Gout and Kidney Disorders Quiz
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Questions and Answers

Uric acid deposition in the joints leads to the formation of what structures characteristic of gout?

  • Chondrocytes
  • Osteophytes
  • Tophi (correct)
  • Amyloid plaques
  • In which part of the body does increased excretion of uric acid potentially cause crystal deposition?

  • Urinary tract (correct)
  • Bile ducts
  • Hepatic ducts
  • Pancreatic duct
  • What is the approximate percentage of primary gout cases that can be classified as idiopathic?

  • Approximately 5%
  • Approximately 10% (correct)
  • Approximately 50%
  • Approximately 20%
  • Which enzyme abnormality is mentioned as a potential cause of primary gout?

    <p>Abnormal PRPP synthetase (B)</p> Signup and view all the answers

    Increased nucleic acid turnover rate is a cause of increased uric acid production. In which condition is this turnover rate commonly seen?

    <p>In rapid growing malignant tissues (C)</p> Signup and view all the answers

    What is a major cause of reduced uric acid excretion leading to secondary gout?

    <p>Renal failure (C)</p> Signup and view all the answers

    What level of proteinuria (protein in urine) is classified as Glomerular proteinuria?

    <p>1000 mg/day (A)</p> Signup and view all the answers

    Why is microalbuminuria significant in patients with diabetes mellitus and hypertension?

    <p>It is an early indication of nephropathy. (A)</p> Signup and view all the answers

    Which hormone primarily influences water balance in the kidneys?

    <p>Arginine vasopressin (A)</p> Signup and view all the answers

    What is the primary nitrogen-containing product of protein catabolism?

    <p>Urea (A)</p> Signup and view all the answers

    What is defined as abnormally high BUN in the blood?

    <p>Uremia (D)</p> Signup and view all the answers

    Which of the following is NOT a laboratory test commonly used to assess kidney function?

    <p>Liver Function Test (B)</p> Signup and view all the answers

    Which test is primarily used to assess the glomerular filtration rate (GFR)?

    <p>Serum creatinine (D)</p> Signup and view all the answers

    What substance makes up more than 75% of the total non-protein nitrogen (NPN) in the body?

    <p>Urea (D)</p> Signup and view all the answers

    What does the BUN/Creatinine ratio help distinguish among?

    <p>Causes of elevated BUN (A)</p> Signup and view all the answers

    What characterizes intrinsic renal failure?

    <p>Renal parenchymal damage (B)</p> Signup and view all the answers

    What condition is indicated by abnormally high urea nitrogen levels in the blood?

    <p>Uremia (A)</p> Signup and view all the answers

    Which substance is used as a standard measure to estimate GFR?

    <p>Creatinine (D)</p> Signup and view all the answers

    Which hormone promotes tubular reabsorption of calcium in the kidneys?

    <p>Parathyroid hormone (D)</p> Signup and view all the answers

    What enzymatic cycle is responsible for the biosynthesis of urea?

    <p>Urea cycle (D)</p> Signup and view all the answers

    What is microalbuminuria indicative of?

    <p>Early stage nephropathy (C)</p> Signup and view all the answers

    Which of the following substances does not contribute significantly to the formation of urea?

    <p>Glucose from glycolysis (C)</p> Signup and view all the answers

    What is a common consequence of hyperuricemia?

    <p>Gout (D)</p> Signup and view all the answers

    What is the nephrotic-range proteinuria threshold?

    <blockquote> <p>1000 mg/day (B)</p> </blockquote> Signup and view all the answers

    What is an early indicator of onset of nephropathy?

    <p>Proteinuria (D)</p> Signup and view all the answers

    What type of proteinuria is characterized by the overflow of small molecular weight proteins into urine?

    <p>Overflow proteinuria (B)</p> Signup and view all the answers

    Which condition is associated with hemoglobinuria?

    <p>Hemolytic conditions (B)</p> Signup and view all the answers

    What is the primary biochemical finding associated with pre-renal failure?

    <p>High serum urea compared to creatinine (A)</p> Signup and view all the answers

    What condition often results from the accumulation of urate crystals in synovial fluid?

    <p>Gout (C)</p> Signup and view all the answers

    Which cause is classified as prerenal uremia?

    <p>Dehydration (B)</p> Signup and view all the answers

    What laboratory assessment is primarily used to measure the end product of protein catabolism?

    <p>Blood Urea Nitrogen (BUN) (A)</p> Signup and view all the answers

    Which biochemical condition is caused by high levels of endogenous H+ excretion inability in acute renal failure?

    <p>Metabolic acidosis (D)</p> Signup and view all the answers

    Which type of proteinuria indicates damage to the renal tubules?

    <p>Tubular proteinuria (D)</p> Signup and view all the answers

    How is the majority of urate excreted from the body?

    <p>Through the kidney (C)</p> Signup and view all the answers

    Which of the following is a cause of post-renal failure?

    <p>Renal calculi (A)</p> Signup and view all the answers

    What condition causes an increase in both urea and creatinine levels?

    <p>Intrinsic kidney disease (B)</p> Signup and view all the answers

    Which type of proteinuria can occur due to physical exertion or fever?

