Biochemical Testing III Flashcards Preview

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Flashcards in Biochemical Testing III Deck (36):
1

What is in highest concentration in a patent who is oxidizing fatty acids?

Beta-hydroxybutyrate

2

Ketones:
- principle

Acetoacetate + sodium nitroprusside -> purple color

3

Ketones:
- Ketonemia and ketonuria occurs when the body metabolizes _____ _____ due to inadequate amounts of _______

Fatty Acids
Carbohydrates

4

Ketones:
- 3 general reasons for ketonemia

1. inability to use carbohydrates (type 1/gestational diabetes)
2. Inadequate intake of carbs (starvation/diets)
3. Loss of carbohydrates (vomiting/starvation/dieting=Atkins diet)

5

Ketones:
- specificity is to what?

sensitive to acetoacetate

6

Ketones:
- False Postives

Drugs that contain free-sulfhydryl groups

7

Ketones:
- False Negatives

- improper storage and handling
- improper storage of strips
- uncapped specimens
- acidosis

8

Urobilinogen:
- principle (2 methods)

- Multistix (Ehrlich's Reaction)
- Chemstrip (Diazo reaction)

9

Urobilinogen:
- what is the increased production of bilirubin leading to increased urobilinogen produced and consequently increased urobilinogen in urine

Prehepatic mechanism

10

Urobilinogen:
- What conditions lead to pre hepatic urobilinogen?

hemolytic anemia, sickle cell, hereditary spherocytosis, thalassemia, pernicious anemia or transfusion reactions

11

Urobilinogen:
- what is it when a damaged liver is not capable of reabsorping urobilinogen from the portal circulation leading to additional urobilinogen entering the blood stream?

Hepatic Mechanism

12

Urobilinogen:
- Conditions that cause hepatic urobilinogen?

Hepatitis
Cirrhosis

13

Urobilinogen:
- What is it called when conjugated bilirubin will not be able to enter the intestine due to blockage in the bile duct leading to no urobilinogen production?

Post-hepatic Mechanism

14

Urobilinogen:
- False Positives

- p-aminosalicylic Acid
- sufamethoxazol

15

Urobilinogen:
- False Negatives

- exposure to light
- High Nitrites

16

Bilirubin:
- principle

uses the diazo reaction

17

Bilirubin:
- What test has greater sensitivity to bilirubin?

ictotest

18

Bilirubin:
- In what mechanism is bilirubin negative?
- Examples

Prehepatic Mechanism
- hemolytic disease like transfusion reactions or hemolytic anemia

19

Bilirubin:
- In what mechanism does conj bilirubin "leak" from damaged hepatocyte back into the blood, thus increasing urine bilirubin?
- examples?

Hepatic mechanism
- Hepatitis and Cirrhosis

20

Bilirubin:
- In what mechanism is conj bilirubin unable to pass though the bile duct and thus back up not the liver and bloodstream leading to bilirubin in the urine?
- examples?

Post-Hepatic Mechanism
- Bile duct blockage

21

Bilirubin and Urobilinogen:
- Which one (or both) is positive in Prehepatic (hemolytic disease)

Bili: neg
Uro: Pos

22

Bilirubin and Urobilinogen:
- Which one (or both) is positive in Hepatic (Liver damage)

Bili: Pos
Uro: Pos

23

Bilirubin and Urobilinogen:
- Which one (or both) is positive in Posthepatic (bile duct obstruction)

Bili: Pos
Uro: Neg

24

Bilirubin:
- False Positives

- pH > 9.0
- some meds

25

Bilirubin:
- False Negatives

- Ascorbic Acid
- Hight Nitrites
- Improper storage

26

Blood:
- What all does it detect?

hemoglobin, intact RBC's and myoglobin

27

Blood:
- Principle

based off of the peroxidase-like activity of hemoglobin

28

Blood:
- What is hematuria
- what clarity?

- intact red cells in the urine
- cloudy (red cells seen microscopically)

29

Blood:
- what causes hematuria?

- trauma
- renal calculi
- advanced glomerular damage
- infection
- Neoplams

30

Blood:
- What is hemoglobinuria
- What clarity?
- color?
- What should you look for?

- Hemoglobin in the urine
- usually clear
- yellow to red to brown
- Hemosiderin granules

31

Blood:
- Hemoglobinuria is caused by what?

Associated with hemolysis
- hemolytic disease
- poisoning
- burns
- transfusion reaction
- paroxysmal nocturnal hemoglobinuria

32

Blood:
- What is myoglobinuria
- clarity?
- color

- myoglobin in the urine
- clear
- reddish brown

33

Blood:
- Myoglobinuria is caused by what?

Associated with muscle destruction
- traumatic accidents
- alcoholism or drug use
- muscle wasting disease

34

Blood:
- False Positives

- menstrual contamination
- microbial peroxidases

35

Blood:
- False Negatives

- Ascorbic Acid
- Unmixed specimens
- High specific gravity leading to crenelated RBC's

36

What situation makes it impossible to interpret a reaction?

In highly colored urine from meds or pigments from certain foods