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[2S] CC LAB > creatinine > Flashcards

creatinine Flashcards

1
Q

t/f Creatinine is primarily formed from amino acids arginine and methionine

A

F - from creatine and creatine phosphate

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2
Q

primary source of creatinine in the body

A

muscle catabolism

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3
Q

Creatine is converted to __________ via the creatine kinase enzyme

A

creatine phosphate

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4
Q

Select: Creatinine
A) It is synthesized in the kidneys.
B) It is a product of muscle metabolism.
C) It is not filtered by the glomerulus.
D) It has no relation to kidney function.

A

B

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5
Q

Select: Creatinine
A) 99% of creatinine is reabsorbed in the kidneys.
B) Creatinine is formed from creatine and creatine phosphate.
C) Creatinine levels are unaffected by muscle mass.
D) Creatinine is synthesized only in the kidneys

A

B

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6
Q

T/F creatinine levels in the plasma are inversely related to glomerular filtration rate (GFR).

A

t (the higher the plasma creatinine, the lower the glomerular filtration rate)

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7
Q

Creatinine is excreted primarily in the __________

A

urine

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8
Q

t/f Creatinine is mostly reabsorbed by the kidneys.

A

F - 99% of creatinine is excreted in urine and <1% is reabsorbed

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9
Q

relationship between muscle mass and creatinine levels

A

Larger muscle mass leads to higher creatinine levels

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10
Q

OOO: Affects creatinine levels
A) Muscle mass
B) Age
C) Renal function
D) Creatine turnover

A

B

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11
Q

t/f creatinine is completely reabsorbed by the kidneys after filtration

A

f - less than 1% is reabsorbed

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12
Q

Creatinine is a product of the catabolism of __________

A

muscle

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13
Q

t/f Monitoring plasma creatinine levels can help assess kidney function

A

T

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14
Q

Select: Indication of increase in plasma creatinine
A) Improved kidney function
B) Decreased kidney function
C) Increased muscle mass
D) Dehydration

A

B

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15
Q

t/f Creatinine is synthesized in the liver from arginine, glycine, and methionine.

A

t

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16
Q

what happens to creatine phosphate in muscle tissue

A

loses phosphoric acid to form creatinine

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17
Q

cyclic compound formed from the loss of water from creatine

A

creatinine

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18
Q

t/f Creatinine is used as an energy source by muscles

A

F - Creatine phosphate is used as a high-energy source, not creatinine

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19
Q

t/f Jaffe reaction is the most frequently used method for measuring creatinine.

A

t

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20
Q

t/f Jaffe reaction is a chemical method used to determine creatinine levels

A

t

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21
Q

main principle of the Jaffe reaction

A

creatinine reacts with picric acid in an alkaline medium to form a creatinine-picrate complex.

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22
Q

Select: Main difference in timing for the Kinetic Jaffe method
A) Reaction time is not important
B) Incubation time and absorbance readings are critical
C) Absorbance should be read after 5 minutes only

A

B

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23
Q

The Jaffe reagent is a combination of picric acid and 10% __________

A

sodium hydroxide

*Picric acid (Reagent 1); sodium hydroxide with disodium phosphate (Reagent 2)

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24
Q

The intensity of the orange-red product formed in the Jaffe reaction is __________ to the amount of creatinine present

A

directly proportional

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25
Q

T/F The Folin-Wu method requires the use of an adsorbent

A

F - Folin-Wu method does not use adsorbents

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26
Q

t/f Folin-Wu method is specific and not prone to false positives.

A

F - non-specific and can give false positives with substances like ascorbic acid and glucose

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27
Q

Select: False-positive results in the Folin-Wu method
A) Ascorbic acid
B) Sodium chloride
C) Glucose
D) Uric acid
E) Insulin
F) Hemoglobin

A

A C D

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28
Q

T/F Jaffe method with adsorbent is more accurate than the Folin-Wu method.

A

T

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29
Q

adsorbent used in the Jaffe with adsorbent method to improve accuracy

A

Fuller’s earth (aluminum magnesium silicate)

Lloyd’s reagent (sodium aluminum silicate).

