Renal Function and Urine Analysis
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Questions and Answers

Which of the following is a sensitive indicator of tubular damage?

  • Presence of urobilinogen in urine
  • Microglobulin excretion in urine (correct)
  • Excretion of protein > 1000 mg/day in urine
  • High serum ALP levels

    • Excretion of protein in urine more than 1000 mg/day indicates which type of proteinuria?

  • Prerenal proteinuria
  • Tubular proteinuria
  • Postrenal proteinuria
  • Glomerular proteinuria (correct)

    • The clearance of a substance that is freely filtered, not reabsorbed, and fully secreted equals:

  • Effective GFR
  • GFR (correct)
  • Twice the GFR
  • Renal plasma flow

    • Which mineral is an important constituent of body proteins, chondroitin sulfates present in hair and nails?

    <p>Sulfur</p> Signup and view all the answers

    Which mechanism contributes to a decrease in plasma calcium concentration?

    <p>The action of calcitonin on the kidney</p> Signup and view all the answers

    Which organ cannot perform beta oxidation, thus requiring the use of ketone bodies when glucose stores are depleted?

    <p>Brain</p> Signup and view all the answers

    Which symptom is not commonly associated with severe diabetes?

    <p>Increased hunger</p> Signup and view all the answers

    What does the mixture constituting bile include?

    <p>Electrolytes, bile acids, cholesterol, phospholipids, and bilirubin</p> Signup and view all the answers

    What results when cholesterol precipitates from solution in the body?

    <p>Gallstones</p> Signup and view all the answers

    Which term refers to the yellowing of body tissues due to bilirubin deposition?

    <p>Jaundice</p> Signup and view all the answers

    Which structure is essential for the production of ultrafiltrate based on blood flow?

    <p>Glomeruli</p> Signup and view all the answers

    What is not a part of the investigation of acute kidney injury?

    <p>Glucose</p> Signup and view all the answers

    What is reduced tubular function with a normal glomerular filtration rate characterized by?

    <p>All of these</p> Signup and view all the answers

    Which plasma concentration rises after a meal, unlike plasma cholesterol?

    <p>Triglyceride</p> Signup and view all the answers

    Which of the following is the volume of extracellular fluid (ECF) as a percentage of body weight for a 70 kg individual?

    <p>20 kg</p> Signup and view all the answers

    What characteristic of water accelerates many chemical reactions in the body?

    <p>Solvent</p> Signup and view all the answers

    What condition describes an increase in extracellular fluid volume but normal plasma osmolarity due to simultaneous water and solute gain?

    <p>Overhydration</p> Signup and view all the answers

    What is the primary regulator of water intake?

    <p>All of these</p> Signup and view all the answers

    What effects can occur due to disturbances in acid-base balance?

    <p>All of them</p> Signup and view all the answers

    What condition is characterized by increased pCO2 due to inadequate alveolar ventilation?

    <p>Respiratory acidosis</p> Signup and view all the answers

    Which of the following is an example of a condition that can cause respiratory alkalosis?

    <p>All of them</p> Signup and view all the answers

    What minerals are required for a variety of physiological functions?

    <p>All of the above</p> Signup and view all the answers

    Which process results in the formation of Nicotinamide adenine dinucleotide (NADH) in B-cells?

    <p>Oxidation of pyruvate by pyruvate dehydrogenase</p> Signup and view all the answers

    Which of the following functions is not performed by the liver?

    <p>Contraction</p> Signup and view all the answers

    Which of the following is associated with liver metabolism?

    <p>Protein metabolism</p> Signup and view all the answers

    Which structures are found in the cortex of the kidney?

    <p>Proximal convoluted tubules</p> Signup and view all the answers

    Reduced glomerular filtration rate with normal tubular function is characterized by which condition?

    <p>Reduced blood flow</p> Signup and view all the answers

    Which component is primarily monitored in the investigation of acute kidney injury?

    <p>All these</p> Signup and view all the answers

    What condition can result from abnormal levels of lipids, especially cholesterol?

    <p>Atherosclerosis</p> Signup and view all the answers

    Which factor is not a cause of high cholesterol?

    <p>High fruit intake</p> Signup and view all the answers

    What percentage of body weight does the intracellular fluid (ICF) approximate to?

    <p>40%</p> Signup and view all the answers

    Which condition involves a loss of volume due to water, but not solute, resulting in increased plasma osmolarity?

    <p>Dehydration</p> Signup and view all the answers

    What regulates fluid levels in the body within a narrow range?

    <p>All of these</p> Signup and view all the answers

    What is one function of water due to its ionizing power?

    <p>Catalytic action</p> Signup and view all the answers

    Which condition is associated with the kidneys and leads to a decrease in pH?

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

    What is the major cation that contributes significantly to the osmolality of the extracellular fluid?

    <p>Sodium</p> Signup and view all the answers

    Which mineral is essential for the synthesis of hemoglobin (Hb)?

    <p>Iron</p> Signup and view all the answers

    Which of the following changes does not occur in blood chemistry during severe diarrhea?

    <p>Increased pCO2</p> Signup and view all the answers

    What is the primary function of the hormone ADH?

