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Flashcards

Kidney function tests and urinalysis

Angela Haché Biochemistry Inglês 72 flashcards

Flashcards do conjunto (72)

  1. 1What does the kidney do:1. urine formation
    2. regulate fluid and electrolyte balance
    3. regulate acid-base balance
    4. excrete waste products (urea, creatinine)
    5. hormone functions (renin, vit D, erythropoietin)
    6. protein conservation
    7. the kidney receives 25% of blood flow from the heart
  2. 2What are the filtration properties of the glomerulus:1. it prevents cells and most proteins > 40 000 MW from passing through
    2. proteins that do get through are catabolized by renal tubular cells
    3. all small molecules are filtered including electrolytes, amino acids and glucose, which are largely reabsorbed by the nephron
    4. Creatinine and urea are not reabsorbed
  3. 3What role does aldosterone and ADH play:Plays a role in distal tubule to fine tune the amount of water and sodium excreted.
  4. 4List four tests to determine glomerular filtration:1. creatinine clearance
    2. plasma/serum creatinine
    3. urea
    4. cystatin C
  5. 5Why is measuring GFR the most important kidney function test:It reflects the number of functioning nephrons in the kidney.
  6. 6What are the characteristics of the ideal molecule used to measure GFR:1. one that is freely filtered
    2. not reabsorbed or metabolized by the tubular cells
    3. easily measured
  7. 7Why is creatinine used as a test of kidney function:1. the amount of creatinine produced is related to the muscle mass
    2. it is freely filtered, not reabsorbed
    3. some active secretion by tubules
    4. eaasily measured
    5. is an endogenous molecule
  8. 8What are the two methods used to measure creatinine:1. Jaffe reaction (colorimetric alkaline picrate method)
    2. enzymatic method
  9. 9What other factors other than GFR will cause a decrease in creatinine:1. starvation
    2. wasting disease
    3. pregnancy
    4. following surgery
    5. steroid therapy
    6. low muscle mass
  10. 10What other factors other than GFR will cause an increase in creatinine:1. meals
    2. interferences such as ketones (Jaffe)
    3. interferences such as creatine (enzymatic method)
  11. 11What are the advantages of using cystatin C to monitor kidney function:Not affected by muscle mass, diet or gender.
  12. 12What are the disadvantages of using Cystatin C to monitor kidney function:1. more expensive
    2. not standardized
    3. affected by steroid use and thyroid function
  13. 13What tests caan be used for the assessment of glomerular integrity:1. Urinalysis dipstick looking for protein in random urine sample
    2. 24 hour urine protein
    3. random protein to creatinine ratio
    4. random albumin to creatinine ratio
    5. urine protein electrophoresis
  14. 14What is the concentration test:It is a sensitive indicator of nephron function by withholding water for up to 15 hours.
  15. 15What is the dilution test:Water loading (1 litre)
  16. 16What should be the results of the concentration tests:1. specific gravity >1.025
    2. osmolality > 800 mosm/kg
  17. 17What should be the results of the dilution tests:1. specific gravity < 1.005
    2. osmolality < 100
  18. 18What are the other tests that can be used to test renal function:1. electrolytes: potassium increases in renal failure
    2. bicarbonate and pH: look for metabolic acidosis
    3. phosphate: accumulates in renal failure
    4. glucose in urine
    5. amino acids in urine
  19. 19List the four classes of kidney disorders:1. proteinuria
    2. acute kidney failure
    3. chronic kidney failure
    4. renal tubular defects
  20. 20Glomerulus is an effective barrier to what size proteins:> 40 000 MW
  21. 21When do patients with acute kidney failure require dialysis:1. if they become fluid overloaded
    2. develop severe acidosis
    3. develop hyperkalemia
  22. 22What are the principle uremic symptoms (GI):1. anorexia
    2. nausea
    3. vomiting
    4. abnormal taste
  23. 23What are the principle uremic symptoms (Cardiac):1. volume overload
    2. pericarditis
  24. 24What are the principle uremic symptoms (neurologic):1. fatigue
    2. concentration difficulty
    3. convulsion
    4. coma
    5. neuropathy
  25. 25What are the principle uremic symptoms (hematologic):1. anemia
    2. bleeding
  26. 26What are the principle uremic symptoms (bone):1. pain
    2. fractures
  27. 27What are the principle uremic symptoms (endocrine):1. amenorrhea
    2. decreased libido
    3. low sex hormone
  28. 28What are the principle uremic symptoms (skin):Itching
  29. 29What does routine urinalysis consist of:1. chemical analysis (dipstick)
    2. microscopic examination
