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Clinical Chemistry > Non-Protein Nitrogen Compounds (NPNs) > Flashcards

Non-Protein Nitrogen Compounds (NPNs) Flashcards

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1
Q

What different things can affect the kidney’s function?

A

Protein intake, salt intake, tobacco, drugs, doctors prescriptions..etc

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2
Q

What is the functional unit of the kidney?

A

The nephron, blood flows into the bowmans cap

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3
Q

What substance dissolves the glomerular membrane?

A

Ethanol

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4
Q

T/F: kidney disease can have both acute and chronic phases, acute being destruction of the nephron and chronic being the inflammation of the entire structure (from over working)

A

False: Acute phase involves the inflammation of the entire structure while the Chronic phase includes the total destruction of the nephron

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5
Q

In plasma, what substance has the highest % of total NPN?

A

Urea, Amino acids make around <5%

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6
Q

Where is urea sythesized?

A

In the liver, the liver also has ammonia which is catabolized and moved out of the body, high ammonia is liver issue marker

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7
Q

T/F: the highest concentration of NPN in blood is with BUN

A

True

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8
Q

T/F: BUN releases ammonia that is converted into nitrogen

A

False, BUN releases nitrogen that is converted into ammonia

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9
Q

Ref Range for BUN and 24hr Urine range?

A

BUN: 6-20 mg/dL
24 hr Urine: 12-20mg/dL

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10
Q

what is the range for pre-dialysis in BUN?

A

40mg/dL (higher than normal range)

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11
Q

T/F: 30% of BUN is reabsorbed into the tubules and 40% of the total is excreted

A

False, 40% is reabsorbed and 40% is excreted (thats what I have written idk)

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12
Q

What affects concentration of BUN? list a few examples

A

renal function,
dietary intake
Protein intake

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13
Q

T/F: Urea goes up the ascending limb

A

true

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14
Q

T/F: most urea is excreted/reabsorbed actively and can be used to assess renal function and hydration

A

False, everything is true besides the fact that it is reabsorbed PASSIVELY

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15
Q

What is the definition of Azotemia?

A

Elevated concentration of urea in blood, usually accompanied by uremia

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16
Q

Briefly describe/ID the location of:
Pre renal azotemia
Renal azotemia
post renal azotemia

A

Pre renal - issues before the kidney (eg heart)
Renal - Kidney (duh)
Post renal - after kidneys (bladder, urethra…etc)

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17
Q

Briefly describe Pre-Renal Azotemia, possible diseases associated with, and primary organs involved

A

Less blood to the kidneys = less urea filtered
Congestive heart failure due to thickening of cell walls
Primary Organs: Heart, brain, lungs

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18
Q

T/F: Systolic refers to the shrinking of cardiac walls

A

false, it is the STRETCHING of cardiac walls

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19
Q

Briefly describe Renal Azotemia, possible associated dieases and primary organs

A

decreased renal function = increased BUN (poor excretion)
renal failure, golm. neph, tube necrosis
LACK OF OXY TO KIDNEY TISSUES

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20
Q

T/F: the kidney has two blood supplies, one to filter and one to supply oxygen

A

true

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21
Q

Describe GolmeruloneNephritis (one word? idk)

A

inflammation of glomeruli and small blood vessels, bacteria or hypertension

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22
Q

Briefly describe post-renal azotemia, possible diseases associated and primary organs

A

obstruction of urine flow
renal calculi (calcium stones)
tumors of bladder or prostate

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23
Q

T/F: kidneys can “turn off” when needed

A

true

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24
Q

What are a few things that cause decreased Urea Nitrogen?

A

low protein intake
liver disease (lack of synthesis)
severe vomiting or poopy
increased protein synthesis

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25
Q

T/F: Urease is caused from the hydrolysis of urea to ammonium ions to detect NH4+

A

true

26
Q

What is the most common method for Urea Nitrogen?

A

Coupled reaction with urease and glutamate dehydrogenase

27
Q

what is the cofactor for urea nitrogen?

A

NADH –> NAD+

28
Q

T/F: less NADH = more absorbance
more NADH = more BUN

A

False:
Less NADH = less absorbance
More NADH = less BUN

29
Q

What must you avoid in urea specimens/requirements?

A

avoid ammonium and high citrate, susceptible to bacterial decomposition, use quickly or put in fridge

30
Q

T/F: creatine/creatinine is synthesized in the liver from arginine, gylcine and methionine

A

true

31
Q

What is a high energy source for muscles?

