KIDNEY FUNCTION TEST part 6

Question 1

The deficiency of this enzyme leads to Lesch-Nyhan Syndrome.

Answer 1

Hypoxanthine guanine phosphoribosyl transferase (Muricase)

Question 2

It is a x-linked genetic disorder

Answer 2

Lesch-Nyhan Syndrome.

Question 3

This disease is a self-destructive behavior such as chewing of fingertips and lips and is associated with delayed motor developments and “Gout-like swelling joints”

Answer 3

Lesch-Nyhan Syndrome.

Question 4

This enzyme prevents reutilization of purine bases in the nucleotide salvage pathway.

Answer 4

Abnormal phosphoribosyl pyrophosphate synthetase

Question 5

This disease occurs when monosodium urate precipitates from supersaturated body fluids.

Answer 5

Gout

Question 6

The characteristics of this disease has a urate crystals in joint fluids.

Answer 6

Gouty arthritis

Question 7

This is the other term for urate crystals

Answer 7

Tophi

Question 8

This occurs in renal parenchyma.

Answer 8

Gouty nephropathy

Question 9

This refers to the atrophy of the liver

Answer 9

Hypourecemia

Question 10

What is the reference interval of females for hypourecemia?

Answer 10

F: 2.6 - 6.0 mg/dL
M: 3.5 - 7.2 mg/dL

Question 11

What is the conversion factor for uric acid?

Answer 11

0.059

Question 12

This substance is the product of amino acid deamination, is often used for liver function test and urea production.

Answer 12

Ammonia

Question 13

What is the primary site of Ammonia production?

Answer 13

Small intestine

Question 14

Where is ammonia derived from?

Answer 14

• Breakdown of AA
• Hydrolysis of urea

Question 15

Ammonia exists in ionized or unionized form. Therefore, if Ammonia is in lower pH, what would be the result?

Answer 15

There is a formation of ammoniun ions

Question 16

Ammonia exists in ionized or unionized form. Therefore, if Ammonia is in higher pH, what would be the result?

Answer 16

There is a formation of unionized form of ammonia

Question 17

What is level of Ammonia if there is a severe liver damage?

Answer 17

Increased ammonia levels

Question 18

How many ug/dL if the plasma level is low?

Answer 18

15 - 45 ug/dL

Question 19

This method is quantitated by titration or colorimetry wherein Ammonia is released from an alkaline solution and determined by back titration with acid because NH3 is trapped in an acid medium of the diffusion cell. Despite the process, it is still time consuming with poor accuracy and precision.

Answer 19

Conway and Cook diffusion method (Microdiffusion method)

Question 20

If Conway and Cook is quantitated by titration. How about for Forman’s Resin absorption method?

Answer 20

Berthelot reaction/ Nesslerization

Question 21

This method of determination of Ammonia uses cation-exchange resin. Wherein NH3 is absorbed by the resin and eluted.

Answer 21

Forman’s Resin Absorption Method

Question 22

What is the normal value of Forman’s Resin Absorption Method?

Answer 22

16 - 33 umol/L

Question 23

In Kunahashi, Ishihora and Euhera method, NH3 is obtained through the use of this column.

Answer 23

Dowax column

Question 24

This method is assayed using the Berthelot method.

Answer 24

Kunahashi, Ishihora and Euhera method

Question 25

Van Anken Ezymatic Method is also known as?

Answer 25

Coupled enzymatic method

Question 26

What is the normal value of Van Anken Enyzmatic method?

Answer 26

11 - 35 umol/L

Question 27

If ammonia reacted with a-ketoglutarate and NADPH in the presence of glumate dehydrogenase to form what?

Answer 27

Coupled enzymatic method

Question 28

This method places ammonia through a selective membrane into NH4 chloride causing pH change which is determined potentiometrically.

Answer 28

Ion Selective Electrode

Question 29

What are the sources of Ammonia contamination?

Answer 29

Smoking
Laboratory atmosphere
Poor venipuncture technique
Metabolism of nitrogenous constituents

Question 30

Under laboratory atmosphere, glassware should be soaked and rinsHyod with?

Answer 30

Soaked: Hypochlorite solution
Rinsed: Deionized water

Question 31

Under laboratory atmosphere, blood collection and NH3 should be done where?

Answer 31

Laboratory with restricted traffic

Question 32

Poor venipuncture technique could cause an increase in NH3 levels by?

Answer 32

100 - 200 ug/L

Question 33

What are the accepted anticoagulants?

Answer 33

EDTA and non-NH4 heparin salts

Question 34

This means that there are enzyme defects in the Kreb’s Henseleit Cycle and there is a defect in the metabolism of AA such as Lysine and Ornithine

Answer 34

1° / Inherited Hperammonemia

Question 35

What are the impairment of Acquired Hyperammonemia?

Answer 35

Severe liver disease
Impaired venous drainage
Impaired renal excretion

Question 36

Under severe liver disease, this is toxic or fulminant viral hepatitis and Reye’s syndrome. Which mean that it is?

Answer 36

Acute

Question 37

The presence of cirrhosis under severe liver disease indicates that it is?

Answer 37

Chronic

Question 38

This impairment is from the intestine to liver by portal vein.

Answer 38

Impaired venous drainage

Question 39

What is this impairment?
- Decreased urine output
- Increased BUN reabsorbed
- Increased excretion of urea into intestines
- Converted into Ammonia

Answer 39

Impaired renal function

Question 40

This disease is caused by the following, what is this?
- GIT bleeding
- Excess dietary proteins
- Constipation
- Infections
- Drug effects

Answer 40

Hepatic encephalopathy

Question 41

What is the reference interval of Ammonia in adult?

Answer 41

19 - 60 ug/dL
11 - 35 umol/L

Question 42

To which reference value are these?
68 - 136 ug/dL
40 - 80 umol/L

Answer 42

Reference interval of a child aging 10 days to 2 years old.

Question 43

What is the conversion factor of Ammonia?

Answer 43

0.587