Name: INSONG, OSANNAH IRISH B.

Section: BSMT 3C
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Laboratory Exercise NPNs
EXERCISE 9 MT 116

1. In pre-renal failure (circulatory insufficiency), what will be the expected BUN level? Justify
your answer. (2 pts)

In pre-renal failure, the BUN level is increased. This is because hypoperfusion or insufficient
blood supply to the kidneys causes a decrease in the filtration rate of urea allowing them to
accumulate in the bloodstream.

2. Give one advantage of the Berthelot reaction over Nesslerization in the determination of
urea. (2 pts).

Berthelot reaction is a much more simple procedure than nesslerization which calculates
protein concentration depending on the exact protein composition of a sample as each
protein has a different nitrogen content according to amino acid composition. However,
clinical samples consist of unpredictable mixtures of different proteins making the
measurement of nitrogen content by nesslerization a complex process.

3. Why are ammonium-containing anticoagulants contraindicated in enzymatic methods? (2 pts)

Ammonium-containing anticoagulants are contraindicated in enzymatic methods

because it will interfere in the results as it will cause falsely elevated ammonia levels.

4. What endogenous substance (NPN) may cause a positive interference in the

urease/glutamate dehydrogenase assay? What type of specimen gives this kind of
interference? (3 pts)

Ammonia causes a positive interference in the urease/glutamate dehydrogenase assay.

This occurs when an arterial specimen is used.

5. Give 2 specimen considerations for ammonia determination? (3 pts)

1.) The specimen which is arterial blood is stored and transported in ice.
2.) The plasma must be separated from the Red Blood Cells within 20 minutes after collection.

6. A urine specimen is submitted in the laboratory. Upon examination of the request, the
medtech noticed that the indicated specimen in the requisition is “plasma.” How will the
medtech clinically confirm the type of specimen submitted? (3 pts)

For the medical technologist to confirm the type of specimen submitted, he/she must test
for the levels of urea and creatinine. The levels of the aforementioned analytes are usually
: increased or higher in a urine specimen than in plasma specimen.

References:

- NeedhamE:Managementofacuterenalfailure.AmFamPhysician2005;72:1739–1746.
- Professional Practice in Clinical Chemistry: A Review. Workshop materials, sponsored
by the American Association for Clinical Chemistry and the National Academy of Clin- ical Biochemists in cooperation with The George Washington
University Medical Cen- ter. Washington, DC: AACC Press, 1991. 1