Non-Protein Nitrogens (Urea, Uric Acid, Creatinine & Ammonia)

Question 1

4 types of Non-Protein Nitrogens

Answer 1

• Urea
• Creatinine
• Uric Acid
• Ammonia

Question 2

NPN with the HIGHEST concentration in the blood

Answer 2

Urea

Question 3

Major excretory product of protein metabolism.

Answer 3

Urea

Question 4

Ammonia is bound with Carbon Dioxide to form

Answer 4

Carbamoyl Phosphate

Question 5

This enzymatically catalyzed process is also an important pathway to reduce the levels of ammonia in the blood.

Answer 5

Urea Cycle

Question 6

Urea is commonly termed as?

Since?

Answer 6

Blood Urea Nitrogen (BUN) since urea was based on the measurement of your Nitrogen

Question 7

• Most of the urea in the glomerular filtrate is excreted in the ____________
• Some urea is reabsorbed by ________________ during passage of the filtrate through the renal tubules.

Answer 7

• Urine
• Passive Diffusion

Question 8

Formula for Urea

Answer 8

BUN x 2.14

Question 9

Protein will undergo ___________ to get amino acids.

Answer 9

Proteolysis

Question 10

Amino acids will undergo _____________ or oxidative deamination to get ammonia

Answer 10

Transamination

Question 11

• Transfer of your amino group
• Removal of your amino group

Answer 11

• Transamination
• Oxidative deamination

Question 12

Urea is formed in the liver, especially in the __________

Answer 12

Hepatocytes

Question 13

• A portion of your hepatocytes where the forming of Urea BEGINS
• A portion of your hepatocytes where the forming of Urea ENDS

Answer 13

• Mitochondria
• Cytoplasm

Question 14

CO2 and NH3 is converted into

Answer 14

Carbamoyl Phosphate

Question 15

The enzyme to catalyze carbamoyl phosphate is?

Answer 15

Carbamoyl Phosphate synthetase 1

Question 16

Carbamoyl Phosphate will combine with ___________ to form ______________

Answer 16

• ornithine
• citrulline

Question 17

the enzyme to catalyze Citrulline is

Answer 17

Ornithine transcarbamylase

Question 18

another importance of the Urea Cycle is to prevent the accumulation of _________

Answer 18

Ammonia

Question 19

2 Areas where your Urea can be excreted

Answer 19

• Kidneys
• GI tract (Gastro Intestinal)

Question 20

90%, is present and can be detected in urine

Answer 20

Kidneys

Question 21

10%, through the action of the bacteria, urea will be converted back to ammonia which then be reabsorbed and recycled in the liver

Answer 21

GI tract

Question 22

Concentration of urea in the blood is affected by the:

Answer 22

• Protein content of the diet
• Rate of protein metabolism
• Renal function and Perfusion

Question 23

Passage of your fluid through your blood vessels to an organ or tissue.

Answer 23

Perfusion

Question 24

2 types of Urea Disorders

Answer 24

• Azotemia
• Uremia

Question 25

Elevation of urea in the blood

Answer 25

Azotemia

Question 26

Azotemia + renal failure

Answer 26

Uremia

Question 27

3 causes of Azotemia in the blood:

Answer 27

- Prerenal - Renal - Postrenal

Question 28

Occurs as a result of reduced renal blood flow

Answer 28

Prerenal

Question 29

Occurs as a result of decreased renal function

Answer 29

Renal

Question 30

Occurs due to obstruction of urine flow anywhere in the urinary tract by renal calculi, tumors of the bladder or prostate, or severe infection.

