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RENAL FUNCTION TEST Flashcards

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1
Q

4 MAIN COMPONENTS OF URINARY SYSTEM

A

KIDNEY

URETERS

BLADDER

URETHRA

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2
Q
  • URINE IS BY FILTRATION OF BLOOD

-CARRY URINE TO BLADDER

-SOTRES THE URINE

-DELIVERS URINE FOR EXCRETION

A

KIDNEY

URETERS

BLADDER

URETHRA

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3
Q

URINE FORMATION

URINE IS AN ___________

_________&_________ ESSENTIAL TO BODY FUNCTION

CONVERTS _________ OF FILTERED PLASMA TO AVERAGE DAILY URINE OUTPUT OF ________

A

ULTRAFILTRATE OF PLASMA

REABSORPTION OF WATER & FILTERED SUBSTANCES

170,000 mL

1200 mL

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4
Q

3 KIDNEY’S FUNCTION

A

MAINTAINING HOMEOSTASIS

EXCRETION OF WASTE PRODUCTS

CONCERNED WITH MAINTENANCE OF BLOOD PRESSURE AND ERYTHROPOIESIS

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5
Q

FUNCTIONAL UNIT OF THE KIDNEY

_______ MILLION EACH KIDNEY

A

NEPHRON

1 TO 1.5

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6
Q

3 INTERNAL STRUCTURE OF KIDNEY

A

CORTEX

MEDULLA

RENAL PELVIS

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7
Q

-OUTER LAYER OF KIDNEY & LOCATED BELOW THE RENAL CAPSULE

-REGIONS OF CORTEX

-INNERMOST PART OF KIDNEY

-RENAL MEDULLA IS SPLIT UP INTO NUMBER OF SECRETIONS

-FUNNEL-LIKE DILATED PART OF URETER

A

CORTEX

RENAL COLUMS

MEDULLA

RENAL PYRAMINDS

RENAL PELVIS

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8
Q

9 PARTS OF NEPHRON

A

GLOMERULUS/ RENAL CORPUSCLE

BOWMAN’S CAPSULE

PROXIMAL CONVOLUTED TUBULE

LOOP OF HENLE

DISTAL CONVOLUTED TUBULE

AFFERENT ARTERIOLE

EFFERENT ARTERIOLE

PERITUBULAR CAPILLARIES

VASA RECTA

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9
Q

-CONSISTS OF COIL OF 8 CAPILLARY LOBES

-DESCENDING/ ASCENDING

-POINT OF ENTRY/ UNFILTERED BLOOD

-POINT OF EXIT/ FILTERED BLOOD

  • SURROUND PROXIMAL AND DISTAL CONVOLUTED TUBULES

-LOCATED ADJACENT TO ASCENDING AND DESCENDING LOOP OF HENLE

A

GLOMERULUS

LOOP OF HENLE

AFFERENT ARTERIOLE

EFFERENT ARTERIOLE

PERITUBULAR CAPILLARIES

VASA RECTA

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10
Q

2 TYPES OF NEPHRON

A

CORTICAL NEPHRON

JUXTAMEDULLARY NEPHRON

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11
Q

-85%, RESPONSIBLE FOR REMOVAL OF WASTE PRODUCTS & REABSORPTION

-15%, CONCENTRATION OF URINE

A

CORTICAL NEPHRON

JUXTAMEDULLARY NEPHRON

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12
Q

RENAL BLOOD FLOW

______SUPPLIES BLOOD TO KIDNEY

KIDNEYS RECEIVE A LARGE BLOOD FLOW_____

AVERAGE BODY SIZE_______

TOTAL RENAL BLOOD FLOW________

TOTAL RENAL PLASMA FLOW_______

A

RENAL ARTERY

25%

1.73m^2

1200 mL/min

600 TO 700 mL/min

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13
Q

GLOMERULUS

-CONSIST OF COIL OF 8 CAPILLARY LOBES CALLED _________

-SERVED AS ________OR ___________WITH MOLECULAR WEIGHT OF________

-LOCATED WITHIN THE ___________(FORM BEGINNING OF RENAL TUBULE)

3 FACTORS INFLUENCE THE ACTUAL FILTRATION PROCESS:

RAAS STAND FOR:

A

CAPILLARY TUFT

SIEVE OR FILTER OF PLASMA, < 70,000

BOWMAN’S CAPSULE

CELLULAR STRUCTURE OF CAPILLARY WALLS AND BOWMAN’S CAPSULE

HYDROSTATIC AND ONCOTIC PRESSURE

FEEDBACK MECHANISMS OF RAAS

RENINANGIOTENSIN-ALDOSTERONE SYSTEM

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14
Q

3 CELLULAR LAYERS OF GLOMERULUS

A

CAPILLARY WALL MEMBRANE

BASEMENT MEMBRANE (BASAL LAMINA)

