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[2S] CC LAB > bua > Flashcards

bua Flashcards

1
Q

T/F Elevated levels of NPNs indicate liver problems

A

F - elevated NPNs generally indicate kidney problems

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2
Q

only NPN that tells the liver is in trouble when elevated in the bloodstream

A

ammonia

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3
Q

uric acid is produced in the ___ and filtered by the glomerulus

A

liver

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4
Q

ammonia is the toxic byproduct that needs to be converted to ____ for detoxification

A

urea

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5
Q

t/f Uric acid is the end product of protein catabolism

A

F - end product of purine catabolism; urea - end product of protein catabolism

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6
Q

Elevated levels of ammonia in the bloodstream indicate a problem with the ___

A

Liver

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7
Q

precursor for uric acid

A

xanthine

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8
Q

enzyme that converts xanthine to uric acid

A

Xanthine oxidase

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9
Q

Select: Waste products
A) Amino acids
B) Urea
C) Uric acid
D) Creatinine
E) Ammonia

A

B C D E

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10
Q

t/f Most uric acids are reabsorbed and only about 1% is excreted

A

t

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11
Q

t/f Uric acid is 98-100% reabsorbed in the distal tubules

A

f - reabsorbed in the proximal tubules

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12
Q

Select: uric acid form mainly found in plasma
A) Allantoin
B) Monosodium urate
C) Ammonia

A

B

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13
Q

condition characterized by monosodium urate crystals forming in urine due to abnormally high uric acid concentrations

A

gout

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14
Q

condition a physician is likely suspecting when requesting a uric acid test due to an inflammatory condition in the joints (arthritis)

A

gout

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15
Q

t/f Humans and apes can catabolize purines to allantoin just like most mammals

A

t

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16
Q

gout commonly affects men aged ___

A

30-50 years old

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17
Q

t/f Females are more commonly affected by gout before menopause

A

f - more common after menopause

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18
Q

when present in high concentrations, uric acid can deposit in joints and tissues as ___, leading to gout

A

tophi

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19
Q

treatment that involves monitoring uric acid levels because of its effects on cancer cells

A

chemotherapy

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20
Q

Select: Cancer cells during chemotherapy
A) They grow larger
B) They disintegrate
C) They stop reproducing

A

B

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21
Q

Cancer cells have a high nucleus-cytoplasm ratio, meaning they contain much ___.

A

DNA

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22
Q

Uric acid levels decrease when chemotherapy is effective because fewer cells are destroyed.

A

f - More cells destroyed leads to higher uric acid levels

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23
Q

t/f Decrease in serum uric acid is a common condition.

A

f - uncommon

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24
Q

Select: Elevated serum uric acid levels
A) Increased purine synthesis
B) Lesch-Nyhan syndrome
C) Nutritional disturbances
D) Tumor cell proliferation
E) Renal failure

A

A B C D E

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25
Q

OOO: Elevated serum uric acid levels
A) Psoriasis
B) Leukemia
C) Cytotoxic drugs
D) Fanconi Syndrome
E) Increased nucleic acid turnover

A

D

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26
Q

Select: High levels of uric acid in the plasma
A) Megaloblastic anemia
B) Hypothyroidism
C) Cancer

A

A C

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27
Q

organ’s disease that leads to decreased uric acid concentration due to destruction of the cells that produce it

A

liver disease

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28
Q

reference value for BUN (Blood Urea Nitrogen) is ___ mg/dL.

A

6-20 mg/dL

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29
Q

t/f uric acid measurement is the most reliable assessment fot kidney function

A

f - not as reliable as urea and creatinine

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30
Q

occur in urine when uric acid concentrations is abnormally high

A

Urate crystals

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31
Q

functional unit of the liver

A

Lobules

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32
Q

_____ are the cells that make up the lobules and are responsible for producing uric acid

A

hepatocytes

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33
Q

t/f liver is a highly vascular organ, rich with blood vessels

A

t

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34
Q

Select: Uric acid produced in the hepatocytes
A) It stays in the liver.
B) It is disposed of directly by the liver.
C) It travels through the bloodstream to be disposed of properly.

A

C

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35
Q

Sequence: Liver to disposal of UA
A) Hepatocytes
B) Bloodstream
C) Kidney

A

A B C

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36
Q

t/f kidneys are connected to the bloodstream where waste products like uric acid are filtered out

A

t

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37
Q

functional unit of the kidney is the ___.

