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Clinical II > Nitrogen Compounds > Flashcards

Nitrogen Compounds Flashcards

1
Q

What is renal disease?

A

When something is physically wrong with the kidneys, but the function may not be affected

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2
Q

What is renal failure?

A

When something is functionally wrong with the kidney, at least 75% of total nephron population is non-functional

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3
Q

What happens to the kidneys in renal failure?

A

The kidneys are no longer able to maintain the regulatory, excretory and endocrine functions required

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4
Q

What happens to hormone production to kidneys in renal failure?

A

The kidney produces less erythropoietin hormone, which results in anemia especially in cats

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5
Q

What is the result of renal failure?

A

It results in retention of nitrogenous solutes and derangement of fluid, electrolyte, and acid balance

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6
Q

What is azotemia?

A

A build up of waste in the blood due to failure of kidneys and an increased concentration of non-protein nitrogenous waste products in the blood

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7
Q

What us pre-renal azotemia?

A

A problem occurring before the kidney involving impaired blood flow to the kidney

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8
Q

What is pre-renal azotemia due to?

A

A decrease in glomerular filtration rate from circulatory disturbances causing decreased renal perfusion

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9
Q

What is renal azotemia?

A

A primary failure of the kidney which results from decreased GFR, check functionality with a specific gravity

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10
Q

What is post-renal azotemia?

A

When the urine does not leave the body and results from obstruction or rupture of urinary outflow tracts and hyperkalemia

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11
Q

What is uremia?

A

A condition involving abnormally high levels of waste products in the blood from a critical loss of functioning nephrons

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12
Q

What are the clinical signs of uremia?

A
  • PU/PD
  • Mild non-regenerative anemia
  • Vomiting
  • Weight loss
  • Depression
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13
Q

What is ammonia?

A

Produced from dietary proteins and by catabolism of proteins and nitrogenous wastes in peripheral tissues

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14
Q

What converts amino acids and urea into ammonia?

A

Gastrointestinal micro-organisms in the colon and cecum which are then absorbed into the portal circulation

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15
Q

How much ammonia is shunted to the liver?

A

80-90% and then it is converted into urea via the urea cycle

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16
Q

What peripheral tissues metabolize 10-20% of ammonia?

A

The kidneys, heart and brain

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17
Q

How is ammonia measured?

A

With arterial blood collection and heparinized plasma samples

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18
Q

What can result of increased ammonia?

A

Ammonia is toxic to the CNS and is one cause of hepatic encephalopathy (damage to the CNS due to the build up of ammonia)

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19
Q

What could be a physiologic normal body function that would result in elevated ammonia?

A

A high protein diet, can also result in increase GFR and urea excretion

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20
Q

What kind of artifact may result in a increased ammonia?

A

It may not be an accurate number

21
Q

What kind of disease may result in an increased ammonia level?

A

It can be a liver shunt, dehydration or a tumor

22
Q

How is urea formed?

A

2 NH3 molecules are combined with 1 molecule of CO2

23
Q

What is the chemical formula of urea?

A

CO(NH2)2

24
Q

What is urea?

A

The end product of protein and amino acid catabolism

25
Q

How is urea metabolized?

A

Synthesized in the liver using ammonia derived from amino acids

26
Q

How is urea excreted?

A

By the kidneys which is the most important route of urea excretion

27
Q

Where is urea filtered?

A

At the glomeruli and requires no metabolic work by the kidneys because glomerular filtration is driven by cardiac output

28
Q

How is urea concentration measured?

A

As blood urea nitrogen, and is a screen for decreased GFR

29
Q

What are the non-renal factors contributed to increased BUN?

A
  • High protein meal
  • Hemorrhage into gastrointestinal tract
  • Increased catabolism (breakdown of protein)
  • Drugs
30
Q

What are the renal factors contributing to increased BUN?

A
  • Pre-renal: shock, dehydration, congestive heart failure
  • Primary: kidney is not functioning properly
  • Post-renal: Urethral obstruction, ruptured bladder
31
Q

What are some reasons that could contribute to a decreased BUN?

A
  • Low protein diet
  • Severe liver disease of portosystemic shunting
  • Anabolic steroids due to building protein instead of breaking it down
32
Q

What is creatinine?

A

Spontaneous, non-enzymatic breakdown product of phosphocreatine in muscle and is released into the blood from muscle at a constant rate

33
Q

Which gender tends to have more creatinine?

A

Males due to higher muscle mass

34
Q

Where is creatinine excreted?

A

By glomerular filtration and the rate of excretion is relatively constant and a good estimate of GFR

35
Q

What is creatinine a measurement of?

A

It is a screen for decreased GFR?

36
Q

What might be some reasons for increased creatinine?

A
  • Non renal: massive muscle necrosis and prolonged strenuous exercise
  • Pre-renal: shock, dehydration, congestive heart failure
  • Post-renal: urethral obstruction, ruptured bladder
37
Q

What does an increased BUN:creatinine ratio suggest?

A

Non-renal azotemia, may be due to an increased protein diet

38
Q

What does a decreased BUN:creatinine ratio suggest?

A

Chronic liver failure

39
Q

What are plasma proteins?

A

Total proteins consist of albumins and globulins, also includes fibrinogen

40
Q

What could decreased plasma protein level indicate?

A
  • Glomerular disease
  • Liver disease
  • Starvation
  • Malabsorption
  • Hemorrhage
41
Q

What organ produces albumin?

A

The liver

42
Q

What could a increased plasma protein level indicate?

A
  • Severe dehydration
  • Neoplasia (lymphoma and plasm
  • Infection
43
Q

What is albumin?

A

It contributes to plasma colloid oncotic pressure and synthesized in the liver and catabolized by all metabolically active tissues, serves as a carrier protein for many insoluble organize substances

44
Q

What can contribute for hypoalbuminemia?

A
  • Physiologic: low protein diet
  • Increased loss: kidney, liver, gut and bleeding
  • Catabolism
45
Q

Where are globulins produced?

A
  • Alpha and beta are synthesized by the liver, and gamma globulins are produced by b-lymphocytes and plasma cells
46
Q

What does a high total protein with a normal A:G ratio indicate?

A

Dehydration

47
Q

What does a high total protein with a low A:G ratio suggest?

A

Hyperglobulinemia

48
Q

What us hyperglobulinemia?

A

Decreased gamma globulins are seen when there is a deficiency of immunoglobulins

Clinical II (11 decks)

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