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CC lab > NPNs > Flashcards

NPNs Flashcards

1
Q

urea is the product of what

A

product of protein and amino acid catabolism

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2
Q

what is the major excretory product of protein metabolism

A

urea

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3
Q

urea are formed from ___ and ___ generated during protein catabloism

A

amino groups, free ammonia

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4
Q

what is the major nitrogen that contains the metabolic product of protein catabolism

A

urea

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5
Q

catabolism reactions that form urea are carried out by what

A

hepatic enzymes in the liver

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6
Q

urea is excreted via

A

the kidneys, can also be through skin and GIT

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7
Q

clinical applications of urea

A

evaluate renal function
assess hydration status
determine nitrogen balance
aid in diagnosis of renal disease
verify adequacy of dialysis

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8
Q

increased urea indicates what

A

kidneys are not working properly

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9
Q

increase protein intake may elevate

A

urea

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10
Q

urea enzymatic method

A

urease reaction
coupled method
second coupled method

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11
Q

end product of urease reaction

A

2NH4 + CO3

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12
Q

dry chemistry systems are used in

A

automated systems
multilayer film reagents
dry reagent strips

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13
Q

a semipermeable membrane separates the first stage of the reaction involving urease, and ammonia is detected by using a simple pH indicator reaction

A

dry chemistry systems

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14
Q

dry chemistry systems formula (urea)

A

ammonia + pH indicator = color change

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15
Q

this urea determination is specific and rapid

A

conductimetric

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16
Q

in conductimetric, conversion of — to — and — results in increased conductivity (urea)

A

unionized urea to NH4 and CO3

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17
Q

what is the test for spectrophotometric method in urea

A

Berthelot reaction

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18
Q

end product of Berthelot reaction (urea) that will be measured by the spectrophotometer

A

indophenol

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19
Q

what are the three enzymatic methods for urea

A

urease reaction
coupled method
second coupled method

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20
Q

what enzymes are used in coupled method (urea)

A

urease
glutamate dehydrogenase

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21
Q

what is measured for coupled method (urea enzymatic method)

A

rate of disappearance of nicotinamide adenine dinucleotide

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22
Q

what nm is coupled method measured

A

340nm

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23
Q

reference method for urea determination

A

coupled method

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24
Q

end product of second coupled method

A

quinone-monoamine dye

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25
Q

chemical method for urea

A

Fearon reaction

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26
Q

relationship of color intensity and quantity of urea

A

directly proportional

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27
Q

what nm is Fearon reaction read

A

540nm

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28
Q

what is added to urea in Fearon reaction

A

diacetyl monoxime

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29
Q

term for increased urea in blood

A

azotemia

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30
Q

3 types of azotemia and its causes

A

PRE-RENAL (problems in circulation
-heart problems (CHF)
-decreased renal blood flow (hypovolemia)
-increased protein
-dehydration
-shock, fever, hemorrhage
RENAL
-kidney disease
-glomerulonephritis
-tubular necrosis
-nephropathy
-uremia (urea in blood with renal failure)
POST-RENAL
-urinary tract obstruction: urea—>blood
-kidney stone
-UT and prostate tumors
-infections

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31
Q

creatinine is symthesized in

A

the liver, kidneys, and pancreas

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32
Q

creatinine is synthesized from

A

arginine, glycine, and methionine

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33
Q

transamidation forms (creatinine)

A

guanidino acetic acid

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34
Q

methylation of guanidino acetic acid is via the

A

activity of S-adenosyl methionine

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35
Q

creatine is transported to — and will be converted to —

A

muscles, creatine phosphate (phosphocreatine)

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36
Q

creatine phosphate loses — and creatine loses — to form —

A

phosphoric acid, water, creatinine

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37
Q

it is the cyclic anhydride of creatine

A

creatinine

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38
Q

what is the final product of decomposition of phosphocreatine

A

creatinine

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39
Q

what is the final product of decomposition of proteins

A

urea

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40
Q

creatinine is released into the circulation at a — rate and is proportional to the —

