Term
| Name 4 Protein-Free Nitrogen-Containing Compounds in Plasma |
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Definition
Ammonia
Urea
Creatinine
Uric Acid |
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Term
| Ammonia is derived from protein breakdown in what 2 organs? |
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Definition
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Term
| AA taken up by the liver, produce ammonia, then converted into what? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Are Decreased levels of Ammonia Significant or Insignificant? |
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Definition
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Term
| What are the 3 disease correlations with Ammonia |
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Definition
Hepatic failure
Reye's Syndrome
Poor Circulation |
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Term
| What is Reye's Syndrome usually preceded by? |
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Definition
| Viral infection + aspirin |
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Term
| Reye's Syndrome - Fatty infiltration of what organ? |
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Definition
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Term
| What type of tube should you use when collecting for Ammonia? |
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Definition
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Term
| After placing the tube in Heparin or EDTA what should you do? |
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Definition
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Term
| After putting your ammonia sample on ice what do you do? |
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Definition
Centrifuge at 0-4 Degrees Celsius and assay ASAP
Freeze |
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Term
| Which Nonprotein Nitrogen is affected by cigarette smoking? |
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Definition
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Term
| Enzymatic reaction of Ammonia measure the amount of what consumed? |
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Definition
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Term
| Name 2 interfering factors for Ammonia lab analysis |
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Definition
Glassware detergents
Impure water |
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Term
| What is the reference range for Ammonia? |
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Definition
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Term
| If the ammonia value is greater than what it is considered a panic value? |
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Definition
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Term
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Definition
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Term
| Where is Urea synthesized? |
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Definition
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Term
| Almost half of all NPN is found where? |
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Definition
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Term
| What is the major waste product of protein metabolism? |
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Definition
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Term
| Urea is filtered by which organ? |
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Definition
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Term
| Decreased BUN is seen in what 3 conditions? |
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Definition
Low protein diets
Starvation
Liver Disease |
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Term
| What should the BUN/Cr ratio be? |
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Definition
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Term
| >20:1 is associated with Pre-renal or Renal? |
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Definition
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Term
| <10:1 is associated with Pre-renal or Renal? |
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Definition
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Term
| What word is given to describe High levels of BUN in the blood? |
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Definition
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Term
| What can cause Pre-renal diseases in association with Urea? |
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Definition
Reduced blood flow to kidneys
High Protein Diets
Increased breakdown of proteins |
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Term
| What can cause Renal diseases in association with Urea? |
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Definition
Any renal condition that reduces GFR
Uremia
Uremic Syndrome |
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Term
| What can cause Post-renal diseases in association with Urea? |
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Definition
| Obstruction of urine flow |
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Term
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Definition
| High Levels of BUN with Renal Failure |
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Term
True or False:
Uremic Syndrome is fatal if untreated by dialysis or transplant |
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Definition
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Term
| What type of reactions do you perform in the lab when analyzing urea? |
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Definition
| Coupled reaction using urease enzyme |
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Term
| What 2 substances inhibit urease? |
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Definition
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Term
| What is the reference range for Urea? |
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Definition
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Term
| What 2 collection tubes should be avoided when analyzing urea? |
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Definition
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Term
| Creatine is used in production of what? |
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Definition
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Term
| What is the end-product of Creatine producing energy in muscle? |
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Definition
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Term
| What is the major waste product of muscle metabolism? |
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Definition
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Term
True or False:
Creatinine is excreted at a constant rate daily |
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Definition
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Term
True or False:
Creatinine is proportional to a person's muscle mass |
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Definition
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Term
| What non-protein nitrogen-containing substance is NOT affected by exercise? |
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Definition
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Term
| What is Creatinine filtered by? |
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Definition
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Term
| What is the main disease that correlates with Creatinine? |
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Definition
| Renal dysfunction affecting filtration |
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Term
| Creatine Clearance Test Formula: |
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Definition
