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Questions and Answers
What is the primary function of erythropoietin in the body?
What is the primary function of erythropoietin in the body?
Which of the following renal function tests measures waste products in the blood?
Which of the following renal function tests measures waste products in the blood?
What condition is indicated by a glomerular filtration rate (GFR) of less than 60?
What condition is indicated by a glomerular filtration rate (GFR) of less than 60?
What does the urinalysis measure in relation to urine?
What does the urinalysis measure in relation to urine?
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How is post void residual (PVR) typically assessed?
How is post void residual (PVR) typically assessed?
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A decrease in renal blood flow in geriatric patients is associated with which of the following?
A decrease in renal blood flow in geriatric patients is associated with which of the following?
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What is a potential risk for pediatric patients regarding renal function?
What is a potential risk for pediatric patients regarding renal function?
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Which test provides visual inspection of the urinary tract?
Which test provides visual inspection of the urinary tract?
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What is the primary functional unit of the kidney?
What is the primary functional unit of the kidney?
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Normal urine characteristics usually do not include which of the following?
Normal urine characteristics usually do not include which of the following?
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Which value represents a normal Glomerular Filtration Rate (GFR)?
Which value represents a normal Glomerular Filtration Rate (GFR)?
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Which hormone increases the permeability of kidney tubules to water?
Which hormone increases the permeability of kidney tubules to water?
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What role does creatinine play in assessing kidney function?
What role does creatinine play in assessing kidney function?
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What happens to urine volume when ADH levels decrease?
What happens to urine volume when ADH levels decrease?
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The primary function of the renal system includes all except which of the following?
The primary function of the renal system includes all except which of the following?
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Which of the following statements about the urethra is correct?
Which of the following statements about the urethra is correct?
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What is the effect of aldosterone on the kidneys?
What is the effect of aldosterone on the kidneys?
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What indicates a potential urinary tract infection based on urine composition?
What indicates a potential urinary tract infection based on urine composition?
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Study Notes
Kidney Structure
- The functional unit of the kidney is the nephron.
- There are 1.2 million nephrons per kidney.
- The glomerulus is a network of capillaries within Bowman's capsule.
- Blood flows through the glomerulus and filters out wastes and water into the tubule.
Nephron Function
- The nephron forms a protein-free filtrate.
- The nephron regulates the filtrate to maintain fluid volume, electrolytes, and pH.
Renal Blood Flow
- Glomerular Filtration Rate (GFR) is the rate at which the glomeruli filter blood.
- Normal GFR is 87-139 mL/minute.
- Creatinine clearance is the most accurate measure of GFR.
- Creatinine is filtered by the glomeruli but not reabsorbed.
- Creatinine is a waste product of skeletal muscles.
- The higher the blood creatinine level, the lower the estimated GFR.
Urinary Structures
- Ureters transport urine from the kidneys to the bladder.
- The bladder is a muscular container that holds urine (300-500 mL).
- The urethra is a narrow passageway from the bladder to the outside of the body.
- The urethra has internal and external sphincters.
- Females have a 3-4 cm long urethra, while males have 18-20 cm.
Urine Composition
- Normal urine is clear yellow or amber in colour.
- Cloudiness may indicate the presence of bacteria, cells, or high solute concentration.
- Urine pH ranges from 4.6 - 8.0, but is normally acidic.
- Normal urine does not contain glucose or blood cells, and only occasionally contains trace protein.
- A healthy human should produce 0.5-1 cc of urine/kg per hour (average 30 cc/hr).
Kidney Functions
- Maintaining fluid and electrolyte concentration.
- Maintaining acid-base balance.
- Detoxifying the blood and eliminating wastes.
- Regulating blood pressure.
- Aiding RBC production.
- Regulating vitamin D and calcium formation.
Hormones and Renal Function
- Antidiuretic hormone (ADH) alters the tubules’ permeability to water.
- Increased ADH leads to concentrated, low-volume urine.
- Decreased ADH leads to less concentrated, high-volume urine.
- Aldosterone regulates water and sodium reabsorption.
- Increased aldosterone increases H2O & Na reabsorption.
- Decreased aldosterone promotes H2O & Na reabsorption.
- Renin is secreted in response to decreased extracellular volume.
- Vitamin D is converted to its active form in the kidneys for calcium and phosphate absorption.
- Erythropoietin stimulates RBC production when there is decreased oxygen to the kidney.
Tests of Renal and Bladder Function
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Renal Function Tests:
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Blood Studies:
- BUN: Blood Urea Nitrogen, measures urea which is a cellular waste product removed from the blood.
- Creatinine: Waste product of skeletal muscles.
- Electrolytes (K+, Na+).
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Glomerular Filtration Rate (GFR).
- GFR < 60 indicates renal injury.
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Urinalysis:
- Appearance: Colour, turbidity (cloudiness), pH, specific gravity, blood.
- Microscopic Urine: bacteria, RBC, WBC, crystals, fat, casts.
- Urinary Chemistry: bilirubin, ketones, glucose, sodium, potassium, protein.
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Blood Studies:
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Bladder Function Tests:
- Cystometry: measures bladder pressure using a pressure-measuring catheter.
- Uroflowmetry: measures the time it takes to empty a full bladder.
- Post Void Residual (PVR): measures residual urine in the bladder after voiding (usually with US--bladder scanner).>200ml is abnormal.
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Direct visualization tests:
- Cystoscopy: camera inserted through the urethra and visualizes the interior of the bladder.
- Ureteroscopy: camera inserted through the urethra and bladder directly into the ureter to visualize the upper urinary tract.
Age-Related Renal Function
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Pediatric
- Decreased ability to remove excess water and solutes.
- Decreased concentrating ability.
- Narrow margin for fluid and electrolyte balance.
- Increased risk of medication toxicity.
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Geriatric
- Decrease in renal blood flow and GFR.
- Altered sodium and water balance.
- Number of nephrons decrease due to renal vascular and perfusion changes.
- Response to acid-base changes delayed.
- Increased risk for medication toxicity.
- Alterations in thirst and water intake.
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Description
Test your knowledge on the structure and function of the kidney, including the nephron and renal blood flow. This quiz covers glomerular filtration rate, urine transport, and important kidney structures in detail. Challenge yourself to understand the critical roles these components play in the body's filtration system.
