NPNs Flashcards

1
Q

NPNs are traditionally used to monitor ________________

A

Renal Function

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2
Q

NPN Concentration

A

Urea > AA > Uric acid > Creatinine > Creatinine > Ammonia

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3
Q

Major excretory product of PROTEIN CATABOLISM

A

Urea

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4
Q

Major ORGANIC solute in Urine

A

Urea

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5
Q

_____ of Urea is reabsorbed by passive in renal tubules

A

40%

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6
Q

First to increase in Renal Disease

A

Urea

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7
Q

Urea is used to evaluate:

  1. ________________
  2. ________________
  3. ________________
A
  1. Renal Function
  2. Nitrogen Intake
  3. Hydration
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8
Q

Increase BUN: _________

Decrease BUN: _________

A

Increase BUN: Kidney Disease
*not excreted by Kidneys - Dehydration

Decrease BUN: Liver Disease
*synthesized in liver; do not produce

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9
Q

___________ refers to Increased NPNs or BUN (Laboratory Description) with no signs and symptoms

A

Azotemia

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10
Q

Refers to increased NPNs with SYMPTOMS

A

Uremia/Uremic Syndrome

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11
Q

Three Types of Azotemia

Pre-Renal: ______________ - Heart Problems
Renal: ____________ - Kidney Diseases
Post-Renal: Obstructed urine flow - ___________

A

Pre-Renal: Reduced blood flow - Heart Problems
Renal: Reduced Kidney function - Kidney Diseases
Post-Renal: Obstructed Urine Flow - Kidney Stones & Tumor

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12
Q

Analytical methods report urea in terms of ___________ concentration rather than urea concentration

A

Nitrogen concentration

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13
Q

Fearon Reaction

A

Diacetyl Monoxime Method

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14
Q

End Product: Fearon Reaction

A

Yellow Diazine Derivative

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15
Q

Most common method of Urea Determination

A

Couple Enzymatic Method

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16
Q

Coupled Enzymatic Method
Initial Step: ___________ - converts urea to ammonia
Secondary Reaction: ____________ - quantifies ammonium ions

A

1st reaction: Urease Method

2nd reaction: Glutamate Dehydrogenase

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17
Q

End product - Muscle Metabolism

A

Creatinine

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18
Q

Creatinine

A

Most common to monitor renal function

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19
Q

Creatinine is DIRECTLY proportional to ________, but INVERSE to _______________-

A

Direct Proportional - Muscle Mass

Inverse Proportional - Glomerular Filtration Rate

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20
Q

In Creatinine is increased: ____________

A

Low GFR (>50%)

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21
Q

Most Frequently used Methods to measure creatinine

A

Jaffe Reaction

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22
Q

Jaffe Reaction

A

Creatinine reacts with PICRIC ACID in an ALKALI Solution to form a RED-ORANGE CHROMOGEN

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23
Q

Adsorbent used to prevent interferences in Creatinine measurement

A

Fuller’s Earth

Lloyd’s Reagent

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24
Q

Fuller’s Earth: ______________

Lloyd’s Reagent: ____________

A

Fuller’s Earth: Aluminum Magnesium Silicate

Lloyd’s Reagent: Sodium Aluminum Silicate

25
Q

Measures between two time points using serum mixed with alkaline picrate

A

Kinetic Jaffe

26
Q

Coupled Enzymatic Method in Creatinine Determination

A

Creatinase-Hydrogen Peroxide method

27
Q

Anticoagulants that Inhibits Urease

A

Citrate

Fluoride

28
Q

Major End product of PURINE METABOLISM

A

Uric Acid

29
Q

Most abundant form of Uric acid in plasma

A

Monosodium Urate

30
Q

Value for Crystallization deposited in the joints & tissues

A

> 6.8 mg/dl

31
Q

Clinical Significance Uric Acid

A

Gout
Increased Nuclear Metabolism (Cancer)
Renal dysfunction - Renal stones

32
Q

Inflammation in the Joints caused by precipitation of SODIUM URATE

A

Gout

33
Q

Gout most common in _______ at age _________

A

Most common in males

Age: 30-50 years

34
Q

Refers to Increased Uric Acid

A

Hyperuricemia

35
Q

Chemical Method - Uric Acid

A

Caraway Method - Phosphotungstic Reduction Test

36
Q

Treatment for chemotherapeutic patients which inhibit xanthine oxidase

A

Allopurinol

37
Q

An X-linked disorder due to complete deficiency of HGPT

A

Lesch-Nyahan Syndrome

38
Q

HGPT

A

Hypoxanthine -guanine phosphoribosyltransferase

39
Q

End color - Caraway Method

A

Blue

40
Q

Parameters for Kidney Function

A

BUN
BUA
Creatinine

41
Q

Can be used as a lone parameter for Kidney Function

A

Creatinine

42
Q

Enzyme used in converting uric acid to allotoin

A

Uricase

43
Q

End Color - Coupled Enzymatic Method for BUA

A

Red

44
Q

Free Ammonia is toxic to the ______ and ______

A

Neurotoxic

Hepatotoxic

45
Q

Principal source of ammonia

A

Glutamine

46
Q

Chemical Method - Ammonia

A

Conway Method

47
Q

Conway method measures ammonia through ____________

A

Back Titration

48
Q

Measurement of ammonia

A

Nesslerization

Berthelot Reaction

49
Q

Berthelot “indophenol” reaction uses ______________

A

hydrochlorite - sodium nitroprusside

50
Q

End Color - Berthelot reaction

A

Blue Color

51
Q

NPN substance that depend on Liver Function

A

Ammonia

52
Q

Most common method for Ammonia Determination

A

Glutamate Dehydrogenase

53
Q

Clinical Significance of Ammonia

A

Liver Disease
Reyes Syndrome
Hepatic Coma

54
Q

Can Increase Ammonia Concentration

A
Ammonium salts
Asparaginase
Barbiturates
Diuretics
Ethanol
Hyperalimentation
Narcotic Analgesics
55
Q

Can Decrease Ammonia Concentration

A

L. acidophilus
Lactose
Levodopa
Diphenhydramine

56
Q

Specimen collection - Ammonia

A

WB is not used
On ICE, ASAP!
Centrifuge - 0-4C for 20 mins
Preferred Anticoagulant - EDTA

57
Q

Inhibits Uricase

A

EDTA

Flouride

58
Q

Three Basic Renal Processes

A

Filtration
Reabsorption
Secretion

59
Q

Excretion Formula

A

Filtration - Reabsorption + Secretion