Question | Answer |
what is bilirubin derived from? | myeoglobin, hemoglobin, destroyed RBC's, hemolysis |
How can drugs cause jaundice? | causes hemolysis, causes bile stasis, competing with bilirubin for albumin, direct hepatic effect on toxic cells |
jendrassik Grof | method for bilirubin, uses diazotized sulfanilic acid |
evelyn malloy | measures unconjugated bilirubin, dependent upon addition of methanol |
serum bilirubin methods | bilirubinometer,Jandrassik Grof, bilirubin oxidase |
Liver failure | increased PTA, bile NH3 and decreased albumin |
functions of liver | -synthesis of cholesterol and bile acids, storage of vitamin A, |
how are liver fxns assessed | ALT and AST |
potentially toxic byproduct that is detoxified by the liver | NH3 |
urobilin | breakdown product of bilirubin metabolism produced in colon from the oxidation of urobiligen by microorganisms |
jaundice | yellow pigmentation of skin |
kernictious | abnormal accumulation of bile in the brain |
bilirubin metabolism | RBC disenegrate, Hmg released and converted to pigment bilirubin by the spleen |
direct bilirubin | conjugated in the liver, attached to glucoronic acid, excreted in urine of jaundice patient |
biliary destruction | increased total bilirubin, hemolytic jaundice,criggler najjar syndrome, |
hemolytic jaundice types | cirhosis,criggler najjar, hepatitis, increased unconjugated bilirubin serum |
criggler najjar | defficiency of an enzyme needed to conjugate bilirubin |
dubin johnson | excessive conjugated bilirubin in urine |
cirrhosis | alcoholism |
complete obstrucion of bile duct characterized by | neg urobilogen in urine, neg fecal urobilogin in urine, excretion of pale colored stool |
major compund in non protein nitrogen | urea |
how does nh3 keptbetween limits to maintain acid base balance | synthesis of urea from nh3 |
disorders associated w increased blood nh3 | reyes syndrome, renal failure, chronic liver failure |
serum creatinine v GFR | serum creatinine increases, GFR decreases |
BUN/ creatinine ratio and whats associated w increased BUN | 1:20, kidney failure, heart failure, dehydration and high protein |
process of creatinine | creatine is precursor of creatinine |
Bartholat | urea test blue green complex |
gaffe rxn | colorimetric test for creatinine, alpaline conditions |
creatinine clearance test | UxV/P, p =serum creatinine, used to assess GFR |
if urine is not fresh and requiring a creatinine level what must be done | pH adjusted to 7 |
why is creatinine a good substance for a claearnce test ? | blood levels are stable |
creatine process | filtered by glomeruli, not reabsorbed by tubule, only secreted by tubules when plasma levels become elevated |
tests increased in renal failure | K,mg,phos,urea,creatinine,uric acid, decreased are Ca and erythropoietin |
gout | increase in uric acid |
why do pple in chemo get gout sometimes? | chemo increases uric acid |
end product of protein metabolism | urea |
proximal tubule fxn | -reabsorbs 80% of salt and H20 |
relationship between serum creatinine and GFR | inverse |
normal renal plasma flow | 600ml/min |
what happens to the BUN/creatinine ratio in prerenal azotemia? | increased BUN/creatinine, (BUN should be higher) |
Proximal tubule | returns substances back to blood and secrete products of kidney metabolism, |
Proximal tubule | returns substances back to blood and secrete products of kidney metabolism, |
loop of henle | reabsorbs H20, Na + Cl |
how to estimate Bun | creatinine age race gender |
best accurate test for GFR | creatinine=Unpaired renal function |
dialysis | method for seperating macromolecules from solvent |
urea:urea nitrogen ratio | 2.14:1.0 |
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