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CC Lec Revalida > NPNs > Flashcards

NPNs Flashcards

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1
Q

Major NPN found in the blood (45-50% of total NPN)

A

UREA

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2
Q

Major excretory product from protein metabolism

A

UREA

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3
Q

Synthesized in the liver from CO2 + Ammonia
generated during protein catabolism

A

UREA

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4
Q

Urea is synthesized in the liver from CO2 + Ammonia generated during ___

A

protein catabolism

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5
Q

Urea cycle process in mitochondria will produce ?

A

Carbamoyl Phosphate and Citrulline

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6
Q

The enzyme ___ is important to the release of urea

A

arginase

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7
Q

How many percent of urea is reabsorbed?

A

40%

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8
Q

How many percent of urea is excreted in the urine?

A

50%

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9
Q

How many percent of urea is excreted through GI and skin?

A

<10%

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10
Q

very high levels of plasma urea accompanied by renal failure

A

Uremia/uremic syndrome

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11
Q

an elevated concentration of urea in the
blood

A

Azotemia

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12
Q

Decreased blood flow to kidneys

A

PRERENAL AZOTEMIA

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13
Q

Possible causes (which affect urea transport)
○ Congestive heart failure
○ Shock, hemorrhage
○ Dehydration
○ Other factors resulting in significant marked
decreased volume

A

PRERENAL AZOTEMIA

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14
Q

● Acute/chronic renal failure
● Glomerulonephritis
● Tubular necrosis
● Other intrinsic renal disease

A

RENAL AZOTEMIA

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15
Q

Urinary tract obstruction caused by:
○ Renal calculi
○ Tumors of the bladder/prostate
○ Severe infection

