Lab Section Date Urine Physiology Questions for Urine Physiology Lab A patikent
ID: 3524228 • Letter: L
Question
Lab Section Date Urine Physiology Questions for Urine Physiology Lab A patikent with high blood presure (2o0mmlg/'110nmsh) has protein in the urine.Esplain, as the leve of the glomerlun, why thie would occur 2. A patient has uncontrolled diabetes and is found to have glucose in the urine. Physiologically, at the level of the proximal convoluted tubule (PCT), why is this occurring 3. The above patient was also found to have ketones in their urine. Explain, physiologically, why this solute is in the urine of the patient. 4. Referring to your graph, explain how a large intake of water affects specific gravity, Explain using your knowledge of hormone influence on water balance, why the specific gravity changed in this way: Be specific LAB 7 Ufine PhExplanation / Answer
1. A patient with high blood pressure (200 mmHg/110 mmHg) has protein in the urine. Explain at the level of the glomerulus, why this would occur?
= Proteinuria is a condition when excess amount of protein is excrete in the urine. In normal condition kidney does not allow proteins to be filtered out of the blood. Glomerulus is a network of afferent and efferent blood vessels at the begining of the neuron. Here blood gets filtered. Generally small waste molecules are filtered here. As the diameter of the vessels are very small, a pressure is constanly present inside glomerulus. This pressure creates the normal glomerulation filtration of blood.
But in patients with high blood pressure there is an increased pressure inside glomerulus. This makes protein to move out of the blood vessels and into the nephron. Also the proteins do not get reabsorbed. Thus excess protein is excreted with urine in patient of hypertension.
2. A patient has uncontrolled diabetes and is found to have glucose in the urine. Physiologically at the level of the proximal convoluted tubule (PCT), why is this occuring?
= The condition where excess glucose is present in the urine is called glucosuria. Normally glucose concentration in urine is none or very low (about 0.8 mmol/litre of urine). Because glucose is completely reabsorbed by the proximal convoluted tubule of nephron, if any glucose is filtered out from the blood inside glomerulus. As PCT also reabsorb sodium, glucose is cotransported via SGLT2 transporter protein of PCT wall.
But diabetic patients has excess amount of blood glucose concentration (more than 110 mg/dl), so the excess glucose is filtered through glomerulus. The PCT is not capable of reabsorbing the excess amount of glucose, as sodium is not present enough to supplement the co-transport. So glucose is excreted with urine. This also is the reason why diabetic patients have to release urine more often.
3. The above patient was also found to have ketones in their urine. Explain, physiologically, why this solute is in the urine of the patient.
= Ketones are end product of fatty acid metabolism. Ketones are alternate source of energy, specially for brain. As diabetic patient has either have insulin in insufficient amount (type 1 diabetes) or insensitive cells to insulin (type 2 diabetes), their blood glucose levels remain high and tissue can not avail the glucose. So they has to find an alternate source of energy. Liver burns fat to produce ketone body to meet the requirement. So concentration of ketone body is increased in blood of diabetic patients. This reflects on urine also, as excess ketone are filtered out in urine. If this condition remains for prolonged time, ketacidosis may occur, blood becoming acidic.
4. Referring to your graph explain how a large intake of water affects specific gravity. Explain using your knowledge of hormone influence on water balance, why the specific gravity changed in this way. Be specific.
= Specific gravity measures the kidney's ability to produce urine, its concentration. It is a parameter of kidney function. The normal range of urine specific gravity is 1.01 to 1.03. Hypersthenuria is a condition where specific gravity or the urine concentration increases. Also the specific gravity can decrease in large intake of water. Excess water in blood will be removed via urine. The urine will be diluted, so the specific gravity will decrease.
Anti-Diuretic Hormone or ADH is released by pituitary and it controls the concentration of urine by regulating water reabsorption through nephron. ADH increases water retention. Thus keeps the water balance normal in blood. The baroreceptors and chemoreceptors of blood vessels monitors the blood pressure. When ever the BP falls due to less water in blood, ADH is released from pituitary and it gives signal to kidney to retain water.
Excess drinking of water will increase the blood pressure, which will increase the glomerulus filtration rate and in turn the urinary output will increase. As the blood pressure remains high it signals hypothalamus to stop producing ADH, as it is not required and the excess water needs to be excreted.
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