nephrons and cells

At what rate is plasma filtered into urine? How many liters of urine are made a day?

120 mL/minute, 1-2 liters

urine is 95% what?

water

what percentage of urine is solutes?

5%

what compounds make up the 5% solutes in urine?

urea (50%), creatinine, amino acids, glycoproteins, salts, miscellaneous (sugar, fats), formed elements

what are the three abnormal crystals to lookout for in urine?

leucine, cytosine, tyrosine

what parasite do we typically associate with urine?

Trichamonas

what is the acceptable urine output range in a healthy person?

600-2000

what factors influence urine volume?

vomiting, diarrhea, sweating, hormone secretion, water intake

causes of oliguria

dehydration, sweating, vomiting, diarrhea, renal ischemia, renal obstruction, kidney stones, acute glomerulonephritis

causes of polyuria

increased water intake, diuretics, nervousness, diabetes mellitus, diabetes insipidus, kidney disease

how are infant urine collections done?

polyethylene bag

can timed collections be used for urinalysis?

no

what are the three urine specimen collections we use?

voided sample, catheterized, suprapubic

room temperature urines are only stable for _____ minutes and must be processed within _______ hours. Refrigerated urine specimens are stable for _____ hours

30, 2 , 6-8

Refrigeration may cause more _____ to form in urine

crystals

urine cultures must be done within _____ hours

24

what chemical is sometimes added to urine specimens to preserve them? What does this change the pH to?

Boric Acid, 6

what happens to each of the urine dipstick tests after more than 30 minutes at room temperature?

bacteria increases, glucose decreases, nitrites increase, pH increases, cells and casts decrease, false positive protein, crystals increase, ketones decrease, bilirubin false negative, urobilinogen false negative

what are the 4 main kidney functions?

regulates composition and volume of extracellular fluid, removal of waste products, Acid base balance, production/secretion

Glomerular filtration is achieved via a semipermeable membrane called the _______ which is made up of the _______ which is negatively charged and _______ which are cells closely packed together creating small openings called ____

fenestrated capillary endothelium, basement membrane, podocytes, slits

is creatine reabsorbed?

no

uric acid is filtered, reabsorbed in the _____ and sent back out in the ______.

proximal convoluted tubule, distal convoluted tubule

Tubular reabsorption happens in the _____ and involves both active transport and passive transport. ____, ______, _____, _____, ____, _____, are all actively transported and _____ and _____ are passively transported

glucose, albumin, amino acids, most sodium, salts, uric acid, urea, water

what are these?

squamous epithelial cells

what is this cell?

renal tubular epithelial cell

what kind of cells are these?

transitional epithelial cells

what happens in the descending loop of Henle?

water is passively reabsorbed

what happens in the ascending loop of Henle?

chloride is actively reabsorbed, urea is passively absorbed, impermeable to H2O

_____, ______, and _____ are not filtered by the glomerulus and instead are put straight into the collecting duct in a process called _______.

creatine, uric acid, toxins

what four conditions fall under primary kidney disease

glomerulonephritis, tubular necrosis, nephrotic syndrome, pyelonephritis

what 5 conditions fall under secondary kidney disease?

systemic hypertension, vascular/heart disease, diabetes mellitus, inborn errors of metabolism, liver disease

oval fat bodies are ______ cells full of _____. ID is done via ______ and/or _______ stains. cholesterol molecules can be identified via the characteristic ________. oval fat bodies may be seen alongside ______ and a strong _____ on the urine dipstick. urine is often _____ and presence of oval fat bodies is frequently associated with ______.

tubular epithelial cells, lipids, polarizing microscope, fat, Maltese cross, free fat droplets, protein, cloudy, nephrotic syndrome

what are the 4 conditions that allow casts to form?

concentrated urine, acidic pH, decreased urinary flow, increased protein

casts are mostly made up of what proteins?

Tamm Horsefall and plasma proteins

what 2 conditions are casts associated with?

kidney diseases and temporary proteinuria

WBC casts are associated with what 2 conditions?

pyelonephritis, acute interstitial nephritis

RBC casts are associated with ____?

acute disorders of the glomerulus

RTE casts are associated with______

renal tubular injury

Waxy casts are the last stage of cast degration. they are always associated with a positive test for _____. Waxy casts indicate _____ and are associated with dilated ____ or ____ and a poor prognosis.

protein, end stage renal disease, tubules, collecting ducts

Fatty casts are associated with ____, ______, and _____.

nephrotic syndrome, crush injuries, advanced tubular necrosis

what is the juxtamedullary apparatus?

where the renal afferent arteriole touches the distal convoluted tubule

what is the macula densa?

cells lining the DCT that monitor changes in salts

ammonium biurate

ancyclovir

bilirubin

calcium carbonate

calcium oxalate

calcium phosphate

cholesterol

cystine

hippuric acid

indinivir

leucine

radiopaque dye

starch

sulfa

trichamonas

triple phosphate

tyrosine

uric acid

yeast

acute glomerular nephritis has findings of what 6 things?

positive protein, positive blood, RBC’s, hemoglobin casts, hyaline casts, granular casts

chronic glomerulonephritis has findings of what 7 things?

positive protein, positive blood, RBC’s, WBC’s, renal tubular epithelial cells, granular casts, waxy casts

nephrotic syndrome has findings of 7 things?

hypoalbuminemia, hyperlipidemia, positive protein, free fat, oval fat bodies, casts

pyelonephritis has findings of what 7 things?

positive protein, positive leukocytes, positive nitrites, WBC’s, RBC’s, bacteria, WBC casts

what are the 3 findings for acute tubular necrosis?

renal tubular epithelial cells, granular casts, waxy casts

what are the 4 findings for chronic renal failure

fixed specific gravity of 1.010, positive protein, positive RBC’s, all casts especially broad waxy casts

what are the 6 findings for lower UTI?

positive leukocytes, positive nitrite, wbc’s, bacteria, rbc’s, transitional epi’s

what are the 4 findings of kidney stones

fixed pH, increased urine concentration, stone forming substances, RBC’s

what are the two cancer findings?

positive blood, abnormal transitional epithelial cells