T1: Non-Protein Nitrogens and Glomerular Function Tests (PART2) Flashcards
ESSAY
Uric Acid
- One specific major source
Catabolism of the purine base nucleosides, adenosine and guanosine (=purine base metabolism)
ESSAY
Uric Acid
- two specific minor sources
- Food
- Conditions of increased nucleic acid turnover (cancer patients)
ESSAY
Uric Acid
- four sequential steps in its renal handling
- Free glomerular filtration
- Reabsorption of >90% in PCT
- Tubular secretion in the distal portion of the PCT
- Reabsorption in the DCT
ESSAY
Uric Acid
- One (2) primary cause of hyperuricemia associated with increased formation
- Idiopathic
2. Inherited metabolic disorders
ESSAY
Uric Acid
- Four secondary causes of hyperuricemia associated with increased formation
- Excess dietary purine intake
- Increased nucleic acid turnover
- Altered ATP metabolism
- Preeclampsia
ESSAY
Uric Acid
- Once secondary disease state associated with decreased excretion
- acute or chronic renal disease, increased renal reabsorption, lead poisoning (**much more in lecture)
ESSAY
Uric Acid
- Causes of primary and secondary gout
Primary: overproduction of purines, decreased renal secretion of uric acid, increased dietary intake of purines (problem handling Uric acid)
Secondary: consumption of alcohol, fructose drinks, meat, and seafood (dietary gout, acute/chronic renal disease)
ESSAY
Uric Acid
- Reference range for men and women
Men: 4.0 - 8.5 mg/dL
Women: 2.7 - 7.3 mg/dL
Reagents used and scientist’s name associated with the chemical method for uric acid
Caraway method , oxidation of Uric acid with reduction of phosphotungstic acid to tungsten blue
Reagents used in the enzymatic method for uric acid
Uricase method: uricase oxydizes urate to allantoin
ESSAY
ammonia
- three specific sources
- Deamination of proteins in liver
- Bacterial proteases, creases and amine oxidases act on contents of colon in GI tract
- Hydrolysis of the glutamine in both the small and large intestines
ESSAY
ammonia
- one primary cause of increased ammonia
Inherited urea cycle deficiencies
ESSAY
ammonia
- four secondary causes of increased ammonia
- Advanced liver disease
- renal failure
- Reye’s syndrome
- hepatic encephalopathy in individuals with cirrhosis
ESSAY
ammonia
- Four special specimen collection and handling procedures
- Good venipuncture technique must be used
- Must be put on ice immediately and analyzed within 20 minutes of venipuncture
- Patient must not smoke after midnight for a fasting specimen draw; no smoking in phleb area
- Lab area and glassware should be free from ammonia contamination
ESSAY
ammonia
- reference range
14-45 micromol/L