A

relatively constant rate, individual’s muscle mass

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41
Q

creatinine is — by the glomerulus and small amounts is secreted by the PCT

A

freely filtered

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42
Q

what substance tested is preferred for renal function and reason behind

A

creatinine because it is excreted fully unlike urea that some are still reabsorbed

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43
Q

this is used to measure the completeness of 24-hour urine collection

A

creatinine

44
Q

clinical applications of creatinine

A

assess kidney function
assess severity and progression of kidney damage
measure the completeness of 24hr urine collection
effectiveness of dialysis

45
Q

list of chemical methods for creatinine

A

Jaffe reaction
Kinetic assays (Kinetic Jaffe method)
Jaffe with adsorbent

46
Q

Jaffe reaction is based on the activity of creatinine when reacted with an —

A

alkaline picrate

47
Q

temperature required for Jaffe reaction

A

25C

48
Q

wavelength for Jaffe reaction

A

485nm or 490-500nm

49
Q

this method for creatinine is non-specific

A

Jaffe reaction

50
Q

this chemical method for creatinine has an improved specificity and duration

A

kinetic assays (Kinetic Jaffe method)

51
Q

kinetic assays (kinetic Jaffe method) is used in

A

automated methods
wet chemistry analytical systems

52
Q

this test gives more accurate results when creatinine in a protein-free filtrate is adsorbed into — and —

A

Jaffe with adsorbent
Fuller’s earth reagent
Lloyd’s reagent

53
Q

composition of Fuller’s earth reagent and Lloyd’s reagent

A

aluminum magnesium silicate
sodium aluminum silicate

54
Q

in Jaffe adsorbent method, the mixture is eluted and reacted with —

A

alkaline picrate

55
Q

true or false: Jaffe with adsorbent method is rapid and specific

A

false, it is time consuming but is specific because it is an enzymatic mehtod

56
Q

what are the enzymatic methods for creatinine

A

creatininase (creatine amidohydrolase)
creatininase and creatinase (creatine amidinohydrolase)
creatine deaminase (creatine imino-hydrolase)

57
Q

other methods for creatinine

A

high performance liquid chromatography
isotope dilution mass spectrophotometry

58
Q

required specimen for urea and creatinine

A

serum, plasma, urine

59
Q

true or false: fasting specimen is needed for urea and creatinine

A

false, it is not required since these are already waste products

60
Q

what specimens should be avoided in testing creatinine

A

hemolyzed specimen, icteric samples, lipemic samples

61
Q

a measure of the amount of creatinine eliminated from the blood by the kidneys

A

creatinine clearance

62
Q

define glomerular filtration rate

A

volume of plasma filtered by the glomerulus per unit of time

63
Q

most common error in creatinine clearance

A

incorrect timing

64
Q

these causes increased creatinine clearance

A

high cardiac output
pregnancy
burns
carbon monoxide poisoning

65
Q

these causes decreased creatinine clearance

A

impaired kidney function
dehydration
hemorrhage
CHF

66
Q

this method for creatinine is prone to interferences (what are these interferences and how to minimize)

A

creatininase and creatinase (creatine amidinohydrolase)
-bilirubin: +potassium ferricyanide or bilirubin oxidase
-ascorbic acid: +ascorbic oxidase

67
Q

this creatinine method is used in point of care testing

A

creatininase and creatinase (creatine amidinohydrolase)

68
Q

uric acid is the result of

A

purine degredation

68
Q

it is the ionized form of uric acid

A

urates

68
Q

purine nucleotides are synthesized and degraded in all tissues but urate is produced only in tissues with — which can be found primarily in the —

A

xanthine oxidase in liver and small intestines

69
Q

true or false: urates are nearly or completely unbound to a plasma protein

A

true

69
Q

urates predominates in what samples

A

plasma, extracellular fluid, synovial fluid

69
Q

this percentage of urates exists as — at pH —

A

98% exists as monosodium urate at pH 7.4

70
Q

production of uric acid is dependent on the

A

purine content of diet
rate of purine biosynthesis, degredation, and salvage

71
Q

this amount of uric acid is excreted by the kidneys, and the rest of it is excreted via the —

