Chemistry 17 (Body Fluids)

Question 1

“renal threshold” for glucose

Answer 1

180

Question 2

enzymes used by glucose dipstick test

Answer 2

glucose oxidase

peroxidase

Question 3

normal urine protein

Answer 3

150mg/d

Question 4

unique solubility properties of Bence-Jones proteins

Answer 4

when heating: precipitate at 40 and redissolve at 100

when cooling: precipitate at 60 and redissolve at 40

Question 5

ketone dipstick sensitive to

Answer 5

acetoacetic acid only

Question 6

clues to myoglobinuria over hemoglobinuria

Answer 6

increased CK, increased aldolase, normal haptoglobin

Question 7

urinary bilirubin

Answer 7

conjugated only

Question 8

urobilinogen in urine seen when

Answer 8

liver dz prevents re-excretion or increased bilirubin leads to increased urobilinogen formation

Question 9

Nitrate neg organisms that may cause UTI

Answer 9

enterococci
N. gonorrhea
MTB

Question 10

false + leukocyte esterase with

Answer 10

trichomonads

eosinophils

Question 11

Isosthenuria

Answer 11

urinary specific gravity fixed at 1.010

renal medullary dysfunction (seen in SS)

Question 12

urine pH in RTA

Answer 12

inappropriately alkaline relative to blood, and unable to acidify below 6.5

Question 13

ascorbic acid interferes with what urine dipstick tests

Answer 13

glucose, hgb, bilirubin, nitrate, leukocyte esterase

Question 14

majority of renal stones are

Answer 14

calcium oxalate

Question 15

oxaluria is found in

Answer 15

Crphn, small bowel bypass, increased oxalate ingestion

Question 16

alkalotic urine promotes

Answer 16

Calcium phosphate stones

Question 17

Dent dz

Answer 17

(x-linked nephrolithiasis)
chloride channel 5 (CLCN5)
causes hypercalciuria and stones

Question 18

what drug increases Ca absorption

Answer 18

thiazides

Question 19

stones promoted by acidotic urine pH

Answer 19

urate

Question 20

stones adds with markedly alkalotic urine

Answer 20

struvite

Question 21

urate stones commonly seen in

Answer 21

UC, Crohn, colectomy

Question 22

stones inhibited by urine alkalinization

Answer 22

urate, cystine

Question 23

rarest stones

Answer 23

2,8-dihydroxyadenine

AR deficiency of adenosine phosphoribosyl transferase

Question 24

“coffin-lid” cystals

Answer 24

struvite (triple phosphate, magnesium ammonium phosphate)

Question 25

hexagonal crystals

Answer 25

cysteine

Question 26

"sheave of wheat" cystals

Answer 26

tyrosine

Question 27

Red cell casts

Answer 27

glomerulonephritis

Question 28

white cell casts

Answer 28

tubulointerstitial nephritis/pyelonephritis

Question 29

tubular casts

Answer 29

ATN

Question 30

broad casts

Answer 30

ESRD

Question 31

fatty casts

Answer 31

nephrotic syndrome

Question 32

normal CSF protein

Answer 32

15-45mg/dL

Question 33

normally to quantitate CSF protein, must first

Answer 33

be precipitated with TCA or SSA

Question 34

normal CSF/serum albumin ratio

Answer 34

<1:230

Question 35

____ is suggestive for CSF when seen in a fluid

Answer 35

asialated transferrin

Question 36

____ is sensitive marker in CSF for cerebral adrenoleukodystrophy

Answer 36

increased intrathecal IgA

Question 37

CSF glutamine is increased in

Answer 37

hepatic encephalopathy

Question 38

Latex agglutination tests are available for these bugs

Answer 38

H. influenza, S. pneumoniae, N. meningitides, Group B strep

Question 39

Dressler syndrome

Answer 39

pleural effusion with MI

Question 40

Meigs syndrome

Answer 40

pleural effusion with ovarian fibromas

Question 41

Light's criteria

Answer 41

pleural:serum protein >0.5 pleural:serum LDH >0.6 pleural LDH >200

Question 42

pleural fluid in RA

Answer 42

pH 700 | glucose <30

Question 43

low pH alone in pleural fluid suggestive of

Answer 43

esophageal perforation

Question 44

low pH with low glucose in pleural fluid suggestive of

Answer 44

empyema, malignancy, RA

Question 45

lymphocytes in pleural fluid without mesothelial cells

Answer 45

TB or RA

Question 46

for peritoneal fluid, use ____ to tell cirrhosis related

Answer 46

serum-ascites albumin gradient | in portal HTN >1.1

Question 47

+ diagnostic peritoneal lavage

Answer 47

>15mL blood RBCs > 100,000 WBC >500 bacteria on gram stain

Question 48

synovial lactate increased in

Answer 48

septic arthritis

Question 49

synovial complement decreased in

Answer 49

RA, SLE

Question 50

crystals in pseudogout =

Answer 50

calcium pyrophosphate

Question 51

hydroxyapatite crystals can only be seen with

Answer 51

Alizone red S stain