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8 Cards in this Set
- Front
- Back
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Explain the various parameters tested in a routine urinalysis.
Specific gravity, Protein (Nephritic Syndrome, Specific proteins), Glucose, Ketones, Bilirubin/Urobilinogen, Blood |
• Specific gravity: normally 1-1.03… Renal failure if fixed at 1.010
• Protein o Nephritic Syndrome if <3.5g/24 hrs; Nephrotic Syndrome if >3.5g/24 hrs o Specific proteins may indicate specific diseases (ie Bence-Jones proteins in Multiple Myeloma, myoglobin in muscular injury, etc) • Glucose: Diabetes Mellitus if positive • Ketones: Diabetic Ketoacidosis if positive • Bilirubin/Urobilinogen: Hemolysis or block in heme breakdown pathway if positive • Nitrites & Leukocyte esterase: Urinary tract infection (UTI) if positive • Blood: Nephritic Syndrome, physical injury, cancer, etc. if positive |
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Define azotemia (pre renal, renal and post renal). Define renal failure, uremia, and list its clinical manifestations.
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"Azotemia" = elevated BUN/Creatinine => ↓GFR from failing kidney
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Define prerenal azotemia
BUN:Cr ratio? Examples? |
decreased perfusion of kidneys leading to ↓GFR
- “BUN:Cr ratio” >15 [explanation: BUN and Cr both aren’t filtered as well due to decreased perfusion; however, urea is reabsorbed, so BUN decreases not as much as Cr does] - Examples: CHF, shock, hypovolemia |
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Define renal azotemia
BUN:Cr ratio? Examples? |
renal parenchymal damage leading to ↓GFR
- “BUN:Cr ratio” <15 [explanation: BUN and Cr both aren’t filtered well, but now urea isn’t reabsorbed due to renal injury] - Examples: Acute tubular necrosis (ATN), Chronic renal failure (CRF) |
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Define postrenal azotemia
BUN:Cr ratio? Examples? |
obstruction of urinary tract with back up leading to ↓GFR
- Initially “BUN:Cr ratio” >15 [back up causes increased Urea reabsorption] - Later “BUN:Cr ratio” <15 [persistant obstruction leads to renal azotemia] - Examples: BPH, Kidney stones, Cancer |
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Define the nephrotic and nephritic syndromes.
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4. Explain the difference between the various mechanisms of glomerular injury (immune complex deposition, anti-GBM, and Heyman nephritis).
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Outline the distinguishing features of the various forms of primary glomerulonephritis:
Acute diffuse Proliferative (post streptococcal and non post streptococcal) Rapidly progressive glomerulonephritis Membranous glomerulonephritis Minimal change disease Focal glomerulonephritis (i.e. IgA Nephropathy) Membranoproliferative Glomerulonephritis End stage renal disease |
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