C5 Glucose through Ketones

Question 1

The most frequent chemical analysis performed on urine?

Answer 1

glucose

Question 2

clinical significance of glucose:

Answer 2

major screening test for DM, renal threshold is 160-180 mg/dl, higher blood sugar

Question 3

disease state when placental hormones block action of insulin?

Answer 3

gestational diabetes

Question 4

hormonal disorders

Answer 4

pancreatitis, pancreatic cancer, acromegaly, Cushing’s syndrome, hyperthyroidism, pheochromocytoma

Question 5

Hormones

Answer 5

glucagon, epinephrine, cortisol, thyroxine, growth hormone oppose glucose

Question 6

Insulin

Answer 6

converts glucose to storage glycogen

Question 7

hormones

Answer 7

glycogen back to glucose

Question 8

epinephrine

Answer 8

inhibits insulin; seen with stress, cerebral trauma, and MI

Question 9

Renal glycosuria

Answer 9

tubular reabsorption disorder, end-stage renal disease, Fanconi syndrome, cystinosis

Question 10

Reagent strip: chromogens used:

Answer 10

potassium iodide (green to brown) & tetramethylbenzidine (yellow to green)

Question 11

Reaction interferance: false positive

Answer 11

only peroxide, oxidizing detergents

Question 12

Reaction interference: false negative

Answer 12

enzymatic reaction interferance ((ascorbic acid and strong reducing agents))

Question 13

Copper Reduction Test (Clinitest)

Answer 13

reduction of copper sulfate to cuprous oxide with alkali & heat, color change- negative blue (CuSO4) through green, yellow, and orange/red (Cu2O)

Question 14

CuSO4(cupric sulfide)+reducing substance=

Answer 14

heat

Question 15

CuSO4(cupric sulfide)+oxidized substance+color

Answer 15

alkali

Question 16

In a clinitest, hygroscopic tablets: strong blue color and excess fizzing=

Answer 16

deterioration

Question 17

Interferance from reducing sugars:

Answer 17

galactose, lactose, fructose, maltose, pentoses, ascorbic acid, cephalosporins

Question 18

What is the major use for the clinitest?

Answer 18

inborn error of metabolism, in children up to 2 yrs, not specific for glucose

Question 19

Ketones

Answer 19

3 intermediate products of fat metabolism: acetone: 2%, acetoacetic acid: 20%, B-hydroxybutyrate: 78%

Question 20

diabetic ketoacidosis

Answer 20

increased accumulation of ketones in the blood (electrolyte imbalance, dehydration, & diabetic coma)

Question 21

Reagent Strip, primary reagent

Answer 21

sodium nitroprusside

Question 22

Acetest

Answer 22

not a urine confirmatory test, tablet=sodium nitorprusside, glycine, disodium phosphate, lactose…. test for ketones

Question 23

Hematuria

Answer 23

intact RBCs, cloudy red urine

Question 24

Hemoglobinuria

Answer 24

product of RBC destruction

Question 25

any amount of blood greater than five cells per microliter of urine is considered?

Answer 25

clinically significant

Question 26

Hemoglobinuria may result from?

Answer 26

lysis of RBCs in dilute, alkaline urine

Question 27

myoglobinuria

Answer 27

heme containing protein in muscle tissue: clear, red/brown urine

Question 28

rhabdomyolysis

Answer 28

muscle destruction

Question 29

urine bilirubin is an indicator of?

Answer 29

liver disease

Question 30

bilirubin is a normal degredation product of?

Answer 30

hemoglobin

Question 31

protophorphyrin is broken down in to?

Answer 31

bilirubin

Question 32

bilirubin is bound to?

Answer 32

albumin

Question 33

unconjugated bilirubin

Answer 33

water insoluble

Question 34

conjugated biliruin

Answer 34

water soluble

Question 35

conjugated bilirubin appears in urine with?

Answer 35

bile duct obstruction, liver disease/damage

Question 36

What is hepatitis, cirrhosis

Answer 36

conjugated bilirubin leaks back into circulation from damaged liver, some bilirubin passes into intestines

Question 37

Reagent strip reactions principle

Answer 37

diazo reaction

Question 38

Ictotest

Answer 38

confirmatory test for bilirubin, use specified mat for test, mat keeps bilirubin on surface for reaction

Question 39

Positive reactions for Ictotest is what color?

Answer 39

blue to purple

Question 40

bilirubin in intestine converted to ?

Answer 40

urobilinogen & stercobilinogen

Question 41

urobilinogen is

Answer 41

reabsorbed into circulation

Question 42

stercobilinogen is

Answer 42

not reabsorbed into circulation

Question 43

There is always a small amount of urobilinogen filtered by the kidneys & is found in the urine, what is that amount?

Answer 43

<1 mg/dl

Question 44

Negative bilirubin and strong positive urobilinogen are seen in what type of disorders?

Answer 44

hemolytic disorders

Question 45

in a urine with bile duct obstruction, how much urobilinogen is seen?

Answer 45

none

Question 46

Multistix principle?

Answer 46

Ehrlich's aldehyde reaction- light to dark pink

Question 47

Chemstrip principle?

Answer 47

diazo (azo-coupling) reaction- white to pink

Question 48

Nitrite

Answer 48

rapid screening test for the presence of UTI, tests ability of bacteria to reduce nitrate into nitrite

Question 49

Greiss reacton:

Answer 49

nitrite reacts w/ aromatic amine to form a diazonium salt that then reacts with tetrahydrobenzoquinoline to form a pink azodye

Question 50

Leukocyte esterase (LE)

Answer 50

standardized means for the detection of leukocytes, so as to not rely on microscopic, detects presence of esterase in the granulocytes and monocytes, detects presence of lysed leukocytes, perform microscopic if +

Question 51

clinical significance of leukocyte esterase (LE)

Answer 51

UTIs, inflammation of urinary tract, also seen with trichomonas, chlamydia, yeast & interstitial nephritis

Question 52

Leukocyte esterase (LE) reaction

Answer 52

catalyzes the hydrolysis of acid esterase on pad to aromatic compound and acid; aromatic compound reacts with diazonium salt on pad for purple color

Question 53

How long is the reaction time for Leukocyte Esterase (LE)

Answer 53

2 minutes

Question 54

Specific gravity

Answer 54

bases on pka (dissociation constant) of a polyelectrolyte in alkaline medium, polyelectrolyte ionizes releasing Hydrogen in relation to concentration of urine

Question 55

Reagent strips

Answer 55

provide a simple, rapid means for performing routing chemical tests on urine