A

nephron

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38
Q

part of the kidney responsible for draining urine into the ureter

A

calyxes and pelvis

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39
Q

acts as a filter for the blood, removing waste products like uric acid in the nephron

A

glomerulus

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40
Q

Blood enters the glomerulus through the ___ arteriole and exits through the ___ arteriole.

A

afferent, efferent

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41
Q

t/f Each kidney contains approximately 1 million to 1.5 million nephrons

A

t

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42
Q

where is uric acid secreted to be thrown into the urine

A

distal convoluted tubule

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43
Q

In renal failure or tubular failure, the proximal convoluted tubule fails to reabsorb ___, leading to decreased concentration

A

uric acid

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44
Q

Uric acid is reabsorbed in the nephron because it is used as raw material for the synthesis of ___

A

purines

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45
Q

OOO: Part of the nephron
A) Glomerulus
B) Bowman’s capsule
C) Calyxes

A

calyxes

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46
Q

Sequence: Passage of filtrate in the nephron
A) Proximal convoluted tubule
B) Distal convoluted tubule
C) Collecting ducts
D) Descending loop of Henle
E) Ascending loop of Henl

A

A D E B C

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47
Q

In renal failure, _____ of uric acid will be reabsorbed

A

0%

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48
Q

t/f Waste products like uric acid are entirely reabsorbed and not excreted by the kidney

A

f - most are reabsorbed for purine synthesis, some are excreted

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49
Q

OOO: Increase uric acid levels
A) Gout
B) Liver disease
C) Chemotherapy

A

B - decrease

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50
Q

Renal failure leads to an increase in uric acid levels because the kidneys reabsorb more of it

A

f - renal failure leads to decreased reabsorption of uric acid

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51
Q

wavelength used to measure the maximum absorbance of uric acid

A

293 nm

52
Q

Uric acid is readily oxidized to ___ in the presence of water, oxygen, and the enzyme uricase

A

allantoin

53
Q

conversion of uric acid to ___ is the historical method for determining uric acid.

A

allantoin

54
Q

t/f The concentration of allantoin is measured directly to determine uric acid levels

A

f - Allantoin has no absorbance, uric acid is measured at 293 nm

55
Q

In the spectrophotometric assay, the difference in absorbance at 293 nm before and after incubation with uricase is directly proportional to ___

A

Uric acid concentration.

56
Q

decrease in absorbance is directly proportional to the concentration of ___ in the uric acid determination method

A

uric acid

57
Q

enzyme that catalyzes the oxidation of uric acid to allantoin

A

uricase

58
Q

t/f : The enzymatic method using uricase is more specific and commonly used than the chemical Caraway method

A

t

59
Q

t/f in the coupled enzymatic reaction, the concentration of quinoneimine (colored end product in the uric acid reaction) is inversely proportional to the concentration of uric acid

A

f - directly proportional

60
Q

In the presence of uricase, uric acid is converted to allantoin and ___, a reducing agent

A

hydrogen peroxide (h2o2)

61
Q

secondary enzyme responsible for catalyzing the reaction between hydrogen peroxide and amino-4-antipyrine (4-AAP) to form quinoneimine

A

peroxidase

62
Q

reagent used to convert hydrogen peroxide into oxygen and water in the enzymatic method

A

peroxidase

63
Q

wavelength used to measure the concentration of quinoneimine in the uric acid assay

A

540 nm

64
Q

OOO: Byproduct of the reaction involving uricase
A) Allantoin
B) Quinoneimine
C) CO2

A

B - from peroxidase-catalyzed rxn

65
Q

t/f Enzymatic assays are less specific than chemical assays for uric acid determination

A

f - more specific

66
Q

The chemical method for uric acid determination uses phosphotungstic acid, which is reduced to ___ during the process.

A

tungsten blue

67
Q

most common chemical method for uric acid determination

A

Phosphotungstic Acid Method (Caraway Method)

68
Q

In the Caraway method, uric acid is oxidized to ___, and phosphotungstic acid is reduced in alkaline solution to tungsten blue.

A

allantoin

69
Q

t/f Caraway method is highly specific and does not require protein removal.

