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AUBF LEC MIDTERMS > Chemical > Flashcards

Chemical Flashcards

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1
Q

_______: function of kidney is to help maintain acid-base balance in the body

  1. continuous reabsorption of HCO3- leads to a drop in pH resulting in ______
  2. pH determination
    - physiologically impossible; suspect adulteration of urine specimen
    - high protein, cranberry ingestion, metabolic acidosis
    - vegetables, citrus fruits, low CHO diet, metabolic alkalosis
    - physiologically impossible; presence of iatrogenic substance
  3. reading time
  4. principle
  5. indicator: _____ & _____
    - acid pH & color
    - basic pH & color
  6. interferences:
    - improper storage of specimen w/ bacterial proliferation
    - contamination of specimen container before collection
    - improper reagent strip technique causing acid buffer
A

URINE PH
1. ACIDIC URINE
2. pH determination
- <4.5
- 4.5-6.9
- 7.0-7.9
- >8.0
3. 60s
4. Double Indicator System
5. methyl red, bromthymol blue
- 6.0 pH & orange
- 9.0 pH & blue
6. interferences:
- false increased
- false increased/ decreased
- false decreased

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2
Q

_______: most indicative of renal disease

  1. normal each day
  2. readily pass thru glomerular filtration barriers; reabsorbed
  3. unable to penetrate healthy glomerular filtration barrier
  4. approx.____ of plasma albumin: enters ultrafiltrate
  5. ___% filtered protein is reabsorbed
  6. absorbed = __ = albumin; __ = globulin
  7. 3 particular proteins that originate from urinary tract
  8. reading time
  9. principle
  10. indicator
  11. sensitivity
    - chemstrip
    - multistix
    - vChem
A

PROTEIN
1. 150mg
2. low m.w
3. high m.w
4. <0.1%
5. 95-99%
6. 1/3; 2/3
7. Uromodulin, Urokinase, Secretory IgA
8. 60s
9. Protein Error of Indicators
10. tetrabromphenol blue
11. sensitivity
- 6.0mg/dL (90%)
- 15-30mg/dL
- 20mg/dL (67%)

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3
Q

PROTEIN CLINSIG

PRE RENAL
1. increased quantities of plasma proteins in blood passing thru glomerular filtration barriers into urine
- normal proteins (3)
- abnormal proteins (1)
2. identified in urine by unique solubility as related to temp ; indicates presence of
immunoglobulin light chains
- coagulation at
- dissolved at

RENAL
1. most common and serious type of proteinuria
- proteinuria >3.5g/day (hallmark: _____)
- glucose capability to bind w/
various proteins
- normal = ___/day
2. normal plasma proteins reabsorbed normally is increased in the urine
- normal = ___/day

_____: due to renal congestion or ischemia
1. first morning =
2. second specimen =

A

PRE RENAL
1. OVERFLOW PROTEINURIA
- myoglobin, hemoglobin, acute
phase reactants
- immunoglobulin light chains
2. BENCE JONES PROTEIM
- 40-60C
- 100C

RENAL
1. GLOMERULAR PROTEINURIA
- NEPHROTIC SYNDROME (Fatty Casts)
- HYPERGLYCEMIA
- <30mg/day
2. TUBULAR PROTEINURIA
- <2.5g/day

POSTURAL/ ORTHOSTATIC
1. N
2. +

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4
Q

PROTEIN METHODS

  1. detects all proteins in urine (inc. albumin & globulins)
    - false (+)
  2. immunochemical-based reagent strip rxn
    - lower band that is darker than top
    - bands of equal intensity
    - top band darker than lower band
  3. uses gold-labeled monoclonal antibodies in its immunochemical reagent strip
    - detection limit
    - rxn time
    - color stable
  4. uses dye-binding method to determine low levels of urine albumin
    - detection limit
    - rxn time
  5. visual interpretation: protein-low = comparing color of rxn pad to color block provided
    - same principle as ____
A
  1. SULFOSALICYLIC ACID POT TEST
    - x-ray contrast medial & certain drugs in high conc.
  2. IMMUNODIP TEST
    - <12mg/L (1.2mg/dL)
    - 12-18mg/L (1.2-1.8mg/dL)
    - 20mg/L (2.0mg/dL)
  3. MICRAL TEST
    - 12-18mg/L
    - 1min
    - < 5mins
  4. CLINITEK
    - 20-40mg/dL
    - approx. 2mins
  5. MULTISTIX
    - CLINITEK
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5
Q

______: hemoglobin > ferritin –denatured > hemosiderin

  1. abnormal quantity of RBC in urine
  2. urinary presence of hemoglobin
  3. urinary presence of myoglobin
  4. reading time
  5. principle
  6. chromogen
  7. color
  8. reagents:
    - chemstrip
    - vChem
A

BLOOD

  1. HEMATURIA
  2. HEMOGLOBINURIA
  3. MYOGLOBINURIA
  4. 60s
  5. Pseudoperoxidase Activity of Heme
  6. tetramethylbenzidine & peroxide
  7. yellow to green
  8. reagents:
    - proprietary iodate-impregnated mesh
    - includes separate ascorbic acid test pad
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6
Q

HEMOGLOBINURIA vs MYOGLOBINURIA

  1. serum color:
    - hemoglobinuria
    - myoglobinuria
  2. haptoglobin
    - hemoglobinuria
    - myoglobinuria
  3. myoglobin
    - hemoglobinuria
    - myoglobinuria
  4. free hemoglobin
    - hemoglobinuria
    - myoglobinuria
  5. CK
A
  1. serum color:
    - pink to red
    - pale yellow
  2. haptoglobin
    - decreased to absent
    - normal
  3. myoglobin
    - normal
    - increased
  4. free hemoglobin
    - increased
    - normal
  5. CK
    - increased but <10x
    - increased but >10x
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7
Q

