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Questions and Answers
Which of the following best describes the role of hydrostatic pressure in glomerular filtration?
Which of the following best describes the role of hydrostatic pressure in glomerular filtration?
- It draws fluid into the glomerulus.
- It pushes fluid and solutes out of the glomerulus. (correct)
- It regulates oncotic pressure within Bowman's capsule.
- It opposes filtration by pulling fluid back into the capillary.
A patient's urinalysis reveals a high concentration of protein. Which nephron structure is most likely affected?
A patient's urinalysis reveals a high concentration of protein. Which nephron structure is most likely affected?
- Proximal convoluted tubule
- Distal convoluted tubule
- Glomerulus (correct)
- Loop of Henle
In a healthy individual, which of the following substances is completely reabsorbed from the filtrate in the proximal convoluted tubule?
In a healthy individual, which of the following substances is completely reabsorbed from the filtrate in the proximal convoluted tubule?
- Glucose (correct)
- Inulin
- Urea
- Creatinine
What effect does increased aldosterone secretion have on potassium levels in the late distal convoluted tubule and collecting ducts?
What effect does increased aldosterone secretion have on potassium levels in the late distal convoluted tubule and collecting ducts?
What is the primary mechanism by which the kidneys help to regulate acid-base balance in the body?
What is the primary mechanism by which the kidneys help to regulate acid-base balance in the body?
If a patient's glomerular filtration rate (GFR) decreases, what compensatory mechanism would help maintain a consistent GFR?
If a patient's glomerular filtration rate (GFR) decreases, what compensatory mechanism would help maintain a consistent GFR?
A patient with diabetes mellitus has consistently high blood glucose levels, exceeding the renal threshold. What finding would be expected in a urinalysis?
A patient with diabetes mellitus has consistently high blood glucose levels, exceeding the renal threshold. What finding would be expected in a urinalysis?
Which of the following factors would decrease the glomerular filtration rate (GFR)?
Which of the following factors would decrease the glomerular filtration rate (GFR)?
Inulin is used to measure GFR because it is:
Inulin is used to measure GFR because it is:
A high BUN to creatinine ratio typically indicates:
A high BUN to creatinine ratio typically indicates:
What finding in a urinalysis is most indicative of acute glomerulonephritis?
What finding in a urinalysis is most indicative of acute glomerulonephritis?
A patient is diagnosed with distal renal tubular acidosis. Which of the following findings would be expected in a urinalysis?
A patient is diagnosed with distal renal tubular acidosis. Which of the following findings would be expected in a urinalysis?
What primary change in urine characteristics is associated with diabetes insipidus?
What primary change in urine characteristics is associated with diabetes insipidus?
The presence of 'muddy brown casts' in the urine is indicative of:
The presence of 'muddy brown casts' in the urine is indicative of:
How would angiotensin-converting enzyme inhibitors (ACEIs) affect glomerular filtration rate (GFR)?
How would angiotensin-converting enzyme inhibitors (ACEIs) affect glomerular filtration rate (GFR)?
What is the primary function of the loop of Henle in urine formation?
What is the primary function of the loop of Henle in urine formation?
Which of the following characteristics is associated with nephrotic syndrome?
Which of the following characteristics is associated with nephrotic syndrome?
Which hormone directly increases water reabsorption in the collecting ducts of the kidney?
Which hormone directly increases water reabsorption in the collecting ducts of the kidney?
In the context of urinalysis, what does 'specific gravity' measure?
In the context of urinalysis, what does 'specific gravity' measure?
Following a kidney donation, what adaptation typically occurs in the remaining kidney?
Following a kidney donation, what adaptation typically occurs in the remaining kidney?
Which of the following best describes how the kidneys contribute to maintaining blood pH during acidosis?
Which of the following best describes how the kidneys contribute to maintaining blood pH during acidosis?
What is the clinical significance of finding lipiduria (lipid droplets in urine) along with proteinuria?
What is the clinical significance of finding lipiduria (lipid droplets in urine) along with proteinuria?
If a patient's afferent arteriole is constricted, what direct effect will this have on the glomerular hydrostatic pressure?
If a patient's afferent arteriole is constricted, what direct effect will this have on the glomerular hydrostatic pressure?
What role do natriuretic peptides (e.g., ANP) play in electrolyte homeostasis managed by the kidneys?
What role do natriuretic peptides (e.g., ANP) play in electrolyte homeostasis managed by the kidneys?
A patient presents with edema, frothy urine, and persistent albuminuria. Which condition is most likely?
A patient presents with edema, frothy urine, and persistent albuminuria. Which condition is most likely?
How does increased sympathetic activity affect the glomerular filtration rate (GFR)?
How does increased sympathetic activity affect the glomerular filtration rate (GFR)?
What is the expected urine osmolality range in a healthy individual?
What is the expected urine osmolality range in a healthy individual?
What segment of the nephron is primarily responsible for the absorption of nutrients and bicarbonate?
What segment of the nephron is primarily responsible for the absorption of nutrients and bicarbonate?
Under what circumstances would increased levels of ketone bodies be found in urine?
Under what circumstances would increased levels of ketone bodies be found in urine?
The kidneys compensate for respiratory alkalosis by:
The kidneys compensate for respiratory alkalosis by:
Which of the following would result in decreased GFR?
Which of the following would result in decreased GFR?
Which of the following is true regarding creatinine?
Which of the following is true regarding creatinine?
What should a physician do when a patient has persistent proteinuria and WBC and RBC in blood
What should a physician do when a patient has persistent proteinuria and WBC and RBC in blood
What is the expected ADH response to a patient who is dehydrated?
