Clinical Chemistry Flashcards
(120 cards)
1
Q
What detects Glucose on Urine Reagent Strips?
A
Enzymatic reaction of glucose oxidase
2
Q
What detects Ketones on Urine Reagent Strips?
A
Nitroprusside reaction
3
Q
With Pregnancy, will Hematocrit go up or down?
A
- Decreases; first trimester
- Reaches lowest; end of second trimester
- Increases; third trimester
4
Q
With Pregnancy, will Fibrinogen go up or down?
A
Increase progressively from first to last trimester
5
Q
With Pregnancy, will Glomerular Filtration go up or down?
A
Increases 40% - 50% in a normal pregnancy
6
Q
24 Hour Urine: Reference Range
A
800 - 2,000 mL/day
7
Q
24 Hour Urine: Anuria
A
- Absent/no urine
- Kidney’s aren’t producing urine
8
Q
24 Hour Urine: Polyuria
A
- Large amounts of urine
- More than 3 L/day
9
Q
24 Hour Urine: Oliguria
A
- Low urine output
- Less than 400 mL/day or 20mL/hour
10
Q
Hyaline Casts: Are they Normal?
A
Occassional is normal
11
Q
Hyaline Casts: Increased Result of
A
- Stress
- Strenuous Exercise
- Chronic renal disease
- Glomerulonephritis
- Pyelonephritis
- Congestive heart failure
12
Q
Hyaline Casts: Formed by
A
Formed by aggregated Tamm-Horsfall protein
13
Q
Hyaline Casts: Location
A
Kidney Tubules
14
Q
Crystals in the Urine: Amorphous Urates
A
Dark or yellow-red granules
15
Q
Crystals in the Urine: Calcium Oxalate - Dihydrate
A
- Envelope shape (dihydrate form)
- Oval, dumbbell (monohydrate form)
16
Q
Crystals in the Urine: Calcium Oxalate - Monohydrate
A
- Found in both normal and abnormal urine
- Can be found in a range of urine pH from acidic to neutral
17
Q
Crystals in the Urine: Uric Acid - Various Shapes
A
Colorless-to-yellow or brown
- Rhombus
- Hexagonal plates
- Rosettes
- Rectangles
- Irregular
18
Q
Crystals in the Urine: Ammonium Biurate
A
- Round; thorny projections
- Dark yellow to brown
19
Q
Crystals in the Urine: Amorphous Phosphate
A
Amorphous granules
20
Q
Crystals in the Urine: Calcium Phosphate
A
- Flat rectangles
- Prisms
- Rosettes
21
Q
Crystals in the Urine: Triple Phosphate
A
4-6 sided prisms resembling coffin lids
22
Q
What is Usually present in Urine?
A
- 95% water
- 5% solutes
23
Q
Name the 3 Liver Functioning Tests and Tubes Used
A
- Albumin & total protein
- Bilirubin (protect from light)
- Prothrombin Time (PT)
- Use yellow-gold & blue tubes
24
Q
What does it mean if there’s indication of Bilirubin in the urine?
A
Early signs of liver damage / Disease
25
Bence-Jones Protein: Precipitate
45-60C temp
26
Bence-Jones Protein: Redissolve
Heated near 130C
27
Confirmatory Tests in Urinalysis: Bilirubin
Ictotest
28
Confirmatory Tests in Urinalysis: Ketones
Acetest
29
Confirmatory Tests in Urinalysis: Protein
- Acid precipitation
- Dilute sulfosalicylic acid
- Dilute acetic acid
30
Key Ingredients in Clinitest in Urinalysis: Copper Reduction Tests
- Detects reduced sugars
- Use for sugars other than glucose
- Galactosuria
- Caustic reagent
31
Orange Urine will indicate the presence of what?
- Dehydration
- Problem with liver or bile duct
32
What will indicate the presence of Ketones in Urine?
- Some ketones is normal
- High ketone levels; body is too acidic
33
Fecal Absorbance Test (Patient Instructions)
- 100-150 grams; fat
- 100 grams; protein
- 180 grams; carbohydrates
34
Grades of Water: Water = ?