_____: detection of wbc (usually neutrophils) even when they are no longer viable/visible

  1. increased LE = inflammatory process within
  2. reading time
  3. principle
  4. reagents
    - chemstrip & vChem:
    - multistix:
A

LEUKOCYTE ESTERASE

  1. urinary tract
  2. 120s
  3. Hydrolysis of Ester
  4. reagents
    - indoxylcarbonic acid ester
    - derivatized pyrrole amino acid ester
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8
Q

identification of urinary tract infection

  1. screening for nitrite and LE provides identification of patient w/
  2. reading
  3. principle
  4. chromogen
A

NITRITE
1. BACTERIURIA
2. 60s
3. diazotization rxn of nitrite w/ aromatic amine
4. any degree of pink

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9
Q

GLUCOSE
1. presence of glucose in urine
- pre renal condition
- renal condition
2. non-glucose sugars are present in urine
3. inability to metabolize galactose to glucose
4. renal threshold
5. reading time
6. principle
7. reagents
- chemstrip
- vChem
- multistix

A
  1. Glucosuria
    - Hyperglycemia
    - Defective Tubular Absorption
  2. Glycosuria
  3. Galactosemia
  4. 160-180 mg/dL
  5. 30s
  6. Double Sequential Enzyme Reaction
  7. reagents
    - tetramethylbenzidine
    - tolidine hydrochloride
    - potassium iodide
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10
Q

METHODS OF GLUCOSE

____: benedict’s test tablet version

  1. To detect
  2. Result (+) ___ to ____ to ____
  3. false _____ reagent strip due to contaminants
  4. false _____ clinitest due to presence of radiographic contrast
A

COPPER REDUCTION TEST/ CLINITEST

  1. reducing substances
  2. blue to green to orange
  3. +
  4. -
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11
Q

_____: liver oxidizes FA  large amounts of acetyl coenzyme A  Kreb’s cycle 
increased ketogenesis  release of large quantities of ketones are released into
blood stream

  1. ## what is tested in urine:-
    -
  2. ____mg/dL of ketones are excreted out in the urine (ketonuria)
  3. reading time
  4. principle
  5. sensitivry
    - chemstrip
    - vChem
    - multistix
  6. methods: _____ = tablet detection of ketones in urine
    - limit
    - enables rxn of acetone & lactose which
    enhances color
A

KETONES

  1. what is tested in urine:
    - 78% B-hydroxybutyrate
    - 20% acetoacetate
    - 2% acetone
  2. > 70 mg/dL
  3. 40s
  4. Nitroprusside Reaction (Legal’s Test)
  5. sensitivry
    - 9.0 mg/dL acetoacetate; 70 mg/dL acetone
    - 3.0 mg/dL acetoacetate
    - 5-10 mg/dL acetoacetate
  6. ACETEST
    - 5mg/dL
    - GLYCINE
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12
Q

_____: from breakdown of hemoglobin; heme is catabolized into hemoglobin

  1. increased plasma bilirubin: early indicators of _____
  2. Bilirubinemia & Bilirubinuria: early detection prior to dev’t of _____
  3. principle: ___, _____
  4. reading time
  5. principle
  6. reagents
    - chemstrip, vChem
    - multistix
A

BILIRUBIN & UROBILINOGEN

  1. liver disease
  2. jaundice
  3. Increased bilirubin, urobilinogen
  4. 30s; 60s
  5. Diazo Reaction:
  6. reagents
    - diazo coupling reaction
    - ehrlich’s reaction
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13
Q

BILI&URO CLINSIG

  1. abnormality occurs before handling of bilirubin by liver (over production of bilirubin)
    - _____ bilirubin
    - _____ urobilinogen
  2. inability of hepatocytes in uptaking, conjugating, excreting
    - _____ bilirubin
    - _____ urobilinogen
  3. altered bilirubin metabolism involves
    obstruction of the bile duct or biliary system
    - _____ bilirubin
    - _____ urobilinoge
A
  1. Prehepatic
    - negative bilirubin
    - increased urobilinogen
  2. Hepatic/ Hepatocellular Disorder
    - positive/N bilirubin
    - increased urobilinogen
  3. Post-hepatic/ Obstruction
    - positive bilirubin
    - decreased urobilinogen
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14
Q

BILI&URO METHODS

  1. for detection of bilirubin in urine
    - low detection limit
    - positive color
  2. based on rxn of urobilinogen w/ p-
    dimethylaminobenzaldehyde (Ehrlich’s reagent)
    - positive color
    - specimen
    - reagents
    - procedure
  3. rapid screening test for urine porphobilinogen (≥2 mg/dL)
    - reagent
    - procedure
    - interference
    - positive color
  4. differentiate urobilinogen from
    porphobilinogen based on miscibility characteristics
    - extractable in both butanol &
    chloroform
    - immiscible in butanol &
    chloroform
    - Other Ehrlich Reactive Compounds: miscible in _____ but not in _____
A
  1. Ictotest
    - 0.05-0.1 mg/dL
    - purple or blue
  2. Classic Ehrlich’s Reaction
    - cherry red
    - 2-hr postprandial urine
    - p-dimethylaminobenzaldehyde; sodium acetate
    - 1-part reagent + 10 parts urine
  3. Hoesch Test
    - Ehrlich’s reagent in 6M HCI
    - 2 drops urine + 2 mL
    - highly pigmented, methyldopa, indicans
    - red
  4. Watson Schwartz Test
    - Urobilinogen
    - Porphobilinogen
    - butanol; chloroform
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AUBF LEC MIDTERMS (6 decks)

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