Creatinine Flashcards

1
Q

Creatine

• Synthesized primarily in the liver from (3)

A

arginine, glycine, and methionine

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2
Q

Creatine is transported to tissues and is converted to_______, which serves as a high-energy source

A

phosphocreatine

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3
Q

EC 2.1.4.1

A

L-ARGININE: GLYCINE AMIDINOTRANSFERASE (AGAT)

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4
Q

EC 2.1.1.2

A

GUANIDINOACETATE METHYLTRANSFERASE (GAMT)

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5
Q

(GAA)

A

GUANIDINOACETATE

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6
Q

arginine&raquo_space;> guanidoacetate

Happens in the

A

in kidney

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7
Q

guanidoacetate&raquo_space;> creatine

Happens in the

A

Liver

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8
Q

creatine&raquo_space;> creatine phosphate

What enzyme caused the conversion?

A

creatine phosphokinase

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9
Q

creatine phosphate&raquo_space;> creatinine

Unsa gitanggal?

A

P + H2O

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10
Q

Creatinine&raquo_space;> creatine phosphate

What enzyme is added?

A

Creatine kinase

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11
Q

Creatinine&raquo_space;> ______&raquo_space;> Glomerular filtration&raquo_space;> _____

A

Plasma

Urine

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12
Q

• Endogenous substance
• With a MW of 113 Da

A

Creatinine

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13
Q

Creatinine

• Waste product of____ metabolism

A

muscle

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14
Q

Creatinine

Produced by the muscle from creatine and creatine phosphate thru non-enzymatic (2) process

A

dehydration and dephosphorylation

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15
Q

Disease Correlation:

^^^______
Muscle diseases
Muscular dystrophy
Poliomyelitis
Hyperthyroidism
Trauma

A

Creatine

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16
Q

Disease correlation

^^^^______
Associated with abnormal renal function

A

Creatinine

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17
Q

• Most widely used marker for GFR

A

Creatinine

18
Q

Creatinine

Advantages:

A

~ Endogenous substance with constant rate of production

~ Not bound to plasma proteins
Not reabsorbed by the tubules

~ Only a small amount is secreted by the tubules

19
Q

Creatinine

Disadvantages:

A

× Depends mainly on muscle mass
× Quantity of meat ingestion can substantially influence the total
daily production
× Method is subjected to many interferences

20
Q

The Diagnostic Function of
Creatinine

If the kidneys are damaged or impaired and cannot work normally

The amount of creatinine in urine goes____ while its level in blood goes____

Creatinine has been found to be a fairly reliable indicator of kidney function.

Serum creatinine level is an important diagnostic tool to asses renal function

A

down; up.

21
Q

How is Creatinine Used to Monitor Renal Function..?

In renal failure the kidney will not be able to excrete creatinine in urine leading to an_____ in serum creatinine level.

A

elevation

22
Q

Is there other factors mav affect creatinine level in the blood…’
?

A

The amount of muscle tissue you have.

Protein in diet.

23
Q

:
Measures how well creatinine is removed from blood by kidneys which reflects glomerular filtration rate (GFR)]

A

Creatinine Clearance Test

24
Q

• Creatinine reacts with picric acid (trinitrophenol)
in alkaline solution to form a red-orange chromogen

A

Direct Jaffe Reaction (1886)

25
Q

Direct Jaffe Reaction (1886)

• Creatinine reacts with_____
in alkaline solution to form a____ chromogen

A

picric acid (trinitrophenol)

red-orange

26
Q

DJR

A
  • Folin-Wu Method (1919)
  • Fuller’s Earth
  • Method of Hare (addition to Lloyd’s Reagent)
27
Q
  • Fuller’s Earth
  • Method of Hare (addition to Lloyd’s Reagent)
A
  • Folin-Wu Method (1919)
28
Q

Hare (addition to Lloyd’s Reagent)
- PFF + sodium aluminum silicate
• Eluted and reacted with alkaline pirate

A

• Method of Hare (addition to Lloyd’s around for and in wannabee

29
Q
  • PFF + sodium aluminum silicate
    • Eluted and reacted with alkaline pirate
A

• Method of Hare (addition to Lloyd’s Reagent)

30
Q

Creatinine + Picric acid

A

Yellow color

31
Q

Creatinine Picrate

Orange color
Measured at

A

colorimetrically

520 nm

32
Q

• performed directly on sample
• serum is mixed with alkaline picrate and the rate of change in absorbance is measured

A

Kinetic Jaffe Reaction

33
Q

• Interferences:
(2)

A
  • a-ketoacids
  • cephalosporins
34
Q

Coupled-Enzymatic Method (2)
Creatininase

A

a. Creatininase-CK Method

b. Creatininase-Hydrogen Peroxide Method

35
Q

Creatininase-CK Method

A

• Creatininase
• CK, PK, LDH
- NADH to NAD+ (340 nm)

36
Q

Creatininase-Hydrogen Peroxide Method

A

• Creatininase

Creatinase
Sarcosine oxidase
Peroxidase

37
Q

specimen requirement

A

Plasma; serum

Urine

38
Q
  • Hemolyzed and icteric samples should be avoided
  • Lipemic samples produce erroneous results
  • Fasting is not required
A

Plasma, serum

39
Q

should be refrigerated or frozen if longer than 4 days

A

Urine

40
Q

Creatinine in serum or urine is stable for at least__ days at___

A

7

4°C

41
Q

interfering substances

A

False increase;
reacts with picrate solution

• Ascorbic Acid
• Glucose
• Protein, urea
• Alpha-keto acids/ ketones
• Cephalosporins, Dopamine, Lidocaine

false decrease
• Hemoglobin and bilirubin
• Uric acid
- Decreased in kinetic methods