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1)Which of the following is NOT associated with a normal first-void urine finding?
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trace protein |
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positive glucose |
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0.1 urobilinogen |
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pH of 6.0 |
2)A BUN of 60 mg/dL and a 3.5 mg/dL is consistent with which of the following?
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congestive heart failure |
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nephrotic syndrome |
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glomerulonephritis |
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pyelonephritis |
3)A sensitive test for the early detection of renal disease in diabetic patients is the ________________ test.=
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urine creatinine |
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blood urea nitrogen |
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urinary microalbumin |
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urine pH |
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4)An increased serum osmolality is associated with a decreased glomerular filtration rate.
| True | |
| False |
=
5)Select the influences below that will cause an elevated blood urea concentration.
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increased dietary protein |
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decreased renal function |
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increased protein catabolism |
|
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pregnancy |
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- The set of results that most accurately reflects severe renal disease is: 1) Serum creatinine, 1.0mg/dL;creatinine clearance, 110 ml/min; BUN, 17mg/dL 2) Serum creatinine, 1.0mg/dL; creatinine clearance, 95 ml/min; BUN, 43 mg/dL 3) Serum creatinine, 2.0mg/dL; creatinine clearance, 120 ml/min; BUN, 14 mg/dL 4) Serum creatinine, 3.7 mg/dL; creatinine clearance, 44 ml/min; BUN, 88 mg/dLAn 85 year old women with a history of diabetes mellitus and a broken hip has been confined to bed for 3 months. She has been complaining of aching muscles and her recent blood glucose result is 250mg/dL (Normal Range 70 - 100mg/dL) Urinalysis is with the following results: Color: Reddish brown Appearance: Clear Sp Gr: 1.020, pн 5.0 Protein: 2+ Glucose: 100 mg/dL (3+) Ketones: Negative Blood: Moderate Bilirubin: Negative Urobilinogen: Normal Nitrite: Negative Leukocyte esterase: Negative Microscopic exam: 0 – 2 WBC/hpf; few squamous epithelial cells/hpf Questions (3): A. What is the significance of the negative Ketones result? a. Increased fat metabolism b. Fat is not being metabolized for energy c. Starvation d. Patient has just consumed a high fat meal B. Glucose will appear in the urine when the: a. Blood level of glucose is greater than 180 mg/dL b. Tm (Transport maximum) for glucose in tubular cells is exceeded c. Renal threshold for glucose is exceeded d. All of the above C. The…Table 3. Serum creatinine values at admission and after 12h Admission +12h SCR(mg/dL) 1.55 1.42 Using the “MDRD” (Modification of Diet in Renal Disease) equation for estimating glomerularfiltration, provided below, and the data available in the above table, calculate the patient's (a 34 year old white male) estimated glomerularfiltration rate (eGFR) at admission and 12h after admission.MDRD GFR Equation (mL/min/1.73 m2)= 175 × (Scr)-1.154 × (Age)-0.203 × (0.742 if female) × (1.212 if African American)Based on your calculated values, state whether LF’s function is normal or abnormal?Previous research suggests that patients with asthma have an increased risk for chronic kidneydisease, but the mechanisms underlying this increased risk are poorly understood. Propose one potential mechanism by which asthma might impair kidney function, and discuss how this dysfunction may impair thebody’s ability to respond to respiratory alkalosis
