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CC > cc KIDNEY > Flashcards

cc KIDNEY Flashcards

1
Q

CLINICALLY SIGNIFICANT NPN
COMPOUNDS

A
  • Urea 45%
  • Amino acids 20%
  • Uric acid 20%
  • Creatinine 5%
  • Creatine 1-2%
  • Ammonia 0.2%
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2
Q

used
assess renal function

A

Urea, Uric acid, and Creatinine

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3
Q

used to assess liver function

A

Ammonia

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4
Q

TOTAL NPN METHODOLOGY
TWO STEPS

A

KJELDAHL DIGESTION and MEASUREMENT OF AMMONIA FORMED

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5
Q

Nitrogen in a pff is converted to NH3
using hot H2SO4

A

KJELDAHL DIGESTION

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6
Q

MEASUREMENT OF AMMONIA FORMED

A

NESSLERIZATION, BERTHELOT METHOD and MONITORING CONSUMPTION OF NH3

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7
Q

Nessler’s reagent

A

Double iodide salt of K and Hg

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8
Q

Product in Nesslerization

A

Dimercuric ammonium iodide
▪ Yellow to orange
brown

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9
Q

Catalyst in Berthelot method

A

Na nitroprusside

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10
Q

Product of Berthelot method

A

Indophenol Blue

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11
Q

Forms Glutamate + NAD

A

NH3 + a-ketoglutarate + NADH

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12
Q

Catalyst in Monitoring consumption of NH3

A

Glutamate DH

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13
Q

Measure the decrease in absorbance(Monitoring Consumption of NH3)

A

340 nm

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14
Q

Also called GLDG coupled reaction

A

Monitoring consumption of NH3

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15
Q

Major N-containing product of protein
catabolism and Major organic component of urine

A

UREA

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16
Q

Clearance of urea is
proportional to the
Glomerular
Filtration Rate
(GFR) T/F

A

True

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17
Q

BUN is reliable to monitor renal function
because T/F

A

False

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18
Q

Formula for Urea Concentration

A

BUN x 2.14= urea
concentration

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19
Q

Stability of urea in serum

A

o 24 hrs at RT
o Several days at 2-6°C
o 2-3 months when frozen

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20
Q

Inhibits the urease
enzyme

A

Fluoride and nitrate

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21
Q

Use of ammonium containing
coagulants is a must T/F

A

True

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22
Q
  • Based on the preliminary hydrolysis
    of urea with urease
  • Quantitation of ammonium ion liberated
A

Indirect/Enzymatic method

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23
Q

Where is Urease often derived?

A

Jack
beanmeal

24
Q

Berthelot pH in Secondary Reaction

25
Beckman BUN analyzer
Conductimetric method
26
Reactants in Conductimetric method
o Urease o K2CO3 o BCG- tartaric acid
27
Forms an unstable photosensitive yellow complex (Diazine) and what is the absorbance
Urea + DAM + strong acid + heat and 540nm
28
Reference method for urea
IDMS (Isotope Dilution Mass Spectrometry)
29
Biochemical abnormality pertaining to increase NPN compounds (creatinine & urea) defining GFR defect
Azotemia
30
Increase in the nitrogen containing compound in the blood
Uremia
31
Due to reduced blood flow to the kidneys (Categories of Azotemia)
Pre-renal
32
* Defect GFR * Lesions along renal parenchyma ( Categories of Azotemia)
Renal
33
BUN: CREATININE RATIO (Normal)
10-20: 1
34
✓ Acute tubular necrosis ✓ Low protein intake; Starvation ✓ Sever liver disease ✓ Repeated dialysis ✓ Severe vomiting or diarrhea
. BUN: CREA ratio <10: 1
35
✓ Catabolic states w/ tissue breakdown ✓ Pre-renal azotemia ✓ High protein intake ✓ After GIT hemorrhage
BUN: CREA ratio >10-1 with normal creatinine
36
✓ Post-renal obstruction ✓ Pre-renal azotemia superimposed on renal disease
High ratio with elevated creatinine level
37
o Produce when creatine loses water o Or Creatine PO4 loses its phosphoric acid by dephosphorylation
Anhydride of creatine
38
Principal waste product of muscle metabolism derived from creatine * Constitutes about 5% of total NPN * used as an accurate monitor of kidney function
Creatinine
39
muscles energy source
Creatine PO4
40
formed from the non-enzymatic cyclization of creatinine or creatine PO4
Creatine
41
* Chemical method * Trichloroacetic filtrate of serum
COLORIMETRIC: JAFFES REACTIONS
42
Creatinine + alkaline picrate →
creatinine picrate (red/yellow)
43
Picric acid + NaOH
Alkaline picrate
44
Product of Colorimetric: Jaffes reaction (including the absorbance)
Janovski complex (red orange) ▪ 490-205 nm
45
Uses hydrated aluminum silicate to absorb interfering substances
Lloyd’s reagent/ Fuller’s earth
46
Adsorbent Na Aluminum silicate
Lloyd’s
47
Absorbent aluminum magnesium silicate
Fullers
48
Preferred than the endpoint
Kinetic method
49
Measure the change of NADH to NAD
Creatinine amidohydrolase/ creatine kinase method
50
Measures formation of the color as a benzoquinoneimine dye forms
Creatininase hydrogen peroxide method
51
* Accepted reference method * Detection of characteristics fragments follows ionization and quantification using isotopically labelled compound
IDMS
52
METHODS FOR DETERMINATION
A. COLORIMETRIC: JAFFES REACTIONS and B. ENZYMATIC METHODS
53
B. ENZYMATIC METHODS
F. Lim: Creatininase or creatine aminohydrolase and G.A. Moss: Creatininase amidohydrolase
54
55
Creatine>N-methylhydantoin + NH3 NH3 + a-ketoglutarate + NADH> Glutamate + NAD + H+
F. Lim: Creatininase or creatine aminohydrolase
56
Creatinine > Creatine Creatine + ATP > Creatine PO4 + ADP ADP + PEP > Pyruvate +ATP Pyruvate + NADH + H+ > Lactate + NAD
G.A. Moss: Creatininase amidohydrolase
57

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