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exam II Flashcards

1
Q

how does the pH of urine relate to it’s hydrogen ion concentration?

A

it’s an inverse relationship
increased hydrogen ion : decreased pH
decreased hydrogen ion : increased pH

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2
Q

Ketone bodies in the urine are suggestive of elevated _____ metabolism

A

fat

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3
Q

what causes myoglobinuria?

A

extensive muscle injury

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4
Q

what is the general purpose of test strip screening?

A

immediate answer to whether or not pathological concentrations of substances are present in the urine

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5
Q

what color is a (+) positive nitrate on the dipstick?

A

pink

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6
Q

what substance is most likely to be present in urine that could cause a false (=) negative reaction on the dipstick for glucose?

A

ascorbic acid or vitamin C

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7
Q

what is SSA used for?

A

confirmatory test for proteins

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8
Q

what test is used for detecting reducing sugar in the urine?

A

clinitest

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9
Q

what would be expected in the microscope examination, if reducing sugars are detected?

A

nothing

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10
Q

what two dipstick reactions are usually (+) positive in pyelonephritis and cystitis?

A

leukocytes and nitrates

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11
Q

name several conditions that could be indicated by an elevated urinary urobilinogen

A

hepatitis & cirrhosis
hemolytic anemia
pernicious anemia

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12
Q

name several conditions that can cause hemoglobinuria

A

extensive burns

incompatable blood transfusions

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13
Q

what is specificity (as related to dipstick reactions)?

A

each test zone should react specifically to the substance being test and to no other

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14
Q

the test pad for ketone bodies detects _____?

A

acetoacetic acid

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15
Q

what is the principle of the dipstick method for protein?

A

protein of error indicators:
-tetrabromphenol blue buffered at a constant pH 3 without proteins is yellow, but in the presence of proteins, hydrogen ions are released by indicator dye causing color changes ranging from yellow-green to blue-green

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16
Q

what unusual urinary protein is associated with multiple myeloma?

A

bence-jones

50% of patients have this

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17
Q

what sugar (especially in infants) is most likely indicaated by a (=) dipstick reaction for glucose but a (+) clinitest?

A

galactose

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18
Q

what specimen is used to detect orthostatic proteinuria?

A

2 specimens:

first morning and a second after the patient has been upright for a few hours

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19
Q

what is the active ingredien in ehrlich’s reagent?

A

P-dimethylamino-benzaldehyde

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20
Q

what is the reagent used to detect bilirubin in the icotest?

A

2,4 dichlorobenzene diazonium tetrachlorozincate

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21
Q

the reagent strip for hemoglobin detects ___,___&___

A

hemoglobin
myoglobin
RBC

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22
Q

what is the action of the enzyme peroxidase?

A

to catalyze the oxiation of chromogen (3,3,5,5 tetramethyl benzidine) by the O2 released from peroxidase on reagent pad to produce a color changing from yellow-green
pseudo peroxidase activity

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23
Q

why is there normally no glucose in the urine?

A

because it is absorbed in convoluted tubules

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24
Q

what is the advantage of using phase contract microscopy in the examination of urinary sediment?

