Non-Protein Nitrogen (9866-09)
Review non-protein nitrogens, such as creatine, creatinine, urea, uric acid and ammonia - pathways, measurement, detection methods and reference ranges.
PEP hours: 11
CPS/ART credits: 0
- Draw the urea cycle and describe the detoxification of ammonia to urea.
- Describe the estimation of urea by the diacetyl monoxime, phenol-hypochlorite (Berthelot), glutamate dehydrogenase and conductance electrode methods.
- Write the reference range of urea; state the effect of age, sex and diet on the range.
- State the significance of abnormal urea values in terms of pre-renal, renal and post renal causes.
- Describe creatine, creatine phosphate and creatinine, their formation, and usefulness in the body. State the importance of creatinine in assessing renal function.
- Describe the estimation of creatinine detailing specimen preparation and storage, principles of the Jaffe method, specificity, modifications used, precautions necessary and the compound actually measured in the final step.
- State the principles of creatinine measurement by creatinine amidohydrolase and creatinine iminohydrolase enzymatic methods.
- Write the reference range of creatinine in serum and 24 hour urine collection.
- State the significance of abnormal serum creatinine values in the assessment of renal function.
- Tabulate the factors that affect serum creatinine levels.
- Define clearance; write the mathematical formula used for clearance defining each term used.
- State the procedure use, reference range and the clinical significance of abnormal value.
- Explain the logic and list the formulae for the two most common calculations for eGFR.
- Describe the formation, structure, function, solubility and fate of uric acid.
- Describe the estimation of uric acid by the phosphotungstic acid and uricase methods.
- State the stability of uric acid in the specimen, sample preparation, reactions catalyzed, specificity, precautions necessary and the compounds actually measured in the final step of the methods.
- State the reference range of serum uric acid, and its dependence on sex and diet.
- State the urinary excretion of uric acid.
- Discuss the significance of abnormal uric acid values and specific causes of gout, hypouricemia and hyperuricemia.
- Describe the formation and utilisation of ammonia.
- Discuss the measurement of blood ammonia levels with respect to the specimen, methods used, reaction catalyzed and special precautions required.
- State the reference range for blood ammonia, and the significance of abnormal values.
Instructor: John Chapman, FCSMLS, FIMLS, CLSp(H)
Equipment: Computer with Internet is required
Start Date: Upon registration
Completion: Up to 52 weeks
Version Date: January 2009