Lesson 6: Non-protein Nitrogenous Compounds Flashcards by Esther Caalem

What must be performed first during NPN determination?

Deproteinization (lysis of protein)

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What is the method used when NPN sources in the protein-free filtrate are broken down to release the nitrogen?

Kjeldahl Digestion Method

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Major inherited metabolic diseases associated with
hyperuricemia:

HGPRT deficiency (Lesch Nyhan syndrome)
PRPP synthetase deficiency
Glucose-6-phosphatase deficiency (GSD-1)
Fructose-1-phosphate aldolase deficiency

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It is the end product of purine metabolism

-BUA

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BUA is formed in the liver and the intestinal mucosa from xanthine by ______?

-xanthine oxidase

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Where is the blod uric acid filtered and reabsorbed?

-PCT

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Enzymes that degrade the BUA when it is secreted in the gastrointestinal tract?

-bacterial enzymes

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In the formation of uric acid, IMP and guanosine monophosphate are converted into in their nucleoside forms through the action of 5’nucleotidase. What are these two forms?

-guanosine and inosine

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In the third part of uric acid formation, purine nucleoside phosphorylase converts inosine and guanosine in what respective purince bases?

-hypoxanthine and guanine

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What is called when purines is being recycled in the body due to its normal turnover of cellular nucleic acids?

-salvage pathway

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What are the two enzymes involved in the Blood uric acid?

-APRT & HGPRT
-adenine phosphoribosyl transferase
(APRT) and hypoxanthine-guanine phosphoribosyl
transferase (HGPRT)

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How many days will the uric acid becomes stable for both urine and serum at room temperature?

-3 days

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What is the only chemical method in measuring uric acid?

-Redox reaction

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What are the four enzymatic mehod in measuring uric acid?

-differential UV absorption
-couple urice reaction
-uricase-hantzch reaction
-polarographic urcase method

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This is added to uric acid as a preservative for it is susceptble to bacterial degradation.

-thymol

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An anticoagulant that is contraindicated when doing redox method?

-potassium oxalate
(it forms patassium phosphotung state, which forms turbidity)

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Uric acid is increased in:

-gout
-renal failure
-chemotheraphy
-poisoning
-alcohol and dietary intake

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Uric acid is decrease in:

-xanthinuria
-wilson disese
-drug administration

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What is the most common cause of increase blood uric acid level?

-gout

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A major inherited metabolic disease associated with
hyperuricemia that decreased the activity in the salvage pathway.

-HGPRT deficiency (Lech Nyhan Syndrome)

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Metabolic disease is associated with hyperuricemia, which is when PRPP synthase is the first enyme in the purine synhesis pathway.

-PRPP synthase deficiency

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What are the diseases associated with increase ammonia?

-hepatic coma
-nuerotoxicity
-encephalopathy

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Hepatic failure is the most common cause of disturbed ammonia metabolism that may lead to what disease?

-hepatic coma

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It is the most common cause of disturbed ammonia metabolism that may lead to hepatic coma.

-Hepatic failure

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What is called to a disease that causes the liver to show fatty acid infiltration, and that is common in children?

-Reye's syndrome

What is the factor that increases the value of ammonia?

-Smoking

What are the four methods in determining the ammonia?

1. Conoway microdiffusion 2. Ion-exchange chromatography 3. Enzymatic methods 4. Ammonia-sensing electrode

What is the test that determines the ability of the kidney to handle waste products?

-kidney function test

Test that measures the clearance of normal molecules that are not bound to protein and are freely filtered by glomeruli.

- Clearance test (test for glumerular function)

It is considered for the best indicator of the level of kidney function.

-Clearance test (test for glumerular function)

It is the removal of substance from the plasma into the urine that represents the volume of plasma that would contribute all the solute excreted.

-clearance

What is the unit expressed for clearance?

-milliliter per minute (mL/min)

What are the two general classifications of clearance tests?

-Endogenous and exogenous cleaaarance test

What is the classification of clearance test that the test substance is already present in the body?

-Endogenous clearance test

What is the classification of the clearance test that the test substance must be infused in the body?

