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RENAL FUNCTION AND DIAGNOSTIC TESTS LABORATORY VALUES COMPREHENSIVE ASSESSMENT 2026 FULL Q, Exams of Clinical chemistry

University of Pennsylvania (UPenn)Clinical chemistry

RENAL FUNCTION AND DIAGNOSTIC TESTS LABORATORY VALUES COMPREHENSIVE ASSESSMENT 2026 FULL QUESTIONS AND ANSWERS EXPERT REVIEWED

Typology: Exams

2025/2026

Available from 04/24/2026

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RENAL FUNCTION AND DIAGNOSTIC TESTS
LABORATORY VALUES COMPREHENSIVE
ASSESSMENT 2026 FULL QUESTIONS AND
ANSWERS EXPERT REVIEWED
โ—โ— CBC.
Answer: RBC, hemoglobin, and hematocrit are all low in chronic renal
failure due to lack of erythropoietin stimulation.
-RBCs needed to help with oxygenation of the tissues
-normal values: RBC (4.2-5.9million/mm3), hemoglobin (12-17g/dL),
hematocrit (36%-52%)
โ—โ— WBCs.
Answer: -needed to fight infection
-elevated with urinary tract infection, peritonitis, and transplanted
kidney rejection
-normal: 5,000-10,000/mm3
โ—โ— Serum creatinine.
Answer: -more accurate estimate of renal function than BUN
-normal: 0.5-1.5mg/dL
-double of the normal value can indicate 50% reduction in GFR
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RENAL FUNCTION AND DIAGNOSTIC TESTS

LABORATORY VALUES COMPREHENSIVE

ASSESSMENT 2026 FULL QUESTIONS AND

ANSWERS EXPERT REVIEWED

โ—โ— CBC.

Answer: RBC, hemoglobin, and hematocrit are all low in chronic renal failure due to lack of erythropoietin stimulation.

  • RBCs needed to help with oxygenation of the tissues
  • normal values: RBC (4.2-5.9million/mm3), hemoglobin (12-17g/dL), hematocrit (36%-52%) โ—โ— WBCs. Answer: - needed to fight infection
  • elevated with urinary tract infection, peritonitis, and transplanted kidney rejection
  • normal: 5,000-10,000/mm โ—โ— Serum creatinine. Answer: - more accurate estimate of renal function than BUN
  • normal: 0.5-1.5mg/dL
  • double of the normal value can indicate 50% reduction in GFR
  • know baseline and if a rise has occurred in the past 48 hours. When their is an abrupt cessation in GFR, this will usually rise between 1- 2mg/dL each day โ—โ— Creatinine Clearance. Answer: - most accurate of GFR
  • values below normal show 50% loss of nephron functioning
  • normal value range between 85-125ml/min/1.73m2 for adult male and 75 - 115ml/min/1.73 m2 for adult women โ—โ— - azotemia:. Answer: - occurs when there is accumulation of nitrogenous waste products in the blood and clinical characteristics of uremia
  • azotemia symptoms:see table โ—โ— uremia. Answer: can occur once the creatinine clearance is below 10-20ml.min
  • dialysis should be initiated when signs or symptoms of uremia are present and are not treatable by other medical therapies โ—โ— GFR: Glomerular filtration rate. Answer: - rate at which the urinary filtrate is formed
  • spasms of the hand and wrist, Trousseau's sign may become apparent when BP cuff placed on arm is inflated to 20mmHG above the systolic pressure for at least 3 minutes
  • serious affects happen when total calcium levels<7.0 and ionized calcium levels <0.8.. patient can then develop tentany or convulsions โ—โ— TX for hypocalcemia. Answer: oral supplementation.. in serious cases managed with IV calcium replacement โ—โ— serum chloride. Answer: - important in acid-base balance
  • this level will increase when HCO3 decreases
  • elevation suggests metabolic acidosis reflective of chronic renal failure normal: 96- 115 โ—โ— serum osmolality. Answer: - concentration of solutes in the serum
  • normal: 275- 295
  • elevation is osmolality suggests dehydration --drop suggests fluid overload โ—โ— serum Phosphorus.

Answer: - mostly found in bones

  • assists with ATP and acid-base balance
  • this value is opposite of calcium
  • regulated by parathyroid stimulating hormone
  • this value will be high in renal failure
  • normal: 2.5-4. Hyper value does not occur until GFR has decreased to 10-20% of normal. Hyper value usually accompanied by hypocalcemia
  • only few symptoms are shown until problems with hypocalcemia or soft tissue calcifications develop Tx: adequate hydration, dietary restriction of phosphate (less than 200mg/day very difficult), calcium supplementation and administration of phosphate binders (because too hard to maintain good phosphate restriction for most, so primary way to reduce) โ—โ— Sevelamer (renagel) or lanthanum carbonate (fosrenol). Answer: may limit atherosclerosis in the chronic renal failure patient and therefore should be preferred phosphate binder โ—โ— serum potassium. Answer: - retained in renal failure: causing serious cardiac effects normal: 3.5-5. hyper: can be life threatening

Answer: 125-135: no manifestation 111 - 124: headache, lethargy, disorientation 100 - 110: confusion, nausea/vomiting, lethargy or violence less than 100: delirium, convulsion, coma, cheyenne-stokes respirations โ—โ— uric acid. Answer: - in renal failure, this rises as the kidney's are unable to excrete this by product of purine metabolism normal: 2.5-7. โ—โ— urine osmolality. Answer: - tests concentration of solutes in the urine

  • ability to concentrate urine is lost in renal failure
  • normal:1.010-1. โ—โ— urine protein. Answer: - kidneys do not excrete this as it is a large molecule and does not pass through the nephron
  • in renal diseases, proteinuria will result
  • normal urine contains no protein โ—โ— urinary RBCS.

Answer: since this are too big they do not normally pass into the urine. Presence in indicative of UTI, renal obstruction, inflammation, or trauma normal: contains no RBCs in urine โ—โ— urniary WBCS. Answer: urinary infections and inflammation will result in an increase in WBC growth in the urine.

  • normal urine contains no more than 4 WBCs per high powered field โ—โ— check Hgb, HCT, and RBC. Answer: by producing Erythropoietin: kidneys stimulate production of RBCs.
  • by secreting renin, which is converted to angiotensin 1 and 2, they also have a role in the regulation of blood pressure โ—โ— hemodilution. Answer: - intenitally removing RBCs to lower the HCT.
  • Cause: large amounts of IV fluids
  • decrease in hemoglobin, Hct, and serum sodium values are seen
  • manifestations: most apparent is the low serum sodium levels fall from normal to 120-125 in less than 12 to 24 hours
  • serum sodium levels less than 120 show some symptoms, but is less than 110 will show severe symptoms

โ—โ— if symptomatic or ph falls below 7.2 with bicarbonate below 15. Answer: - sodium bicarbonate often given

  • can result in hypernatremia and hyperosmolality and decreased release of oxygen from hemoglobin to the tissues โ—โ—