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CLINICAL CHEMISTRY > Lesson 6: Non-protein Nitrogenous Compounds > Flashcards

Lesson 6: Non-protein Nitrogenous Compounds Flashcards

1
Q

What must be performed first during NPN determination?

A

Deproteinization (lysis of protein)

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2
Q

What is the method used when NPN sources in the protein-free filtrate are broken down to release the nitrogen?

A

Kjeldahl Digestion Method

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3
Q

Major inherited metabolic diseases associated with
hyperuricemia:

A
  1. HGPRT deficiency (Lesch Nyhan syndrome)
  2. PRPP synthetase deficiency
  3. Glucose-6-phosphatase deficiency (GSD-1)
  4. Fructose-1-phosphate aldolase deficiency
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4
Q

It is the end product of purine metabolism

A

-BUA

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5
Q

BUA is formed in the liver and the intestinal mucosa from xanthine by ______?

A

-xanthine oxidase

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6
Q

Where is the blod uric acid filtered and reabsorbed?

A

-PCT

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7
Q

Enzymes that degrade the BUA when it is secreted in the gastrointestinal tract?

A

-bacterial enzymes

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8
Q

In the formation of uric acid, IMP and guanosine monophosphate are converted into in their nucleoside forms through the action of 5’nucleotidase. What are these two forms?

A

-guanosine and inosine

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9
Q

In the third part of uric acid formation, purine nucleoside phosphorylase converts inosine and guanosine in what respective purince bases?

A

-hypoxanthine and guanine

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10
Q

What is called when purines is being recycled in the body due to its normal turnover of cellular nucleic acids?

A

-salvage pathway

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11
Q

What are the two enzymes involved in the Blood uric acid?

A

-APRT & HGPRT
-adenine phosphoribosyl transferase
(APRT) and hypoxanthine-guanine phosphoribosyl
transferase (HGPRT)

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12
Q

How many days will the uric acid becomes stable for both urine and serum at room temperature?

A

-3 days

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13
Q

What is the only chemical method in measuring uric acid?

A

-Redox reaction

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14
Q

What are the four enzymatic mehod in measuring uric acid?

A

-differential UV absorption
-couple urice reaction
-uricase-hantzch reaction
-polarographic urcase method

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15
Q

This is added to uric acid as a preservative for it is susceptble to bacterial degradation.

A

-thymol

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16
Q

An anticoagulant that is contraindicated when doing redox method?

A

-potassium oxalate
(it forms patassium phosphotung state, which forms turbidity)

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17
Q

Uric acid is increased in:

A

-gout
-renal failure
-chemotheraphy
-poisoning
-alcohol and dietary intake

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18
Q

Uric acid is decrease in:

A

-xanthinuria
-wilson disese
-drug administration

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19
Q

What is the most common cause of increase blood uric acid level?

A

-gout

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20
Q

A major inherited metabolic disease associated with
hyperuricemia that decreased the activity in the salvage pathway.

A

-HGPRT deficiency (Lech Nyhan Syndrome)

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21
Q

Metabolic disease is associated with hyperuricemia, which is when PRPP synthase is the first enyme in the purine synhesis pathway.

A

-PRPP synthase deficiency

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22
Q

What are the diseases associated with increase ammonia?

A

-hepatic coma
-nuerotoxicity
-encephalopathy

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23
Q

Hepatic failure is the most common cause of disturbed ammonia metabolism that may lead to what disease?

A

-hepatic coma

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24
Q

It is the most common cause of disturbed ammonia metabolism that may lead to hepatic coma.

A

-Hepatic failure

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25
Q

What is called to a disease that causes the liver to show fatty acid infiltration, and that is common in children?

A

-Reye’s syndrome

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26
Q

What is the factor that increases the value of ammonia?

A

-Smoking

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27
Q

What are the four methods in determining the ammonia?

A
  1. Conoway microdiffusion
  2. Ion-exchange chromatography
  3. Enzymatic methods
  4. Ammonia-sensing electrode
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28
Q

What is the test that determines the ability of the kidney to handle waste products?

A

-kidney function test

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29
Q

Test that measures the clearance of normal molecules that are not bound to protein and are freely filtered by glomeruli.

A
  • Clearance test (test for glumerular function)
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30
Q

It is considered for the best indicator of the level of kidney function.

A

-Clearance test (test for glumerular function)

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31
Q

It is the removal of substance from the plasma into the urine that represents the volume of plasma that would contribute all the solute excreted.

A

-clearance

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32
Q

What is the unit expressed for clearance?

A

-milliliter per minute (mL/min)

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33
Q

What are the two general classifications of clearance tests?

A

-Endogenous and exogenous cleaaarance test

34
Q

What is the classification of clearance test that the test substance is already present in the body?

A

-Endogenous clearance test

35
Q

What is the classification of the clearance test that the test substance must be infused in the body?