- What is the patient's creatinine clearance given the following data? Serum creatinine 0.6 mg/dL Urine creatinine 102 mg/dL 24 hr urine volume 1650 mL Patient's BSA 1.93 m2 1) 195 mL/min 2) 130 mg/dL 3) 93 mL/min 4) 175 mL/min no references, just homeworkA 2-year-old child, admitted to hospital following diarrhoea and vomiting, had the fol- lowing results on analysis of plasma, 24 hours after admission (reference ranges are given in brackets): Sodium (135-145) Potassium (3.5-5.0) Urea (3.5-6.6) Creatinine (70-150) Osmolality (285-305) The urine sodium concentration was 55 mmol/L and its osmolality was 314 mOsm/kg. Comment on these results. 151 mmol/L 3.7 mmol/L 4.9 mmol/L 65 μmol/L 314 mOsm/kgA 68-year old woman presents with hypertension and oliguria. A CT of the abdomen reveals a hypoplastic left kidney. based on the following laboratory data which of the following is her estimated RPF? Renal artery p-amino hippuric acid (PAH) = 6mg/dL Renal vein PAH = 0.6mg/dL urinary PAH = 25mg/mL urine flow= 1.5mL/min hematocrit = 40%
- A uremic patient has a urine output of 1.8 L/24 h and an average creatinine concentration of 2.2 mg/dL. What is the creatinine clearance? How would you adjust the dose of a drug normally given at 20 mg/kg every 6 hours in this patient (assume the urine creatinine concentration is 0.1 mg/mL and creatinine clearance is 100 mL/min)?Following surgery to correct a massive hemorrhage, a 55-year-old patient exhibits oliguria and edema. Blood test results indicate increasing azotemia and electrolyte imbalance. The glomerular filtration rate is 20 mL/min. Urinalysis results are as follows: COLOR: Yellow KETONES: Negative CLARITY: Cloudy BLOOD: Moderate GRAVITY: 1.010 BILIRUBIN: Negative pH: 7.0 UROBILINOGEN: Normal PROTEIN: 3+ NITRITE: Negative GLUCOSE: 2+ LEUKOCYTE: Negative Microscopic: 50–60 RBCs/hpf 2–3 granular casts/lpf 3–6 WBCs/hpf 2–3 RTE cell casts/lpf 3–4 RTE cells/hpf 0–1 waxy casts/lpf 0–1 broad granular casts/lpf What diagnosis do the patient’s history and laboratory results suggest? What is the most probable cause of the patient’s disorder? Is this considered to be of prerenal, renal, or postrenal origin?Describe the clinical significance and interpretation of urine test strip reactions for the following: pH, protein, glucose, ketones, nitrites, blood, bilirubin, leukocyte and urobilinogen. Clinical Significance and Interpretation of Normal and Abnormal Results Tests pH Protein Glucose Ketones Nitrites Blood Bilirubin Leukocyte Urobilinogen
- The Golden standard for evaluating GFR and renal clearance is urea creatinine creatinine and urea inulin, continuous infusion inulin, single bolus A deficiency of the xanthine oxidase due to severe hepatocellular disease will lead to: increased urea concentration decreased creatinine concentration hyperuricemia hypouricemia xanthinuria None of the above Both C and E Both D and EA 21 year-old man with nausea, vomiting, and jaundice has the following laboratory findings: Total serum bilirubin 8.5 mg/dL (normal 0-1.0 mg/dL) Direct serum bilirubin 6.1 mg/dL (normal 0-0.5 mg/dL) Urine urobilinogen Increased Urine bilirubin Positive AST 200 U/L (normal 0-50 m/L) ALP 160 U/L (normal 0-150 m/L) What disease state are these findings consistent with? 1) Hemolytic anemia 2) Early hepatitis 3) Chronic liver disease 4) Obstructive jaundice no references, just homeworkIn reviewing the patient’s current information, a concern exists that acute kidney injury has developed. Select to highlight the laboratory information that would support this concern.UrinalysisCasts - +++Cola-color to urineProteinuriaBlood ValuesRBC - 3.9 cells/L (4.0-4.9 cells/L)Hgb 10 g/dL (12-16 g/dL)Hct-40% (37%-48%)WBC 11.0 cells/L (4.0-10.0 cells/L)Platelets - 140 cells/L (150-450 cells/L)Sodium - 140 mEq/L (135-145 mEq/L)Potassium - 4.5 mEq/L (3.5-5.2 mEq/L)BUN - 32 mg/dL (5-20 mg/dL)Creatinine 1.8 mg/dL (0.5-1.5 mg/dL)Blood Glucose - 180 mg/dL (nonfasting) (<200 mg/dL)AST-40 Units/mL (5-40 Units/mL)ALT - 30 Units/mL (5-35 Units/mL)Bilirubin (total)- 0.8 mg/dL (<1.0 mg/dL)Albumin - 4.0 (3.5-5.5 g/dL)PT-22 (11.5-14 seconds)