A

2/3-3/4 excreted by kidney, the rest via the GIT

72
Q

increased uric acid causes what diseases

A

gout arthritis, kidney stones, formation of crystals

73
Q

in general, what foods causes high uric acid

A

foods that have more cells (meat, etc)
more cells=more purines

74
Q

urates are filtered by the — and secreted by the —

A

glomerulus, DCT

75
Q

urates are cleared from the plasma via the activities of

A

organic anion transporters

76
Q

what transporters are located in the basolateral membrane of the PCT

A

OAT1 (SLC22A6)
OAT2 (SLC22A7)
OAT3 (SLC22A8)

77
Q

what transporters are located in the apical brush-border membrane of PCT

A

OAT4 (SLC22A11)
OAT10 (SLC22A13)
URAT (SLC22A12)

78
Q

OATs 1, 2, and 3 facilitates the movement of urates from — to the — in exchaneg with some —

A

from interstitium to the cell cytosol in exchange with decarboxylates

79
Q

OATs 4, 10, and URAT carries urate and other organic anions into the — from the — in exchange for —

A

into the tubular cells from the lumen in exchange for intracellular organic anions

80
Q

counter ions include

A

chloride
lactate
pyrazinoate
nicotinate

81
Q

once inside the cell, urates must pass to the basolateral side of the lumen in a process controlled by — like —

A

voltage-dependent carriers like GLUT9

82
Q

these transporters of urates facilitates movement from renal epithelial cells to the renal interstitium

A

OAT4, OAT10, URAT

83
Q

main purpose for testing uric acid

A

confirm diagnosis and monitor treatment of gout
others include:
-prevent UA nephropathy during chemotherapeutic treatment
-assess inherited disorders of purine metabolism
-detect kidney dysfunction

84
Q

enzymatic method for uric acid determination

A

uricase method

85
Q

sources of uricase (urate oxidase)

A

aspergillus flavus
candida utilis
bacillus fastidious
hog liver

86
Q

it is an oxireductase

A

uricase (urate oxidase)

87
Q

hydrogen peroxide in uricase method is measured using

A

horseradish peroxidase and an oxygen acceptor
list of oxygen acceptors:
-4-aminophenazone
-3-methyl-1-benzothiazoline-hydrazone
-2,2-azino-di-(3-ethyl benzathiazoline)-6-sulfate
-O-dianisidine

88
Q

which is more specific for uric acid determination: uricase method or phosphotungstic acid method

A

uricase method

89
Q

uricase method measures different absorption of — and — at —nm

A

uric acid, allantoin, 293nm

90
Q

interferences in uricase method

A

proteins
hgb
xanthine
bilirubin
ascorbic acid

91
Q

chemical method for uric acid determination

A

phosphotungstic acid method (Caraway method)

92
Q

PTA requires this kind of specimen

A

protein free serum or plasma (requires deproteinization step)

93
Q

PTA is read at —nm

A

700nm

94
Q

other methods used for UA determination

A

high performance liquid chromatography
isotope dilution mass spectrophotometry

95
Q

specimen requirements for UA test

A

urine, serum, or heparinized plasma
EDTA and fluoride should not be used in uricase method
avoid lipemia, bilirubin, and hemolysis

96
Q

true or false: UA test needs fasting

A

false, recent meals have no effect

97
Q

associated diseases for hyperuricemia

A

gout
leukemia
megaloblastic and hemolytic anemia
tophi

98
Q

associated diseases in hypouricemia

A

severe liver disease
allopurinol overdose

99
Q

final product in uricase method

A

allantoin + CO2 + H2O2

100
Q

what is added to uric acid in uricase method

A

H2O2 + O2

101
Q

end products of PTA method

A

allantoin + CO2 + tungsten blue

102
Q

at what nm is creatininase is read

A

340 nm

103
Q

this creatinine method requires large sample

A

creatininase

CC lab (5 decks)

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