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MT 6317 LAB: CLINICAL CHEMISTRY > Blood Uric Acid > Flashcards

Blood Uric Acid Flashcards

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1
Q

BUA is a byproduct of _ catabolism.

A

purine nucleic acid

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2
Q

BUA is produced in the _ and filtered by _.

A

liver; glomerulus

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3
Q

BUA excreted _% in the proximal tubules.

A

98-100%

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4
Q

What is the main form of BUA in plasma?

A

monosodium urate

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5
Q

What are the clinical applications in measures BUA? (5)

A
  1. Confirm diagnosis and monitor treatment of gout
  2. Prevent uric acid nephropathy during chemotherapeutic treatment
  3. Assess inherited disorders of purine metabolism
  4. Detect kidney dysfunction
  5. Assist in the diagnosis of renal calculi
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6
Q

Blood uric acid is a _ (reducing, oxidizing) agent.

A

reducing agent.

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7
Q

BUA chemical method:

Based on the reduction of phosphotungstic acid in alkaline solution to tungsten blue.

A

Caraway method

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8
Q

BUA chemical method:

Caraway method is _ (nonspecific, specific) and requires protein removal.

A

nonspecific

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9
Q

Fill in the blank:

Uric acid + H3PW12O40 + O2 → ___ + tungsten blue + CO2

A

allantoin

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10
Q

In enzymatic enzyme, what enzyme is use to catalyze oxidation of uric acid to acid?

A

uricase enzyme

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11
Q

T/F:

Enzymatic methods is more specific and commonly used.

A

T

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12
Q

BUA enzymatic methods:

It measures the hydrogen peroxide produced as uric acid is converted to allantoin.
- sources of error: reducing agents (bilirubin and ascorbic acid)

A

Coupled enzyme reaction

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13
Q

BUA enzymatic methods:

The color produced is directly proportional to uric acid concentration.

A

Coupled enzymatic reaction

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14
Q

BUA enzymatic methods:

What is the source of error in Coupled Enzymatic Reaction?

A

reducing agents (bilirubin and ascorbic acid)

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15
Q

BUA enzymatic methods:

Product in the first step of Coupled enzymatic reaction:

A

allantoin from uric acid

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16
Q

BUA enzymatic methods:

Two enzymes used in Coupled enzymatic reaction:

A
  1. Uricase
  2. Peroxidase
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17
Q

BUA enzymatic methods:

What is the enzyme used in this reaction?

Uric acid + O2 + 2 H2O2 → allantoin + CO2 + H2O2

A

uricase

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18
Q

BUA enzymatic methods:

What is the enzyme used in this reaction?

2 H2O2 + 4-AAP + EHSPT → quinoneimine + HCl + 4 H2

A

peroxidase

19
Q

BUA enzymatic methods:

It measures differential absorbance before and after incubation with uricase at 293 nm.

A

Spectrophotometric assay

20
Q

BUA enzymatic methods:

The difference is directly proportional to uric acid concentration.

A

Spectrophotometric assay

21
Q

BUA enzymatic methods:

What are the sources of error in Spectrophotometric assay?

A
  • Presence of protein
  • Hemoglobin
  • Xanthine
22
Q

BUA Determination:

This method typically uses UV detection.

A

High-performance liquid chromatography (HPLC)

23
Q

BUA Determination:

A proposed candidate reference method, detects characteristic fragments following ionization, and quantifies uric acid using isotopically labeled compound.

A

Isotope Dilution Mass Spectrometry (IDMS)

24
Q

Specific requirements in BUA

What is the sample needed in quick preparation?

A

serum sample

25
Q

Specific requirements in BUA

Does the patient requires fasting?

A

No

26
Q

Specific requirements in BUA

Three samples that are rejected in BUA:

A
  1. Hemolysis
  2. Lipemia
  3. Icteric
27
Q

Specific requirements in BUA

What should we do if the samples are not processed immediately?

A

refrigerate

28
Q

Specific requirements in BUA

What are the drugs needed to be avoided to prevent the increase values for uric acid?

A
  • Salicylates
  • Thiazides
29
Q

Specific requirements in BUA

Tubes that should not be used:

A
  1. EDTA
  2. Sodium fluoride
30
Q

Specific requirements in BUA

The urine sample must be _ (acidic, alkaline)

A

alkaline

31
Q

What are the two Uric Acid Reagent Kit?

A
  1. Phosphate buffer (EHSPT, Amino-4-antipyrine, Uricase, peroxidase, ferrocyanide, sodium azide
  2. Standard Uric acid: 6 mg/dL or 0.357 mmol/L (may vary depending on manufacturer)
32
Q

Assay requirements:

Wavelength

A

546 nm

33
Q

Assay requirements:

Optical path

A

1 cm

34
Q

Assay requirements:

Temperature

A

37 C

35
Q

Calculation:

Concentration of Standard of Serum/Plasma:

A

6 mg/dL or 0.357 mmol/L

36
Q

Calculation:

Concentration of Standard of Urine:

A

88 mg/dL or 5.235 mmol/L

37
Q

Calculation:

Conversion factor from mg/dL to mmol/L:

A

0.0595

38
Q

Reference range of plasma/serum of male (adult):

A

3.5-7.2 mg/dL

39
Q

Reference range of plasma/serum of female (adult):

A

2.6-6.0 mg/dL

40
Q

Reference range of plasma/serum of a child:

A

2.0-5.5 mg/dL

41
Q

Reference range in 24-hour urine:

A

250/750 mg/day

42
Q

Clinical significance of Hyperuricemia: (10)

A
  1. Gout
  2. Treatment of myeloproliferative
    disease with cytotoxic drugs
  3. Hemolytic and proliferative
    processes
  4. Purine-rich diet
  5. Increased tissue catabolism or
    starvation
  6. Toxemia of pregnancy
  7. Lactic acidosis
  8. Chronic renal disease
  9. Drugs and poisons
  10. Enzyme deficiencies
43
Q

What are the 4 types of Enzyme Deficiencies in BUA?

A
  1. Lesch-nyhan syndrome (hypoxanthine guanine phosphoribosyltransferase deficiency)
  2. Phosphoribosylpyrophosphate synthetase deficiency
  3. Glycogen storage disease type 1 (glucose-6-phosphate deficiency)
  4. Fructose intolerance (fructose-1-phosphate aldolase deficiency)
44
Q

Clinical significance of Hypouricemia: (4)

A
  1. Liver disease
  2. Defective tubular reabsorption (Fanconi syndrome)
  3. Chemotherapy with azathioprine or 6-mercaptopurine
  4. Overtreatment with allopurinol

MT 6317 LAB: CLINICAL CHEMISTRY (3 decks)

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