NONPROTEIN NITROGENOUS COMPOUNDS

Question 1

Give me the 4 NPNS

Answer 1

1. Urea
2. Creatine
3. Uric acid
4. Ammonia

Question 2

________ is an amino acid

Answer 2

Creatine

Question 3

Chemical name of creatine

Answer 3

Methyl guanidine-acetic acid

Question 4

__________ can be converted into the phosphocreatine

Answer 4

creatine

Question 5

___________ is storage mechanism muscle cells use to regenerate the cells primary source of energy ATP

Answer 5

Phosphocreatine

Question 6

ATP meaning

Answer 6

Adenosine triphosphate

Question 7

__________ is the waste product formed muscle from high energy storage compound, creatine phosphate (phosphocreatine)

Answer 7

Creatinine

Question 8

Creatine synthesized primarily in the liver from _______, _______, and _______

Answer 8

arginine, glycine, methionine
AGM

Question 9

transported tissues and is converted to phosphocreatine which serves as __________

Answer 9

Creatine - high energy source

Question 10

It is an endogenous substance with a MW of 113 Da

Answer 10

Creatinine

Question 11

It is a waste product of muscle metabolism

Answer 11

Creatinine

Question 12

Released into the circulation at a relative constant rate in proportional to an individuals muscle mass

Answer 12

Creatinine

Question 13

what are the disease correlated with creatine

Answer 13

Muscle disease

Muscular dystrophy
Poliomyelitis
Hyperthyroidism
Trauma

Question 14

What are the disease correlated with creatinine

Answer 14

abnormal renal function

Question 15

Give me the advantages of GFT

Answer 15

Endogenous substance with constant rate of production
Not bound to plasma protein
Not reabsorbed by the tubules
Only a small amount is secreted by the tubules

Question 16

Give me the disadvantages of GFT

Answer 16

Depends mainly on muscle mass
Quantity of meat ingestion can substantially influence the total daily production
Method is subjected to many interferences

Question 17

Why we need to measure the creatinine

Answer 17

To determine the sufficiency of kidney function and the severity of kidney damage

To monitor progression of kidney disease

Question 18

What happens to creatinine level in both blood and urine if the patient has renal function

Answer 18

decrease in urine
and increase in blood

Question 19

Remedy: increased creatinine

Answer 19

dialysis or kidney transplant

Question 20

Creatinine: below normal range =

Answer 20

muscle
dystrophy

Question 21

is an important diagnostic tool to
assess renal function

Answer 21

serum creatinine level

Question 22

Most widely used marker for Glomerular Filtration Tests
(GFTs)

Answer 22

CREATININE

Question 23

Measures how well creatinine is removed from blood by
kidneys (which reflects glomerular filtration rate (GFR))

Answer 23

Creatinine Clearance Test

Question 24

Ucr

Answer 24

Urine Creatinine

Question 25

Vur

Answer 25

Urine Volume

Question 26

Pcr

Answer 26

- Plasma Creatinine

Question 27

1440 mins/24 hrs -

Answer 27

Constant number

Question 28

1.73 -

Answer 28

constant number

Question 29

A

Answer 29

Area or service of area

Question 30

Creatinine reacts with __________ (trinitrophenol) in alkaline solution to form a ___________ chromogen

Answer 30

picric acid red-orange

Question 31

Creatinine reacts with picric acid (trinitrophenol) in alkaline solution to form a red-orange chromogen

Answer 31

DIRECT JAFFE REACTION (1886)

Question 32

PFF + Aluminum Magnesium Silicate

Answer 32

Fuller’s Earth

Question 33

PFF + Sodium Aluminum Silicate ■ Eluted and reacted with alkaline picrate

Answer 33

Method of Hare (Addition to Lloyd’s Reagent)

Question 34

______ is mixed with alkaline picrate and the rate of change in absorbance is measured

Answer 34

Serum

Question 35

interferences of folin-wu method

Answer 35

Acetoacetate, Acetone, Ascorbate, Glucose, Pyruvate

Question 36

kinetic jaffe reaction

Answer 36

alpha-ketoacids and cephalosporins

Question 37

More than one enzyme used in reaction process to quantitate creatinine.

Answer 37

COUPLED-ENZYMATIC METHOD

Question 38

2 most commonly used enzymatic production:

Answer 38

Creatininase-CK Method Creatininase-Hydrogen Peroxide Method

Question 39

measurement of creatine from reduced form to oxidized form at 340nm. The reaction happens only if an oxidized form of NAD is achieved

Answer 39

● Creatininase-CK Method

Question 40

Has a MW of approx. 11,800 Daltons

Answer 40

BETA-2-MICROGLOBULIN

Question 41

● Has a MW of approx. 13,000 Da

Answer 41

CYSTATIN C

Question 42

Polymer of fructose ● Extremely stable substance that is not reabsorbed or secreted by the tubules ● Not a normal body constituent ● Not routinely done because necessary for continuous IV infusion ● Ideally reference method but not usually done due to its laborious procedure

Answer 42

INULIN

Question 43

● Also known as prostaglandin D2 synthase

Answer 43

BETA TRACE PROTEIN

Question 44

● 2-(alpha-mannopyranosyl)-L-tryptophan (MPT)

Answer 44

TRYPTOPHAN GLYCOCONJUGATE

Question 45

USE OF RADIOISOTOPES

Answer 45

● ex. technetium diethylenetriaminepentaacetic

Question 46

REFERENCE STANDARD

Answer 46

Isotope dilution-mass spectrometry ● Requires a lot of sample (large sample of pre-incubation) ● sample used: plasma or serum (actual set-up: serum only)

Question 47

Creatinine in serum or urine is stable for at least __________

Answer 47

at least 7 days at 4 oC

Question 48

Urine specimens should be refrigerated or frozen if longer than ___________

Answer 48

4 days

Question 49

avoid starving

Answer 49

● Alpha-keto acids/ketones

Question 50

avoid because it can potentially falsely increase creatinine

Answer 50

Cephalosporins, Dopamine, Lidocaine

Question 51

False Decrease

Answer 51

Hemoglobin and Bilirubin

Question 52

Decreased in kinetic methods

Answer 52

Uric Acid

Question 53

interfere Peroxidase

Answer 53

Ascorbic acid

Question 54

Inhibitor of cysteine proteinase ● Produced by all nucleated cells at constant rate ● Freely filtered and completely reabsorbed in the PCT (normally not seen in urine) ● Plasma concentration appear to be unaffected by gender, race, age, and muscle mass ● Measurements are difficult and expensive - NOT routinely used

Answer 54

cystatin C

Question 55

Dissociates from human leukocyte antigens at a constant rate ● Rapidly removed from the plasma by glomerular filtration then reabsorbed completely by the PCT ● Not reliable in patients with immunologic conditions > multiple myeloma & lymphoma (increased production of WBC which has nucleus) ● found in nucleated cells

Answer 55

Beta2-microglobulin

Question 56

PFF meaning

Answer 56

Peptide fragment fingerprinting

Question 57

Addition to Lloyd’s Reagent

Answer 57

Methods of Hare

Question 58

Eluted and reacted with alkaline picrate

Answer 58

Methods of hare

Question 59

IBW

Answer 59

Ideal Body weight

Question 60

SCR

Answer 60

Serum creatinine concentration

Question 61

_________ produce erroneous results

Answer 61

Lipemic samples