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CLIN CHEM > NPNs & PROTEINS > Flashcards

NPNs & PROTEINS Flashcards

1
Q

Present in highest concentration in the blood ; formed in the liver from CO2 and ammonia ; major excretory product of the metabolism of proteins and other nitrogen-containing chemicals

A

Urea

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2
Q

Concentration of urea is expressed in terms of nitrogen content (BUN) :

A

BUN X 2.14 = urea
Urea / 2.14 = BUN

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3
Q

Reference method for NPN measurement

A

Isotope dilution mass spectrometry

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4
Q

Chemical method for urea is also called

A

Fearon method / diacetyl monoxide method / direct method

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5
Q

Chemical method (Fearon) : color of diazine

A

Yellow

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6
Q

Enzymatic method for urea

A

Urease method / Indirect method

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7
Q

Colorimetric enzymatic method for urease : Nessler’s reagent

A

Dipotassium mercuric iodide / K2(HgI4)

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8
Q

Colorimetric enzymatic method for urease : color of dimercuric ammonium iodide

A

Yellow-orange

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9
Q

Colorimetric enzymatic method for urease : components of Berthelot reagent

A

Sodium hypochlorite + phenol + sodium nitroprusside

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10
Q

In GLDH-coupled reaction, NAD (product) is detected and measured with ____

A

Decreased absorbance @ 340 nm (UV)

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11
Q

Measurement of the increase in conductivity due to NH4+ (ammonium ions) and CO32- (carbonate ions)

A

Conductimetric

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12
Q

BUN Reference value

A

6-20 mg/dL

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13
Q

Reference value for BUN/Creatinine ratio

A

10 - 20 : 1

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14
Q

Increased BUN is termed as

A

Azotemia

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15
Q

Azotemia due to dehydration, low blood volume, high protein diet, increased protein catabolism

A

Pre-renal azotemia

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16
Q

Value of BUN:creatinine ratio and creatinine in pre-renal azotemia

A

BUN/crea ratio >20 ; Normal creatinine

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17
Q

Azotemia due to low excretion (glomerulonephritis, renal failure)

A

Renal azotemia

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18
Q

Azotemia due to urinary tract obstruction (nephrolithiasis, tumors, severe infection)

A

Post renal azotemia

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19
Q

Value of BUN:creatinine ratio and creatinine in renal and postrenal azotemia

A

BUN/Crea ratio >20 ; High Creatinine

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20
Q

Postrenal azotemia : very high plasma urea concentration accompanied by renal failure

A

Uremia/uremic syndrome

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21
Q

Value of BUN:creatinine ratio and creatinine in uremia/uremic syndrome

A

High BUN, High Crea, Low GFR

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22
Q

Repeated dialysis, liver disease, low protein diet

A

Low BUN

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23
Q

NPNs from most to least concentrated

A

Urea
Amino acid
Uric acid
Creatinine
Creatine
Ammonia

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24
Q

NPN : 45-50%

A

Urea

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25
Q

NPN : 25%

A

Amino acid

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26
Q

NPN : 10%

A

Uric acid

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27
Q

NPN : 25%

A

Creatinine

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28
Q

NPN : 1-2%

A

Creatine

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29
Q

NPN : 0.2%

A

Ammonia

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30
Q

Creatinine is a substance formed from

A

Methionine, arginine, glycine

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31
Q

Excreted into plasma at a constant rate proportional to an individual’s MUSCLE MASS

A

Creatinine

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32
Q

Creatinine is removed from circulation by ______ ; concentration is _____ related to GFR

A

glomerular filtration ; Inversely

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33
Q

Creatinine analytical method : colorimetric, ENDPOINT, nonspecific ; subject to positive bias due to ascorbic acid, glucose, glutathione, keto acids, uric acid, cephalosporins

A

Chemical method (Jaffe)

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34
Q

Creatinine + alkaline pi rate —> red-orange tautomer

A

Jaffe reaction

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35
Q

Techniques to improve Jaffe reaction

A

Kinetic - timed rate reaction
Use of adsorbents : Lloyd’s reagent (sodium aluminum silicate), Fuller’s Earth (Magnesium aluminum silicate)

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36
Q

Adsorbent : LLOYD’S REAGENT

A

Sodium aluminum silicate

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37
Q

Adsorbent : Fuller Earth’s reagent

A

Magnesium Aluminum silicate

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38
Q

POD-coupled : oxidized chromogen aka

A

Quinoneimine

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39
Q

POD-coupled : color of quinoneimine

A

Red to red-purple

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40
Q

Standard formula for creatinine clearance

A

C = Urine crea (mg/dL) x volume of 24h urine (mL/min / plasma or serum crea (mg/dL)

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41
Q

Creatinine clearance formula if the patients is a child, physically wasted, or obese

A

C = U x V / P (1.73 / Actual body surface area)

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42
Q

Variables used in Cockcroft-Gault formula

A

Age
body weight
serum creatinine
gender

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43
Q

Cockcroft-Gault correction factor (if patient is a female)