What is the expected ADH response to a patient who is dehydrated?
Increased exhalation of CO2 would shift the body into a state of:
Increased exhalation of CO2 would shift the body into a state of:
Albumin is absent in the Bowman's space because?
Albumin is absent in the Bowman's space because?
The cells of the glomerulus are the following, EXCEPT:
The cells of the glomerulus are the following, EXCEPT:
What is the result for the following ABG values: pH = 7.25; HCO3 = 28 mmHg; PCO2 = 60 mmHg
What is the result for the following ABG values: pH = 7.25; HCO3 = 28 mmHg; PCO2 = 60 mmHg
Flashcards
Renal Clearance
Renal Clearance
Volume of plasma cleared of a substance by the kidneys per unit time.
Glomerular Filtration Rate (GFR)
Glomerular Filtration Rate (GFR)
Volume of filtrate formed per minute by all nephrons.
Creatinine
Creatinine
Constant muscle metabolism product used to estimate GFR.
Blood Urea Nitrogen (BUN)
Blood Urea Nitrogen (BUN)
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Urinalysis
Urinalysis
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Hydrostatic Pressure
Hydrostatic Pressure
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Oncotic Pressure
Oncotic Pressure
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Inulin Clearance:
Inulin Clearance:
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Casts
Casts
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Acid-Base Balance
Acid-Base Balance
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Sodium (Na+) Homeostasis
Sodium (Na+) Homeostasis
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Potassium (K+) Homeostasis
Potassium (K+) Homeostasis
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Calcium & Phosphate Homeostasis
Calcium & Phosphate Homeostasis
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Nephrotic Syndrome
Nephrotic Syndrome
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Arterial Pressure and Glomerular Filtration
Arterial Pressure and Glomerular Filtration
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Factors Affecting Creatinine levels
Factors Affecting Creatinine levels
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Dietary Influence on pH
Dietary Influence on pH
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Study Notes
- Kidneys filter blood, reabsorb necessary substances, secrete waste, and maintain homeostasis of fluids, electrolytes, and acid-base balance.
- Renal clearance refers to the volume of plasma cleared of a substance per unit time.
- Renal clearance includes glomerular filtration, tubular reabsorption, and secretion.
- Measuring plasma and urine concentrations can describe renal blood flow, GFR, and tubular functions.
- Formula for clearance rate: Cs = (Us x V)/Ps.
Glomerular Filtration Rate (GFR)
- GFR is the volume of filtrate formed per minute by all nephrons, normally 90-120 mL/min.
- GFR determinants: hydrostatic and oncotic pressures, and permeability.
- Hydrostatic pressure is the "pushing" pressure exerted by water.
- Oncotic pressure is the "pulling" pressure, primarily from proteins.
- Substances can undergo filtration only, filtration with partial reabsorption, or filtration with complete reabsorption.
- Some substances may experience filtration and secretion.
- Inulin is only filtered, used to measure GFR.
- Glucose is filtered and partially or completely reabsorbed based on blood glucose levels.
- Substances like potassium are filtered, reabsorbed, and secreted based on the body's needs, regulated by aldosterone.
- Certain medications and disease states decrease GFR.
- Renal disease, diabetes mellitus, and hypertension reduces filtration coefficient (Kf) leading to reduced GFR.
- Urinary tract obstructions (e.g., kidney stones) increases Bowman's capsule hydrostatic pressure which reduces GFR.
- Decreased renal blood flow or increased plasma proteins, reduces GFR.
- Inulin clearance measures renal clearance as it is filtered freely
- It is not reabsorbed or secreted in the renal tubes
- Creatinine also used to measure GFR
- Serum creatinine: 0.6-1.2 mg/mL
- eGFR is determined using Cockroft-Gault, MDRD, or CKD-EPI formulas.
Urinalysis Key Aspects
- Physical characteristics: color, clarity, and specific gravity.
- Chemical: pH, presence of protein, glucose, and ketones.
- Microscopic: presence of RBCs, WBCs, casts, and crystals.
- Urinalysis identifies infections, glomerular diseases, and tubular disorders.
- The nephron segments in urine production are the glomerulus, proximal convoluted tubule, loop of Henle, distal convoluted tubule (DCT), and collecting duct.
- Specific gravity: solute concentration in urine/urine density
- Proteinuria and Hematuria indicates glomerulus issues
- Glucose and Ketones indicates glomerulus issues
Normal Urinalysis Findings
- Volume: 1-2 liters in 24 hours, varying with intake.
- Color: yellow or amber.
- Odor: mildly aromatic.
- pH: 4.6-8.0 (average 6.0).
- Specific gravity: 1.001-1.035.
- Normal urine should NOT contain albumin, glucose, or RBCs.
Abnormal Findings in Urine
- Albumin (albuminuria): Indicates increased permeability of the filtration membranes.
- Glucose (glucosuria): Indicates diabetes mellitus.
- RBCs (hematuria): Indicates a pathological condition.
- Nephrotic syndrome: heavy proteinuria and lipiduria
Tubular Function and Acid-Base Balance
- Kidneys maintain acid-base balance by reabsorbing bicarbonate (HCO3) and excreting hydrogen ions (H+).
- Acid-base regulation happens in the proximal tubule, thick ascending limb, and intercalated cells of the distal tubule and collecting duct.
- Proximal tubule: bicarbonate reabsorption.
- Intercalated cells in the collecting duct: potassium-hydrogen exchange.
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