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Flashcards in Chemical Analysis Deck (62):
1

What is the result on urine of high protein intake?

more acidic
more phosphates and sulfates are produced

2

What is the normal pH of a vegetarian diet?

>6

3

What are some factors that result in persistent urine acidity?

dehydration, illness (diarrhea/fever), gout, diabetes ketoacidosis, gout, pulmonary emphysema, metabolic acidosis

4

What are some factors that result in persistent urine alkalinity?

renal failure, UTIs, bacterial contamination, alkaline drugs and diuretics

5

What are 4 methods of proteinuria? OGTS

Overflow - too much in system
Glomerular - too much coming through glomerulus
Tubular - inability to resorb
Secreted - inappropriate secretion into convoluted tubules

6

What is the strip primarily identifying in urine protein detection?

albumen

7

Does a negative protein test rule out all proteins?

NO

8

What 5 things can create a false positive protein test?

- Highly buffered alkaline urine
- old/exposed sample
- contaminated container
- some skin cleaners
- blood in urine

9

What 2 things may cause a false negative protein test?

- diluted urine
- other elevated proteins (other than albumen)

10

What are some things that can cause transient proteinuria?

- stressors (physical/emotional)
- dehydration
- exposure heat/cold (fever)
- pregnancy
postural proteinuria

11

3 diseases that cause PERSISTENT proteinuria GPM

-glomerulonephritis
- pyelonephritis
- malignant hypertenstion

12

What percentage of glucose is normally reabsorbed?

100%

13

what is the threshold where glucose will start entering urine? what condition?

160-180 mg/dl
Diabetes melitis

14

What sugars can give a positive on the dipstick?

glucose only

15

What drug can cause a false positive for glucose in urine? what condition?

Levodopa (parkinson's)

16

What are three things that can cause a false positive glucose test?

- some cleaning agents
- drugs (levodopa)
- high [ketone] in urine

17

What are 4 things that can cause a false negative glucose test?

- cool urine
- high specific gravity
- alkaline urine (bacterial contamination)
- Vitamin C (ascorbic acid) in high doses

18

What is it called when someone has elevated glucose shortly after eating sweet food

transient glucosuria

19

What three things does glucosuria depend on?

- ++ blood glu levels
- -- glomerular filtration rate
- -- tubular reabsorption

20

What 6 general things can contribute to persistent glucosuria?

- DM
- CNS issues
- kidney issues
- endocrine issues
- liver issues
- pharmaceuticals

21

what is a pheochromocytoma?

benign medullary tumor of the adrenal gland

22

what does the clinitest test for?

glucose and OTHER reducing sugars

23

What is clinitest most often used to assess?

how well diabetes is being managed

24

What 4 things can give a false positive clinitest?

- Vit C
- cephalosporins (-cillins)
- drugs for gout and hyperuricemia
- urinary preservatives

25

What can give a false negative clinitest?

technique errors

26

What does the Benedict's test test for? FGMGL

reducing sugars - fructose, glucose, maltose, galactose, lactose

27

What two conditions are commonly assessed by a urine reducing sugar test?

galactosemia and diabetes, genetic carbohydrate metabolism disorders

28

How are ketones produced? Where?

liver as part of fatty acid metabolism

29

Normally, how many ketones are detectable in the urine

none

30

Why would ketones be in the urine?

if the body doesn't have enough glucose it switches to the fatty acid metabolism process, releasing ketones

31

What 3 ketone bodies most commonly appear in urine when fats are burned for energy?

- acetoacetic acid
- beta-hydroxybutyric acid (most)
- acetone

32

what is the most common ketone that strips test for?

acetoacetic acid

33

What can contribute to a false positive ketone test or atypical color?

- combo high specific gravity and low pH
- dehydration
- phenylketones
- some meds
- ascorbic acid

34

what can cause a false negative ketone test?

- old urine
- loss of regent reactivity

35

What diabetes will have positive ketone bodies?

DM

36

What diabetes will have negative ketone bodies?

DI

37

What 3 conditions are indicated by positive blood/hemaglobin in urine?

- hematuria
- hemoglobinuria
- myoglobinuria

38

what is hematuria?

presence of blood or intact RBC's in urine

39

what is a cause of RBC lysis which will release hemoglobin into the urine?

highly alkaline or very low specific gravity (1.007) urine

40

How long does transient hematuria last?

2-3 days

41

What two situations can cause transient hematuria

- strenuous exercise
- menstrual contamination

42

what 6conditions can cause persistent hematuria

- renal diseases (all parts and incl trauma)
- urolithiasis (kidney stones)
- UTI
- urinary tract tumor
- prostatic cancer
- virus infection (ebola)

43

can incompatible blood transfusions result in intravascular hemolysis?

yes

44

what sort of hypersensitivity reaction is hemolytic anemia?

hypersensitivity reaction type 2

45

how much conjugated bilirubin is usually present in healthy subjects?

<10%

46

what two conditions can an elevated level of conjugated serum bilirubin imply?

- liver disease
- cholestatic/bile duct diseases

47

what is unconjugated bilirubin tightly bound to?

albumin

48

is unconjugated bilirubin found in urine?

No, glomerulus filters it out

49

what is the confirmation of bilirubin presense in urine?

Ictotest

50

What 4 things can cause a false positive urobilinogen test?

- asprin
- sulfonamides
- nitrates
- porphyria

51

What 3 things can cause a false negative urobilinogen test?

- old urine, exposed to light
- formalin
- broad spectrum antibiotics

52

At what time are peak levels of urobilinogen?

between 2-4pm

53

what 3 conditions can give elevated levels of urobilinogen?

- liver disease
- intestinal obstruction
- hemolytic anemia

54

what can the nitrite test indicate early on?

significant and asymptomatic bacteriuria

55

what do mahy bacteria convert (and to what) that could indicate UTI?

nitrates to nitrites

56

To detect bacteriuria, which urine sample is the one to choose? Why?

first morning urine, because it must incubate in bladder at least 4 hours

57

false positive nitrite test?

too much air exposure after collection

58

false negative nitrite test? 6

- wrong pathogens
- <4 hours in bladder
- low or no nitrate diet
- high specific gravity
- high level of urobilinogen
- vit C

59

What is the only thing the nitrate test is used to identify?

UTI

60

Why might leukocytes be in urine?

it's normal, could be elevated with UTI

61

False positive for leukocytes (3)

- Trichomonas infection
- vaginal discharge contamination
- formalin used as preservative

62

false negative for leukocytes (3)

- high levels of Vit C
- high levels of protein, glucose, specific grav.
- some antibiotics