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?

Sulfur Signup and view all the answers

Which mechanism contributes to a decrease in plasma calcium concentration?

The action of calcitonin on the kidney Signup and view all the answers

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

Brain Signup and view all the answers

Which symptom is not commonly associated with severe diabetes?

Increased hunger Signup and view all the answers

What does the mixture constituting bile include?

Electrolytes, bile acids, cholesterol, phospholipids, and bilirubin Signup and view all the answers

What results when cholesterol precipitates from solution in the body?

Gallstones Signup and view all the answers

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

Jaundice Signup and view all the answers

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

Glomeruli Signup and view all the answers

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

Glucose Signup and view all the answers

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

All of these Signup and view all the answers

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

Triglyceride 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?

20 kg Signup and view all the answers

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

Solvent 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?

Overhydration Signup and view all the answers

What is the primary regulator of water intake?

All of these Signup and view all the answers

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

All of them Signup and view all the answers

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

Respiratory acidosis Signup and view all the answers

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

All of them Signup and view all the answers

What minerals are required for a variety of physiological functions?

All of the above Signup and view all the answers

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

Oxidation of pyruvate by pyruvate dehydrogenase Signup and view all the answers

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

Contraction Signup and view all the answers

Which of the following is associated with liver metabolism?

Protein metabolism Signup and view all the answers

Which structures are found in the cortex of the kidney?

Proximal convoluted tubules Signup and view all the answers

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

Reduced blood flow Signup and view all the answers

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

All these Signup and view all the answers

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

Atherosclerosis Signup and view all the answers

Which factor is not a cause of high cholesterol?

High fruit intake Signup and view all the answers

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

40% Signup and view all the answers

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

Dehydration Signup and view all the answers

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

All of these Signup and view all the answers

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

Catalytic action Signup and view all the answers

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

Metabolic acidosis Signup and view all the answers

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

Sodium Signup and view all the answers

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

Iron Signup and view all the answers

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

Increased pCO2 Signup and view all the answers

What is the primary function of the hormone ADH?

It is a hormone secreted by the pituitary. Signup and view all the answers

Polydipsia is characterized by which symptom?

Thirst and increased fluid intake Signup and view all the answers

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

2 hours Signup and view all the answers

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

Non-insulin-dependent Signup and view all the answers

The normal value of iron in infants is:

10-18 mg Signup and view all the answers

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

Bilirubin Signup and view all the answers

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

21 and 30 Signup and view all the answers

Which of the following elements is responsible for gray hair?

Copper (Cu) Signup and view all the answers

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

Respiratory alkalosis Signup and view all the answers

Metabolic alkalosis includes all the following except?

Mineralocorticoid deficiency Signup and view all the answers

Transport of sodium in the renal tubules involves:

Na/K-ATPase located on the membrane of distal tubules. 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?

Bicarbonate buffer Signup and view all the answers

What are hormones inhibiting gluconeogenesis?

Insulin Signup and view all the answers

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

Aspartate transaminase Signup and view all the answers

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

Measurement of HbAlc Signup and view all the answers

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

Diuretic use Signup and view all the answers

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

Severe injury Signup and view all the answers

What is aldosterone's role in potassium balance?

Promotes sodium reabsorption and potassium excretion Signup and view all the answers

What is a feature of metabolic acidosis?

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

What increases plasma zinc levels?

None of the above Signup and view all the answers

Which element catalyzes the formation of hemoglobin?

Iron (Fe) Signup and view all the answers

Which cation is predominant in plasma?

Sodium (Na+) Signup and view all the answers

Which enzyme catalyzes the formation of bilirubin diglucuronide?

Bilirubin UDP-glucuronosyltransferase Signup and view all the answers

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

By correcting the hydrogen ion concentration by 50% to 70% 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?

Acute hepatic disease Signup and view all the answers

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

Synthesis and Assembly of Chylomicrons Signup and view all the answers

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

17.3 liters Signup and view all the answers

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

Glycated Hemoglobin (HbA1c) Signup and view all the answers

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

Carbonic acid-bicarbonate buffer system Signup and view all the answers

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

1400 ml/day Signup and view all the answers

Hypokalemia occurs in which condition?

Cushing's syndrome Signup and view all the answers

Deficiency of magnesium is commonly associated with which condition?

Alcoholism Signup and view all the answers

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

Intravascular compartment (plasma) 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?

Hypovolemia Signup and view all the answers

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

Zinc 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?

Iron Signup and view all the answers

Which condition is indicated by fluid overload?

Hypervolemia 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?

Renin 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.