KIDNEY FUNCTION TEST part 6 Flashcards
The deficiency of this enzyme leads to Lesch-Nyhan Syndrome.
Hypoxanthine guanine phosphoribosyl transferase (Muricase)
It is a x-linked genetic disorder
Lesch-Nyhan Syndrome.
This disease is a self-destructive behavior such as chewing of fingertips and lips and is associated with delayed motor developments and “Gout-like swelling joints”
Lesch-Nyhan Syndrome.
This enzyme prevents reutilization of purine bases in the nucleotide salvage pathway.
Abnormal phosphoribosyl pyrophosphate synthetase
This disease occurs when monosodium urate precipitates from supersaturated body fluids.
Gout
The characteristics of this disease has a urate crystals in joint fluids.
Gouty arthritis
This is the other term for urate crystals
Tophi
This occurs in renal parenchyma.
Gouty nephropathy
This refers to the atrophy of the liver
Hypourecemia
What is the reference interval of females for hypourecemia?
F: 2.6 - 6.0 mg/dL
M: 3.5 - 7.2 mg/dL
What is the conversion factor for uric acid?
0.059
This substance is the product of amino acid deamination, is often used for liver function test and urea production.
Ammonia
What is the primary site of Ammonia production?
Small intestine
Where is ammonia derived from?
- Breakdown of AA
- Hydrolysis of urea
Ammonia exists in ionized or unionized form. Therefore, if Ammonia is in lower pH, what would be the result?
There is a formation of ammoniun ions
Ammonia exists in ionized or unionized form. Therefore, if Ammonia is in higher pH, what would be the result?
There is a formation of unionized form of ammonia
What is level of Ammonia if there is a severe liver damage?
Increased ammonia levels
How many ug/dL if the plasma level is low?
15 - 45 ug/dL
This method is quantitated by titration or colorimetry wherein Ammonia is released from an alkaline solution and determined by back titration with acid because NH3 is trapped in an acid medium of the diffusion cell. Despite the process, it is still time consuming with poor accuracy and precision.
Conway and Cook diffusion method (Microdiffusion method)
If Conway and Cook is quantitated by titration. How about for Forman’s Resin absorption method?
Berthelot reaction/ Nesslerization
This method of determination of Ammonia uses cation-exchange resin. Wherein NH3 is absorbed by the resin and eluted.
Forman’s Resin Absorption Method
What is the normal value of Forman’s Resin Absorption Method?
16 - 33 umol/L
In Kunahashi, Ishihora and Euhera method, NH3 is obtained through the use of this column.
Dowax column
This method is assayed using the Berthelot method.
Kunahashi, Ishihora and Euhera method
Van Anken Ezymatic Method is also known as?
Coupled enzymatic method
What is the normal value of Van Anken Enyzmatic method?
11 - 35 umol/L
If ammonia reacted with a-ketoglutarate and NADPH in the presence of glumate dehydrogenase to form what?
Coupled enzymatic method
This method places ammonia through a selective membrane into NH4 chloride causing pH change which is determined potentiometrically.
Ion Selective Electrode
What are the sources of Ammonia contamination?
Smoking
Laboratory atmosphere
Poor venipuncture technique
Metabolism of nitrogenous constituents
Under laboratory atmosphere, glassware should be soaked and rinsHyod with?
Soaked: Hypochlorite solution
Rinsed: Deionized water
Under laboratory atmosphere, blood collection and NH3 should be done where?
Laboratory with restricted traffic
Poor venipuncture technique could cause an increase in NH3 levels by?
100 - 200 ug/L
What are the accepted anticoagulants?
EDTA and non-NH4 heparin salts
This means that there are enzyme defects in the Kreb’s Henseleit Cycle and there is a defect in the metabolism of AA such as Lysine and Ornithine
1° / Inherited Hperammonemia
What are the impairment of Acquired Hyperammonemia?
Severe liver disease
Impaired venous drainage
Impaired renal excretion
Under severe liver disease, this is toxic or fulminant viral hepatitis and Reye’s syndrome. Which mean that it is?
Acute
The presence of cirrhosis under severe liver disease indicates that it is?
Chronic
This impairment is from the intestine to liver by portal vein.
Impaired venous drainage
What is this impairment?
- Decreased urine output
- Increased BUN reabsorbed
- Increased excretion of urea into intestines
- Converted into Ammonia
Impaired renal function
This disease is caused by the following, what is this?
- GIT bleeding
- Excess dietary proteins
- Constipation
- Infections
- Drug effects
Hepatic encephalopathy
What is the reference interval of Ammonia in adult?
19 - 60 ug/dL
11 - 35 umol/L
To which reference value are these?
68 - 136 ug/dL
40 - 80 umol/L
Reference interval of a child aging 10 days to 2 years old.
What is the conversion factor of Ammonia?
0.587