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30
Q

role of fuller’s earth or Lloyd’s reagent in the Jaffe method with adsorbent

A

adsorb creatinine from a protein-free filtrate

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31
Q

measures the rate of change in absorbance to avoid interference from non-creatinine chromogens

A

Jaffe kinetic

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32
Q

t/f Jaffe kinetic methods are not routinely performed due to high costs

A

f - routinely performed because they are inexpensive and easy to execute

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33
Q

t/f Kinetic methods for measuring creatinine levels are less expensive and more rapid than other methods.

A

t

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34
Q

Select: False positive in Jaffe kinetic methods
A) Alpha-keto acids
B) Bilirubin
C) Cephalosporins
D) Hemoglobin

A

A C

*B D - false negative

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35
Q

Creatininase converts creatinine to __________

A

creatine

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36
Q

t/f Creatinase converts creatine to sarcosine and urea

A

t

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37
Q

enzyme that oxidizes sarcosine to form formaldehyde and glycine

A

sarcosine oxidase

38
Q

reaction catalyzed by peroxidase measures the __________ produced in the reaction.

A

peroxide

39
Q

Accepted reference method for measuring creatinine

A

Isotope dilution mass spectrometry

40
Q

t/f Fasting is required before measuring creatinine levels.

A

f

41
Q

type of specimens can be used for creatinine measurement

A

plasma, serum, or urine

42
Q

T/F High protein ingestion can increase creatinine levels.

A

F - may transiently elevate serum creatinine concentration, but not significant to increase creatinine levels

43
Q

t/f Hemolysis, lipemia, and icteric samples can interfere with the Jaffe reaction.

A

t

44
Q

If samples cannot be processed immediately, they must be __________.

A

refrigerated

45
Q

t/f urine samples that are not processed within 4 days can be frozen.

A

t

46
Q

reagent used in the creatinine reagent kit to create the Jaffe reaction

A

picric acid

47
Q

standard creatinine concentration is __________ mg/dL or 176.8 mmol/L

A

2 mg/dL

48
Q

t/f procedure for measuring creatinine levels requires mixing reagents before adding them to the sample

A

t

49
Q

at what wavelength should the spectrophotometer be set for measuring creatinine

A

520 nm

50
Q

incubation temperature for the creatinine assay is __________ °C

A

37

51
Q

Sequence: Creatinine Procedure
A) Set up the spectrophotometer at 520 nm.
B) Add the reagent by touching the pipet tip to the bottom of the tube.
C) Mix the solution by covering the mouth of the tube with parafilm.
D) Deliver the sample volume by touching the pipet tip to the bottom of the tube.
E) Read and record absorbance at 10 seconds as A1.

A

D A B C E

52
Q

t/f absorbance is recorded twice during the procedure: once at 10 seconds and again at 120 seconds

A

t

53
Q

optical path used in the assay is __________ cm.

A

1 cm

54
Q

conversion factor from mg/dL to µmol/L is ____

A

88.402

55
Q

reference range for plasma/serum creatinine for adult males using the Jaffe method

A

0.9 - 1.3 mg/dL or 80 - 115 µmol/L

56
Q

reference range for plasma/serum creatinine for adult females using the enzymatic method is __________ mg/dL or __________ µmol/L.

A

0.5 - 0.8 mg/dL or 44 - 71 µmol/L

57
Q

reference ranges for children using the Jaffe method

A

0.3 - 0.7 mg/dL
0.6 - 1.1 mg/dL or 53 - 97 µmol/L.

58
Q

t/f There is no significant difference in creatinine reference ranges between males, females, and children

A

f

59
Q

urine creatinine reference range for adult males over 24 hours

A

800 - 2000 mg/day or 7.1 - 17.7 mmol/day

60
Q

urine creatinine reference range for adult females over 24 hours is __________ mg/day or __________ mmol/day

A

600 - 1800 mg/day or 5.3 - 15.9 mmol/day

61
Q

t/f Creatinine concentration in the body is independent of body mass.

A

f

62
Q

reference range for plasma/serum creatinine for adult males using the enzymatic method is __________ mg/dL or __________ µmol/L.

