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WorksheetsCLINICAL CHEMISTRY 2 (PRELIM)
Total questions: 60
Worksheet time: 2hrs 0mins
A waste product of muscular metabolism
Creatinine
Uric Acid
Urea
Ammonia
Plasma creatinine is ____ related to glomerular filtration rate
Inversely
Directly
Creatinine if formed from these amino acids
Lysine, Glutathione, Alanine
HIstidine, Aspartic acid, Proline
Methionine, Arginine, Glycine
Threonine, Aspargine, Valine
Cause of increase in Creatinine levels
Hemodilution
Myopathy
Denutrition
Heart failure
Cause of decrease in Creatinine levels
Severe Muscular Atrophy
Old age
Prolonged fasting
Leukemia
Strenuous exercise or fist clenching can result to a falsely increased creatinine result
True
False
Dopamine and Lidocaine can falsely decrease creatinine result
True
False
This method produces a Red-orange complex known as Janovski Complex
Jaffe reaction
Blauch & Koch
Fearon Reaction
Xanthydral Reaction
An enzymatic method where Creatinine reacts with DNBA to form a purplish rose colored product
3,5 Dinitrobenzoic Acid
Creatinase Method
Iminohydrolase
Creatinine Aminohydrolase
In this method, protein-free filtrate is first absorbed by hydrated aluminum silicate to remove interfering substances to measures the value of true creatinine.
Folin-Wu
Lloyd’s Method
Berthelot Reaction
Nesslerization
Major excretory product of protein digestion
Creatinine
Uric Acid
Urea
Ammonia
Urea is ________ in the kidney
Reabsorbed
Secreted
Filtered
Bothe a & b
Both a & c
This occurs when there is a lesion in the kidney
Renal Azotemia
Pre-renal Azotemia
Post-renal Azotemia
None of the above
This is seen in kidney stones, prostatic enlargement, and tumor of the urinary tract
Renal Azotemia
Pre-renal Azotemia
Post-renal Azotemia
None of the above
A clinical syndrome in a patient suffering from loss of renal function
Hyperkalcemia
Edema
Azotemia
Uremia
In this method, urea reacts directly with xanthydral reagent to form dixanthydral urea
Fearon Reaction
Xanthydral Reaction
Acid titration
Nesslerization
This measures the conductivity of a mixture where NH4+ and HCO3- are generated by the urease reaction.
Conductivity Rate
Urograph Method
Ammonium sensing electrode
NADH Consumption
Normal value for serum urea
5-10 mg/dL
10-20 mg/dL
20-40 mg/dL
40-80mg/dL
Adaptation of Nesslerization method for measuring urea
Gentzkow-Masen
Jaffe reaction
Folin-wu
DNBA
Urea is stable in urine samples for up to
2 days without preservative
4 days with preservative
6 days without preservative
8 days with preservatives
End-product of purine metabolism
Creatinine
Uric Acid
Urea
Ammonia
Confirm diagnosis and monitor treatment of gout
Creatinine
Uric Acid
Urea
Ammonia
High bilirubin concentration may ____ result in uric acid obtained by peroxidase methods
Falsely decrease
Falsely increase
No effect
High bilirubin concentration may falsely decrease result obtained by peroxidase method
True
False
In Blaunch & Koch method, the uric acid concentration in the sample is proportional to the ___ in absorbance
Increase
Decrease
No effect
Method where the hydrogen peroxide produced is used to oxidize methanol to formaldehyde.
Uricase-Hantzch reaction
Polarographic Uricase method
Differential UV Absorption
Direct Redox Method
The enzyme uricase may be extracted from
Bacillus subtilis
Candida albicans
Bacillus fastidiousus
Candida krusei
Normal value for uric acid (female)
2.6-6.0mg/dL
35-72mg/dL
2.8-4.28umol/L
1.55-3.57umol/L
Uric acid levels is increased in
Liver disease
Enzyme deficiency
Purine-rich diet
Toxemia of pregnancy
Uric acid levels is increased in
Lesch-Nyhan syndrome
Over-treatment of allopurinol
Fanconi syndrome
Chemotherapy
Conversion factor for Creatinine
88.4
0.357
0.0595
4.329
Conversion factor for Uric Acid
88.4
0.357
0.0595
4.329
Normal value of total NPNs in wholeblood
20-35mg/dL
25-50mg/dL
250-400mg/L
150-255mg/L
Which of the following is a fasting specimen
Uric acid
Creatinine
Urea
All of the above
None of the above
Most accurate for GFR determination
Creatinine clearance
B-trace protein
Inulin clearance
Cystatine C
Most common endogenous substance used for GFR determination.
