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Clinical Chemistry 1 > NPN > Flashcards

NPN Flashcards

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1
Q

Most abundant NPN in the blood

A

Urea

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2
Q

Take Note!

A

For urea analysis, avoid using sodium citrate and sodium fluoride additives for plasma

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3
Q

Urea conversion factor

A

0.357

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4
Q

BUN to urea conversion factor

A

2.14

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5
Q

Reference method for urea analysis

A

IDMS

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6
Q

Fearon Reaction produces what color by diacetyl monoxime?

A

Pink

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7
Q

Fearon Reaction produces blue color by?

A

Alkaline (hypochlorite or phenol)

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8
Q

Stage of Increased Concentration

Congestive Heart Failure
Shock, hemorrhage
Increased protein metabolism
High protein diet

A

Pre-Renal

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9
Q

Stage of Increased Concentration

Acute and chronic renal disease

A

Renal

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10
Q

Stage of Increased Concentration

Urinary Tract Obstruction

A

Post-renal

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11
Q

Decreased Concentration of Urea happens during

A

Low protein intake
Severe vomiting and diarrhea
Liver disease
Pregnancy

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12
Q

Urea to Creatinine Ratio

A

10:1 or 20:1

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13
Q

Increased urea, normal creatinine

A

Pre-Renal

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14
Q

Increased creatinine

A

Renal or Post-Renal

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15
Q

Decreased both

A

Post-Renal

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16
Q

Second most abundant NPN in the blood

A

Uric Acid

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17
Q

Take Note for Uric Acid!

A

Avoid icteric samples (peroxidases)

Do not use EDTA and sodium fluoride
anticoagulants/additives (inhibits uricase)

Use heparin for plasma samples (preferably red top)

Bilirubin and ascorbic acid destroys peroxidase enzyme

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18
Q

Conversion Factor for Uric Acid

A

0.0595

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19
Q

Uric acid + phosphotungstic acid – allantoin +
tungsten blue

A

Caraway Method

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20
Q

Decreased Concentration of Uric Acid occurs during

A

Liver disease
Defective tubular reabsorption (Fanconi)
Chemotherapy (azathioprine/6-mercaptopurine)
Overtreatment with allopurinol

21
Q

Product of muscle contraction and energy (ATP) usage

A

Creatinine / Creatine

22
Q

Amino Acid Components of Creatinine

A

Arginine
Glycine
Methionine

23
Q

Conversion Factor of Creatinine

A

88.4

24
Q

Take Note for Creatinine!

A

Ascorbic acid, glucose and alpha ketoacids may affect Jaffe reaction (creatinine)

25
Q

Drug Interferences for Jaffe

A

Cephalosporin
Dopamine

26
Q

Drug Interferences for Enzymatic

A

Lidocaine
Dopamine

27
Q

Creatinine + Picric acid; Mixture of Reagent A and B – alkaline picrate; red-orange complex
(red tautomer)

A

Jaffe Method

28
Q

Used to isolate creatinine from the sample

A

Fuller’s earth/Aluminum magnesium silicate

Lloyd’s reagent/sodium aluminum silicate

29
Q

Creatininase-Hydrogen Peroxide

Creatinine is converted into creatine via?

A

Creatininase

30
Q

Creatininase-Hydrogen Peroxide

Creatine is converted into sarcosine and urea via?

A

Creatine amidinohydrolase

31
Q

Creatininase-Hydrogen Peroxide

Sarcosine is converted into glycine, formaldehyde and hydrogen peroxide via?

A

Sarcosine oxidase

32
Q

Creatininase-Creatine Kinase

Creatine is converted into creatine phosphate and ADP via?

A

Creatine kinase

33
Q

Creatininase-Creatine Kinase

ADP and Phosphoenolpyruvate is converted into pyruvate and ATP via?

A

Pyruvate kinase

34
Q

Creatininase-Creatine Kinase

Pyruvate and NADH is converted into Lactate and NAD via?

A

Lactate Dehydrogenase

35
Q

Product of protein metabolism → converted
immediately to urea by the liver

A

Ammonia

36
Q

Take Note for Ammonia!

A

Used EDTA or Heparin anticoagulants

Extracted specimen should be placed on ice container immediately

Plasma for ammonia analysis is stable at -20oC for several days

37
Q

Ammonia MOA: Microdiffusion chamber; Blood gas determination

A

Conway

38
Q

Ammonia MOA: Glutamate dehydrogenase (urease method) – decreasing absorbance (NADH to NAD)

A

Enzymatic Method

39
Q

Ammonia MOA: Bromphenol blue (intense blue in alkaline environment of ammonia)

A

Dry Slide Method

40
Q

Creatinine is endogenous, synthesized by the body at constant rate (muscle mass), and majority is cleared by renal filtration; It is the relationship between urine and serum
creatinine

A

Creatinine Clearance

41
Q

Low molecular weight protein produced by all tissues; Filtered and metabolized by the proximal convoluted tubules at fixed rate

A

Cystatin C

42
Q

Assess renal transplant rejection; Also increased in myeloproliferative and
lymphoproliferative disorders

A

Beta-2-Microglobulin

43
Q

May causes acute renal failure in patients with rhabdomyolysis

A

Myoglobin

44
Q

Presence of protein in the urine

A

Urinalysis and Microalbuminuria

45
Q

Protein produced by neutrophils and epithelial cells; Early marker of acute kidney injury; Upregulation of genes in renal ischemia, tubule injury and nephrotoxicity

A

Neutrophil Gelatinase-Associated Lipocalin
(NGAL)

46
Q

Take Note for Cystatin C

A

Cystatin C – high within-subject variation (early
detection)

Creatinine – high between subject variation (for monitoring purposes)

47
Q

Measured by urine or blood; Secretory ability – kidney must excrete since it is foreign substance

A

Phensulfonthalein Test

48
Q

Concentrating ability of renal tubules; First morning – high SG, high concentration; Low SG, low concentration

A

Urine Specific Gravity

Clinical Chemistry 1 (5 decks)

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