front 1 5 functions of kidney | back 1 elimination, reabsorption, homeostasis (water and electrolyte balance), metabolic, endocrine |
front 2 how much percent cardiac output goes through kidney | back 2 25% |
front 3 responsible for the production, storage, and release of a hormone called renin which regulates blood pressure | back 3 Juxtaglomerular apparatus |
front 4 renin released from where | back 4 kidney |
front 5 main function to create a gradient in medulla of kidney | back 5 loop of Henle |
front 6 what part of kidney has countercurrent multiplier system and an area of high urea concentration | back 6 loop of Henle |
front 7 cutoff values for anuria, oliguria, polyuria, | back 7 anuria < 100 mL/day oliguria <400 mL/day polyuria >2L |
front 8 definition oncotic pressure | back 8 created by ALB to prevent movement of water from one solution to another |
front 9 what is hydrostatic pressure in kidney | back 9 The blood inside the glomerulus creates glomerular hydrostatic pressure which forces fluid out of the glomerulus into the glomerular capsule |
front 10 definition uremia (azotemia) | back 10 excess blood of urea, CRE, and other nitrogen compounds |
front 11 definition nephritis (glomerulonephritis) | back 11 kidney inflammation |
front 12 purpose of furosemide | back 12 as a loop diuretics, inhibit Na reabsorb at the ascending loop -> water loss in urine |
front 13 purpose of thiazide type diuretics, example? | back 13 example: hydrochlorothiazide ->distal convoluted tubule ->retention of water in the urine |
front 14 purpose of carbonic anhydrase inhibitors is to | back 14 in proximal convoluted tubule -> inhibit enzyme carbonic anhydrase -> HCO3 accumulate in the urine -> decrease Na absorption |
front 15 purpose osmotic diuretics and drawbacks an example of osmotic diuretics | back 15 increase osmolarity but limited tubular permeability example: glucose |
front 16 purpose of Tamm-Horsfall glycoprotein | back 16 protects against bacterial UTI by blocking bacterial adherence to the bladder epithelium |
front 17 most abundant urine protein | back 17 Tamm-Horsfall glycoprotein (THP) |
front 18 healthy U24h? pH, total volume, color, specific gravity, abundant protein | back 18 slightly acidic (5-6), 500mL+, amber color, 1.024 specific gravity, THP |
front 19 where is urine formation/water filtration | back 19 glomeruli |
front 20 what is the high threshold (almost completely absorbed) of reabsorption? what is the low threshold (minimally absorbed)? | back 20 high threshold: glucose, aa low: CRE (minimally reabsorbed), |
front 21 what electrolyte highly permeable at the proximal tubule? | back 21 Na |
front 22 approximately 90% of HCO3 reabsorbed where, remainder in where? | back 22 proximal tubule, remainder in distal tubule, |
front 23 percentage of water reabsorbed through the kidney pathway? | back 23 70% proximal, 5% loop of Henle, 10% distal, remainder collecting duct |
front 24 what is countercurrent multiplication mechanism in the kidney | back 24 spends energy to reabsorb water from the tubules -> high osmolarity in the inner medulla |
front 25 regulation by countercurrent multiplier mechanism where? | back 25 loop of Henle |
front 26 what part of the kidney that ADH has effect on | back 26 distal tubule, collecting duct |
front 27 at kidney, what the primary hormones, secondary, catabolic (degrade hormones)? | back 27 primary: renin, erythropoietin, prostaglandin secondary: PTH, PRL, GH Catabolic: insulin, aldosterone, |
front 28 renal blood flow can be measured by what substances | back 28 p-aminohippurate (PAH) |
front 29 for a healthy glomerulus, proteins larger than what protein are retained? | back 29 larger than ALB |
front 30 Glomerular Sieving Coefficient (GSC) formula | back 30 GSC = tubule plasma conc / ratio of freely permeable compound (CRE, inulin) |
front 31 difference acute and chronic kidney failure | back 31 ARF: rapid, electrolyte, acid-base, fluid imbalance -> difficult to control, high mortality CRF: small, shrunken kidney; diabetes is one of major causes |
front 32 what stage of kidney failure for uremic syndrome | back 32 terminal, kidney unable to function normally |
front 33 classic signs of uremic syndrome | back 33 fatigue, loss of appetite, nausea, vomiting, tremors, mental, shallow breathing, metabolic acidosis |
front 34 primary lab findings of uremic syndrome | back 34 reduced GFR, high BUN, CRE, hyperP, hypoCa hyperK (myocardial contraction and rhythm) |
front 35 secondary symptoms of uremic syndrome | back 35 acidemia (increased respiration to clear carbon dioxide); anemia (low erythropoietin); osteomalacia (low 1,25-D), HTN |
front 36 cause of glomerulonephritis | back 36 immune-mediated injury: SLE, Wegner's disease, IgA nephropathy |
front 37 findings of acute nephritic syndrome (acute glomerulonephritis) | back 37 hematuria, proteinuria (<3g/day), reduced GFR, sodium and water retention, HTN, localized edema RBC cast -> glomerulonephritis, hyaline + granular cast -> common, waxy cast -> chronic process |
front 38 nephrotic syndrome lab findings | back 38 proteinuria (>3g/day; ALB>1.5g/day), hypoALB, hyperCHOL, fat particles, edema high alpha-2 globulin and beta globulin |
front 39 cause of nephrotic syndrome | back 39 glomerulonephritis, SLE, diabetic nephropathy |
front 40 what main lab result for pyuria | back 40 leukocyte esterase |
