Treatments Quiz 3

Question 1

Urine Dipstick for Proteinuria

Answer 1

Important notes:

• Sensitive only to albumin
• pH dependent (false + in alkaline urine)
• False positive w/ gross heamturia or dilute urine

*This will not detect bence jones (light chains) protein in multiple myeloma

Question 2

Acid precipitation Urine Proteinalysis

Answer 2

Detects albumin and globulins (will detect Bence Jones)

False + w/ gross hematuria and some meds

Question 3

Acid Base Evaluation

Answer 3

1. ) Acidosis or Alkalosis (never fully compensates!)
2. ) Calculate Anion Gap (MUDPILES)
3. ) If Anion Gap is elevated –> calculate osmolal gap (DDX Ethylene glycol and methanol form salicylate, DKA, lactic)
4. ) Calculate Delta Gap (high = metabolic alkalosis; low = nongap acidosis
5. ) Clinical picture!

Question 4

Anion gap

Answer 4

Na - (Cl + HCO3-)

Normal 8-12

Question 5

Osmolol Gap

Answer 5

Measure if anion gap is elevated

2(Na) + Glucos/18 + BUN/2.8 = calculated osmolols

Measured osmoles - calculated osmoles = osmol gap.

This will be elevated in ethylene glycol and methanol (not in aspirin, DKA, lactate)

Question 6

Delta Gap

Answer 6

Exess ion gap and bicarb should equal normal bicarb.

If low = non gap acidosis present

If high = metabolic alkalosis present