A

allows to see unstained cellular components and casts

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25
how does the phase contrast microscope relate to the refractive index?
the refractive index (mucus, hyaline casts) is the same as urine making them hard to see
26
what is the use of the polarizing microscope in urine microscopics?
lipid material and crystals
27
cells are recorded as number per __ power field (__x)
high | 40
28
how many field should be expmined in a microscopic exam?
10
29
what is the most common type of WBC found in the urinary sediment?
neutrophils
30
casts in urine are usually accompanied by a (+) test for what
protein
31
casts containing cells indicate problems in what part of the urinary tract?
kidneys
32
where are transitional epithelial cells found?
bladder, renal pelivs , 2/3 male urethra
33
amorphous phosphates are found in urine of what pH?
alkaline
34
what disease is indicated when tyrosine and leucine are found in the urine?
severe liver disease
35
nephrotic syndrome is characterized by
proteinuria and lipiduria
36
casts which have at least two distinct components are called
mixed casts
37
casts should be reported as the number per ___ power field (_-x)
low | 10
38
which WBC is most likely to be found in a transplant rejection
lymphocyte
39
in what specific portions of the nephron are casts formed?
lumen of DCT and collecting ducts
40
what specific type of epithelial cells are found in epithelial cell casts
renal tubular epi. cells
41
in what type of diseases (in general) are RBC casts found?
basement membrane ducts of glomerulus has been damaged
42
glitter cells are associaed with urine of ___ specific gravity
low
43
what type of epithelial cells are indicative of vaginal contamination?
squamous
44
calcium oxalate crystals are normally found in __ pH urine
acidic
45
what condition is indicated by large numbers of uric acid crystals?
gout
46
candida albicans (a yeast) is often found in the urine of patients with __________
diabetes mellitus
47
if flat, hexagonal, colorless crystals are found in the ruine what constituent s suggested?
cystine
48
what should the technologist do prior to reporting out cystine crystals?
chemical confirmation for cystine
49
how can RBC and yeast be differentiated?
acetic acid will lyse RBC's not yeast.
50
what is the appearance of waxy casts?
waxy, highly refractive, colorless or gray-yellow uneven ends, cracks/fissures
51
name several organisms whose urinary presence indicates contamination?
- RBC's with no casts , proteinuria (menstrual/ hemorrhoidal) - squamous - sperm - parasites
52
the order for the aging process of casts is ....
cellular, coarsely granular finely granular waxy
53
what is the term for the presence of elevated numbers of casts in urine?
cylinduria
54
how can a precipitate of amorphous phosphate be removed?
soluble in dilute acetic acid
55
how can a precipitate of amorphous urates be removed?
heated to 60C / dissolved in alkali
56
what would be the appearance of RBC in hypertonic urine?
crenated
57
can the multistix detect a negative urobilinogen?
no
58
how would you interpret a (=) nitrate but a (+) bacteria?
- bacteria cannot convert NO3 to NO2 - no nitrates in diet - urine hasn't been in bladder long enough - so much bacteria that it further reduces NO3 to N2
59
what happens if you dip the reagent strip too much?
leeching or run over of reagents
60
what type of casts may be formed in the urine of a normal pH?
hyaline
61
what are shadow cells?
RBC that have lost HB
62
what is the significance of the shape and size of a cast?
shape and size aid in ID
63
urine for testing should be at ___ temperature
room
64
why do we use the refractometer for specific gravity rather than the dipstick?
because the refractometer can detect ionic and nonionic solutes
65
how does the watson-schwartz test differentiate between urobilinogen and porphobilinogen?
urobilinogen is solube in chloroform and butenol | porphobilinogen is soluble in the aqueous layer
66
what is the principle of the automated instruments for dipstick reading?
reflectance photometrey
67
glucose in the urine is referred to as ___ or ___
glucosuria | glycosuria
68
the two different forms of blood in the urine are described as ___ and ___
hemoglobinuria | hematuria
69
what reagent is used to differentiate urinary hemoglobin and myoglobin?
80% ammonium sulfate ( precipitates out hemoglobin)
70
what is the normal range for urinary urobilinogen?
0.1 - 1
71
which test is the most sensitive for bilirubin?
icotest
72
what is ketonuria?
ketones present in urine
73
what symptoms would make you suspect the patient is suffering from orthostatic proteinuria
children and adolescence who have proteinuria
74
what are some possible causes of hematuria?
``` kidney stones glomerulonephritis pyelonephritis trauma strenuous exercise smoking ```
75
ketones
sodium nitroprusside
76
urobilinogen
para-dimethlyaminobenzaldehyde
77
protein
tetrabromphenol blue
78
pH
bromthymol blue | methyl red
79
nitrite
1,2,3,4-tetrahydrobenzoquinoline-3-olpara-arsanilic acid
80
bilirubin
2,4-dichlorobenzenediazonium tetrachlorozincate (aka-diazotized 2,4-dichloroaniline)
81
glucose
``` glucose oxidase gluconic acid hydrogen peroxide potassium iodide peroxidase ```
82
blood
3,3,5,5-tetramethylbenzidine hydrogen peroxide

urinalysis (3 decks)

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