AUBF BOOK (Finals) Flashcards
Reagent strips currently provide a simple, rapid means
for performing medically significant chemical analysis of
urine including
pH
protein
glucose
ketones
blood,
bilirubin
urobilinogen
nitrite
leukocytes
specific gravity
Two major brands for reagent strips
Multistix and Chemstrip
Reagent strips should be read between
60 to 120 secs
Strips are dependent on ____
temperature
Manufacturers recommend that reagent strips be stored at
room temperature below
30 deg C
QC of reagent strips
Reagent strips must be checked with both positive and negative
controls a minimum of once every
24 hours
can cause a highly dark yellow colored urine
Phenazopyridine
CARE OF REAGENT STRIPS
Store with desiccant in an opaque, tightly closed container
Store below 30°C; do not freeze.
Do not expose to volatile fumes.
Do not use past the expiration date.
Do not use if chemical pads become discolored
Remove strips immediately prior to use
A healthy individual usually produces a first morning specimen with a slightly acidic pH of
5.0 to 6.0
An alkaline pH is found following
meals
The pH of normal random samples can range from
4.5 to 8.0
Persons with high protein and high meat pH:
more acidic urine
Vegetarians urine pH
more alkaline
Cranberries produces an
acidic urine
Medications such as methenamine, mandelamine, or monurol are metabolites to produce
acidic urine
The pH of freshly excreted urine does not reach above
8.5
A pH above 8.5 is associated with an
improperly preserved specimen
Amorphous urate is seen in pH
Acidic
Amorphous phosphate is seen in pH
alkali
Renal alkali seen in urine indicates
kidney stones
The Multistix and Chemstrip brands of reagent strips measure urine pH in 0.5- or 1-unit increments between pH 5 and 9 color change
5 orange > yellow > 9 blue
produces a color change from red to yellow in the pH range 4 to 6,
Methyl red
Turns from yellow to blue in the range of 6 to 9
bromothymol blue
Most indicative of renal disease is the —- determination
Protein
Often associated with early renal disease.
Proteinuria
Normal urine contains very little protein: usually, less than ___ is excreted
10 mg/dL or 100 mg per 24 hours
Consist of low molecular proteins that have been filtered by the ____
glomerulus
major serum protein found in normal urine
Albumin
Much of the filtered albumin is reabsorbed by the _______.
tubules
Produced in renal epithelial tubular cells and prostatic seminal and vaginal secretions
Tamm-Horsfall protein (uromodulin)
Routinely produced in the DCT (distal convoluted tubule)
Tamm-Horsfall protein (uromodulin)
Clinical proteinuria is indicated at
30 mg/dL or greater (300 mg/L)
Normal value of proteinuria
Normal – less than 10 mg/DL
caused by conditions affecting the plasma prior to it reaching the kidney, and therefore, is not indicative of actual renal disease
Prerenal proteinuria
A proliferative disorder of the immunoglobulin producing plasma cells, the serum contains markedly elevated levels of monoclonal immunoglobulin light chains
Bence Jonce Protein (Multiple Myeloma)
Renal proteinuria associated with true renal disease may be the result of either
glomerular or tubular damage
toxic substances, and the immune complexes found in lupus erythematosus and streptococcal glomerulonephritis
Amyloid material
Proteinuria that occurs during the latter months of pregnancy may indicate a
pre-eclamptic state
Indication of strenuous exercises, high fever, dehydration, exposure to cold, protein shakes with amino acids
Benign proteinuria
Indicates the presence of an abnormal urinary excretion of albumin, signifying endothelial dysfunction and an increased risk for cardiovascular morbidity and mortality
Microalbuminuria
Occurs following periods spent in a vertical posture and disappears when a horizontal position is assumed.
Orthostatic (Postural) Proteinuria
Causes – exposure to toxic substances and heavy metals
Tubular proteinuria
The amount of protein that appears in the urine following glomerular damage ranges from slightly above normal to
4g/day
Bacterial and fungal infections and inflammations produce exudates containing protein from the interstitial fluid
Post Renal Proteinuria
tetrabromophenol blue multistix detects:
Protein
tetrachlorophenol acid buffer
protein