front 41 nitrite in urine is an indicator for | back 41 UTI |
front 42 what test should be order for urine DM patients | back 42 microALB |
front 43 3 nephropathies secondary to systemic disease | back 43 diabetic nephropathy, hypertensive nephropathy, vasculitides |
front 44 what substances can cause renal calculi | back 44 Ca-oxalate, Ca-PO4, UA, cystine, Mg-NH4-PO4 |
front 45 5 enzymes in urea cycle | back 45 CPS I (carbamoyl phosphate synthetase I) |
front 46 T/F: urea actively reabsorbed or secreted by tubules | back 46 F |
front 47 important! normal BUN/CRE | back 47 12-20 |
front 48 testing reagents for urea (enzyme) monitor decrease in what absorbance | back 48 urease, glutamate dehydrogenase -> glutamate 340nm |
front 49 advantages of enzyme method and chemical method for urea testing | back 49 EZ: specificity chemical: Fearon rxn, run at 45C, faster, good for urine and serum |
front 50 fearon reaction for urea method -> describe | back 50 urea + diacetyl + heat -> diazine |
front 51 conversion factor from urea to urea nitrogen | back 51 28/60=0.467 |
front 52 where synthesize creatine | back 52 liver, kidney, pancreas, |
front 53 how much free creatine convert to CRE daily | back 53 1-2% |
front 54 formula CRE clearance (mL/min) or Cockgroft-gault formula | back 54 (140-age)*weight(kg)x0.85 (if female) divided by serCRE*72 |
front 55 eGFR formula | back 55 Cs = (Us * V*1.73) divided by A*Ps Cs (mL plasma cleared /min; Us (urine conc of substance; V (volume flow of urine mL/min); Ps (plasma conc of substance) |
front 56 important! chemical method for CRE | back 56 Jaffe-alkaline picrate -> red-orange complex |
front 57 enzyme method for CRE, what pros and cons | back 57 creatininase (more specific but more expensive) |
front 58 what is major product of purine catabolism | back 58 UA |
front 59 UA relates to what disease | back 59 Gout |
front 60 hyperuricemia -> primary and secondary causes | back 60 Primary: overproduction of purines or underexcretion of UA Secondary: renal retention, acidemia, increased nucleic acid turnover (tumor) |
front 61 what pH for UA renal stone | back 61 pH<6 |
front 62 what range is for hyperuricemia, for hypouricemia | back 62 serum UA > 7, serum UA <2 |
front 63 does UA specimen needs protein removal step, why | back 63 yes, because of protein interference, turbidity, quenching |
front 64 what chemical for UA method what product color (what absorbance) | back 64 phosphotungstic acid, PTA PTA is reduced by UA at pH alkaline->blue color (650-700nm) |
front 65 advantage of EZ method for UA testing | back 65 uricase -> more specific than phosphotungstic acid, PTA |
front 66 gold standard for GFR marker | back 66 inulin |
front 67 why inulin is a gold standard marker for GFR | back 67 low MW, free cross membrane, not affected by tubule (not reabsorbed, not secreted, not metabolized) |
front 68 list out the endogenous markers for GFR, pros and cons | back 68 CRE: most common |
front 69 ranges for The ratio of urine osmolality to serum osmolality | back 69 normal: 1-3 |
front 70 what substance to use to calculate renal plasma flow (RPF) | back 70 PAH: para-aminohippuric acid |
front 71 what is the relationship between GFR and RPF? what is the normal in this number | back 71 the normal FF (filtration fraction) equals GFR/RPF normal example: 120/600=20% |
front 72 3 chemistry methods for total protein in urine | back 72 Lowry: copper -> bind with peptide in pH>7 |
front 73 formula selectivity index, normal? | back 73 IgG clr / ALB clr less than 0.2->high selectivity |
front 74 important indicator of myeloma? name and what type of protein | back 74 Bence Jones Protein-> light chains |
front 75 classic test for Bence Jones Protein for myeloma | back 75 heating (precipitate at 56C and redissolve as temp going to boiling point) |
front 76 2 current tests for Bence Jones Protein for myeloma | back 76 electrophoresis followed by immunofixation and typing can also be done by nephelometry |
front 77 formula Fractional Excretion of Bicarbonate | back 77 FE-HCO3 = (uHCO3 x sCr) / (sHCO3 x uCr) |
front 78 why we use Fractional Excretion of Bicarbonate? what range tells us what | back 78 diagnosis of renal tubular acidosis proximal RTA: FE=10-15%; distal <10% |
front 79 pink brown color of urine can be due to | back 79 Hb or myoglobin |
front 80 fat particles in urine can be due to what disease | back 80 nephrotic syndrome |
front 81 dipstick color indications for TP. Hb, Gluc | back 81 TP: green, yellow in absence Hb: orange to dark green Gluc: green to dark brown |
front 82 dipstick color indications for nitrite, WBC, pH | back 82 nitrite: pink WBC: purple pH: orange to blue |
front 83 microscopic and possible conclusion disease for RBC, polymorphonuclear leukocyte with or without cast | back 83 RBC->hematuria, glomerular disease with: upper UTInflammation, no cast: lower |
front 84 testing procedure for oxalate stones what chemical | back 84 EZ, acidify urine pH 1.8 to solubilize all salts -> thru charcoal column to remove interference methyl-2-hydrazone |
front 85 testing procedure for citrate stones | back 85 EZ, preincubation w/out citrate lyase ->remove endogenous compounds -> serum deproteinated -> pH 8 |
front 86 in conclusion, what are the best indicators for loss of renal function | back 86 CREclr and GFR |
front 87 what are early substances for early signs of renal loss function | back 87 proteinuria, microALBuria |