    <p>It is a hormone secreted by the pituitary.</p> Signup and view all the answers

    Polydipsia is characterized by which symptom?

    <p>Thirst and increased fluid intake</p> Signup and view all the answers

    After how many hours is blood glucose measured in a glucose tolerance test?

    <p>2 hours</p> Signup and view all the answers

    Which of the following statements does not apply to type 1 diabetes?

    <p>Non-insulin-dependent</p> Signup and view all the answers

    The normal value of iron in infants is:

    <p>10-18 mg</p> Signup and view all the answers

    Which of the following is the yellowish product of normal RBC catabolism?

    <p>Bilirubin</p> Signup and view all the answers

    Insulin is a dimer. How many amino acids are present in the A and B chains, respectively?

    <p>21 and 30</p> Signup and view all the answers

    Which of the following elements is responsible for gray hair?

    <p>Copper (Cu)</p> Signup and view all the answers

    A student is nervous for a big exam and is breathing rapidly. What do you expect?

    <p>Respiratory alkalosis</p> Signup and view all the answers

    Metabolic alkalosis includes all the following except?

    <p>Mineralocorticoid deficiency</p> Signup and view all the answers

    Transport of sodium in the renal tubules involves:

    <p>Na/K-ATPase located on the membrane of distal tubules.</p> Signup and view all the answers

    The pH of the body fluids is stabilized by buffer systems. Which of the following buffers is the most effective buffer system at physiological pH?

    <p>Bicarbonate buffer</p> Signup and view all the answers

    What are hormones inhibiting gluconeogenesis?

    <p>Insulin</p> Signup and view all the answers

    Which of the following enzyme is a sensitive marker of alcoholic liver disease?

    <p>Aspartate transaminase</p> Signup and view all the answers

    Which of the following laboratory measurement best indicates blood glucose control over a period of weeks?

    <p>Measurement of HbAlc</p> Signup and view all the answers

    Hyponatremia is decreased in serum Na concentrations <136mEq/L and caused by?

    <p>Diuretic use</p> Signup and view all the answers

    What triggers the release of intracellular potassium into the extracellular space?

    <p>Severe injury</p> Signup and view all the answers

    What is aldosterone's role in potassium balance?

    <p>Promotes sodium reabsorption and potassium excretion</p> Signup and view all the answers

    What is a feature of metabolic acidosis?

    <p>Bicarbonate concentration of 10 mEq/L</p> Signup and view all the answers

    What increases plasma zinc levels?

    <p>None of the above</p> Signup and view all the answers

    Which element catalyzes the formation of hemoglobin?

    <p>Iron (Fe)</p> Signup and view all the answers

    Which cation is predominant in plasma?

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

    Which enzyme catalyzes the formation of bilirubin diglucuronide?

    <p>Bilirubin UDP-glucuronosyltransferase</p> Signup and view all the answers

    How does the respiratory system contribute to acid-base balance?

    <p>By correcting the hydrogen ion concentration by 50% to 70%</p> Signup and view all the answers

    The biochemical investigation of the blood specimen showed Bilirubin- 4.5 mg/dl, ALT- 150 IU/L, AST- 200 IU/L, and Albumin- 25 mg/dL. What is the likely biochemical diagnosis?

    <p>Acute hepatic disease</p> Signup and view all the answers

    Which of the following is not the metabolic function of the liver?

    <p>Synthesis and Assembly of Chylomicrons</p> Signup and view all the answers

    A person weighing 86.5 kg has how much plasma in the body?

    <p>17.3 liters</p> Signup and view all the answers

    Which of these serum measurements are used for the diagnosis of diabetes mellitus type 1 and type II?

    <p>Glycated Hemoglobin (HbA1c)</p> Signup and view all the answers

    Quantitatively, what is the most significant buffer system in plasma?

    <p>Carbonic acid-bicarbonate buffer system</p> Signup and view all the answers

    What is the approximate amount of water produced during oxidation of food in an adult?

    <p>1400 ml/day</p> Signup and view all the answers

    Hypokalemia occurs in which condition?

    <p>Cushing's syndrome</p> Signup and view all the answers

    Deficiency of magnesium is commonly associated with which condition?

    <p>Alcoholism</p> Signup and view all the answers

    Which compartment contains the least amount of total body water (TBW)?

    <p>Intravascular compartment (plasma)</p> Signup and view all the answers

    What condition occurs when the extracellular fluid (ECF) decreases due to a simultaneous decrease in both water and solutes, while osmolarity remains normal?

    <p>Hypovolemia</p> Signup and view all the answers

    Which metal ion deficiency causes acrodermatitis enteropathica due to absorption issues?

    <p>Zinc</p> Signup and view all the answers

    High concentrations of which metal ion are found in tissues rich in mitochondria and pigments, such as the retina and dark skin?

    <p>Iron</p> Signup and view all the answers

    Which condition is indicated by fluid overload?

    <p>Hypervolemia</p> Signup and view all the answers

    When the RAAS (Renin-Angiotensin-Aldosterone System) is activated due to changes in body hemodynamics, which hormone do juxtaglomerular cells release?

