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List the NPN constituents found in the blood (4)
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How are NPN compounds formed?
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nonprotein nitrogen

SCC chemistry

QuestionAnswer
List the NPN constituents found in the blood (4) Urea, creatinine, uric acid and ammonia
How are NPN compounds formed? The majority of them arise from the breakdown of proteins and nucleic acids.
Which of the NPN makes up the largest fraction? Urea
In which organ of the body are NPN synthesized? Liver
5. What term is given to urea plasma measurements? BUN
6. What does BUN stand for? Blood Urea Nitrogen
7. Define azotemia an ELEVATED level of urea in the blood
7. Define Uremia VERY HIGH levels of urea accompanied by renal failure
Prerenal azotemia is caused by what? Reduced renal blood flow. Less blood to the kidneys means less urea is filtered anything that causes decrease in blood volume contributes to this: heart failure, shock hemmorrage, dehydration
Decreased renal function causes what? Causes an increase in plasma urea concentration due to compromised urea excretion
what is the reference interval (normal pat. reference range) for BUN/Creatinine? Normally 10:1 to 20-1
What analytical methods are used to measure BUN levels? enzymatic method, indicator dye, conductimertric
what is the enzymatic methods that are used to measure BUN levels urease reaction coupled wit L-glutamate dehydrogenase (GLDH) to quantify ammonium ions
what is the indicator dye method to measure BUN levels urese +pH indicator, this is used in instruments using liquid reagents, a multilayer film format and reagent strips
what is the conductimetric method that is used to measure BUN levels an electrode that is used to measure the amount of ammonium ions that are produced from urea
11. What is the reference interval (normal patient reference range) for BUN? 7-18 mg/dL
Where does creatinine come from? Creatine is synthesized in the liver, and broken down to form creatinine.
13. Plasma creatinine levels are related to three sources. What are they? Plasma levels of creatinine are related to the relative muscle mass, the rate of creatine turnover, and renal function.
14. What is the creatinine test that measures renal function (glomerular filtration)? creatinine clearance
What does "clearance of a substance" mean? The clearance of a substance is “the volume of plasma from which that substance is cleared per unit time.”
What is the creatinine clearance formula CrCl = UCr x VU / PCr x t
What are the reported units of measure for creatinine clearance tests? - mL/minute and is corrected for body surface
17. Why are creatinine clearance test results corrected for muscle mass? Creatinine levels are related to muscle mass men have more (typically) then men, the more fit the more mass vs. obese....etc
18. What is the most common analytical method used to measure plasma creatinine levels? Jaffe reaction
What is the Jaffe reaction In this reaction creatinine reacts with picric acid.
19. What is the reference interval (normal patient reference range) for creatinines? • Males: 0.9-1.3 mg/dL • Females: 0.6-1.1 mg/dL
20. Where does uric acid come from? Uric acid is formed from the breakdown of purines.
21. Where do purines come from? Purines come from the breakdown of nucleic acids or from tissue destruction. Purines are converted to uric acid in the liver.
22. What three major disease states are associated with elevated uric acid levels? • gout, • increased catabolism of nucleic acids, and • renal disease
23. Define hyperuricemia. Increased level of uric acid in the plasma
24. What analytical methods are used to measure uric acid? • Uricase (enzymatic method) • Coupled enzymatic method using either catalase or peroxidase
25. What is the reference interval (normal patient reference range) for uric acid? • Male: 3.5-7.2 mg/dL • Female: 2.6-6.0 mg/dL
26. Where does ammonia come from? The breakdown of amino acids (proteins)
27. What two clinical conditions are associated with elevated ammonia levels? Hepatic failure and Reye's syndrome
28. What is the special handling requirement for ammonia levels? placed IMMEDIATELY on ice to prevent brkdown of amino acids which would cause ammonia levels to rise. Seperate plasma and assayed ASAP or frozen.
29. What is the reference interval (normal patient reference range) for ammonia? 19-60 μg/dL
Created by: nizhoni
 

 



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