| ((Urine cr)/(Serum cr))/ ((Urine Volume)/Urine Collection Time)) |
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Term
| How do you correct Creatine Clearance for body surface area? |
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Definition
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Term
| Renal Damage = Decrease in what? |
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Definition
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Term
| Renal Damage = Increase in what? |
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Definition
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Term
| Are Decreased Levels of Creatine Significant or Not Significant? |
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Definition
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Term
True or False:
50% of renal function may be lost before CrCl is Decreased |
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Definition
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Term
| What is the classic method of Creatine lab analysis based on? |
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Definition
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Term
| What can cause a false negative in Creatine lab analysis? |
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Definition
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Term
| What 4 substances can cause a false positive in Creatine lab analysis? |
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Definition
Cephalosporins
Uric Acid
Ascorbic acid
Glucose |
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Term
| What is the reference range for Creatinine? |
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Definition
| 0.6-1.0 mg/dL (m/f average) |
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Term
| Uric acid is the breakdown product of what? |
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Definition
| Purines from nucleic acids |
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Term
| What type of reaction is used for the laboratory analysis of Uric acid? |
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Definition
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Term
| What is the carraway reaction? |
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Definition
| Reduction of phosphotungstic acid to tunsten blue |
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Term
| What can cause false negatives for the lab analysis of Uric Acid? |
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Definition
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Term
| What is the reference range for Uric acid? |
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Definition
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Term
| Is uric acid a very sensitive indicator for renal disease? |
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Definition
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Term
| If levels of Uric Acid become high it might precipitate in tissues as what? |
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Definition
| Monosodium Urate Crystals |
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Term
| If levels of Uric Acid become high it might precipitate in tubules as what? |
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Definition
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Term
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Definition
| Precipitated urates (MSU) in joins cause pain and swelling |
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Term
| Gout is aggrevated by what? |
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Definition
diet
drugs
alcohol ingestion |
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Term
| Gout correlates with a tendency to form what? |
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Definition
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Term
| What 3 Diseases correlate with Uric Acid? |
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Definition
Gout
Increased breakdown of cell nuclei
Renal disease |
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Term
| What are often associated with Increased breakdown of cell nuclei? |
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Definition
Chemotherapy for leukemia/lymphoma
Tumor Irradiation
Hemolytic anemias if WBC count is high |
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Term
| What are the prominent functions of the Renal system? |
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Definition
Waste removal
Water, Electrolyte, & Acid-Base Balance
Hormone Production |
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Term
| List the steps of Urine Formation & Waste Removal |
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Definition
1. Filtration by the glomerulus
2. Reabsorption by the proximal convoluted tubule
3. Secretion by the proximal convoluted tubule
4. Concentration in the distal convoluted tubules and collecting ducts |
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Term
| What occurs at the Loop of Henle? |
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Definition
| Water, Na, and Cl reabsorption |
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Term
| What occurs at the Distal tubules/collecting ducts? |
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Definition
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Term
| What is sodium reabsorption at the Distal tubules/collecting ducts influenced by? |
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Definition
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Term
True or False:
Substances exceeding renal threshold cannot be reabsorbed |
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Definition
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Term
| What is the defect in D. insipidus? |
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Definition
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Term
| What is the defect in D. mellitus? |
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Definition
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Term
True or False:
The Plasma osmolality and urine volume INCREASE for both D. insipidus & D. mellitus |
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Definition
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Term
| Does Urine Osmolality Increase or Decrease for D. Insipidus? |
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Definition
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Term
| Does Urine Osmolality Increase or Decrease for D. Mellitus? |
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Definition
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Term
| What element is the primary contributor to osmolality? |
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Definition
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Term
| As sodium moves in, what moves out to maintain electrical neutrality? |
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Definition
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Term
| What will be exchanged to maintain Acid-Base Balance? |
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Definition
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Term
| What will be reabsorbed along with Sodium? |
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Definition
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Term
| Why is Chloride reabsorbed along with Sodium? |
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Definition
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Term
|
Definition
| The rate at which a substance is removed or cleared from the body |
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Term
True or False:
Creatine is completely filtered and not reabsorbed |
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Definition
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Term
| What is the standard measure for GFR? |