    <p>Transient proteinuria (B)</p> Signup and view all the answers

    What primarily dictates the formation of uric acid in the body?

    <p>Catabolism of nucleic acids (B)</p> Signup and view all the answers

    What is a common result of hyperuricemia?

    <p>Precipitation of sodium urate (D)</p> Signup and view all the answers

    What substance is commonly used to measure glomerular filtration rate (GFR)?

    <p>Creatinine (C)</p> Signup and view all the answers

    What type of renal failure results from prolonged renal circulatory insufficiency?

    <p>Pre-renal failure (D)</p> Signup and view all the answers

    How does acute renal failure (ARF) primarily manifest in clinical settings?

    <p>Low GFR with increased BUN and creatinine levels (A)</p> Signup and view all the answers

    Which method is NOT used to calculate creatinine clearance?

    <p>Urea concentration in urine (C)</p> Signup and view all the answers

    In the diagnosis of renal insufficiency, what is the primary goal of measuring GFR?

    <p>Adjust drug dosage for kidney-excreted drugs (D)</p> Signup and view all the answers

    What factor is NOT known to affect serum creatinine levels?

    <p>Body temperature (D)</p> Signup and view all the answers

    What is a common cause of pre-renal acute renal failure?

    <p>Vascular obstruction (B)</p> Signup and view all the answers

    How is creatinine clearance expressed mathematically?

    <p>$C_{clearance} = \frac{U/P \times V}{A}$ (B)</p> Signup and view all the answers

    What physiological change occurs in response to decreased blood supply to the kidneys?

    <p>Increased secretion of ADH and aldosterone (C)</p> Signup and view all the answers

    Flashcards

    Blood Urea Nitrogen (BUN)

    A laboratory test that measures urea nitrogen in the blood, assessing kidney function.

    Glomerular Filtration Rate (GFR)

    The volume of filtrate formed per unit time by all nephrons in both kidneys.

    Uremia

    A condition characterized by abnormally high levels of urea in the blood.

    Azotemia

    Elevated levels of both urea and creatinine in blood, indicating renal insufficiency.

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    Prerenal azotemia

    A type of azotemia caused by reduced blood flow to the kidneys.

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    Gout

    A clinical condition caused by hyperuricemia, leading to painful inflammation.

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    Microalbuminuria

    The presence of 30–300 mg of albumin in urine daily, significant for early kidney disease.

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    Proteinuria

    Presence of excess protein in urine, indicative of kidney damage.

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    Kidney Functions

    Regulation of water, electrolytes, and acid-base balance, and excretion of metabolic products.

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    Arginine Vasopressin (AVP)

    A hormone that influences water balance in the body.

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    Aldosterone

    A hormone that affects sodium reabsorption in the nephron.

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    Parathyroid Hormone

    Promotes calcium reabsorption and phosphate excretion in the kidneys.

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    Renin

    An enzyme that catalyzes the formation of angiotensin I and aldosterone synthesis.

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    Serum Creatinine

    A blood marker used to evaluate kidney function.

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    Creatinine Clearance

    The milliliters of plasma cleared of creatinine by kidneys per minute.

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    GFR (Glomerular Filtration Rate)

    The volume of filtrate produced by all nephrons in a kidney per minute.

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    Inulin

    A substance used to measure GFR accurately.

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    Acute Renal Failure (ARF)

    A sudden decline in kidney function, indicated by low GFR.

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    Pre-renal ARF

    Acute renal failure due to reduced blood supply to kidneys.

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    ADH (Antidiuretic Hormone)

    Hormone that helps regulate water balance in the body.

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    Biochemical findings in pre-renal failure

    High urea/creatinine levels, hyperkalemia, metabolic acidosis.

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    Post-renal failure causes

    Obstruction leading to back pressure reduces glomerular filtration.

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    Hyperuricaemia

    Abnormally high uric acid levels in the blood.

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    Uric Acid formation

    Formed from purine metabolism, including DNA and RNA breakdown.

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    Urate excretion pathways

    70% of urate is excreted through kidneys, 30% through the gut.

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    Metabolic acidosis in ARF

    Caused by the kidney's inability to excrete hydrogen ions.

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    Overflow Proteinuria

    Increased small molecular weight proteins in urine due to excess in blood, like hemoglobin or myoglobin.

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    Hemoglobinuria

    Presence of hemoglobin in urine, often due to hemolytic conditions.

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    Myoglobinuria

    Presence of myoglobin in urine, usually following muscle injury.

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    Tubular Proteinuria

    Occurs with tubular damage, leading to low molecular weight proteins in urine.

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    Alpha-1 Microglobulin

    A small protein filtered by kidneys, used as a marker for tubular damage.

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    Transient Proteinuria

    Temporary proteinuria linked to physical activity or illness.

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    Orthostatic Proteinuria

    Proteinuria that is more pronounced when upright as opposed to prone position.

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    High BUN Causes

    High BUN can be due to prerenal or renal causes indicating kidney issues.