Universal solvent
35
Grades of Water: Distillation
Steam rises; free from microbiological impurities, bacteria, minerals
36
Grades of Water: Deionization
Removal of ionic impurities; chemical, bacterial
37
Grades of Water: Type I - Highest Purity
- Trace metals removed
- Used for sensitive analytical procedures
38
Grades of Water: Type II - Less than Type I
- General lab procedures
- Preparations of reagents/stains
39
Grades of Water: Type III - Least Pure
- Washing
- Water baths
- Not tap water
40
Grades of Reagents: American Chemical Society (ACS)
- Sets high standards for reagent purity
- Overseeing body
- Not a rating or grade of chemical
41
Grades of Reagents: Analytical Reagent (AR)
- Highest purity
- Clinical use
- Meets ACS standards
42
Grades of Reagents: Pharmaceutical Grade (USP, CP, BP, NF)
Pharmaceutical manufacturing
43
Grades of Reagents: Lab Grade
- Intermediate purity
- Educational labs
44
Grades of Reagents: Pure Grade
Lower grade
45
Grades of Reagents: Technical/Commercial
Non testing purposes (cleaning chemicals)
46
Properties of Solutions: Concentration
Ratio; solute and diluent
47
Properties of Solutions: % Solution
- w/v
- v/v
- w/w
48
Properties of Solutions: Concentrated
Diluted
49
Properties of Solutions: Molarity
Solid solute in g/100mL
50
Properties of Solutions: Normality
Liquid solute in mL/100mL
51
Properties of Solutions: Diffusion
When a high concentration moves into a low concentration to achieve equilibrium
52
Properties of Solutions: Osmosis
Passage of molecules through a membrane to achieve equilibrium (hypotonic into hypertonic)
53
Kidney Term: Renal Cortex
Nephrons
54
Kidney Term: Renal Medulla
Collection tubes
55
Kidney Term: Calyces
Ducts to renal pelvis
56
Kidney Term: Renal Pelvis
Inner collection tubes BEFORE ureters
57
Kidney Term: Renal Artery
Takes blood TO kidney
58
Kidney Term: Renal Vein
Takes blood FROM kidney
59
What is the function of the Ureter?
Tube that carries urine from kidneys to the bladder
60
Nephron Term: Glomerulus
Cluster of blood capillaries surrounded by Bowman's capsule
61
Nephron Term: Renal Tube
Collects from Bowman's capsule
62
Nephron Term: Loop of Henle
U shaped structure connecting proximal and distal
63
Nephron Term: Distal Convoluted Tube
Empties into collection tube
64
Urine Pathology: Dialysis (Hemodialysis)
- Decreased kidney function/filtration
- Must be done artificially
65
Urine Pathology: Glomerulonephritis
Inflammation of glomerulus
66
Urine Pathology: Pyelonephritis
- aka; UTI
- Polycystic kidney disease
67
Urine Samples: Routine Sample
- Physical
- Chemical
- Microscopic
68
Urine Samples: Random Sample
Fresh void; routine & microscopy
69
Urine Samples: First Void
- Usually fasting
- Culture & sensitivity
- Preferred for pregnancy
70
Urine Samples: Clean Catch Midstream Urine (CCMSU)
- Culture and sensitivity
- UTI
71
Urine Samples: 24 HR Urine
- Evaluate kidney function
- Measures volume
- Creatinine clearance
72
Urine Samples: Storage
- Room temp @ 1 hour
- Refrigeration; no more than 24 hours
- Refrigeration slows metabolism
73
Clinical Tests: hCG, uCG
- Human/Uterine chronic gonadotropin (pregnancy)
- Produced by PLACENTA
74
Clinical Tests: Chem10 (Dipstick Test)
- Glucose
- Protein
- Blood
- Nitrites
- Leukocyte Esterase
- Bilirubin
- Urobilinogen
- Ketones
- pH
- Specific Gravity
75
Other Tests: Clinitest
All reducible sugars
76
Other Tests: Sulphosalicylic Acids (SSA)
Turbidity test
77
Other Tests: Protein
- Albumin
- Globulin
- Bence-Jones
78
Other Tests: Acetest/Ketosix
Ketones
79
Other Tests: Ictotest
Bilirubin
80
Other Tests: 24 Hour Urine Preservatives
- 6N HCI
- Boric acid
- NaCO3
- NaOH
- Formaldehyde
81
Other Tests: Cortisol Tests
No preservative or boric acid
82
Other Tests: 24H Urine Measured
Graduated Cylinder
83
Diabetes: Blood Glucose
Grey tube
84
Diabetes: Fasting Blood Glucose
8-12 hr fasting
85
Diabetes: Oral Glucose Tolerance Test (OGTT)
5 samples after glucose drink (1hr, 2hr...)