VISCERAL EPITHELIUM OF BOWMAN’S CAPSULE

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15
Q

-CONTAINING PORES REFERRED TO AS FENESTRATED

-RESTRICTION OF LARGE MOLECULES OCCUR AS FILTRATE PASSES

-THIN MEMBRANES COVERING THE FILTRATION SLITS FORMED BY THE PROCESSES OF PODOCYTES OF INNER LAYER OF BOWMAN’S CAPSULE

A

CAPILLARY WALL MEMBRANE

BASEMENT MEMBRANE (BASAL LAMINA)

VISCERAL EPITHELIUM OF BOWNMAN’S CAPSULE

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16
Q

GLOMERULAR PRESSURE

PRESENCE OF _________

__________TO OVERCOME THE OPPOSITION OF PRESSURE FROM THE FLUID FROM BOWMAN’S CAPSULE AND ___________OF UNFILTERED PLASMA PROTEIN

AN AUTOREGULARORY MECHANISM WITHIN__________

________DILATION OF AFFERENT ARTERIOLES AND CONSTRICTION OF EFFERENT ARTERIOLES

A

HYDROSTATIC PRESSURE

HYDROSTATIC PRESSURE; ONCOTIC PRESSURE

JUXTAMEDULLARY APPARATUS

BP DROPS

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17
Q

RAAS/ RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM

REGULATES FLOW OF BLOOD WITHIN _______

RESPOND TO CHANGES IN_______&___________

MONITORED BY __________

A

GLOMERULUS

BLOOD PRESSURE AND PLASMA SODIUM CONTENT

JUXTAGLOMERULAR APPARATUS

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18
Q

4 FUNCTIONS OF ANGIOTENSIN II

A

VASODILATION OF AFFERENT & VASOCONSTRICTION OF EFFERENT ARTERIOLE

STIMULATE SODIUM REABSORPTION IN PROXIMAL CONVOLUTED TUBULE

RELEASE OF HORMONE ALDOSTERONE FROM ADRENAL CORTEX

RELEASE OF ANTIDIURETIC HORMONE FROM HYPOTHALAMUS

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19
Q

TUBULAR REABSORPTION

BODY CANNOT LOSE ______ OF WATER CONTAINING ESSENTIAL SUBSTANCES EVERY MINUTE

A

120 mL

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20
Q

2 REABSORPTION MECHANISM

A

ACTIVE TRANSPORT

PASSIVE TRANSPORT

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21
Q

SUBSTANCE TO BE REABSORBED MUST COMBINE TO A CARRIER PROTEIN

PLASMA CONCENTRATION AT WHICH ACTIVE TRANSPORT STOPS

RENAL TRESHOLD FOR GLUCOSE_______

A

ACTIVE TRANSPORT

RENAL TRESHOLD

160-180 mg/dL

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22
Q

MOVEMENT OF MOLECULES ACROSS MEMBRANE AS RESULT OF DIFFERENCES IN THEIN CONCENTRATION OR ELECTRICAL POTENTIAL

A

PASSIVE TRANSPORT

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23
Q

4 SUBSTANCES OF ACTIVE TRANSPORT

A

GLUCOSE

AMINO ACIDS

SALTS

SODIUM

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24
Q

3 SUBSTANCES OF PASSIVE TRANSPORT

A

WATER

UREA

SODIUM

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25
LOCATION OF GLUCOSE, AMINO ACIDS & SALTS IN ACTIVE TRANSPORT
PROXIMAL CONVOLUTED TUBULE
26
LOCATION OF SODIUM IN ACTIVE TRANSPORT
PROXIMAL AND DISTAL CONVOLUTED TUBULE
27
LOCATION OF WATER IN PASSIVE TRANSPORT
PROXIMAL CONVOLUTED TUBULE DESCENDING LOOP OF HENLE COLLECTING DUCT
28
LOCATION OF UREA IN PASSIVE TRANSPORT
PROXIMAL CONVOLUTED TUBULE ASCENDING LOOP OF HENLE
29
LOCATION OF SODIUM IN PASSIVE TRANSPORT
ASCENDING LOOP OF HENLE
30
TUBULAR CONCENTRATION BEGINS IN DESCENDING AND ASCENDING LOOP OF HENLE _____IS REMOVED BY____IN DESCENDING LOOP OF HENLE ____&_______ ARE REABSORBED IN ASCENDING LOOP OF HENLE
WATER ; OSMOSIS SODIUM & CHLORIDE
31
INCREASE BODY HYDRATION: DECREASE BODY HYDRATION: VASOPRESSIN-ANTIDIURETIC HORMONE (ADH) =
DECREASE ADH & INCREASE URINE VOL INCREASE ADH & DECREASE URINE VOL WATER REABSORPTION
32
2 MAJOR FUNCTIONS OF TUBULAR SECRETION BICARBONATE:
