Biochemical Testing II Flashcards Preview

Urinalysis > Biochemical Testing II > Flashcards

Flashcards in Biochemical Testing II Deck (29):
1

Protein:
- principle

Protein error of indicators

2

Protein:
- What protein is primarily tested?

albumin

3

Protein:
- Proteinuria is an indicator of ______ ______ and is often the very first indicator.

renal disease

4

Protein:
- reference range

Varies 1-14 mg/dL (150 mg/dL) is ok, but > 30 mg/dL is considered clinical proteinuria

5

Protein:
- 6 general reasons for protein in the urine

1. Glomerular Damage
2. Increased Glomerular Pressure
3. Decreased Tubular Reabsorption
4. Orthostatic/Postural Proteinuria
5. Overflow Proteinuria
6. Benign Causes

6

Protein:
- Causes of Glomerular Damage (4)

- Amyloidosis
- Toxic Substances
- SLE
- Strep glomerulonephritis

7

Protein:
- Causes of Increased Glomerular Pressure (3)

- Exercise
- Dehydration
- Hypertension

8

Protein:
- Cause of Decreased Tubular Reabsorption (3)

- Toxic Substances
- Viral Infections
- Fanconi's Syndrome (damages prox tubules)

9

Protein:
- Describe Orthostatic/Postural Proteinuria and best urine specimens to collect

- Standing puts pressure on renal vein which leads to protein in the urine but laying down relieves the pressure.
- Best to collect day and night time urine specimens

10

Protein:
- Conditions that lead to PRE-RENAL overflow proteinuria

- Septicemia
- Hemolytic episode (hemoglobinuia)
- Muscle Injury (myoglobinuria)
- Immunoglobulins (Bence-Jones Proteins)

11

Protein:
- Conditions that lead to POST RENAL overflow proteinuria

- Inflammations due to bacterial or fungal infections
- presence of blood
- prostatic fluid or sperm

12

Protein:
- Benign causes of proteinuria (4)

- exposure to the cold
- exercise
- dehydration
- fever

13

Protein:
- Sensitively on Chem strip

6 mg/dL albumin

14

Protein:
- False Negatives

Strips detect albumin, proteins other than that may not be detected

15

Protein:
- False Positives

- very alkaline urines (>9)
- High specific gravity

16

What is albumin present in the urine below the detectable limits of a routine urine strip?

microalbuminuria

17

Principle for detecting microalbuminuria

use sensitive dye-binding reaction that is specific for albumin

18

What alternate test will precipitate all proteins by cold precipitation (not just albumin?)

Sulfosalicyclic Acid (SSA)

19

What will excess protein present look like when shaken?

foamy when shaken

20

What is the most common test performed on urine and why?

Glucose! because of its importance in detection and monitoring of diabetes

21

Glucose:
- Principle

Double sequential enzyme reaction

22

Glucose:
- Renal threshold

180 mg/dL

23

Glucose:
- Hyperglycemic patients will present with glycosuria. What patients are these?

- dabetes and gestational diabetes
- conditions: pancreatitis, cushing's syndrome, hyperthyroidism (oppose function of insulin leading to hyperglycemia)

24

Glucose:
- What causes patients with normal glucose levels to still present with glycosuria?

- damage to tubules that hinders reabsorption
- occurs in end stage real disease
- osteomalacia
- Fanconi's syndrome
- decreased reabsorption threshold in pregnancy

25

Glucose:
- false positives

oxidizing agents

26

Glucose
- False Negatives

- Ascorbic acid
- High Ketones
- High specific gravity
- drugs

27

What test should be performed for patients less than 2 years old to detect reducing sugars other than glucose?

Clinitest

28

What is a pathological condition that can lead to severe mental retardation, liver dysfunction, and cataracts?

Galactosemia

29

Limitation of the Clinitest

1. Not as specific or sensitive as glucose strip
2. man interfering reducing substances (ascorbic acid, drugs)