Answer 30

Postrenal

Question 31

5 examples of Prerenal Azotemia

Answer 31

- Congestive Heart failure - Shock, hemorrhage - Dehydration - Increased protein catabolism - high-protein diet

Question 32

2 examples of Renal Azotemia

Answer 32

- Acute and chronic renal failure - Renal disease, glomerular nephritis and tubular necrosis

Question 33

Inflammation in your glomerulus; no proper filtration of urea

Answer 33

Nephritis

Question 34

Death in body tissue; tubules cannot reabsorb properly

Answer 34

Necrosis

Question 35

1 Example of a Postrenal Azotemia

Answer 35

Urinary tract obstruction

Question 36

4 causes of decreased concentration of Urea

Answer 36

- Low protein intake - Severe vomiting and diarrhea - Liver disease - Pregnancy (due to hormonal changes)

Question 37

Normal BUN/Creatinine ratio

Answer 37

10:1 to 20:1

Question 38

Formed from creatine and creatine phosphate in the muscle; Released to the plasma in proportion to muscle mass

Answer 38

Creatinine

Question 39

Creatinine is synthesized by 3 amino acids which are:

Answer 39

- Arginine - Glycine - Methionine

Question 40

The 3 Amino acids will undergo transamination forming:

Answer 40

Guanidinoacetic acid

Question 41

The transamination between the 3 amino acids and guanidinoacetic acid is catalyzed by the enzyme:

Answer 41

L-Arginine:glycine amidinotransferase (AGAT)

Question 42

Creatine with the help of creatine kinase will form phosphocreatine aka ____________

Answer 42

Creatine Phosphate

Question 43

Creatinine is a byproduct of ________ and ___________

Answer 43

Creatine & Phosphocreatine

Question 44

3 Clinical applications of Creatinine measurement

Answer 44

- Determine the sufficiency of kidney function - Determine the severity of kidney damage - Monitor the progression of kidney disease

Question 45

4 reasons why Creatinine is a nice measurement.

Answer 45

- it is filtered by the glomerulus - it is neither reabsorbed nor secreted - relatively constant in the plasma/blood - not affected by anything unlike urea that is affected by diet

Question 46

3 Muscle diseases on Creatinine:

Answer 46

- Muscular dystrophy - Poliomyelitis - Trauma

Question 47

It is the progressive weakness and loss of muscle mass

Answer 47

Muscular dystrophy

Question 48

It affects our spinal cord that can cause paralysis

Answer 48

Poliomyelitis

Question 49

Product of the catabolism of PURINE NUCLEIC ACIDS (Guanine & Adenosine)

Answer 49

Uric Acid

Question 50

Relatively insoluble in plasma and in high concentrations, can be deposited in the joints and tissue causing pain and inflammation

Answer 50

Uric Acid

Question 51

Example of an inflammation caused by Uric Acid

Answer 51

Gouty Arthritis

Question 52

5 causes in increased concentration of Uric Acid

Answer 52

- Gout - Treatment of myeloproliferative disease with cytotoxic drugs - Hemolytic and proliferative processes - Purine-rich diet - Increased tissue catabolism and starvation

Question 53

8 diseases caused by Enzyme deficiencies on uric acid:

Answer 53

- Lesch-Nyhan syndrome - Phosphoribosyltransferase synthetase deficiency - Glycogen storage disease type-1 - Fructose intolerance - Toxemia in pregnancy - Lactic acidosis - Chronic renal disease - Drugs and poisons

Question 54

4 causes in decreased concentration of Uric Acid

Answer 54

- Liver disease - Defective tubular reabsorption - Chemotherapy with Azathioprine - Overtreatment with allopurinol

Question 55

Pain and inflammation of the joints due to precipitation of monosodium urates

Answer 55

Gout

Question 56

Produced in the deamination of amino acids during protein metabolism

Answer 56

Ammonia

Question 57

Consumed by the parenchymal cells of the liver in the production of urea.

Answer 57

Ammonia

Question 58

3 clinical application of ammonia measurement

Answer 58

- Hepatic failure - Reye's syndrome - Inherited defects in the urea cycle

Question 59

Disease that is common in children; Acute metabolic disorder of the liver; A child's blood sugar would typically drop, while the level of ammonia and acidity in The body would increase; Liver may swell and may develop fatty deposits

Answer 59

Reye's syndrome

Question 60

Cerebral Edema; Intracranial HTN; Neuronal Dysfunction

Answer 60

Hepatic Encephalopathy

Question 61

The result of overproduction of uric acid and may be exacerbated by a purine-rich diet, drugs, and alcohol

Answer 61

Hyperuricemia

Question 62

Less common than hyperuricemia and is usually secondary to severe liver disease or defective tubular reabsorption.

Answer 62

Hypouricemia