25. The Urinary System

Predict the effects the following scenarios would have on glomerular filtration:

a. Having excess proteins in the blood, increasing colloid osmotic pressure

Predict the effects the following scenarios would have on glomerular filtration:

b. Having low arterial blood pressure (hypotension)

Why is urinalysis a routine part of any good physical examination?

Mr. Jessup, a 55-year-old man, is operated on for a cerebral tumor. About one month later, he complains that he is excessively thirsty and that he has been voiding almost continuously. A urine sample is collected, and its specific gravity is 1.001. What is your diagnosis of Mr. Jessup's problem, and how might it be related to his previous surgery?

Raymond is hypertensive and was recently diagnosed with impaired kidney function based on urinalysis and a blood test for creatinine. What sorts of test results would you expect, and how is hypertension related to kidney function?

A 55-year-old woman is awakened by an excruciating pain that radiates from her right abdomen to her flank on the same side. The pain is not continuous, but it recurs every 3 to 4 minutes. Diagnose this patient's problem, and cite factors that might favor its occurrence. Explain why this woman's pain comes in 'waves.'

What happens to the rate of RBC production in a patient on dialysis with total renal failure? What could be given to the patient to counteract such a problem?

Normal urine should have which of the following properties? Circle all that apply.

a. Translucency

b. Yellowish pigment

c. Cloudy appearance

d. pH less than 4.5

The GFR may be estimated by measuring the rate at which certain substances are removed from the blood, which is known as:

a. Renal clearance

b. Plasma creatinine

c. Glomerular hydrostatic pressure

d. Inulin estimation

What might it mean if you found a high concentration of urobilinogen in your patient's urine? (Hint: Consider the source of urobilinogen.)

Patty, aged 55, is awakened by excruciating pain that radiates from her right abdomen to the loin and groin regions on the same side. The pain is not continuous but recurs at intervals of 3 to 4 minutes. Diagnose her problem, and cite factors that might favor its occurrence.

While repairing a frayed utility wire, Kevin, an experienced lineman, slips and falls to the ground. Medical examination reveals a fracture of his lower spine and transection of the lumbar region of the spinal cord. How will Kevin's micturition be controlled from this point on? Will he ever again feel the need to void? Will there be dribbling of urine between voidings? Explain the reasoning behind all your responses.

Contrast the following homeostatic imbalances: oliguria, anuria, polyuria, and nocturia.

Describe the changes that occur in kidney and bladder function in old age.

The glomerular filtration rate is regulated by all of the following, except 

(a) Autoregulation

(b) Sympathetic neural control

(c) Cardiac output

(d) Angiotensin II

(e) The hormone ADH