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Med Lab Test 2 > NPNs > Flashcards

NPNs Flashcards

1
Q

what is the kidney’s function?

A

excrete undesirable end products of metabolism such as NPNs: urea (BUN), creatinine, uric acid, and also excrete organic acids and amino acids. It also maintains body homeostasis and has an endocrine function.

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2
Q

How does the kidney maintain body homeostasis?

A

electrolyte balance
acid base balance
water balance

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3
Q

What is the kidney’s endocrine function?

A

primary: renin, erythopoeitin, and prostaglandins
secondary: produce vit d3

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4
Q

what are NPN compounds?

A

catabolism of proteins and nucleic acids result in the formation of so-called NPN compounds. Some of these metabolic products are derived from exogenous or endogenous proteins.

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5
Q

What does catabolism of proteins form?

A

urea

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6
Q

What does catabolism of purines form?

A

uric acid

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7
Q

What does catabolism of creatine and creatine phosphate form?

A

creatinine

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8
Q

What is Urea?

A

Blood urea nitrogen, >75% of NPN excreted in urine is urea

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9
Q

what is the greatest type of NPN that is excreted in urine?

A

urea, it accounts for more than 75%

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10
Q

Where is biosynthesis of urea carried out?

A

in the liver

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11
Q

Production of urea is dependent on several variables, what are they?

A

hight protein diet, hepatic function, increased protein catabolism (like muscle wasting–starvation), over hydration = urea excretion is increased, post renal obstruction. bacteria in urine causes decreased urea.

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12
Q

What is urea considered a measurement of?

A

renal function.

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13
Q

What are the expected values for urea?

A

plasma= 5-20, critical is over 100

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14
Q

What can cause increased BUN levels?

A

CHF, shock, hemorrhage, dehydration, renal impairment, renal failure, stones, tumors of bladder or prostate, severe infection, fever, stroke, major illness.

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15
Q

What causes decreased BUN levels?

A

low protein diet, malnutrition, newborn, severe hepatic insufficiency, severe vomiting or diarrhea, over hydration.

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16
Q

What are the normal ranges for BUN and what do they correlate with?

A 
<8-10= overhydration
5-20= normal
20-26= dehydration
50-150 = implies impairment of GFR
150-250= extreme impairment
17
Q

What is creatinine?

A

creatine is synthesized mainly in the liver and then transported in blood to other organs such as muscle and brain where it is phosphorylated to phosphocreatine, a high energy compound. A portion of creatine is muscle spontaneously and irreversibly converts to creatinine.

18
Q

does the amount of creatinine vary greatly from day to day?

A

no, based on muscle mass

19
Q

clinical application of creatinine: a test of renal function.

A

creatinine levels are a useful index of renal function, primarily GFR

20
Q

What are CrCl tests used for?

A

to eval the GFR and to eval when administering nephrotoxic drugs.

21
Q

As renal function decreases, what happens to GFR?

A

it decreases, and then the CrCl decreases.

22
Q

What is normal GFR? what is end stage renal failure?

A

125-152, less than 5

23
Q

What is Uric Acid?

A

it is the the major end product of purine nucleotide catabolism The conversion of purine nucleotides occurs in the liver.

24
Q

What do plasma uric acid levels vary with?

A

dietary intake, renal disease, excess purine synthesis

25
Q

In what clinical condition do we see increased uric acid?

A

gout, conditions involving increased cellular destruction, hyperuricemia, dehydration, hematologic conditions, chronic renal disease, chemotherapy, alcohol, lead poising, Lesch-Nyhan syndrome

26
Q

what are some causes of decreased uric acid?

A

alcoholism with liver disease.

27
Q

How is ammonia produced?

A

as amino acids are are deaminiated, ammonia is produced.

28
Q

what could causes increased ammonia?

A

severe liver failure, chronic liver failure, reye’s syndrome

29
Q

expected findings: ACUTE RENAL DISEASE

A

increased: BUN, creatinine,
Decreased: CrCl
normal: uric acid

30
Q

expected findings: chronic renal failure

A

increased: BUN, creatinine, uric acid
Decreased: CrCl

31
Q

expected findings: gout

A

increased: uric acid
normal: BUN, creatinine, CrCl

32
Q

expected findings: chemotherapy:

A

increased: uric acid
normal: BUN, creatinine, CrCl

Med Lab Test 2 (9 decks)

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