CIULLA_NONPROTEIN NITROGENOUS COMPOUNDS Flashcards by makiii rmt

Q

major nitrogen-containing compound in the blood

A

Urea

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Q

urea is synthesized in the _____.

A

liver

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Q

urea is a result of protein (catabolism/anabolism).

A

catabolism

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Q

urea is excreted via the _____.

A

kidneys

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Q

INCREASED/DECREASED SERUM UREA:

renal failure

A

INC

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Q

INCREASED/DECREASED SERUM UREA:

glomerular nephritis

A

INC

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Q

INCREASED/DECREASED SERUM UREA:

UTI

A

INC

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Q

INCREASED/DECREASED SERUM UREA:

congestive heart failure

A

INC

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Q

INCREASED/DECREASED SERUM UREA:

dehydration

A

INC

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Q

INCREASED/DECREASED SERUM UREA:

increased protein catabolism

A

INC

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Q

INCREASED/DECREASED SERUM UREA:

severe liver disease

A

DEC

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Q

INCREASED/DECREASED SERUM UREA:

vomiting

A

DEC

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Q

INCREASED/DECREASED SERUM UREA:

diarrhea

A

DEC

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Q

an older term used for urea; terminology based on previous methodology where nitrogen was measured

A

Blood Urea Nitrogen (BUN)

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Q

BUN to Urea conversion factor

A

2.14

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Q

BUN was based on methodology by measurement of what substance/element?

A

nitrogen

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Q

Urea reference range

A

6-20 mg/dL

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Q

urea can be measured by what methods?

A

Kinetic

Chemical

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Q

a waste product of muscle contraction from phosphocreatine

A

creatinine

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Q

Creatinine is a waste product of muscle contraction from ____.

A

phosphocreatine

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Q

T/F:

Creatinine levels are not changed by diet or rate of urine flow

A

TRUE

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Q

T/F:

Creatinine is reabsorbed by renal tubules.

A

FALSE

not reabsorbed.

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Q

Increased serum creatinine indicates ____________.

A

renal failure

renal disease

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Q

a test method for creatinine which utilizes picric acid

A

jaffe method

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Product of Jaffe method

creatinine picrate

enzymes used in order for enzymatic determination of creatinine

creatinase creatinase sarcosine oxidase peroxidase

Creatinine reference range

Male, 0.9-1.3 mg/dL | Female, 0.6-1.1 mg/dL

Creatinine clearance is used to assess ______.

GFR

required samples for creatinine clearance

plasma | 24-hr urine

average body surface used in creatinine clearance formula

1.73 m2

Creatinine clearance formula

[(UxV)/P] x [1.73 m2 / SA]

T/F: | Creatinine reference range differ according to age and sex

TRUE

Creatinine values (increase/decrease) with age

decrease

CrCl reference range in males

105 +/- 20 mL/min/1.73 m2

CrCl reference range in females

95 +/- 20 mL/min/1.73 m2

uses only a blood creatinine and the MDRD (Modification of Diet in Renal Disease) formula.

eGFR

T/F: Correction for gender and race are required when solving eGFR

TRUE

When are eGFR results reported as numbers?

If <60 mL/min/1.73 m2

considered the major waste product of purine

uric acid

uric acid is synthesized in the ____.

liver

excretion methods of uric acid

majority by the kidneys (via glomerular filtration) GI tract

INCREASED/DECREASED URIC ACID: gout

INC

INCREASED/DECREASED URIC ACID: renal disorders

INC

INCREASED/DECREASED URIC ACID: treatment of myeloproliferative disorders

INC

INCREASED/DECREASED URIC ACID: lead poisoning

INC

INCREASED/DECREASED URIC ACID: lactic acidosis

INC

INCREASED/DECREASED URIC ACID: toxemia of pregnancy

INC

INCREASED/DECREASED URIC ACID: Lesch-Nyhan syndrome

INC

INCREASED/DECREASED URIC ACID: sever liver disease

DEC

INCREASED/DECREASED URIC ACID: tubular reabsorption disorders

DEC

INCREASED/DECREASED URIC ACID: drug induced

DEC

test methodologies for uric acid

chemical | enzymatic uricase method

In enzymatic uricase method for uric acid, decrease in absorbance is monitored at ____ nm.

293

Uric acid reference range

Male, 3.5-7.2 mg/dL | Female, 2.6-6.0 mg/dL

ammonia is produced from ________.

deamination of amino acids

Ammonia is converted to _______ before excretion.

Urea

Converting of ammonia to urea is done by _______.

hepatocytes

T/F: | Ammonia is neurotoxic.

TRUE

With severe liver cell malfunction, blood levels of ammonia (decrease/increase).

increase

important storage manner for ammonia specimens

place on ice

specimen for ammonia determination

venous blood (free of hemolysis)

Tube used for ammonia determination

EDTA | Green top

In ammonia determination, sample must be centrifuged within ______ of collection.

20 minutes

Plasma stability in ice bath

3 1/2 hrs

Plasma stability when frozen?

Stable up to several days

Disorders where increased plasma ammonia levels are seen

hepatic failure | Reye syndrome

Interferences in ammonia determination

Incorrect handling of blood sample | Ammonia contamination

Ammonia reference range

11-32 umol/L

Ammonia test methodology

a-ketoglutarate + NH4+ + NADPH ---(glutamate dehydrogenase)--- glutamate + NADP+ + H2O