Kidney Structure and Function Quiz
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Questions and Answers

Which component of the nephron is primarily responsible for filtration?

  • Proximal tubule
  • Loop of Henle
  • Glomerulus (correct)
  • Collecting duct
  • What is the primary waste product removed by the kidneys?

  • Creatinine (correct)
  • Amino acids
  • Glucose
  • Uric acid
  • Which process in the nephron allows for the transport of molecules needed by the body back into the blood?

  • Glomerular filtration
  • Tubular reabsorption (correct)
  • Membrane diffusion
  • Tubular secretion
  • Which hormone is NOT secreted by the kidneys?

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

    What maintains the pH level of the blood within the kidneys?

    <p>Excreting H+ ions and reabsorbing HCO3- (D)</p> Signup and view all the answers

    Which statement about glomerular filtration is true?

    <p>Smaller proteins are filtered more readily than larger proteins. (A)</p> Signup and view all the answers

    Which ion's reabsorption is crucial for maintaining water-salt balance in the body?

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

    What role do glomeruli play in the kidney's function?

    <p>They filter blood components to form urine. (D)</p> Signup and view all the answers

    What is the approximate glomerular filtration rate (GFR) in a normal adult corrected to body surface area (BSA) of 1.73 m²?

    <p>120 mL/min/1.73 m² (D)</p> Signup and view all the answers

    Which of the following statements about urine formation is accurate?

    <p>Approximately 99% of water is reabsorbed back into the body. (A)</p> Signup and view all the answers

    What does a normal plasma creatinine level imply about renal function?

    <p>It may not necessarily imply normal renal function. (A)</p> Signup and view all the answers

    Which component is NOT typically found in normal urine analysis?

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

    What test is most reliable for measuring glomerular filtration?

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

    Which of the following substances is NOT a serum non-protein nitrogen (NPN) compound used for renal function tests?

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

    In which condition are red blood cells and pus cells typically found in urine?

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

    How is endogenous creatinine production in the body related to muscle mass?

    <p>It is directly proportional to muscle mass. (A)</p> Signup and view all the answers

    What does a urine/plasma osmolality ratio of less than 2 indicate?

    <p>Impaired water reabsorption by the tubules (B)</p> Signup and view all the answers

    In a normal physiological response to water deprivation, what is expected to happen?

    <p>Urine osmolality should rise (C)</p> Signup and view all the answers

    What characteristic differentiates nephrogenic diabetes insipidus from central diabetes insipidus?

    <p>Response of renal tubules to desmopressin (C)</p> Signup and view all the answers

    What is the typical urine pH in normal conditions?

    <p>5 (C)</p> Signup and view all the answers

    Which condition is indicated by a urine pH greater than 5.3 in response to metabolic acidosis?

    <p>Renal Tubular Acidosis (RTA) (C)</p> Signup and view all the answers

    What does the presence of aminoaciduria imply?

    <p>Renal threshold for amino acids is exceeded or tubular damage (D)</p> Signup and view all the answers

    Acute renal failure is characterized by which of the following?

    <p>Urine output less than 400 mL/24 hours (C)</p> Signup and view all the answers

    What indicates chronic renal failure?

    <p>Progressive loss of kidney function over months or years (D)</p> Signup and view all the answers

    What is the main purpose of measuring creatinine clearance (CrCl)?

    <p>To estimate the glomerular filtration rate (GFR) (C)</p> Signup and view all the answers

    What is the normal creatinine clearance (CrCl) value in adults?

    <p>120 mL/min (D)</p> Signup and view all the answers

    Why is it important to collect blood samples after an overnight fast in relation to creatinine levels?

    <p>To minimize the impact of a meat-rich diet on plasma creatinine levels (B)</p> Signup and view all the answers

    What does a creatinine clearance (CrCl) value of 10 mL/min indicate?

    <p>Minimum level of CrCl needed to maintain life without dialysis (C)</p> Signup and view all the answers

    What is a key advantage of using estimated GFR (eGFR) over creatinine clearance (CrCl)?

    <p>It does not require urine collection for assessment (C)</p> Signup and view all the answers

    What does the presence of albumin in urine exceed 250 mg/day indicate?

    <p>Glomerular membrane damage (C)</p> Signup and view all the answers

    What does a urine osmolality measurement that is 2-3 times the normal plasma osmolality suggest?

    <p>Effective renal tubular concentrating ability (D)</p> Signup and view all the answers

    Which of the following factors does cystatin C level NOT depend on?

    <p>Serum urea concentration (A)</p> Signup and view all the answers

    Flashcards

    Nephron

    Basic functional unit of the kidney responsible for filtering waste and regulating fluid balance.

    Glomerular filtration

    The process of filtering blood in the glomerulus, producing a fluid called ultrafiltrate.

    Tubular reabsorption

    The reabsorption of essential molecules back into the bloodstream from the tubules.

