What are non Protein nitrogen compounds?
They are metabolic products that have the element Nitrogen in it but are not proteins
List the most important NPNs
Urea - proteins
Creatinine-creatine, creatine phosphate
Uric acid- nucleic acids
Ammonia- proteins
Amino acids - proteins
Why is the examination of NPN in the blood and urine important?
for monitoring the condition of the liver and kidney(renal status)
Urea diffuses well through cell membranes, so it's concentration is the same in both plasma and intracellular fluid
True or False
True
What factors determine the concentration of blood urea
Dietary protein content
Renal excretion
Hepatic metabolic function
Mention some clinical application of blood urea measurement
Evaluate renal function
To assess hydration status
To determine nitrogen balance
To aid in the diagnosis of renal disease
To verify adequacy of dialysis
What is azotemia
Elevated conc. of urea in the blood
Very high plasma urea Conc. accompanied by renal failure is called…
Uremic syndrome
What causes pre renal azotemia
Anything that produces a decrease in functional blood volume
High protein diet or increased catabolism
Name some of the causes of renal azotemia
Acute or chronic renal failure
Glomerular nephritis
Tubular necrosis
Other intrinsic renal disease
What causes post renal azotemia?
Obstruction of urine flow
Tumors of bladder or prostate
Severe infections
What causes decreased urea nitrogen
Low dietary intake
Liver disease (lack of synthesis)
Severe vomiting
Increase protein synthesis
What is the BUN/Creatinine ratio used for?
And what is its normal range?
And what is the normal range?
Used to distinguish between prerenal and renal causes of azotemia
Normal ratio 10:1 to 15:1
BUN/Creatinine ratio would elevate at the same rate in renal azotemia true or falsetrue
If the BUN/Creatinine ratio is elevated above 15:1…what does it mean?
Azotemia is due to pre renal causes
Which Amino acids is used to make creatine
Arginine
Glycine
Methionine
AGM
Function of creatine phosphate high
High energy source for muscle tissue
What is the waste product of creatine and creatine phosphatecreatinine
Creatinine
Why do we measure Creatinine levels to monitor
To monitor muscle diseases
What is measurement of Creatinine used for to measure
To monitor
Muscle disease
Muscular dystrophy
Poliomyelitis
Nb: it has been replaced by the measurement of creatine
Is creatine kinase elevated in Hepatic or renal disorders? No
No
Creatinine release into circulation is proportional to muscle mass
Plasma Creatinine concentration is a function of
Creatinine is a very good test to evaluate renal function? True
In Which disease is Creatinine elevatedBn
Abnormal renal function
Measurement of Creatinine concentration is used to determine
What is GFR?
GFR is the volume of plasma filtered by the glomerulus per unit of tine
What is GFR used to estimate
Renal function
What is Creatinine clearance
A measure of the amount of Creatinine eliminated from the blood by the kidneys per unit
Relation of plasma concentration to clearanceplasma
Plasma concentration of Creatinine is inversely proportional to clearance
Name the 2 pathways nucleic acids in the body follow
It is oxidized to urate
It is reused for nucleic acid synthesis
What enzyme catalyzes the conversion of nucleic acid to uratexanthine oxidase
Xanthine oxidase
NB: adenine is oxidized to hypoxanthine before xanthine
Guanine is oxidized to xanthine
Which enzymes catalyzes the salvage pathway
Hypoxanthine-Guanine phosphoribosyl transferaseHGPRT
Adenine phosphoribosyl transferaseAPRT
List some of the factors the influence the level of plasma urate concentration
Sex
Obesity
Social class
Diet
Genetic factors
What is hyperuricemia?
And what are the normal ref ranges
It is plasma or serum Uric acid concentration of more than 7.0mg/dl
Normal ref ranges
Males: 2 to 7.5
Females: 2 to 6.5
Hyperuricemia is a necessary precondition for what clinical disease?
Gout
What are the causes of hyper uricemia
Increased rate of urate formation
Reduced rate of urate excretion
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