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    Uric Acid

    A waste product that can cause crystal deposits in joints and urinary tract, leading to gout and kidney stones.

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    Primary Gout

    Gout that is often idiopathic or familial, sometimes due to enzyme defects like abnormal PRPP synthetase.

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    Secondary Gout

    Gout caused by increased production or reduced excretion of uric acid, due to factors like cancer or kidney failure.

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    Glomerular Proteinuria

    Protein in urine due to damage to the glomeruli, increasing permeability to plasma proteins.

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    Protein/Creatinine Ratio

    A measurement used to differentiate types of proteinuria and assess kidney function.

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    Study Notes

    Kidney Function Tests

    • Kidney function tests assess kidney function using blood urea nitrogen (BUN), serum creatinine, and glomerular filtration rate (GFR).
    • Uremia is abnormally high blood urea nitrogen.
    • Azotemia is an elevated plasma concentration of urea and creatinine in renal insufficiency.
    • Prerenal, renal (intrinsic), and postrenal causes of elevated BUN/creatinine differentiate pathophysiologic processes.
    • Calculating creatinine clearance estimates glomerular filtration rate (GFR).
    • Factors affecting plasma creatinine levels include muscle mass, certain drugs, age, and sex.
    • GFR is the volume of filtrate made per unit time by nephrons in both kidneys.
    • Substances used to measure GFR are inulin, creatinine, and cystatin C.

    Acute Renal Failure (ARF)

    • ARF is an abrupt decline in renal function, manifesting as low GFR and increased BUN/creatinine levels.
    • Classification includes pre-renal, renal, and post-renal causes.
    • Pre-renal ARF is caused by reduced blood supply to the kidneys (e.g., hemorrhage, dehydration).
    • Renal ARF is due to intrinsic kidney damage (e.g., glomerulonephritis, toxins, myoglobinuria).
    • Postrenal ARF is caused by obstruction in urine outflow (e.g., stones, prostate issues).

    Urea

    • Urea is the main nitrogenous waste product of protein catabolism.
    • Urea is produced in the liver and primarily excreted via kidneys.

    Creatinine

    • Creatinine is a breakdown product of phosphocreatine in muscle tissue.
    • Measured in serum to assess renal function.
    • Serum creatinine levels are slightly higher in males due to muscle mass.

    Glomerular Filtration Rate (GFR)

    • GFR is the volume of filtrate formed by all nephrons per unit of time.
    • Measuring GFR helps detect and diagnose renal insufficiency.
    • GFR is used to adjust drug dosages in patients with kidney problems.
    • Inulin, cystatin C, and creatinine are used to measure GFR.

    Causes of High BUN (Uremia)

    • Prerenal uremia: reduced blood flow to the kidney
    • Renal uremia: intrinsic kidney disease (acute/chronic glomerulonephritis, polycystic kidney disease)
    • Postrenal uremia: obstruction in urine outflow (stones, prostate enlargement, malignancy)

    Proteinuria

    • Proteinuria is the presence of abnormal amounts of protein in urine.
    • Types of proteinuria include glomerular, overflow, and tubular.
    • Glomerular proteinuria results from damage to the glomeruli.
    • Overflow proteinuria may be caused by elevated low-molecular-weight proteins in the blood (e.g., hemoglobin, myoglobin).
    • Tubular proteinuria is from decreased reabsorption capacity of proteins in the tubules

    Uric Acid and Gout

    • Uric acid is produced from purine metabolism.
    • A high level, hyperuricemia, can cause gout.
    • Gout causes inflammation in joints.
    • Primary Gout is often familial.
    • Secondary Gout can be due to increased production or decreased excretion of uric acid.

    Clinical Significance of Serum Creatinine

    • Creatinine is freely filtered by glomeruli, with minimal tubular secretion.
    • Elevated serum creatinine suggests decreased renal excretion, often a sign of renal dysfunction.
    • Serum creatinine levels are somewhat higher in males and affected by age, sex, muscle mass, certain drugs, exercise, and high protein diets/ catabolic states.

    Creatinine Clearance

    • Creatinine clearance is the volume of plasma cleared of creatinine by the kidneys per minute.
    • Calculating creatinine clearance helps assess kidney function.

    Microalbuminuria

    • Microalbuminuria is a small amount of albumin in urine.
    • It's an early sign of kidney disease, especially in patients with diabetes and hypertension.

    Case Scenario

    • The case scenario presents a patient with possible acute kidney injury (AKI) due to decreased renal function.
    • Reduced renal function (low GFR) and abnormal blood chemistry data may indicate heart failure.

    Summary of Kidney Lecture

    • The lecture covers laboratory assessments of renal function, focusing on key kidney health/disease indicators (BUN, creatinine, etc).
    • Specific tests for renal function include blood urea and blood urea nitrogen (BUN), Uremia, Azotemia , and Creatinine, GFR.

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    Kidney Function Tests PDF

    Description

    Test your knowledge on the pathophysiology of gout and related kidney disorders. This quiz covers topics such as uric acid metabolism, proteinuria, and the significance of certain enzymes. Perfect for students in medical or health-related fields looking to understand these conditions better.

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