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CC Lec Revalida > NPNs > Flashcards

NPNs Flashcards

1
Q

Major NPN found in the blood (45-50% of total NPN)

A

UREA

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2
Q

Major excretory product from protein metabolism

A

UREA

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3
Q

Synthesized in the liver from CO2 + Ammonia
generated during protein catabolism

A

UREA

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4
Q

Urea is synthesized in the liver from CO2 + Ammonia generated during ___

A

protein catabolism

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5
Q

Urea cycle process in mitochondria will produce ?

A

Carbamoyl Phosphate and Citrulline

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6
Q

The enzyme ___ is important to the release of urea

A

arginase

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7
Q

How many percent of urea is reabsorbed?

A

40%

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8
Q

How many percent of urea is excreted in the urine?

A

50%

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9
Q

How many percent of urea is excreted through GI and skin?

A

<10%

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10
Q

very high levels of plasma urea accompanied by renal failure

A

Uremia/uremic syndrome

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11
Q

an elevated concentration of urea in the
blood

A

Azotemia

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12
Q

Decreased blood flow to kidneys

A

PRERENAL AZOTEMIA

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13
Q

Possible causes (which affect urea transport)
○ Congestive heart failure
○ Shock, hemorrhage
○ Dehydration
○ Other factors resulting in significant marked
decreased volume

A

PRERENAL AZOTEMIA

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14
Q

● Acute/chronic renal failure
● Glomerulonephritis
● Tubular necrosis
● Other intrinsic renal disease

A

RENAL AZOTEMIA

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15
Q

Urinary tract obstruction caused by:
○ Renal calculi
○ Tumors of the bladder/prostate
○ Severe infection

A

POSTRENAL AZOTEMIA

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16
Q

High urea : Normal creatinine

A

PRERENAL AZOTEMIA

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17
Q

High urea : High creatinine

A

RENAL AZOTEMIA

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18
Q

Normal urea : High creatinine

A

POSTRENAL AZOTEMIA

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19
Q

Normal Urea Nitrogen : Creatinine ratio

A

10:1 - 20:1

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20
Q

Decreased urea nitrogen: creatinine ratio

A

PRERENAL AZOTEMIA

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21
Q

Product of Fearon’s reaction

A

yellow diazine derivative

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22
Q

Also known as Friedmans Method or Xanthydrol
Method

A

Fearon’s reaction

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23
Q

CONDENSATION WITH DIACETYL MONOXIME METHOD

A

Fearon’s reaction

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24
Q

Product in REACTION WITH 0PHTHALALDEHYDE AND NAPHTHYLETHYLENEDIAMINE

A

chromogen or colored product

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25
Q

Product in MICROKJELDAHL NESSLER METHOD

A

yellow compound

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26
Q

All enzymatic methods use what enzyme?

A

Urease

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27
Q

Product in UREASEBERTHELOTS METHOD

A

indophenol blue

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28
Q

Coupled Enzymatic in Urea Determination

A

UREASE-L-GLUTAMATE DEHYDROGENASE METHOD (GLDH METHOD)

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29
Q

reference method for measuring urea

A

ISOTOPE DILUTION MASS SPECTROMETRY IDMS

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30
Q

If plasma will be used for urea determination, any additive maybe used except ___/____ which
interferes with urease and ammonium ions

A

sodium fluoride / sodium citrate

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31
Q

Reference Ranges for Urea Nitrogen

Plasma or Serum: ____ mg/dL
Urine, 24hr: ____ g/d

A

Plasma or Serum: 6-20 mg/dL
Urine, 24hr: 12-20 g/d

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32
Q

product of catabolism of purines bases Adenine and
Guanine)

A

URIC ACID

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33
Q

How many percent of uric acid is reabsorbed in the proximal tubules

A

98-100%:

34
Q

How many percent of uric acid is excreted in the distal tubules

A

<1%

35
Q

Uric acid excretion

Renal excretion: ___ %
GI excretion: ___%

A

Renal excretion: 70%
GI excretion: 30%

36
Q

Uric acid is Relatively insoluble in plasma as monosodium urate at pH ___

A

pH 7

37
Q

At concentrations ____ mg/dL, plasma is saturated,
urates crystals may form in the tissues

A

6.8 mg/dl

38
Q

At pH ___ , uric acid crystals may form

A

pH 5.75

39
Q

High concentrations accumulate in the joints and
tissue resulting in inflammation

A

Gouty Arthritis

40
Q

Increased: hyperuricemia ____ mg/dL

A

6.0 mg/dL

41
Q

Patients have pain and inflammation of the joints
caused by precipitation of sodium urates

A

GOUT

42
Q

Deposition of Uric Acids in tissues and joints

A

TOPHI

43
Q

Seen in patients undergoing chemotherapy for
leukemia, lymphoma, multiple myeloma, polycythemia