    Tubular secretion

    The secretion of waste products and excess substances from the blood into the tubules.

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    Excretory function of the kidney

    The primary function of the kidney to rid the body of metabolic waste products like urea, creatinine, and uric acid.

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    Regulatory function of the kidney

    The kidney's role in maintaining the body's internal environment (homeostasis) by regulating water, electrolytes, pH, and blood pressure.

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    Endocrine function of the kidney

    The kidney's ability to produce hormones like erythropoietin, renin, and vitamin D3, which influence red blood cell production, blood pressure, and calcium regulation.

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    Urine

    The product of kidney filtration, consisting mainly of water, waste products, and electrolytes.

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    Glomerular Filtration Rate (GFR)

    The rate at which blood is filtered through the glomeruli per minute, typically around 120 mL/min/1.73 m2 in a healthy adult.

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    Creatinine Clearance

    A measure of how well your kidneys are working by assessing how much creatinine is filtered out in your urine. It is a reliable indicator of GFR.

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    Urine Albumin

    A protein found in the blood that is filtered by the glomeruli, but normally not present in urine. An elevated level in urine can indicate kidney damage.

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    Serum NPN (Blood Urea Nitrogen)

    A test that measures the concentration of waste products, such as urea, creatinine, and uric acid, in the blood. These waste products are normally filtered by the kidneys. Elevated levels can indicate problems with kidney function.

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    Urine Osmolality

    The measurement of the concentration of dissolved particles in a solution, typically urine. It reflects the kidneys' ability to concentrate or dilute urine.

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    Water Deprivation Test

    A test that assesses how your kidneys respond to water deprivation by checking for the ability to concentrate your urine. It reflects the function of the collecting ducts.

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    Urine pH

    The measurement of the pH of urine. It helps determine how well the kidneys are regulating acidity.

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    Glycosuria

    The presence of glucose in urine, which can be a sign of diabetes or other conditions affecting glucose regulation.

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    Creatinine levels and factors

    Plasma creatinine levels can be influenced by meat intake and strenuous exercise. Fasting and avoiding intense physical activity before blood collection are crucial for accurate creatinine measurements.

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    Creatinine clearance (CrCl)

    A measure of how efficiently the kidneys filter waste products from the blood. It indicates kidney function by assessing the amount of creatinine cleared per minute.

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    Minimum CrCl for survival

    The minimum CrCl value required to maintain life without needing dialysis.

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    Estimated GFR (eGFR)

    A method for estimating GFR using a formula that considers serum creatinine, age, sex, and race. This eliminates the need for urine collection.

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    Cystatin C

    A small protein produced by cells. Its concentration in the blood reflects GFR more accurately than creatinine as it is not influenced by muscle mass or gender.

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    Albumin in urine

    A marker of glomerular damage. When albumin levels in urine exceed 250 mg/day, it indicates serious glomerular membrane damage.

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    Renal tubular dysfunctions

    Tubular dysfunctions, unlike glomerular issues, affect the kidneys' ability to manage urine concentration, acid excretion, and reabsorption of essential substances.

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    Urine/Plasma Osmolality Ratio

    The ratio of urine osmolality to plasma osmolality, typically ranging from 2 to 3, reflects the kidney's ability to concentrate urine. A ratio lower than 2 indicates impaired water reabsorption by the tubules.

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    Diabetes Insipidus

    A rare condition characterized by the inability to concentrate urine due to insufficient ADH secretion or lack of kidney response to ADH. This results in excessive water loss in urine, causing polyuria and thirst.

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    Nephrogenic Diabetes Insipidus

    A condition where the kidney tubules fail to respond to ADH, leading to dilute urine and excessive water loss. This is a cause of diabetes insipidus.

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    Urine pH Test

    A test that assesses the kidney's ability to acidify urine. It involves measuring the urine pH after inducing metabolic acidosis. Elevated pH (>5.3) indicates tubular dysfunction.

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    1 and 2 Microglobulins

    Small proteins normally filtered and reabsorbed by the kidney tubules. Elevated levels in urine indicate damage to the renal tubules.

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    Renal Glycosuria

    The presence of glucose in urine when blood glucose levels are normal. It indicates the renal tubules' inability to reabsorb glucose.

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    Aminoaciduria

    An elevated amount of amino acids in urine, either due to exceeding the renal threshold or damage to the renal tubules. Amino acids are usually reabsorbed by the kidneys.

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    Study Notes

    Renal Function Tests

    • Renal function tests are a collection of individual tests used to assess kidney function.
    • These tests help determine if the kidneys are performing their tasks adequately.

    Kidney Structure and Function

    • Each kidney contains one million functional units called nephrons.

    • Each nephron can be divided into:

      • The glomerulus (filtration)
      • Tubules (reabsorption and secretion).
        • Proximal tubule
        • Loop of Henle
        • Distal tubule
        • Collecting duct
    • The glomerulus filters blood, producing an ultrafiltrate.