A

X 0.85

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44
Q

MDRD formula variables (OLD)

A

Creatinine, BUN, Albumin
Age
Race
Gender

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45
Q

MDRD formula variables (NEW)

A

Creatinine
Age
Race
Gender

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46
Q

Decreased creatinine clearance or GFR may be due to _____

A

Impaired renal function

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47
Q

CKD stage : kidney damage with normal or high GFR ; GFR value

A

Stage 1 ; 90 and above

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48
Q

CKD stage : kidney damage with normal or low GFR ; GFR value

A

Stage 2 ; 60-89

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49
Q

CKD stage : moderate low GFR ; GFR value

A

Stage 3 ; 30-59

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50
Q

CKD stage : severely low GFR ; GFR value

A

Stage 4 ; 15-29

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51
Q

CKD stage : kidney failure ; GFR value

A

Stage 5 ; 15 or less

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52
Q

Product of catabolism of purines in nucleic acids or nucleoproteins ; relatively insoluble in plasma ; can be deposited in the joints and tissues at concentrations >6.8 mg/dL

A

Uric acid

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53
Q

Chemical method for uric acid determination

A

Phosphotungstic method / Caraway method

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54
Q

Catalysts used in Caraway method

A

Sodium carbonate

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55
Q

Uric acid reference value (MALE)

A

3.5 - 7.2 mg/dL

56
Q

Uric acid reference value (FEMALE)

A

2.6-6.0 mg/dL

57
Q

Chronic nephritis, alcoholism, gout, leukemia, chemotherapy, Lesch-Nyhan syndrome

A

Hyperuricemia

58
Q

Fanconi syndrome,severe liver disease, purine inhibitors, allopurinol

A

Hypouricemia

59
Q

Produced from the catabolism of amino acids ; toxic compound metabolized exclusively in the liver via the urea cycle

60
Q

Measurement of pH change as Ammonia diffuses through a selective membrane

A

Potentiometric

61
Q

Ammonia reference range

A

19-60 ug/dL

62
Q

Building block of proteins

A

Amino acid

63
Q

Determined by the acidic and basic amino acid monomers

A

Net charge and electrophoretic mobility

64
Q

The pH at which a particular protein has a net charge equal to zero

A

Isoelectric point

65
Q

Protein Solubility

A

Lowest at isoelectric point, hydrophilic and more soluble when charged

66
Q

Protein nitrogen content

67
Q

Protein structure level : number and types of amino acids in a SPECIFIC amino acid sequence

68
Q

Protein structure level : Regularly REPEATING structures stabilized by hydrogen bonds between amino acids

69
Q

Protein structure level : OVERALL shape or conformation of the protein molecule

70
Q

Protein structure level : Results from the interaction of MORE THAN ONE A protein molecule or subunit

A

Quaternary

71
Q

Serum samples are applied close to the cathode end of a support medium that is saturated with an alkaline buffer (pH ___) at which proteins carry a ___ charge and migrate toward the ____

A

8.6 ; negative ; anode

72
Q

Stains used in protein electrophoresis

A

Coomasssie brillian blue
Ponceau S
Amido black B
Lissamine green

73
Q

Specialized colorimeter designed to can and quantitate electrophoretic pattern

A

Densitometer

74
Q

Uses a higher voltage coupled with a cooling system and a more concentrated buffer ; separates proteins into 12 or more bands ; detects unusual monoclonal bands

A

High-resolution protein electphoresis

75
Q

Indicator of malnutrition ; forms a distinct band in CSF electrophoresis

A

Prealbumin

76
Q

Prealbumin transports T4 as _____

A

Thyroxine-binding prealbumin

77
Q

Prealbumin forms a complex with ______

A

Retinol binding protein / vitamin A

78
Q

Major contributor to plasma osmotic or oncotic pressure ; general transport protein

79
Q

Most abundant serum protein

80
Q

Increased level in amniotic fluid ; increased in adult serum in cases of hepatocellular carcinoma

A

Alpha-fetoprotein

81
Q

Protease inhibitor ; major component of the alpha 1 region

A

Alpha - antitrypsin

82
Q

Deficiency is associated with SERPINA 1 gene mutation and causes juvenile hepatic cirrhosis, pulmonary emphysema

A

Alpha 1 - antitrypsin

83
Q

Binds progesterone and some drugs ; negatively charged even in acid pH ; has a very high carbohydrate content

A

Alpha 1 - acid glycoprotein

84
Q

Protease inhibitor ; binds prostate-specific antigen

A

A1-antichymotrypsin

85
Q

Transports vitamin D ; low level may lead to abnormal calcium levels

A

Gc-globulin

86
Q

Protease inhibitor ; largest non-Ig protein ; 10x increase in nephrotic syndrome, protein-losing enteropathy

A

A2-macroglobulin

87
Q

Binds hemoglobin to preserve iron ; low level seen in hemolytic disorder, intravascular hemolysis

A

Haptoglobin

88
Q

Copper-binding protein ; has oxidase activity ; low serum level in Wilson’s disease