A

INCREASED NUCLEAR BREAKDOWN

44
Q

inhibit xanthine oxidase

A

allopurinol

45
Q

Enzyme that is targeted by Allopurinol to
lower your Uric Acid

A

Xanthine Oxidase

46
Q

X-linked genetic disorder (seen only in males)

A

LESCH NYHAN SYNDROME

47
Q

caused by the complete deficiency of
hypoxanthine–guanine phosphoribosyltransferase
(HGPRT)

A

LESCH NYHAN SYNDROME

48
Q

Lack of this enzyme prevents the reutilization of
purine bases in the nucleotide salvage pathway

A

hypoxanthine–guanine phosphoribosyltransferase

49
Q

Defective tubular reabsorption (Fanconi’s
Syndrome)

A

HYPOURICEMIA

50
Q

Overtreatment with allopurinol

A

HYPOURICEMIA

51
Q

Chemotherapy with 6-mercaptopurine or
azathiopurine (inhibits de novo purine
synthesis)

A

HYPOURICEMIA

52
Q

Caraway Method/ Henrys Method

A

DIRECT REDOX METHOD

53
Q

Uses phosphotungstic acid and produces tungsten blue

A

Caraway Method/ Henrys Method

54
Q

Based on the oxidation of UA in PFF (Protein-Free
Filtrate) and reduction of PTA (Phosphotungstic Acid)

A

Caraway Method/ Henrys Method

55
Q

Reagent is uricase or urate oxidase

A

URICASE METHOD (BLAUCH AND KOCH)

56
Q

2 enzymes:
○ First reaction: uricase
○ Second reaction: peroxidase

A

COUPLED ENZYMATIC METHOD

57
Q

proposed reference method for uric acid determination

A

ISOTOPE DILUTION MASS SPECTROMETRY IDMS**

58
Q

____ or ____ should not be used in uric acid specimen

A

EDTA or fluoride

59
Q

Uric Acid Plasma or Serum Specimen

Male (Adult): ___ mg/dL
Female (Adult): ___ mg/dL

A

Male (Adult): 3.5-7.2 mg/dL
Female (Adult): 2.6-6.0 mg/dL

60
Q

Waste product of creatine formed during normal
muscle metabolism

A

CREATININE

61
Q

Is formed from creatine and creatine phosphate in
muscle and is excreted into the plasma at a constant
rate related to muscle mass

A

CREATININE

62
Q

Plasma creatinine is ____ related to glomerular
filtration rate

A

inversely

63
Q

Produced by the liver and pancreas from arginine,
glycine, methionine

A

CREATINE

64
Q

CREATINE is produced by the liver and pancreas from ____?

A

arginine, glycine, methionine

65
Q

creatine enters the bloodstream and is distributed in cell especially in the muscle where it is converted to

A

phosphocreatine

66
Q

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

A

Creatinine clearance

67
Q

Creatinine + NaOH & picric acid alkaline picrate
complex

A

JAFFE REACTION

68
Q

Reagents in Jaffe with Adsorbent
○ Fullers Earth – ____
○ Lloyds reagent – ____

A

○ Fullers Earth – aluminium magnesium silicate
○ Lloyds reagent – sodium aluminum silicate

69
Q

CREATININE DETERMINATION CHEMICAL produced what colored compound

A

purple-colored compound

70
Q

Accepted Reference Method for creatinine

A

IDMS (Isotope Dilution Mass Spectrophotometry)

71
Q

____ causes a negative bias in both Jaffe and
enzymatic methods.

A

Bilirubin

72
Q

___causes a positive bias in some enzymatic
methods.

A

Lidocaine

73
Q

____ will interfere in enzymatic methods that use peroxidase as a reagent.

A

Ascorbate

74
Q

Produced from the deamination of amino acids

A

AMMONIA

75
Q

Consumed by the parenchymal cells of the liver in the production of Urea

A

AMMONIA

76
Q

Most ammonia in the blood exists as

A

Ammonium Ion

77
Q

(Blood sugar drops and blood ammonia and
acidity increases) post viral with aspirin
resulting in hepatic dysfunction due to fatty
infiltration of the liver.

A

Reyes syndrome

78
Q

Exploited the volatility of ammonia to separate the
compound in microdiffusion chamber

A

CONWAY METHOD

79
Q

Most common on automated instruments in Ammonia determination

A

ENZYMATIC METHOD - CATALYZED BY GLDH

80
Q

Venous blood for Ammonia specimen should be obtained without trauma and placed on ___ immediately

A

ice

81
Q

Ammonium salts, asparaginase, barbiturates,
diuretics, ethanol, hyperalimentation, narcotic
analgesics, and some other drugs may ____
ammonia in plasma

A

increase

82
Q

Diphenhydramine, Lactobacillus acidophilus, lactulose, levodopa, and several antibiotics ____ ammonia concentrations.

A

decrease

CC Lec Revalida (2 decks)

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