A

POSTRENAL AZOTEMIA

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16
Q

High urea : Normal creatinine

A

PRERENAL AZOTEMIA

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17
Q

High urea : High creatinine

A

RENAL AZOTEMIA

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18
Q

Normal urea : High creatinine

A

POSTRENAL AZOTEMIA

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19
Q

Normal Urea Nitrogen : Creatinine ratio

A

10:1 - 20:1

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20
Q

Decreased urea nitrogen: creatinine ratio

A

PRERENAL AZOTEMIA

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21
Q

Product of Fearon’s reaction

A

yellow diazine derivative

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22
Q

Also known as Friedmans Method or Xanthydrol
Method

A

Fearon’s reaction

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23
Q

CONDENSATION WITH DIACETYL MONOXIME METHOD

A

Fearon’s reaction

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24
Q

Product in REACTION WITH 0PHTHALALDEHYDE AND NAPHTHYLETHYLENEDIAMINE

A

chromogen or colored product

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25
Product in MICROKJELDAHL NESSLER METHOD
yellow compound
26
All enzymatic methods use what enzyme?
Urease
27
Product in UREASEBERTHELOTS METHOD
indophenol blue
28
Coupled Enzymatic in Urea Determination
UREASE-L-GLUTAMATE DEHYDROGENASE METHOD (GLDH METHOD)
29
reference method for measuring urea
ISOTOPE DILUTION MASS SPECTROMETRY IDMS
30
If plasma will be used for urea determination, any additive maybe used except ___/____ which interferes with urease and ammonium ions
sodium fluoride / sodium citrate
31
Reference Ranges for Urea Nitrogen Plasma or Serum: ____ mg/dL Urine, 24hr: ____ g/d
Plasma or Serum: 6-20 mg/dL Urine, 24hr: 12-20 g/d
32
product of catabolism of purines bases Adenine and Guanine)
URIC ACID
33
How many percent of uric acid is reabsorbed in the proximal tubules
98-100%:
34
How many percent of uric acid is excreted in the distal tubules
<1%
35
Uric acid excretion Renal excretion: ___ % GI excretion: ___%
Renal excretion: 70% GI excretion: 30%
36
Uric acid is Relatively insoluble in plasma as monosodium urate at pH ___
pH 7
37
At concentrations ____ mg/dL, plasma is saturated, urates crystals may form in the tissues
6.8 mg/dl
38
At pH ___ , uric acid crystals may form
pH 5.75
39
High concentrations accumulate in the joints and tissue resulting in inflammation
Gouty Arthritis
40
Increased: hyperuricemia ____ mg/dL
6.0 mg/dL
41
Patients have pain and inflammation of the joints caused by precipitation of sodium urates
GOUT
42
Deposition of Uric Acids in tissues and joints
TOPHI
43
Seen in patients undergoing chemotherapy for leukemia, lymphoma, multiple myeloma, polycythemia
INCREASED NUCLEAR BREAKDOWN
44
inhibit xanthine oxidase
allopurinol
45
Enzyme that is targeted by Allopurinol to lower your Uric Acid
Xanthine Oxidase
46
X-linked genetic disorder (seen only in males)
LESCH NYHAN SYNDROME
47
caused by the complete deficiency of hypoxanthine–guanine phosphoribosyltransferase (HGPRT)
LESCH NYHAN SYNDROME
48
Lack of this enzyme prevents the reutilization of purine bases in the nucleotide salvage pathway
hypoxanthine–guanine phosphoribosyltransferase
49
Defective tubular reabsorption (Fanconi's Syndrome)
HYPOURICEMIA
50
Overtreatment with allopurinol
HYPOURICEMIA
51
Chemotherapy with 6-mercaptopurine or azathiopurine (inhibits de novo purine synthesis)
HYPOURICEMIA
52
Caraway Method/ Henrys Method
DIRECT REDOX METHOD
53
Uses phosphotungstic acid and produces tungsten blue
Caraway Method/ Henrys Method
54
Based on the oxidation of UA in PFF (Protein-Free Filtrate) and reduction of PTA (Phosphotungstic Acid)
Caraway Method/ Henrys Method
55
Reagent is uricase or urate oxidase
URICASE METHOD (BLAUCH AND KOCH)
56
2 enzymes: ○ First reaction: uricase ○ Second reaction: peroxidase
COUPLED ENZYMATIC METHOD
57
proposed reference method for uric acid determination
ISOTOPE DILUTION MASS SPECTROMETRY IDMS**
58
____ or ____ should not be used in uric acid specimen
EDTA or fluoride
59
Uric Acid Plasma or Serum Specimen Male (Adult): ___ mg/dL Female (Adult): ___ mg/dL
Male (Adult): 3.5-7.2 mg/dL Female (Adult): 2.6-6.0 mg/dL
60
Waste product of creatine formed during normal muscle metabolism
CREATININE
61
Is formed from creatine and creatine phosphate in muscle and is excreted into the plasma at a constant rate related to muscle mass
CREATININE
62
Plasma creatinine is ____ related to glomerular filtration rate
inversely
63
Produced by the liver and pancreas from arginine, glycine, methionine
CREATINE
64
CREATINE is produced by the liver and pancreas from ____?
arginine, glycine, methionine
65
creatine enters the bloodstream and is distributed in cell especially in the muscle where it is converted to
phosphocreatine
66
measure of the amount of creatinine eliminated from the blood by the kidneys
Creatinine clearance
67
Creatinine + NaOH & picric acid alkaline picrate complex
JAFFE REACTION
68
Reagents in Jaffe with Adsorbent ○ Fullers Earth – ____ ○ Lloyds reagent – ____
○ Fullers Earth – aluminium magnesium silicate ○ Lloyds reagent – sodium aluminum silicate
69
CREATININE DETERMINATION CHEMICAL produced what colored compound
purple-colored compound
70
Accepted Reference Method for creatinine
IDMS (Isotope Dilution Mass Spectrophotometry)
71
____ causes a negative bias in both Jaffe and enzymatic methods.
Bilirubin
72
___causes a positive bias in some enzymatic methods.
Lidocaine
73
____ will interfere in enzymatic methods that use peroxidase as a reagent.
Ascorbate
74
Produced from the deamination of amino acids
AMMONIA
75
Consumed by the parenchymal cells of the liver in the production of Urea
AMMONIA
76
Most ammonia in the blood exists as
Ammonium Ion
77
(Blood sugar drops and blood ammonia and acidity increases) post viral with aspirin resulting in hepatic dysfunction due to fatty infiltration of the liver.
Reyes syndrome
78
Exploited the volatility of ammonia to separate the compound in microdiffusion chamber
CONWAY METHOD
79
Most common on automated instruments in Ammonia determination
ENZYMATIC METHOD - CATALYZED BY GLDH
80
Venous blood for Ammonia specimen should be obtained without trauma and placed on ___ immediately
ice
81
Ammonium salts, asparaginase, barbiturates, diuretics, ethanol, hyperalimentation, narcotic analgesics, and some other drugs may ____ ammonia in plasma
increase
82
Diphenhydramine, Lactobacillus acidophilus, lactulose, levodopa, and several antibiotics ____ ammonia concentrations.
decrease

CC Lec Revalida (2 decks)

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