A

f - non-specific; requires protein removal

70
Q

t/f : High levels of ascorbic acid (Vitamin C) can cause a false increase in uric acid concentration in the enzymatic method.

A

f - false decrease

71
Q

formula for calculating the concentration of the unknown (Cu)

A

Cu = (Au / As) x Cs

72
Q

Calculate: : If the absorbance of the unknown (Au) is 0.8, the absorbance of the standard (As) is 1.0, and the concentration of the standard (Cs) is 6 mg/dL, calculate the concentration of the unknown (Cu)

A

Cu = (0.8 / 1.0) x 6 = 4.8 mg/dL.

73
Q

normal range of uric acid in males

A

3.5-7.2 mg/dL

74
Q

normal range of uric acid in females

A

2.6-6.0 mg/dL

75
Q

principle used in the Caraway method for uric acid determination

A

Reduction-Oxidation reaction

76
Q

Under catalysis of peroxidase with amino-4-antipyrine (4-AAP) and EHSPT, hydrogen peroxide reacts to give a ____ quinoneimine dye.

A

red-violet

77
Q

Monosodium urates are insoluble at pH __, causing them to form crystals that may precipitate in tissues.

A

7

78
Q

t/f Uric acid nephropathy can occur during chemotherapy because of the selective destruction of tumor cells only.

A

F - chemotherapy causes non-selective destruction of both tumor and normal cells

79
Q

OOO: Clinical application of blood uric acid determination
A) Confirming the diagnosis of gout
B) Monitoring liver enzyme levels
C) Detecting kidney dysfunction

A

B

80
Q

OOO: Conditions that blood uric acid determination can help assess
A) Inherited disorders of purine metabolism
B) Diabetes mellitus
C) Renal calculi (kidney stones)

A

B

81
Q

During chemotherapy, increased destruction of tumor and normal cells leads to ____ levels of uric acid in the blood.

A

increased

82
Q

t/f Allantoin is more water-soluble than uric acid and can easily be excreted from the body

A

t

83
Q

t/f uric acid can be readily oxidized to allantoin, and the level of allantoin can be measured in the system for determining uric acid levels

A

t

84
Q

OOO: Source of error in the coupled enzymatic reaction for uric acid determination
A) High bilirubin
B) Ascorbic acid
C) Albumin

A

C

85
Q

proposed as a candidate reference method for uric acid quantification, involving isotopically labeled compounds

A

Isotope Dilution Mass Spectrometry (IDMS)

86
Q

OOO: Error source in spectrophotometric assays for uric acid
A) Hemoglobin
B) Protein
C) Glucose

A

C

87
Q

High-performance liquid chromatography (HPLC) typically uses ___ detection for uric acid quantification

A

uv detection

88
Q

t/f Serum and plasma samples for uric acid determination should be left in contact with cells for a long time to allow nucleic acids to settle.

A

F - should be removed immediately to prevent dilution from intracellular contents

89
Q

sample type should be avoided because of its potential to cause a false decrease in uric acid levels due to the release of glutathione

A

Hemolyzed samples

90
Q

___ is a powerful antioxidant released from red blood cells in hemolyzed samples, which interferes with peroxidase methods.

A

glutathione

91
Q

OOO: Background interference in spectrophotometric analysis for uric acid
A) Hemolysis
B) Lipemia
C) Bilirubin

A

A

92
Q

bilirubin in ____ samples causes false ____ or
may serve as a negative interference in the reaction, especially in the peroxidase methods

A

icteric; decrease

93
Q

t/f recent meal have significant effects on uric acid levels, and fasting is necessary for accurate measurement

A

f - no significant effect on uric acid levels, and fasting is not required

94
Q

uric acid samples are stable for about ___ days when refrigerated.

A

3-5 days

95
Q

Select: Avoided anticoagulant for uric acid determination because it inhibits uricase enzymes
A) EDTA
B) Heparin
C) Lithium
D) Fluoride

A

A D

96
Q

t/f urine samples for uric acid determination must be kept alkaline to prevent the precipitation of monosodium urate

A

T

97
Q

additives cause false elevation of uric acid values and should be avoided before testing

A

Salicylates and thiazides

98
Q

most commonly preferred anticoagulant for plasma samples in uric acid determination is ___

A

heparin

99
Q

OOO: reagent used in the Uric Acid Reagent Kit
A) Amino-4-antipyrine
B) Sodium azide
C) Potassium permanganate
D) Uricase
E) Peroxidase
F) Ferrocyanide
G) Phosphate Buffer (ph 7)

A

C

100
Q

t/f If urine samples are acidic, monosodium urate will precipitate, making uric acid analysis difficult.