ELIMINATION OF WASTE PRODUCTS NOT FILTERED BY GLOMERULUS (EX. UREA AND MEDICATIONS) REGULATION OF ACID-BASE BALANCE ( SECRETION OF HYDROGEN IONS) ACTS AS BUFFER TO BLOOD MAINTAINING NORMAL PH
33
CLEARANCE TEST STANDARD TESTS USED TO MEASURE_______________ REPORTED IN_______
FILTERING CAPACITY OF GLOMERULI mL/min
34
UREA CLEARANCE TEST -STANDARD METHOD FOR GFR -DEMONSTRATE PROGRESSION OF RENAL DISEASE OR RESPONSE TO THERAPY
UREA CLEARANCE TEST
35
-REFERENCE METHOD FOR GFR -NOT ROUTINELY DONE BCOZ OF NECESSITY OF CONTINUES IV INFUSION -HIGHER VALUES IN MALE DUE TO LARGER RENAL MASS -PRIMING DOSE: -CONTINUES INFUSION: -REFERNCE VALUE IN MALE: -REFERENCE VALUE IN FEMALE:
INULIN CLEARANCE TEST 25 mL OF 10% INULIN SOLUTION 500 mL OF 1.5% INULIN SOLUTION 127 mL/min 118 mL/min
36
-MOST COMMONLY USED -SCREENING METHOD FOR GFR -WASTE PRODUCT OF MUSCLE METABOLISM -CREATININE IS FREE FILTERED BY GLOMERULUS BUT NOT REABSORBED -MEASURE OF COMPLETENESS OF 24 HOUR URINE COLLECTION -REF VALUES IN MALE -REF VALUES IN FEMALE
CREATININE CLEARANCE 85-125 mL/min 75-112 mL/min
37
CREATININE CLEARANCE FORMULA
CLEARANCE = URINE CREAM/ PLASMA CREA X URINE VOLUME/ MINUTES X 1.73/ BODY SURFACE OF PATIENT
38
AMOUNT OF PLASMA FILTRATE PRODUCED PER MINUTE IS_______ NORMAL CREATININE CLEARANCE VALUES__________ MEN: WOMEN: NORMAL REF RANGE OF PLASMA CREATININE IS_______
120 mL 120 mL/min 107-139 mL/min 87-107 mL/min 0.5-1.5 mg/dL
39
-INDIRECT ESTIMATE OF GFR -LOW MOLECULAR WEIGHT PROTEASE INHIBITOR -COMPLETELY REABSORBED BY PCT -SPECIMEN: -INCR LVL: -METHOD:
CYSTATIN C SERUM/PLASMA ACUTE & CHRONIC RENAL FAILURE AND DIABETIC NEPHROPHATY IMMUNOASSAY
40
-DISSOCIATES FROM HUMAN LEUKOCYTE ANTIGENS AT CONSTANT RATE -RAPIDLY REMOVED FROM PLASMA BY GLOMERULAR FILTRATION -MORE SENSITIVE INDICATOR OF DEC IN GFR -NOT RELIABLE IN PATIENT WHO HAVE HISTORY OF IMMUNOLOGIC DISORDER -METHOD:
BETA 2 MICROGLOBULIN ENZYME IMMUNOASSAY
41
USED FOR ROUTINELY SCREENING PATIENT AS PART OF METABOLIC PROFILE TO MONITOR PATIENTS ALREADY DIAGNOSED WITH RENAL DISEASE OR AT RISK FOR RENAL DISEASE
ESTIMATED GLOMERULAR FILTRATION RATE
42
MDRD STANDS FOR: NKDEP STANDS FOR:
MODIFICATION OF DIET IN RENAL DISEASE NATIONAL KIDNEY DISEASE EDUCATION PROGRAM
43
STAGES OF CHRONIC KIDNEY DISEASE 1- 2- 3- 4- 5-
KIDNEY DAMAGE WITH NORMAL GFR KIDNEY DAMAGE WITH MILD LOW GFR MODERATE LOW GFR SEVERE LOW GFR KIDNEY FAILIRE GFR > 90 mL/min/1.73m^2 60-89 30-59 15-29 <15 OR DIALYSIS
44
ABILITY OF TUBULES TO REABSORB ESSENTIAL SALTS AND WATER
CONCENTRATION TEST
45
SPECIFIC GRAVITY OF URINE BEFORE ENTERING THE RENAL TUBULES IS
1.010
46
2 SPECIFIC GRAVITY TEST
FISHBERG TEST MOSENTHAL TEST
46
COMPARE THE VOLUME AND SPECIFIC GRAVITY OF URINE DAY AND NIGHT URINE SAMPLES
MOSENTHAL TEST
46
PATIENTS WERE DEPRIVED OF FLUIDS FOR 24 HOURS
FISHBERG TEST
47
MEASURES ONLY THE NUMBER OF PARTICLES IN A SOLUTION SPECIFIC GRAVITY IS INFLUENCED BY NUMBER AND DENSITY _______&_______ DO NOT CONTRIBUTE TO THE EVALUATION OF RENAL CONCENTRATION IT IS PERFORMED FOR MORE ACCURATE EVALUATION OF RENAL CONCENTRATING ABILITY
OSMOLALITY GLUCOSE & UREA
48
PRINCIPLE: MEASUREMENT OF FREEZING POINT DEPRESSION STANDARD REF:
FREEZING POINT OSMOMETERS SODIUM CHLORIDE
48
TEMPERATURE AT WHICH WATER AND ICE ARE IN EQULIBRIUM
FREEZING POINT
49
PRINCIPLE: MEASUREMENT OF DEW POINT STANDARD REF:
VAPOR PRESSURE OSMOMETERS SODIUM CHLORIDE
50
TEST MOST COMMONLY ASSOCIATED WITH TUBULAR SECRETION AND RENAL BLOOD FLOW
P-AMINOHIPPURIC ACID TEST OR PAH TEST
51