A

Ceruloplasmin

89
Q

Transports iron ; low level seen in IDA (pseudoparaprotein)

A

Transferrin

90
Q

Immune response ; most abundant complement protein

A

C3 complement

91
Q

Binds heme ; low level in intravascular hemolysis

92
Q

Component of MHC or HLA molecules ; used to measure GFR

A

B2-microglobulin

93
Q

Enhances phagocytosis in inflammatory disease ; most sensitive ; 1000x increase in inflammatory states

94
Q

Used as a marker for cardiovascular risk

95
Q

Antibodies produced by plasma cells

A

Imunnoglobulins

96
Q

Incraeased protein loss ; malnutrition/malabsorption ; decreased synthesis ; increased protein catabolism

A

Hypoproteinemia

97
Q

Monoclonal gammopathy ; dehydration

A

Hyperproteinemia

98
Q

Low albumin ; 10x increased of a2-macroglobulin

A

Nephrotic syndrome

99
Q

Polyclonal gammopathy

A

Hepatic cirrhosis

100
Q

Beta-gamma bridging ; increased IgA in beta and gamma region

A

Liver cirrhosis

101
Q

Monoclonal spike/gammopathy ; 1 immunoglobulin type is increased

A

Multiple myeloma

102
Q

Alpha1 globulin flat curve

A

Alpha 1 - antitrypsin deficiency

103
Q

a1- and a2- globulin spike

A

Acute inflammation

104
Q

Increased a1-globulin, a2-globulin, and gamma globulin

A

Chronic inflammation

105
Q

Flat gamma curve

A

HYPOGAMMAGLOBULINEMIA

106
Q

Polyclonal gammopathy ; 2 types of globulins are increased

A

Hepatic cirrhosis

107
Q

Negative predictor of AMI ; oxygen-carrying protein in skeletal and cardiac muscles ; detected SOONER that’s TROPONIN but NOT CARDIAC SPECIFIC

108
Q

Gold standard for acute myocardial infarction ; CARDIAC SPECIFIC and show SUSTAINED ELEVATION

A

Cardiac troponins

109
Q

Troponin with greater cardiac specificity

A

Troponin I

110
Q

Used as markers for coronary heart failure ; structurally related neurohormones that affect body fluid homeostasis and blood pressure

A

BNP (brain natriuretic peptide) an NT-proBNP (N-terminal-pro BNP)

111
Q

Endogenous marker of GFR

A

Cystatin C and B-trace protein

112
Q

Useful in cases where creatinine measurement is not appropriate

A

Cystatin C

113
Q

Correlates with serum cystatin C and urine micro proteins ; not influenced by glucocorticoid therapy

A

B trace proteins

114
Q

Biomarker of bacteremia or sepsis ; increases early in infection (3-6 hours) and has a greater specificity for infection than CRP

A

PROCALCITONIN

115
Q

Early predictor of acute kidney infection

A

Neutrophil gelatinase-associated lipocalin

116
Q

Marker for nutritional status ; demonstrates a wide variety of cellular interactions, e.g. cell adhesion, differentiation, growth, and wound healing

A

Fibronectin

117
Q

Low value of this protein marker is associated with increased risk of metabolic syndrome ; inversely correlated with BMI

A

Adiponectin

118
Q

Biochemical marker of bone resorption (osteoporosis) ; proteolyic fragments of collagen I

A

Cross-linked C telopeptides

119
Q

Biomarkers of Alzheimer’s disease

A

Neuronal thread protein, amyloid b42, Tau protein

120
Q

Ultimate reference method based on the measurement of nitrogen content (!6%)

A

Kjeldahl method

121
Q

Measurement of refractive index due to proteins in solution

A

Refractometry

122
Q

Measurement of the change in optical density following precipitation with TCA, SSA, benzalkonium chloride

A

Turbidimetry

123
Q

UV absorption : measurement of protein absorbance at ____ nm owing mostly to ________

A

280 nm ; tryptophan, tyrosine, phenylalanine

124
Q

Detection o peptide bond forming a violet color (540 nm)

A

Biuret method

125
Q

Oxidation of phenolic groups producing a DEEP BLUE color

A

Folin-Ciocalteau (Lowry) method

126
Q

Formation of violet color in the presence of amino groups

A

Ninhydrin method

127
Q

Measurement of the shift in absorbance when proteins bind to a dye

A

Dye-binding technique

128
Q

Dye used for total protein

A

Coummassie brilliant blue

129
Q

Dye used for albumin : nonspecific (globulins may also bind)

A

Methyl orange

130
Q

Dye used for albumin : less sensitive ; subject to interferences

131
Q

Dye used for albumin : most commonly used dye

A

Bromcresol green

132
Q

Dye used for albumin : specific, sensitive, precise

A

Bromcresol purple

133
Q

Protein reference value : total protein, ambulatory

A

6.5-8.3 g/dL

134
Q

Albumin reference value :

A

3.5 - 5.5 g/dL

135
Q

A/G ratio formula

A

Albumin / Total protein - Albumin

CLIN CHEM (10 decks)

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