A

creatine phosphate (kidney biomarker)

32
Q

T/F: creatine phosphate + phosph. acid = creatinine
Creatine + water = creatinine

A

False: Creatine phosphate - phosph. acid = creatinine
Creatine - water = creatinine

33
Q

What is creatine kinase used for?

A

Used to create energy

34
Q

What bodily locations do the following acronyms stand for?
CKBB
CKMB
CKMM

A

CKBB - brain
CKMB - cardiac
CKMM - skeletal muscle

35
Q

T/F: creatinine is released into circulation at a steady rate proportional to muscle mass, daily excretion is stable

A

True, its also good to eval renal function

36
Q

T/F: BUN is influenced by diet

A

true

37
Q

T/F: elevated creatinine is not found in abnormal renal function

A

False: it is found in abnormal renal function

38
Q

What does GFR do?

A

estimates renal function

39
Q

What is creatinine clearance?

A

amount of creatinine eliminated from blood by kidney per unit of time (usually 24hr)

40
Q

T/F: as plasma creatinine goes up, GFR goes down

A

true

41
Q

What is the equation for creatinine clearance?

A

urine creatinine/plasma creatinine x urine vol (ml)/time (min) x 1.73/BSA

42
Q

What is the Jaffe reaction? Kinetic Jaffe?

A

most frequently used for creatinine, turns red orange on chromogen
Kinetic jaffe - rate of change in absorbance measured

43
Q

What does the BUN to creatinine ratio do?

A

explains where the azotemia is coming from, both BUN and creatinine filtered through glomeruli, BUN is reabsorbed

44
Q

What are the BUN to Creatinine rations for:
Pre renal BUN:
Post renal BUN:
Renal BUN:

A

pre-renal >20:1
post renal (BUN brings ratio down) 10-20:1
Renal (BUN not absorbed, damaged) <10:1

45
Q

What is the ref range for BUN and Creatinine?

A

BUN: 7-20 mg/dL
Creat: 0.7-1.2 mg/dL

46
Q

If your BUN was 26, and creatine was 4.2, what is your B/C ratio? Pre-renal, renal or post renal?

A

B/C ratio: 6.19
renal

47
Q

What is the biproduct of purine catabolism?

A

uric acid (pruine –> MSU –> uric acid)
most mammals degrade this to allantonic (idk what this word it tbh)

48
Q

T/F: 70% uric acid is excreted in kidneys, the remaining 30% by GIT (98% reabsorbed by PCT)

A

true, i dont remember what the acronyms stand for

49
Q

What % of uric acid is filtered out?

A

6-12%

50
Q

if the concentration of uric acid is >6.8mg/dL what does this mean?

A

urate crystals are present in tissues, very painful

51
Q

Briefly describe gout, population, Uric acid levels..etc

A

mostly in men 30-50yrs
UA >6.0mg/dL
inflammation of the joints, high risk of renal calculi

52
Q

T/F: hyperuricemia usually is asymptomatic, but leads to gout

A

False: it is asymptomatic but usually does not lead to gout, but if you have gout, you have it (25-30%)

53
Q

Disease correlations: increased catabolism leads to chemo for leukemia and myeloma, what is used for treatment?

A

allopurinal inhibits xanthine oxolose

54
Q

T/F: chronic renal diease has an elevation of uric acid because of bad filtration

A

true

55
Q

What is Lesch-nyhan syndrome? What is the deficient enzyme?

A

self mutilating behaviors, biting tongue/hand banging
Def Enzyme in synthesis of purines (too much uric acid) usually younger people

56
Q

What is Hypouricemia?

A

secondary to severe liver diease, deficient in renal tubular reabsorption
too much ALLPURINOL

57
Q

What is fanconi syndrome?

A

deficient in reabsorption, everything is excreted, its a wasting disease

58
Q

What is the primary method for analytical methods in fanconi syndrome?

A

uses enzyme uricase to convert uric acid to allantonin

59
Q

Briefly describe ammonia

A

deanimation of amino acids, readily diffuses across the membrane, free ammonia is toxic, but low presence is normal

60
Q

T/F: ammonia has special collection requirements including hot chain

A

False, it requires cold chains and is not stable (lasts about 30 min) use quickly!

61
Q

What is Reye’s syndrome?

A

found in children, often preceded by viral infection/brain liver
fatty liver w minimal inflammation

62
Q

T/F direct ISE uses a change in pH of solution and when NADH –> NAD+

A

true

Clinical Chemistry (21 decks)

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