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35 Cards in this Set
- Front
- Back
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What are the three parts of the glomerular filtration barrier?
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-Fenestrated glomerular capillary endothelium
-Glomerular Basement Membrane -Podocytes |
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All the parts of a glomerular filtration barrier have what type of charge?
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Negative charge
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Tamm-Horsfall proteins
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glycoproteins secreted by the ascending thick limb of each nephron
major component of a hyaline cast |
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Urinary caste
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small cylinder of protein or cells that forms within the tubular fluid, takes the shape of the tubular lumen and is excreted in the urine
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3 general categories of intrinsic renal disease
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-the glomeruli- glomerulonephritis-proteinuria
-the tubules- acute tubular necrosis -the interstitium- interstitial nephritis |
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What is the main component of plasma protein?
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albumin
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What will red blood cell casts look like in a urine sample?
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they will be in a large group shaped like the inside of the tubule
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Dysmorphic RBCs
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Indicitive of glomerulonephritis
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Urine dip
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Usually the first evidence of proteinuria
This is a strip of paper similar to a litmus paper, that is simply dipped into a urine sample |
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What do urine dips test for?
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- protein
- blood - bilirubin - pH - glucose - leucocytes - urobilinogen - specific gravity - ketones - nitrites |
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Gross hematuria
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can cause the urine to dip falsely positive for “proteinuria” because 1 ml of whole blood contains about 50 mg of albumin.
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What is the upper limit of normal limit of plasma protein loss in the urine?
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150 mg protein/day
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What level of urine stick requires a 24 hour urine sample?
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Anything over Tract
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How do you know if there is 24 hours of urine in a sample?
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Measure the creatinine levels, between 1 and 2 and it should be okay
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Protein/Creatinine Ratio
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Urinary [protein]/[creatinine]
should be less than .2 |
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What are RBC castes indicitive of?
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Glomerulonephritis
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What are Hyaline castes indicitive of?
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Normal
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What are WBC castes indicitive of?
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Pyelonephritis (infectious nephritis)
Drug induced nephritis |
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What are epithelial castes indicitive of?
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Acute tubular necrosis (lining of the tubules being scraped off)
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proteinuria
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a form of renal malfunction in which more than this small amount routinely gets into the urine
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Normal amount of protein lost in the urine
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less than 150 mg / day
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Orthostatic Proteinuria
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Some healthy adolescents and young adults have increased protein excretion only during the day, when they are ambulatory and, assumedly, blood pressure is higher than at night.
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Orthostatic Proteinuria Tests
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a 24 hour urine sample is collected in two separate aliquots, nighttime and daytime
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Functional Proteinuria caused by
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- high fever
- exposure to extreme cold - strenuous exercise (running a marathon etc ) |
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Mechanisms of Pathologic Proteinuria
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1) Loss of the charge barrier
2) Loss of the size barrier 3) Overload proteinuria 4) Proximal tubular dysfunction |
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selective proteinuria
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proteinuria due to loss of the charge barrier
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Condition causing selective proteinuria
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Minimal change disease- chages the charge barrier
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Bence-Jones proteins
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cannot be detected by urine dip- must be found through electrophoresis
light chains of proteins |
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If a urine dip is positive for blood what is it actually positive for?
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Hemoglobin from hemolysis and possibly myoglobin from rhabdomyolysis
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Two main categories of glomerulonephritis
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Nephritic syndromes
Nephrotic Syndromes |
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What type of renal failure is Glomerularnephritis?
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Intrinsic renal failure
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What is DLco?
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Measures how well the lungs take up Oxygen
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What is a fatty caste indicitive of?
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Minimal change disease
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What antibiotics are aminoglycosides?
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Gentamicin and streptomycin
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In the absence of obvious crush injury,how do you know that rhabdomyolysis is the cause of acute renal failure??
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very high serum CPK
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