A

-Exogenous clearance test

36
Q

What are the examples of the endogenous clearance test?

A

-creatinice
-Urea
-Beta trace protein
-Cystatin C

37
Q

What are the examples of the exogenous clearance test?

A

-Inulin
-Radionucleotides

38
Q

It is not routinely done due to the necessity for continuous IV infusion.

A

-Inulin Clearance

39
Q

Higher values of males in the inulin clearance must be due to ____?

A

-larger renal mass

40
Q

What is the priming dose in the inulin clearance?

A

-25ml to 10% inulin solution

41
Q

What is the continous infusion in the inulin clearance?

A

-500ml of 1.5% inulin solution

42
Q

What are the reference values in the inulin clearance?

A

-M: 127 ml/min
-F:118 ml/min

43
Q

It demonstrates the progression of renal disease or response to the therapy. It is also used as the best predictor of GFR rather than the creatinine.

A

-Urea Clearance

44
Q

The faster the rate of urine flow in ure clearance, the ___ urea reabsorbed vice versa.

A

-less

45
Q

It provides an estimate of the amount of plasma that must flow through the kidney glomeruli/minute and an excellent measure of renal function.

A

-creatinine clearance

46
Q

Production and excretion of creatnie is related directly to _____?

A

-Muscle mass

47
Q

What is the major limitation of creatinine clearance?

A

-accurate urine collection

48
Q

What are the reference values for creatinine clearance?

A

-M:85-125 ml/min
-F: 75-112 ml/min

49
Q

Creatinine clearance is increased in:

A

-high cardiac output
-burns
-pregnancy
-CO2 poisoning

50
Q

Creatinine clearance is decreased in:

A

-impaired kidney function
-shock
-dehydration
-hemorrhage
-congestive heart failure

51
Q

It is a low molcular weight protease inhibitor and is prduced at constant rate by all nucleated cells.

A

-Cystatin C

52
Q

What happens if there’s a presence of Cystatine C in the urine?

A

-denotes the damage of that tubule

53
Q

Where is Cystatine C completely reabsorbed and catabolized?

A

-PCT

54
Q

Cystatin C is not characterized by:

A

-muscle mass
-age
-diet
-gender

55
Q

What are the Advantages for Cystatin C?

A

-Pediatric and elderly and renal transplant patient

56
Q

What disease is Beta trace protein increased?

A

-renal diseases

57
Q

What is the low molecular weight of glycoprotein and isolated primarily in the CSF?

A

-Beta trace protein

58
Q

What family does the beta trace protein belong to?

A

-lipocalin protein family

59
Q

This test measures the renal plasma flow that requires the clearance of the dye.

A

-Pra-amino hipurate test (PAH test)

60
Q

What is the reference value for the PAH test?

A

-600-700 ml/minute

61
Q

This test measures the excretion of dye proportional to renal tubular mass.

A

-Phenolsulfonthalein dye test (PSP test)

62
Q

What is the dos of PSP administered by the IV?

A

-6mg

63
Q

What is the reference value for PSP?

A

-1200ml blood flow/minute

64
Q

What is the specimen used in the concentration test?

A

-morning urine

65
Q

It compares the weight of a fluid with that of distilled water at a reference temperature.

A

-specific gravity

66
Q

What is the simplest test of renal concentrating ability?

A

-Specific gravity

67
Q

This indicates the severe loss of concentrating ability of specific gravity .

A

-Fixation at 1.010

68
Q

What is the reference value for SG?

A

-1.005-1.030

69
Q

What is an expression of concentration in terms of the total number of solute particles present/kg of solvent?

A

-osmolality

70
Q

What is the osmolality of the serum due to electrolytes?

A

-92%

71
Q

What are the reasons for the 8% osmolality of the serum?

A

-proteins
-glucose
-urea

72
Q

What is the reference value of osmolality?

A

-275-295 mOsm/kg

73
Q

What is the normal ratio of urine osmolality to serum osmolality?

A

-1:1

74
Q

What are the two substances that does not contribute to osmolality?

A

-protein and lipids

75
Q

What is the accumulation of NPNs in the blood?

A

-Azotemia

76
Q

This type of azothemia occurs when there is obstruction in the unrinary tract.

A

-Post-renal azotemia

77
Q

Type of azothemia that occurs when renal functions normally, but there is decreased glomerular filtration

A

-Pre-renal azothemia

78
Q

This type of azothemia is when the damage in the kidney caused a decrease in glumerular filtration.

A

-Renal azotemia

79
Q

What is the clinical syndrome comprised of a marked elevation in plasama urea and other nitrogenous waste products, accompanied by acidemia and electrolyre imbalance?

A

-uremia

80
Q

What is called whn kidneys fail to eliminate waste products of metabolism?

A

-uremia

81
Q

If the patient has uremia, what exactly do we see on the peripheral blood films?

A

-echinocytes (burr cells)

CLINICAL CHEMISTRY (1 decks)

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