    • The tubules reabsorb and secrete necessary substances.

    Functions of the Kidney

    • Excretory function: Removes waste products, like urea, creatinine, and uric acid. It also removes other undesirable waste products.
    • Regulatory function (Homeostasis): Maintains a consistent internal chemical balance by reabsorbing and secreting glucose, amino acids, minerals, and vitamins. It also regulates water and electrolyte balance, the body's pH, and blood pressure.
    • Endocrine function: The kidneys produce hormones like erythropoietin, renin, and vitamin D3. They're also influenced by other hormones like ADH, aldosterone, and PTH.

    Urine Formation

    • Urine is a sterile fluid composed primarily of water (95%). It also contains nitrogenous waste and electrolytes.
    • Urine formation in the nephron occurs through three processes:
      • Glomerular filtration: Cells and large proteins are filtered from the blood to produce an ultrafiltrate.
      • Tubular reabsorption: The body reabsorbs essential molecules like glucose and amino acids from the filtrate, returning them to the blood.
      • Tubular secretion: Molecules are transported from the blood into the filtrate, which contributes to urine.

    Glomerular Filtration

    • Glomerular filtration is a passive process.
    • Glomeruli act as filters that are permeable to water and smaller molecules but impermeable to larger molecules like proteins.

    Glomerular Filtration Rate (GFR)

    • GFR measures the blood volume filtered through the glomeruli each minute.
    • It varies based on body size and is usually expressed per 1.73 m² of body surface area.
    • A normal GFR for an adult is around ~ 120 mL/min/1.73 m². It is approximately 180 liters per day in normal adults.

    Tubular Reabsorption and Secretion

    • Water and solutes are reabsorbed throughout the entire length of the tubule.
    • ~99% of water is reabsorbed back into the body, resulting in 1.5-2 liters of urine per day.

    Renal Function Tests (cont.)

    • Glomerular Tests:

      • Urine analysis (physical and chemical examination).
      • Serum NPN (BUN, creatinine, uric acid)
      • Creatinine clearance (CrCl)
      • Cystatin C
      • Urine albumin
    • Tubular Tests:

      • Osmolality
      • Water deprivation test
      • Urine pH
      • Glycosuria
      • Aminoaciduria
    • Glomerular Function Tests (cont.)

    • Physical exam (volume, color, odor, specific gravity (osmolality), reaction (pH) and aspect.

    • Chemical exam (constituents such as proteins, glucose, ketone bodies, bile salts, bilirubin and blood

    • Microscopic exam (cells, casts, and crystals)

    • Serum NPN compounds

      • Plasma concentration of NPN (urea, creatinine, uric acid) are inversely related to GFR.
      • Creatinine is a more reliable indicator of GFR.
    • Creatinine Clearance (CrCl)

      • Measurement of blood completely cleared of creatinine per minute.
      • Best measurement of GFR.
      • Normal value ~ 120 mL/min
    • Cystatin C: Is a reliable indicator of GFR, useful in particular for younger or older patients

    • Albumin in urine: Small amounts (< 25 mg/day) are normal. High urinary albumin indicates glomerular damage.

    Tubular Function Tests

    • Osmolality: Urine osmolality is a marker of tubular function.
      • Normal plasma osmolarity: 280-295 mOsm/kg
      • 24-hr urine osmolality should be 2-3x that of plasma osmolality.
    • Water deprivation test: Used to identify diabetes insipidus.
    • Urine pH: Normal urine pH is slightly acidic (~5).

    Urine Formation: a1 and β2 microglobulins; Glycosuria; Aminoaciduria

    • a1 and β2 microglobulins: present in urine in increased concentrations, suggesting renal tubular damage.
    • Glycosuria: Presence of glucose in urine when blood glucose is normal suggests renal tubular inability to reabsorb glucose.
    • Aminoaciduria: Presence of amino acids in urine in excessive amounts suggests problems with tubular reabsorption or high plasma levels of amino acids.

    Acute Renal Failure (AKI)

    • Sudden loss of kidney function, often over hours or days, indicated by rising serum urea and creatinine
      • Urine output <400 mL/24 hrs
      • Oliguria or anuria
    • Causes: reduced blood supply, kidney stones

    Chronic Renal Failure (CRF)

    • Progressive loss of kidney function over months or years.
    • Causes various kidney diseases leading to loss of nephrons
    • If untreated, leads to end-stage renal failure (ESRF).
    • GFR drops below 15 mL/min
    • Consequences, like disordered water and sodium metabolism, electrolyte imbalances; hyperkalemia, hypocalcemia, etc., and anemia.

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    Description

    Test your knowledge on renal function tests, kidney structure, and the vital functions of the kidneys. This quiz covers the roles of nephrons, glomeruli, and tubules in maintaining bodily homeostasis. Dive deep into how kidneys filter blood and regulate essential substances.

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