URINARY AMMONIA TITRATABLE ACID: AMMONIA: TITRATABLE ACID: AKLAKINE TIDES: LOWEST pH:
SECRETION PRODUCTION & SECRETION NORMAL PERSON EXCRETES 70 meq/day of acid 2-PM-8PM NIGHT
52
INABILITY TO PRODUCE AN ACID URINE IN THE PRESENCE OF METABOLIC ACIDOSIS
RENAL TUBULAR ACIDOSIS
53
Type of nephron responsible for renal concentration
Juxtaglomerular
54
55
Function of the peritubular capillaries is
Reabsorption and secretion
56
Blood flows through the nephron in the following order
Afferent arteriole Peritubular capillaries Vasa recta Efferent arteriole
57
Filtration of protein is prevented in the glomerulus by
The glomerular filtration barrier
58
Renin- angiotensin aldosterone system is responsible for all of the following except
Vasoconstriction of the afferent arteriole
59
Primary chemical affected by the renin-angiotensin aldosterone system is
Sodium
60
Secretion of renin is stimulated by
Macula densa cells
61
Hormone aldosterone is responsible for
Sodium retention
62
Fluid leaving the glomerulus has a specific gravity of
1.010
63
For active transport to occur a chemical
Must combine with a carrier protein to create electrochemical energy
64
Which tubules is impermeable to water
Ascending loop of henle
65
Glucose will appear in the urine when the
Blood level of glucose is 200 mg/dL Tm for glucose is reached Renal threshold for glucose is exceeded
66
Concentration of the tubular filtrate by the countercurrent mechanism depends on all of the following except
Absorption of water in the descending loop of henle
67
ADH regulates the final urine concentration by controlling
Tubular permeability
68
Decreased production of ADH
Produces a high urine volume
69
Bicarbonate ions filtered by the glomerulus are returned to the blood
In the proximal convoluted tubule Combined with hydrogen ions By tubular secretion
70
If ammonia is not produced by the distal convoluted tubule the urine pH will be
Basic
71
Largest source of error in creatinine clearance test
Improperly timed urine specimens
72
Clearance test used to determine the glomerular filtration rate must measure substances that are
Neither absorbed or secreted by the tubules
73
Performing a clearance test using radionucleotides
Eliminate the need to collect urine Provides visualization of the filtration
74
Variables that are included in the MDRD-IDSM estimated creatinine clearance calculations include all of the following except
Weight
75
An advantage to using cystatin C to monitor GFR is that
It does not require urine collection It does not secreted by the tubules It can be measured by immunoassay
76
Solute dissolved in solvent will
Lower the freezing point
77
Substances that may interfere with freezing point, measurement of urine and serum of osmolarity include all of the following except
Sodium
78
Clinical osmometers use NaCl as reference solution because
NaCl is partially ionized, similar to the composition of urine
79
The normal serum osmolarity is
275 to 300 mOsm
80
After controlled fluid intake, the urine to serum osmolarity ratio should be at least
1:1
81
To provide an accurate measure of renal blood flow, a test substance should be completely
Cleared on each contact with functional renal tissue
82
Renal tubular acidosis can be caused by the
Inability to produce an acidic urine due to impaired production of ammonia
83
Test performed to detect renal tubular acidosis after administering an ammonium chloride load include all of the following except
Arterial pH
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