnormal bilirubin levels in the urine are related to ___
a. diabetes, liver disease
b. pancreatitis, adrenal disease
c. liver disease, pancreatitis
d. renal failure, renal hyperfunction
a
99
On a transverse view of the kidney, how is the upper and lower pole differentiated from the mid pole?
a. more visible pyramids at the mid pole
b. lack of parenchyma in the hilar area at the mid pole
c. color doppler demonstrates blood flow only at the mid pole
d. all the above
b
100
Cortical thickness should be measured:
a. in the transverse view of the mid pole
b. from the outer sinus to the capsule
c. from the base of a pyramid to the outer edge of the parenchyma
d. within 2cm of the hilum
c
