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Clinical Chemistry 2 > 5-8. Urinalysis > Flashcards

5-8. Urinalysis Flashcards

(87 cards)

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1
Q

Urine creatinine should be __x that of plasma creatinine

A

50x

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2
Q

What can be used to differentiate hemoglobin from myoglobin in terms of solubility

A

Ammonium sulfate

  • Hgb precipitates
  • Myo remains soluble
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3
Q

Method for determining glucose on dipstick

A

Glucose oxidase

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4
Q

If these casts remain in tubules long enough, they begin to look waxy

A

Granular

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5
Q

How to differentiate whether hemoglobin or myoglobin is present in urine?

A

Solubility in saturated ammonium sulfate

  • Hgb precipitates
  • Myoglobin is soluble
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6
Q

2 main differences between ischemic and toxic acute tubular necrosis (ATN)

A

Ischemic - affects tubules in random areas; disrupts basement membranes = RTEs in urine

Toxic - tubular necrosis in proximal tubules; doesn’t involve BMs = epi cells in urine

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7
Q

Isosthenuric urine (SG=1.010) occurs when..?

A

Tubules unable to concentrate urine, so SG of excreted urine is same of ultrafiltrates’

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8
Q

These casts signify nephrotic syndrome

A

Fatty casts

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9
Q

Crystal that is a feature of an old specimen

A

Ammonium biurate

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10
Q

3 mechanisms that result in ketonuria

A
  • Inability to use carbs
  • Inadequate intake of carbs
  • Loss of carbs
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11
Q

Responsible for white foam in urine

A

Albumin

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12
Q

Urine preservative when urine is for drug analysis

A

Sodium fluoride

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13
Q

Limitation of chemstrip protein pad?

A

Only detects albumin

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14
Q

What interferes with diazo rxn and how

A

Ascorbic acid; competes w/ nitrite to combine w/ diazonium salt

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15
Q

The refractometer is affected by this parameter and is a source of error

A

Temperature fluctuations

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16
Q

Most commonly requested test on a catheter specimen

A

Bacterial culture

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17
Q

Epithelial casts are mostly composed of this cell

A

RTE

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18
Q

Large colorless needles in fan or wheat sheaf formations w/ eccentric binding

A

Sulfonamide crystals

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19
Q

What does clear, red urine suggest (scientific name)?

A

Hemoglobinuria or myoglobinuria

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20
Q

Pre-hepatic jaundice urobilinogen and bilirubin in urine?

A
  • Uro INCREASED

- NO bili in urine

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21
Q

Usually found together with leucine crystals in patients with terminal cirrhosis or viral hepatitis

A

Tyrosine crystals

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22
Q

What does cloudy, red urine suggest (scientific name)?

A

Hematuria (RBCs present)

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23
Q

Refractile needles occurring in sheaves or clusters; may be colourless but appear black as the field is focused