A

t

101
Q

standard uric acid concentration used in the Uric Acid Reagent Kit is typically ___ mg/dL or ___ mmol/L

A

6 mg/dL or 0.357 mmol/L

102
Q

In the uric acid determination, the reagents are already prepared and ready-made, unlike in ___ where you need to mix R1 and R2.

A

urea determination

103
Q

t/f during the procedure, you deliver the reagent first before the sample to ensure accurate measurement.

A

f - sample first

104
Q

OOO: Part of the procedure for the uric acid test
A) Mix the solution by inverting the tubes 2-3 times
B) Start the incubation immediately
C) Pipet reagent into the sample first

A

C

105
Q

correct wavelength for the uric acid assay

A

546 nm

106
Q

t/f optical path length required for the uric acid assay is 1 cm

A

t

107
Q

For the uric acid assay, the temperature should be set to ___ because the reaction is enzymatic

A

37 C

108
Q

conversion factor from mg/dL to mmol/L for uric acid

A

0.0595

109
Q

OOO: Reference range for blood uric acid
A) Male: 3.5-7.2 mg/dL
B) Female: 2.6-6.0 mg/dL
C) Child: 1.5-3.5 mg/dL

A

C - must be 2.0-5.5 mg/dL

110
Q

reference range for 24-hour urine uric acid is ____

A

250-750 mg/day

111
Q

According to the international unit (SI), the reference range for uric acid in males is ___ mmol/L.

A

0.21-0.43 mmol/L.

112
Q

treatment of myeloproliferative disease with cytotoxic drugs may increase uric acid levels. One such drug is ___, which inhibits the enzyme xanthine oxidase

A

Allopurinol

113
Q

t/f hemolytic processes do not affect uric acid levels since nucleic acids are not released from the cells.

A

f - nucleic acids are released during hemolysis, increasing uric acid

114
Q

OOO: Increased uric acid levels
A) Starvation
B) Purine-rich diet
C) Hypoxanthine

A

C

115
Q

condition during pregnancy where there is a decrease in uric acid excretion due to competition for renal tubule binding sites

A

pre-eclampsia

116
Q

enzyme deficiency that causes an orange sand-like precipitate in newborns’ urine (orange sand diaper syndrome)

A

Hypoxanthine guanine phosphoribosyltransferase deficiency (Lesch-Nyhan syndrome)

117
Q

In glycogen storage disease type 1, a deficiency of ___ causes an increase in uric acid due to excessive production of lactate and triglycerides.

A

Glucose-6-phosphate dehydrogenase

118
Q

t/f Chronic renal disease leads to decreased uric acid excretion, resulting in higher plasma uric acid levels

A

t

119
Q

OOO: Secondary increase in uric acid due to lactate and triglycerides competing for renal excretion
A) Fanconi syndrome
B) Fructose intolerance
C) Glycogen storage disease type 1

A

A) Fanconi syndrome - involves defective tubular reabsorption of uric acid in PCT

120
Q

___ is the inhibitor of de novo purine synthesis, which can lead to hyperuricemia during chemotherapy

A

Azathioprine or 6-mercaptopurine

121
Q

t/f Overtreatment with allopurinol causes hypouricemia by inhibiting uric acid production

A

t

122
Q

condition in which the proximal convoluted tubules fail to reabsorb uric acid, leading to its excessive release in urine, is called ___

A

fanconi syndrome

123
Q

OOO: Hypouricemia
A) Liver disease
B) Fanconi syndrome
C) Increased purine synthesis

A

C - hyperuricemia

124
Q

When there is liver malfunction, there would be a ______ production of uric acid due to reduced function of hepatocytes

A

decreased

125
Q

Select: hyperuricemia
A) Toxemia of pregnancy
B) Fanconi syndrome
C) Overtreatment with allopurinol
D) Chronic renal disease

A

A D

[2S] CC LAB (7 decks)

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