Creatinine clearance
B-trace protein
Inulin clearance
Urea clearance
Decreased Urea clearance may indicate
Pregnancy
Burns
High cardiac output
Hemorrhage
Used to exclude nephrogenic diabetes insipidus.
PSP Dye excretion test
PAH clearance
Water deprivation test
Osmometry
Used to confirm the diagnosis of distal renal tubular acidosis
Specific gravity
Osmolality
Ammonium chloride test
Inulin clearance
Normal value for inulin clearance (Male)
125mL/min
115mL/min
125mmoL/min
115mmoL/min
This substance is independent on the volume of blood perfusing the kidney and has been the reference method for ERPF determination.
PAH clearance
PSP Dye Excretion test
Urea clearance
Inulin clearance
Normal value for PSP Dye excretion test
60-86% excretion in 2hrs
24-58% excretion in 2hrs
80-94% excretion in 2hrs
46-62% excretion in 2hrs
A urinary osmolality <750 mOsmol/Kg H2O implies a normal concentrating ability of tubules.
True
False
This is used to evaluate renal function and to differentiate between etiologies of polyuria.
Osmometry
U/S Osmol ratio
Delta osmolality
Specific gravity
The concentration and dilution of kidney tubules are based on the degree of hydration or tonicity of extracellular fluid.
True
False
What condition does U/S osmol ratio: <1.2 and Urine Na: > <1.2 Urine Na: >20 mEq/L suggests?
Osmotic diuresis
Glomerular impairment
Water diuresis
Acute tubular dysfunction
What condition does U/S osmol ratio: <1 suggests?
Osmotic diuresis
Glomerular impairment
Water diuresis
Acute tubular dysfunction
The principle of this method is NADH consumption which is measured at 340nm
Creatinine Aminohydrolase Method
Creatinine Iminohydrolase
Coupled Creatinine Aminohydrolase
3,5 Dinitrobenzoic Acid
One adaptations of Jaffe reaction that is less specific as in it measures non-creatinine chromogens as well like glucose, proteins, acetoacetate, pyruvate, uric acid, fructose and ascorbic acid
Fuller’s Earth Method
Lloyd’s Method
Folin-wu Method
DNBA
The H2O2 produced by the enzymatic reaction is coupled with peroxidase reaction using chromogens such as o-dianisidine, dimethyl aniline, p-amino phenazone
Coupled Uricase Reaction
Uricase-Hantzch Reaction
Polarographic uricase Method
Differential UV Absorption
It is considered the most reliable test for renal pathology and screening test or index of overall renal function
Creatinine
Ammonia
Uric Acid
Urea
It is a measure of the clearance if normal molecules that are not bound to protein and are freely filtered by the glomeruli neither reabsorbed nor secreted by the tubule
CFG
GFR
RCF
RGC
Calculate for Creatinine Clearance: Serum creatinine = 2.6 mg/dL; Urine volume = 1100mL; Urine creatinine = 240mg/dL
0.066
0.657
0.668
0.068
Calculate for Creatinine Clearance: Serum creatinine = 5.9 mg/dL; Urine volume = 800mL; Urine creatinine = 660mg/dL
0.622
62.157
6.216
0.006
Preservative used for preserving NPNs in urine
Boric acid
Hydrochloric acid
Acetic acid
Thymol
This makes up majority of the NPNs
Urea
Uric Acid
Creatinine
Ammonia
Convert BUN = 2.89mg/dL to Urea (mg/dL)
6.19
0.62
1.35
0.14
Convert Urea = 9.8mg/dL to BUN (mg/dL)
4.58
20.97
0.46
21.0
In measuring creatinine, plasma or serum is preferred over whole blood because of the interference posed by chromogens in red blood cells
True
False
Urine osmolality is the best method to determine maximal concentration and dilution of urine.
True
False