A

Tyrosine

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24
Q

Which rxn principle? Leukocyte

A

Diazo

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25
Urine preservative best for bilirubin/urobilinogen
Freezing
26
Normal pH of urine
4.0 - 8.0
27
Normal urine odour is due to?
Volatile acids
28
Con of refrigeration as a method of preservation?
- Precipitation = adds formed elements | - Changes clairty
29
Clear red urine may be caused by?
Hemoglobin
30
pH on chemstrip source of error?
Bacterial growth
31
Nitrite is detected by this reaction
Greiss
32
Uric acid is soluble at _______ or with addition of ________
60 degC | 10% NaOH
33
The only 4 physical/chemical/microscopic changes that increases rather than decrease in unpreserved urine
- Odour - pH - Nitrite - Bacteria
34
What does significant pyuria WITHOUT bacteria suggest?
UTI involving viruses, yeast, chlamydia
35
4 confirmatory tests?
- Ictotest (bilirubin) - Clinitest (glucose) - Acetest (ketones) - SSA test (protein)
36
3 ingredients in SG reagent strip test pad?
- Polyelectrolyte - Acid-base indicator - Buffers
37
4 clinical reasons for performing a routine urinalysis
1. Aid diagnosis of disease 2. Screen population for disease 3. Monitor progress of disease 4. Monitor effectiveness or complications of therapy
38
The presence of RBC casts is indicative of this disease
Glomerulonephritis
39
Crystal associated with maple syrup disease
Leucine
40
Which rxn principle? Blood
Peroxidase
41
Which rxn principle? Ketones
Nitroprusside
42
Characteristic yellow colour, but oxidizes to biliverdin upon standing => greenish hue
Bilirubin
43
Red-brown urine may be caused by?
Myoglobin (rhabdomyolysis)
44
2 indicators in pH reagent pad
Methyl red, bromothymol blue
45
Post-hepatic jaundice urobilinogen and bilirubin in urine?
- NO uro | - INCREASED bili in urine
46
When do you +0.005 to SG readings on manual chemstrips?
When pH >= 7.0
47
Appearance of "thorny apples"
Ammonium biurate
48
Crystal that is a pink precipitate
Amorphous URATES
49
Gives urine its characteristic yellow colour
Urochrome
50
Colourless, long, thin prisms or needles with on pointed end Often arranged in rosettes or stars
Calcium phosphate
51
Hepatic jaundice urobilinogen and bilirubin in urine?
- Uro VARIABLE | - INCREASED bili in urine
52
Normal temperature of urine
32.5-37.5 degC
53
Normal specific gravity of urine
1.002 - 1.035
54
Outline ketone reagent pad reaction
Acetone + sodium nitroprusside (+glycine) → purple colour
55
3 ketone bodies in urine, and which can't be detected on dipstick and acetest
- Acetone - Acetoacetate - B-hydroxybutryic acid B-hydroxybutryic acid not detected
56
Condition under which glucosuria will occur?
Blood glucose >10 mmol/L
57
This crystal has monohydrate and a dihydrate form
Calcium oxalate
58
Appear as long narrow crystals with points at EITHER end Soluble in acetic acid
Hippuric acid
59
Principle behind automated chemstrip reader
Reflectance photometry
60
3 crystals found in acid pH
- Uric acids - Calcium oxalates - Amorphous urates
61
Urine preservative that acts as a reducing agent (interferes with glucose, blood, leukocyte esterase)
Formalin
62
2 types of timed specimen
Pre-determined length of time (hormones, creatinine clearance) At specific time of day (glucose, urobilinogen)
63
2 crystals soluble at 60C or addition of dilute NaOH
Uric acid | Amorphous URATES
64
2 other urine proteins that may be present in lower concentrations
- Urokinase | - secretory IgA
65
Abnormal crystal associated with ethylene glycol poisoning
Hippuric acid
66
Urine preservative that may interfere with drug and hormone analysis
Acidification
67
Environment that may cause RBCs to appear as 'ghost cells'
Alkaline pH
68
Red-purple urine may be due to..
Porphyrins
69
Hgb oxidation to methehemoglobin in urine is enhanced at this pH range
Alkaline
70
Whcih rxn principle? Glucose
Peroxidase
71
Cloudy red urine may be caused by?
RBCs, menstrual contamination
72
Which rxn principle? Urobilinogen
Ehrlich reaction
73
Casts are mainly composed of this glycoprotein
Tamm-Horsfall
74
Difference between glomerular and tubular proteinuria?
Glomerular - due to increased gloumerular permeability Tublar - due to defective tubular reabsorption
75
Responsible for orange-brown pigment in urine
Urobilin
76
Principle of Greiss reaction in nitrite detection
Nitrite, in acidic pH, reacts with aromatic amine = diazo compound Diazo reacts w/ quinolone compound = pink azodye
77
These cells exude the Tamm-Horsfall mucoprotein
Renal tubular epithelial cells (RTEs)
78
Bacterial decomposition and UTI may give urine this odour
Ammonia odour
79
Potential cause of false positive protein dipstick
Highly alkaline urine
80
Clinitest is based on what reaction and principle?
Cupric sulfate -> cuprous oxide (colour change blue to green to orange) via reducing substances (sugars)
81
Colourless, retractile hexagonal plate
Cysteine
82
Acetest _______ + ______________ -> purple colour
Acetone + sodium nitroprusside
83
Mousy urine odour may be due to what disease?
PKU
84
What is 'alkaline tide'?
When urine is less acidic after a meal due to stomach secreting acid to aid in digestion
85
On urine chemstrip - this ingredient dissociates and releases H+ in response to pH
Polyelectrolyte
86
Pink pigment most evident when it deposits on urate crystals, producing a precipitate
Uroerythrin
87
__________ does not show up in a chemical test for blood on the SUPERNATANT of a spun urine
Myoglobin

Clinical Chemistry 2 (15 decks)

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