A

0.67 - 1.1 mg/dL or 53 - 97 µmol/L

63
Q

reference range for children using the enzymatic method

A

0.0 - 0.6 mg/dL
0 - 53 umol/L

64
Q

reference range for adult females using the Jaffe method is __________ mg/dL or __________ µmol/L

A

0.6 - 1.1 mg/dL or 53 - 97 µmol/L.

65
Q

Measure of the amount of creatinine eliminated from the blood by the kidneys

A

creatinine clearance

66
Q

t/f Creatinine clearance (CrCl) is used to determine the glomerular filtration rate.

A

t

67
Q

primary analyte used to approximate the glomerular filtration rate

A

creatinine

68
Q

Select: Factors considered for determining glomerular filtration rate

A) Analyte should be endogenously produced.
B) Analyte should be externally supplied.
C) Analyte should not be excreted in urine.
D) Analyte should be or almost 100% is
excreted in the urine

A

A D

69
Q

formula for creatinine clearance

A

CrCl = (Ucr x Vu) / Pcr x t [(Urine creatinine x Urine volume) / (Plasma creatinine x Time)]

CrCl = Ucr x urine vol in 24h / Pcr x 1440

70
Q

t/f when collecting a 24-hour urine sample, the first urine voided at the start time should be included in the collection

A

f

71
Q

average body surface area (BSA) of an adult male used in the corrected creatinine clearance formula

A

1.73

72
Q

Formula for Corrected Creatinine Clearance

A

CrCl = [(Ucr x Vu) / Pcr x t ] x (1.73/A)

73
Q

normal creatinine clearance range for males

A

97-137 ml/min

74
Q

normal creatinine clearance range for females is __________ mL/min.

A

88-128 mL/min

75
Q

Select: increase creatinine clearance
A) Impaired renal function
B) Acute kidney injury
C) Chronic kidney disease
D) Muscle wasting

A

A B C

76
Q

T/f If there is an decrease in plasma creatinine, this is most likely due to impaired renal function or a kidney
disease.

A

increase

77
Q

chemical formula of creatinine

A

C4H7N3O

78
Q

t/f creatinine is the anhydride of creatine, which has the chemical formula C4H9N3O2.

A

t

79
Q

Select: Affect the total daily production of creatinine
A) Meat ingestion
B) Water intake
C) Vitamin supplements
D) Exercise

A

A

80
Q

t/f Creatinine clearance is reported in liters per minute (L/min)

A

f - ml/min

81
Q

T/F Creatinine levels in plasma are a sensitive marker for early renal dysfunction

A

F - Plasma creatinine is an insensitive marker for mild or early renal dysfunction; renal damage must be more than 50% to detect changes.

82
Q

OOO: increased creatinine and urinary creatinine
A) Muscular dystrophy
B) Hyperthyroidism
C) Liver cirrhosis
D) Poliomyelitis

A

C

83
Q

Creatinine is considered a more reliable kidney function test because it is not affected by diet, dehydration, or __________ metabolism

A

protein

84
Q

t/f creatininase-H2O2 method is free from interferences by acetoacetate or cephalosporins but may be affected by lidocaine

A

t

85
Q

OOO: Control used in creatinine determination
A) Ellitrol 1
B) Ellitrol 2
C) Citrate control

A

C

86
Q

t/f spectrophotometer should be set up after adding the reagent in the Kinetic Jaffe method

A

F - should be set up prior to adding the reagent

87
Q

In the Kinetic Jaffe method, the absorbance is read at 7 seconds (A1) and exactly __________ minutes (A2).

A

2 minutes

88
Q

formula for calculating the concentration of creatinine in 24-hour urine

A

C (mg/24hr) = mg/dL x urine volume (mL) x 0.01.

89
Q

OOO: Kinetic Jaffe procedure
A) Mixing the solution by inverting the tubes
B) Reading the absorbance at 7 seconds
C) Incubating for 10 minutes at room temperature

A

C

90
Q

formula for calculating creatinine in 24-hour urine in mmol/24hr is mg/24hr x _________

A

0.00884

91
Q

coversion factor umol/L to mg/dL

A

x 0.0113

[2S] CC LAB (7 decks)

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