86
Diabetes: Glucose Tolerance Test (GTT) - Gestational Diabetes
75g glucose in the drink
87
Diabetes: HgA1c
EDTA tube
88
Fluid Samples: Synovial
- EDTA
- Chem test; not hematology
89
Fluid Samples: Serous
- EDTA; cell count/diff.
- Heparin; chem, cyto, micro, serology
90
Fluid Samples: Amniotic
Protect from light
91
Fluid Samples: CSF
- Sterile tube
- no anticoagulants; chem/serology, micro, hematology
92
Other Chem Tests: FOBT
Fecal Occult Blood (replaced by FIT; fecal immunochemical test)
93
Other Chem Tests: Arterial Blood Gas (ABG)
- Heparin
- On ice
94
Chemistry Tubes
- SST/PST ( gold, light green, lime green)
- Red
- Green
- Grey
- Royal blue
95
Ketones: Specifics
- Acetoacetic acid
- Acetone
- 3-hydroxybutyric acid
96
When are Ketones Elevated?
Starvation diets
97
Standard Values, Units, Profiles: Analytes
- mmol/L
- Enzymes - Units/L
- Medications - mg/dL
98
Standard Values, Units, Profiles: Diabetes
Glucose - mmol/L
99
Standard Values, Units, Profiles: Fasting Glucose
3.9 - 6.1 mmol/L
100
Standard Values, Units, Profiles: Diabetic Fasting Glucose
< 7 mmol/L
101
Standard Values, Units, Profiles: Random Glucose
7.8 mmol/L
102
Standard Values, Units, Profiles: Normal HgA1c
< 6%
103
Standard Values, Units, Profiles: Diabetic HgA1c
< 7%
104
Standard Values, Units, Profiles: Fasting Plasma Glucose
7 or less mmol/L
105
Standard Values, Units, Profiles: Critical Ranges
< 2.2 mmol/L
or
>22.2 mmol/L
106
Profiles: Electrolytes
- mmol/L
- Sodium (Na)
- Potassium (K)
- Chlorine (Cl)
- Bicarbonate (HCO3)
107
Profiles: Trace Elements
- mmol/L
- Calcium (Ca)
- Phosphate (PO4)
- Magnesium (Mg)
- Uric Acid
- Amylase (in units/L)
108
Profiles: Renal
- 24hr urine
- Creatine Clearance
- BUN
- eGFR
- Uric Acid
109
Profiles: Lipid Panel
- mmol/L
- Triglycerides
- Total Cholesterol
- HDL
- LDL
- VLDL
110
Profiles: Cardiac Panel
- Units/L
- CK-MB
- Troponins
- BNP
- hs-CRP
- Homocysteine
- Myoglobin
111
Profiles: Liver Panel
- Units/L
- Albumin
- Bilirubin
- Enzymes
- ALT
- AST
- ALP
- LD
- GGT
112
Profiles: Thyroid Panel
- Units/L
- T3
- T4
- TSH
113
Profiles: Therapeutic Drug Monitoring (TDM)
- Digoxin
- Dilantin
- Phenobarbital
- Tegretol
- ASA
114
Other Analytes: Acid Phosphatase
Seen in prostate cancer
115
Other Analytes: Aldosterone
Hormone produced by adrenal glands; responsible for sodium control
116
Other Analytes: Uric Acid
Product of urine metabolism
117
Other Analytes: Cortisol
- Plasma/serum
- Fasting/timed specimen
- Sodium heparin tube (lifelabs)
118
Other Analytes: Estimated Glomerular Filtration Rate
90 - 120 mL/min
119
Other Analytes: CFS
- Glucose (2-4mmol/L)
- Protein (15-45mg/dL)
- Gram stain
- Cell count
- pH 7.3 - 7.5
120
Assorted Terminology From Review: Amorphous Urates
- Acidic urine to be pink
- Disappear when urine is heated