    <p>Renin</p> Signup and view all the answers

    Study Notes

    Urobilinogen and Bilirubin

    • Urobilinogen is absent in urine, but bilirubin is present, indicating a problem with the liver or bile ducts.
    • Microglobulin excretion in urine is a sensitive indicator of tubular damage.

    Glomerular Filtration Rate (GFR)

    • When a substance is freely filtered, not reabsorbed, and fully secreted, its clearance is equal to GFR.
    • GFR is an important indicator of kidney function.

    Lipoproteins

    • Lipoproteins differ in their composition, density, and functions.
    • Lipoproteins are complexes of lipids and proteins that transport lipids in the bloodstream.

    Diabetes Mellitus

    • Pro-insulin is processed in the endoplasmic reticulum by removing a leader sequence of 23 amino acids.
    • The main symptoms of severe diabetes include polyuria, thirst, blurred vision, and weight loss.

    Disorders of the Liver

    • The main disorders of the liver include jaundice, cirrhosis, tumors, and hepatitis.
    • Bile is a mixture of electrolytes, bile acids, cholesterol, phospholipids, and bilirubin.

    Cholesterol

    • Gallstones are formed when cholesterol precipitates from solution, often due to liver damage or obstruction of a bile duct.
    • Jaundice is a clinical term referring to the yellowing of body tissues due to the deposition of bilirubin.

    Water and Electrolyte Balance

    • Water accelerates a large number of chemical reactions in the body due to its ionizing power.
    • Hypervolemia occurs when too much water and solute are absorbed at the same time, leading to an increase in extracellular fluid volume.
    • The thirst mechanism is the primary regulator of water intake and involves hormonal and neural input as well as voluntary behaviors.

    Acid-Base Balance

    • Respiratory acidosis is characterized by increased pCO2 due to inadequate alveolar ventilation (hypoventilation) and consequent reduced elimination of CO2 from the blood.
    • Metabolic acidosis occurs when the body produces too much acid or cannot remove enough acid from the body.
    • The body has mechanisms that regulate fluid levels within a narrow range, including ADH, thirst, sympathetic nervous system, and kidneys.

    Minerals

    • Sodium absorption is very efficient in both the small intestine and colon.
    • The level of potassium in the blood can be affected by various factors, including vomiting, diarrhea, and Cushing syndrome.
    • Zinc is an essential mineral required for a variety of physiological functions, including transport of oxygen, working of the nervous system, and muscle contraction.

    Insulin and Glucagon

    • Insulin is synthesized in the beta cells of the pancreatic islets and promotes glucose uptake and storage.
    • Glucagon, produced by the alpha cells of the pancreatic islets, promotes glycogenolysis and gluconeogenesis.

    Kidney Function

    • The cortex of the kidney contains the glomeruli, proximal convoluted tubules, and distal convoluted tubules.
    • The kidney performs major functions, including excretion, synthesis, detoxification, and storage.

    Lipid Metabolism

    • Abnormal levels of lipids, especially cholesterol, can lead to atherosclerosis and other problems.

    • LDL (low-density lipoprotein) is often referred to as "bad" cholesterol, while HDL (high-density lipoprotein) is referred to as "good" cholesterol.### Fluid Balance and Electrolytes

    • Dehydration occurs when ECF decreases due to a decrease in both water and solute at the same time, but osmolarity remains normal.

    • Hypervolemia is the opposite of dehydration, where ECF increases due to an increase in both water and solute.

    • Overhydration is not the same as hypervolemia, as it refers to an excess of water in the body.

    Mineral Deficiencies

    • Acrodermatitis enteropathica is a condition caused by the inability to absorb zinc ions.
    • Zinc deficiency leads to skin lesions, impaired wound healing, and impaired immune function.

    Tissue Distribution of Minerals

    • Tissues rich in mitochondria and pigments, such as the retina and dark skin, tend to have high concentrations of copper.
    • Copper is essential for the production of melanin, which gives color to the skin and hair.

    Fluid Overload and Hormonal Regulation

    • Fluid overload causes hypervolemia, which can lead to edema and hypertension.
    • The renin-angiotensin-aldosterone system (RAAS) is activated in response to changes in body hemodynamics, such as decreased blood volume or pressure.
    • When the RAAS is activated, the sympathetic nervous system stimulates the juxtaglomerular cells in the kidneys to release renin.
    • Renin catalyzes the conversion of angiotensinogen to angiotensin, which stimulates the adrenal glands to release aldosterone.
    • Aldosterone targets the distal convoluted tubule and collecting ducts in the kidneys, stimulating the reabsorption of sodium and water.

    Aldosterone Function

    • Aldosterone plays a crucial role in regulating electrolyte balance and blood pressure.
    • It increases the reabsorption of sodium and water in the kidneys, leading to increased blood volume and pressure.

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    Description

    This quiz covers various aspects of renal function and urine analysis, including the presence of urobilinogen and bilirubin in urine, microglobulin excretion, proteinuria, and clearance of substances. It's a great resource for medical students and professionals.

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