QuantRenalFunctFall2012WithAnswers (1)

Ketones nitrite leukocyte esterase heme protein or

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Ketones Nitrite Leukocyte esterase Heme Protein or albumin Specific gravity Urine Microscopy Erythrocytes Leukocytes Casts Crystals
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Laboratory Tests Blood urea nitrogen (BUN) Amino acids ammonia urea Reabsorption rate dependent on water reabsorption ↓ urea excretion & water and urea reabsorption due to dehydration BUN Used in combination with serum creatinine as screening test for renal dysfunction
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Laboratory Tests Serum Creatinine (SCr) Degradation product of creatine in muscle Dependent on age, gender, muscle mass, medications, exercise and diet Primarily eliminated by glomerular filtration Increases as glomerular filtration decreases Not sensitive to rapid GFR changes Is NOT reabasorbed Used as screening test for renal dysfunction Normal = 0.5-1.3 mg/dL
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Laboratory Tests BUN:SCr Ratio is normally 10:1 to 15:1 Elevated ratio (>20:1) indicates decreased circulating volume Because BUN level is dependent on water reabsorption Dehydration, prerenal azotemia
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HR has a SCr 0.8 and BUN 18. What is the BUN:SCr ratio? What does it indicate? 1. 0.044:1, which indicates dehydration 2. 0.044:1, which is normal 3. 22.5:1, which indicates dehydration 4. 22.5:1, which is normal
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BUN, SCr or BUN:SCr can be used to diagnose renal dysfunction. 1. TRUE 2. FALSE
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Measuring Kidney Function Glomerular Filtration Rate (GFR) Rate at which blood is filtered through glomerulus Normal > 120 ml/min/1.73m 2 Gold standard for quantifying renal function But…it cannot be directly measured
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Measuring Kidney Function Glomerular Filtration Rate (GFR) Accurately estimated by measuring substances that are filtered through the glomerulus but not secreted or reabsorbed Inulin, iothalamate, iohexol, radiolabeled markers Used in research, but not clinical practice Less accurately quantified by measuring creatinine clearance
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