-Exogenous clearance test

What are the examples of the endogenous clearance test?

-creatinice -Urea -Beta trace protein -Cystatin C

What are the examples of the exogenous clearance test?

-Inulin -Radionucleotides

It is not routinely done due to the necessity for continuous IV infusion.

-Inulin Clearance

Higher values of males in the inulin clearance must be due to ____?

-larger renal mass

What is the priming dose in the inulin clearance?

-25ml to 10% inulin solution

What is the continous infusion in the inulin clearance?

-500ml of 1.5% inulin solution

What are the reference values in the inulin clearance?

-M: 127 ml/min -F:118 ml/min

It demonstrates the progression of renal disease or response to the therapy. It is also used as the best predictor of GFR rather than the creatinine.

-Urea Clearance

The faster the rate of urine flow in ure clearance, the ___ urea reabsorbed vice versa.

-less

It provides an estimate of the amount of plasma that must flow through the kidney glomeruli/minute and an excellent measure of renal function.

-creatinine clearance

Production and excretion of creatnie is related directly to _____?

-Muscle mass

What is the major limitation of creatinine clearance?

-accurate urine collection

What are the reference values for creatinine clearance?

-M:85-125 ml/min -F: 75-112 ml/min

Creatinine clearance is increased in:

-high cardiac output -burns -pregnancy -CO2 poisoning

Creatinine clearance is decreased in:

-impaired kidney function -shock -dehydration -hemorrhage -congestive heart failure

It is a low molcular weight protease inhibitor and is prduced at constant rate by all nucleated cells.

-Cystatin C

What happens if there's a presence of Cystatine C in the urine?

-denotes the damage of that tubule

Where is Cystatine C completely reabsorbed and catabolized?

-PCT

Cystatin C is not characterized by:

-muscle mass -age -diet -gender

What are the Advantages for Cystatin C?

-Pediatric and elderly and renal transplant patient

What disease is Beta trace protein increased?

-renal diseases

What is the low molecular weight of glycoprotein and isolated primarily in the CSF?

-Beta trace protein

What family does the beta trace protein belong to?

-lipocalin protein family

This test measures the renal plasma flow that requires the clearance of the dye.

-Pra-amino hipurate test (PAH test)

What is the reference value for the PAH test?

-600-700 ml/minute

This test measures the excretion of dye proportional to renal tubular mass.

-Phenolsulfonthalein dye test (PSP test)

What is the dos of PSP administered by the IV?

-6mg

What is the reference value for PSP?

-1200ml blood flow/minute

What is the specimen used in the concentration test?

-morning urine

It compares the weight of a fluid with that of distilled water at a reference temperature.

-specific gravity

What is the simplest test of renal concentrating ability?

-Specific gravity

This indicates the severe loss of concentrating ability of specific gravity .

-Fixation at 1.010

What is the reference value for SG?

-1.005-1.030

What is an expression of concentration in terms of the total number of solute particles present/kg of solvent?

-osmolality

What is the osmolality of the serum due to electrolytes?

-92%

What are the reasons for the 8% osmolality of the serum?

-proteins -glucose -urea

What is the reference value of osmolality?

-275-295 mOsm/kg

What is the normal ratio of urine osmolality to serum osmolality?

-1:1

What are the two substances that does not contribute to osmolality?

-protein and lipids

What is the accumulation of NPNs in the blood?

-Azotemia

This type of azothemia occurs when there is obstruction in the unrinary tract.

-Post-renal azotemia

Type of azothemia that occurs when renal functions normally, but there is decreased glomerular filtration

-Pre-renal azothemia

This type of azothemia is when the damage in the kidney caused a decrease in glumerular filtration.

-Renal azotemia

What is the clinical syndrome comprised of a marked elevation in plasama urea and other nitrogenous waste products, accompanied by acidemia and electrolyre imbalance?

-uremia

What is called whn kidneys fail to eliminate waste products of metabolism?

-uremia

If the patient has uremia, what exactly do we see on the peripheral blood films?

-echinocytes (burr cells)