    3. physical characteristics
  30. 30What is the specimen of choice:1. first morning
    2. midstream
  31. 31What can cause a low urine concentration:1., diabetes insipitud
    2. renal diseases with inability to concentrate urine
    3. increased fluid intake
  32. 32What can cause a high urine concentration:1. dehydration
    2. conditions leading to decreased renal perfusion
    3. increased protein or glucose in urine
  33. 33What can cause a urine concentration with a fixed SG of 1.010:1. severe renal disease
    2. inability to concentrate or dilute urine
  34. 34What factors can affect urine color:1. concentration
    2. foods
    3. normal (urochrome) and abnormal metabolites (bilirubin)
    4. hemoglobin or myoglobin
    5. drugs
  35. 35What factors can affect urine turbidity:1. cyrstals
    2. cells
  36. 36Why must urine be fresh to determine pH:It becomes alkaline on storage due to loss of CO2 and bacteria growth.
  37. 37When will glucose be present in urine:1. when glucose concentration exceeds 10 mmol/L in serum
    2. in renal tubular resorption defect
  38. 38When will ketones be in the urine:1. diabetic ketoacidosis
    2. fasting or starvation states
  39. 39What can cause falsely decreased urine hemoglobin results:Ascorbic acid may result in false low results.
  40. 40What are the identifiable elements found in the microscopic examination of urine sediment:1. casts
    2. crystals
    3. bacteria
    4. epithelial cells
    5. yeast
    6. rbc
    7. leukocyte
    8. parasites
    9. mucus
    10. artifacts
    11. spermatozoa
    12. fat globules
  41. 41What are renal casts:Renal casts are formed cylindrical structures organized in the nephron.
  42. 42What are renal casts composed of:Tamm-Horsfall mucoprotein
  43. 43Where are renal casts formed:By the renal tubular cells of the ascending loop of Henle.
  44. 44What causes renal casts:1. urine stasis which results in protein precipitation
    2. acid pH
    3. high salt
  45. 45What determines cast appearance:1. the matrix (hyaline, granular, waxy)
    2. trapped cellular constituents (rbc, leukocytes, renal epithelial cells)
  46. 46Describe a hyaline cast:Transparent
  47. 47What causes hyaline casts to form:1. exercise
    2. dehydration
    3. fever
  48. 48Describe a fine granular cast:Semitransparent
  49. 49Describe a erythrocyte cast:Contains distinct red cells
  50. 50Describe a leukocyte cast:Contain segmented neutrophils.
  51. 51Describe a renal tubular epithelial cast:Contain intact or necrotic epithelial cells.
  52. 52Describe a coarse granular cast:Coarse refractile granules
  53. 53Describe a waxy cast:Sharply defined refractile, homogenous cylinder.
  54. 54Describe a broad waxy cast:Wide width cast, formed in diluted tubules
  55. 55Describe a fatty cast:Refractile droplets
  56. 56What causes fine granular casts to form:Nonspecific
  57. 57What causes erythrocyte casts to form:1. renal bleeding
    2. glomerular injury
  58. 58What causes leukocyte casts to form:Pyelonephritis
  59. 59What causes renal tubular epithelial casts to form:Renal tubular injury
  60. 60What causes coarse granular casts to form:1. cell degeneration
    2. proteinuria
  61. 61What causes waxy casts to form:Cell degeneration
  62. 62What causes broad waxy casts to form:Advanced renal disease
  63. 63What causes fatty casts to form:Lipiduria
  64. 64What is an indication of bilirubin crystals:Liver disease
  65. 65What can cause an increase of RBC in urine:1. trauma
    2. infections
    3. prostatitis
    4. cystitis
    5. calculi
    6. urinary tract malignancies
    7. glomerular damage
  66. 66What can cause increased WBC in the urine:1. urinary tract inflammatory disorder
    2. urinary tract infections
  67. 67What are glitter cells:Swollen WBC caused by hypotonic urine
  68. 68Name two parasites that can be found in urine:1. trichomonas vaginalis
    2. schistosoma hematobium
  69. 69List significant urine microscopic findings:1. >5 RBC or WBC /hpf
    2. >2 renal tubular cells /hpf
    3. >3 hyaline or granular cast /hpf
    4. any WBC, RBC, epithelial cell cast
    5. >10 bacteria /hpf
    6. presence of fungus or parasites
    7. presence of pathological crystals or large number of nonpathological crystals
  70. 70List the macroscopic urine findings in diabetes mellitus:1. glycosura
    2. ketonuria
    3. proteinuria
  71. 71List the microscopic urine findings in diabetes mellitus:After many years
    1. waxy casts
    2. renal epithelial cells
    3. leukocytes
  72. 72EndEnd

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Biochemistry FlashCards sobre Kidney function tests and urinalysis, criado por Angela Haché em 17-10-2016.
Criado por
Angela Haché
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