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Definition
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Term
| When do you correct the Creatinine Clearance? |
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Definition
Big or little people
Elderly
Amputees
Muscle wasting diseases |
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Term
| What is the normal range of CrCl for Men/Women: |
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Definition
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Term
| What is the normal range of CrCl for Women: |
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Definition
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Term
| What is the normal range of CrCl for Children: |
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Definition
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Term
| What is the normal range of CrCl for Newborns: |
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Definition
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Term
| Name the 2 types of test for Creatinine where urine is NOT needed |
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Definition
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Term
| What is the formula for eGFR (mL/min)? |
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Definition
| ((140-age)(weight in kg))/((72)(Serum Creatinine)) |
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Term
| What do you multiply the eGFR by if the patient is female? |
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Definition
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Term
| Cystatin C is unaffected by what? |
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Definition
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Term
True or False:
Cystatin C will be elevated in serum before GFR is decreased |
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Definition
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Term
| What is a better predictor of developing kidney disease? |
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Definition
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Term
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Definition
| Tiny protein produced by nucleated cells at a constant rate |
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Term
| What test do you perform to detect early renal disease in diabetics? |
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Definition
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Term
| Microalbumin will detect as little as ______ / 24 hours? |
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Definition
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Term
| Urine Dipstick is positive for Albumin at what concentration? |
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Definition
|
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Term
You perform the following Chemical Urinalysis Exam to determine what:
pH |
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Definition
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|
Term
You perform the following Chemical Urinalysis Exam to determine what:
Protein |
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Definition
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|
Term
You perform the following Chemical Urinalysis Exam to determine what:
Blood |
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Definition
Renal Disease
Infection
Trauma
Stones |
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Term
You perform the following Chemical Urinalysis Exam to determine what:
SG |
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Definition
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Term
| What are the 6 Infections correlated with Renal Function |
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Definition
Acute Glomerulonephritis
Nephrotic Syndrome
Kidney Infection
Bladder Infection
Chronic Kidney Disease
Acute Renal Failure |
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Term
| What type of infection will you see WBCs & WBC CASTS |
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Definition
Kidney Infection
(Pyelonephritis) |
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Term
| What type of infection will you see WBCs, +/= nitrites, & Hematuria but NO WBC Casts |
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Definition
Bladder Infection
(Cystitis) |
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Term
| Which Disease will you find Massive Proteinuria and Lipiduria? |
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Definition
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Term
| Which Disease will you find Oval fat bodies, fatty casts, and Cholesterol crystals? |
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Definition
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Term
| What disease follows group A beta-hemolytic strep infection? |
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Definition
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Term
The following are seen in what disease:
RBC casts, hematuria, proteinuria, and oliguria |
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Definition
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Term
| With which disease will you see abnormalities of structure or function that persist for more than 3 months? |
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Definition
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Term
| Chronic Kidney Disease: GFR is what? |
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Definition
|
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Term
| What insufficiency are common in Chronic Kidney Disease? |
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Definition
|
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Term
| What are the causes of Chronic Kidney Disease? |
|
Definition
Glomerulonephritis
Polycystic Disease
SLE
Diabetes
Others |
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Term
| You will find albuminuria in what disease? |
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Definition
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Term
Which which disease will you find the following:
Tubular necrosis from transfusion reactions, poisoning, antifreeze, and other toxic exposures |
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Definition
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Term
| Is Acute Renal Failure a sudden shut-down or a long shut-down? |
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Definition
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|
Term
| Acute Renal Failure from reduced blood flow is consistent with what? |
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Definition
Shock
Burns
Cardiac Problems |
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Term
| What does Acute Renal Failure lead to? |
|
Definition
Electrolyte Imbalances
Water Retention
CHF
Arrhythmias |
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Term
| What decreases in Acute Renal Failure |
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Definition
|
|
Term
| What will you find microscopically with Acute Renal Failure? |
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Definition
Renal tubular cells and casts
Waxy casts
Anemia |
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Term
| When ADH decreases what happens? |
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Definition
| Reabsorption Decreases and Urine Increases |
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Term
|
Definition
| # of particles / kg of solvent |
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Term
|
Definition
Renin
Prostaglandins
Erythropoietin |
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|
Term
What is the average GFR?
(Hint: it is the same as average adult CrCl) |
|
Definition
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