Part 1

1. The majority of glomerular disorders are caused by:

a. Sudden drops in blood pressure
b. Immunologic disorders
c. Exposure to toxic substances
d. Bacterial infections

2. Broad and waxy casts are most frequently seen with

a. Chronic glomerulonephritis and chronic renal failure
b. Rapidly progressive glomerulonephritis
c. Acute renal failure
d. Cystitis

3. The presence of WBCs and WBC casts with no bacteria seen is indicative o

a. Chronic pyelonephritis
b. Acute tubular necrosis
c. Acute interstitial nephritis
d. Azotemia

4. A disorder associated with polyuria and low specific gravity is

a. Renal glucosuria
b. Cystitis
c. Nephrogenic diabetes insipidus
d. focal segmental glomerulosclerosis

5. A urine that turns black after sitting by the sink for several hours could be indicative of

a. Alcaptonuria
b. MSUD
c. Melanuria
d. Both A and C

6. Most common composition of renal calculi is ______________

Part 2

1. List urine crystals that can be found in an acidic urine:

2. List urine crystals that can be found in an alkaline urine:

3. Describe the following urine crystals

a. ammonium biurate:
b. calcium carbonate:
c. Cystine:
d. Cholesterol:

4. To dissolve amorphous urates, you could

5. Which of the following crystals is associated with ethylene glycol ingestion

6. Cystine crystals might be confused with

7. A urine specimen refrigerate overnight is cloudy and has a pH of 6. The turbidity is due to what crystals:

Match sediment or crystal to the correct description - Alkaline urine or Acidic Urine

8. Amorphous phosphates -

9. Triple phosphate

10. Ammonium biurate

11. Calcium carbonate

12. Bilirubin

13. Cholesterol

14. Calcium oxalate

15. Amorphous urates

Part 3

Section 1

1. An increase in GCP (glomerular capillary pressure) will do what to GFR?

2. How does increasing age affect the GFR?

3. Starting with the proximal tubule, order the structures listed below in terms of when they are encountered by filtrate as it travels out of the body.

a. Loop on Henle
b. Renal pelvis
c. Distal tubule
d. Proximal tubule
e. Major calyx
f. Collecting duct

Section 2

Fill in the blanks using the following terms

7.35-7.45 Afferent amino acids antidiuretic hormone blood plasma collecting duct Glomerular capsule glomerulus glucose loop of Henle microvilli micturition nitrogenous pelvis peristalsis potassium  proteins reabsorption renal sodium tubule urethra urine urochrome

For your journey through the urinary system, you must be made small enough to filter through the filtration membrane from the bloodstream into a renal ___1___. You will be injected into the subclavian vein and must pass through the heart before entering the arterial circulation. As you travel through the systematic circulation, you have at least 2 minutes to relax before reaching the ___2___ artery supplying a kidney. Soon you see the kidney looming brownish red through the artery wall. Once you have entered the kidney, the blood vessel conduits become increasingly smaller until you finally reach the ___3___ arteriole feeding into the filtering device, or ___4___.

Once in the filter, you maneuver yourself so that you are directly in front of a pore. Within a fraction of a second, you are swept across the filtration membrane into the ___5___ part of the renal tubule. Drifting along, you lower the specimen cup to gather your first filtrate sample for testing. You study the readout from the sample and note that it is very similar in composition to ___6___ , with one exception - there are essentially no ___7___. Your next sample doesn't have to be collected until you reach the "hairpin," or, using the proper terminology, the ___8___ part of the tubule. As you continue your journey, you notice that the tubule cells have dense fingerlike projections extending from their surfaces into the lumen of the tubule. These are ___9___, which increase the surface area of tubule cells, because this portion of the tubule is very active in the process of ___10___. Soon you collect your second sample, and later, in the distal convoluted tubule, your third sample. When you read the computer's summary of the third sample, you make the following notes in your register:

1. Virtually no nutrients such as ___11___ and ___12___ are left in the filtrate.

2. The pH is acid, 6.0. This is quite a change from the pH of ___13___ recorded for the newly formed filtrate.

3. There is a much higher concentration of ¬___14___ wastes here.

4. There are fewer ___15___ ions but more ___16___ ions than there were earlier.

5. The color of the filtrate is yellow, indicating a high relative concentration of the pigment ___17___.
Gradually you become aware that you are moving along much more quickly. You see that the water level has dropped dramatically and that the stream is turbulent and rushing. As you notice this, you realize that the hormone___18___ must have been released recently to cause this water level drop. You take an abrupt right turn and then drop straight downward. You realize that you must be in a ___19___. Within a few seconds, you land with a splash in what appears to be a large tranquil sea with an ebbing tide toward a dark area at the far shore. You drift toward the dark area, confident that you are in the kidney ___20___. As you reach and enter the dark tubelike structure, your progress becomes rhythmic - something like being squeezed through a sausage skin. Then you realize that your progress is being regulated by the process of ___21___. Suddenly, you free-fall and land in the previously stored ___22___ in the bladder, where the air is very close. Soon the walls of the bladder begin to gyrate, and you realize you are witnessing a ___23___ reflex. In a moment, you are propelled out of the bladder and through the ___24___ to exit your hose.

Section 3

Decide whether the following conditions would result in an increase or a decrease in the specific gravity of urine. Write I in the answer blank to indicate an increase and D to indicate a decrease.

1. Drinking excessive fluids
2. Chronic renal failure
3. Pyelonephritis
4. Using diuretics
5. Limited fluid intake
6. Fever

Decide whether the following conditions would cause urine to become more acidic or more basic. If more acidic, write A in the blank; if more basic, write B in the blank.

7. Protein-rich diet
8. Bacterial infection
9. Starvation
10. Diabetes mellitus
11. Vegetarian diet

Section 4

Identify the following parts of the kidney.

Part 4

1. State the purpose of performing Quality Control tests.

2. What is the minimum number of QC levels that must be tested.

3. How often are QC tests performed?