PART 2: Routine examination of urine (week 4)

Question 1

• The ability of proteins to alter the color
  reaction without altering the pH
• The test area is buffered to a constant low so that the changes in color will reflect the presence and concentration of proteins.
• Test area is more sensitive to albumin than globulin, Bence-Jones protein, or mucoprotein
• Indicator – tetrabromphenol blue: (-) yellow; (+) green then blue

Other indicators used:
- Tetrachlorophenol
- Tetrabromosulfonaphthaelin

Answer 1

Reagent Strip Method

Question 2

contains more amino groups
to accept H+ than other proteins

Answer 2

Albumin

Question 3

Reagent Strip Method other indicators used:

Answer 3

• Tetrachlorophenol
• Tetrabromosulfonaphthaelin

Question 4

1) Highly buffered alkaline urine
2) High specific gravity
3) Quaternary ammonium compounds

Answer 4

False positive

Question 5

a) Proteins other than albumin
b) Microalbuminuria

Answer 5

False negative

Question 6

Principle: Precipitation of
protein by heat and coagulation
by chemical agents

Note: Persistent cloudiness indicates protein.

Answer 6

HEAT AND ACETIC ACID

Question 7

(+)result: precipitation
This is a cold precipitation test because it
doesn’t require heating

Answer 7

3% SULFOSALICYLIC ACID TEST (EXTON’S)

Question 8

White opaque ring at the zone of contact

Answer 8

• Heller’s ring or heller’s heat or nitric acid test

Question 9

Light cloudiness to a heavy flocculation

Answer 9

Picric acid test

Question 10

White ring at the point of contact

Answer 10

Robert’s ring test

Question 11

Highly alkaline urine in Acid precipitation
tests

Answer 11

False negative

Question 12

Highly alkaline urine in Rgt strip test

Answer 12

False positive

Question 13

Quaternary ammonium compounds in Rgt strip

Answer 13

False positive

Question 14

Radiographic contrast media in rgt strip

Answer 14

No effect

Question 15

Radiographic contrast media heat and acetic acid test

Answer 15

False positive

Question 16

SSA +TCA ( nephelometer or photometer)

Answer 16

Precipitation

Question 17

TCA- Biuret

Answer 17

Colorimetric

Question 18

• Turbidity methods
• Turbidity is measured by photometer and spectrophotometer

Answer 18

TCA ( Trichloraceteic Acid )
SSA (Sulfosalicylic acid)

Question 19

Dye: Coomasie blue, Ponceau S, Benzethonium chloride, Pyrogallol red molybdate

Answer 19

Dye binding colorimetric methods

Question 20

• Associated with multiple myeloma,
  macroglobulinemia and malignant lymphomas
• Suspected if the specimen is turbid between 40oC - 60oC and is clear at 100oC

Answer 20

BENCE JONES PROTEINURIA

Question 21

1) Heat and HAc Acid test
2) Bradshaw
3) Toluene Sulfonic Acid (TSA) Test
4) Electrophoresis – indicated by single
sharp peak in globulin region; best
method
5) Immunofixation electrophoresis (IFE)

Answer 21

Methods for Bence Jones Protein

Question 22

indicated by single sharp peak in globulin region; best method

Answer 22

Electrophoresis

Question 23

at temperatures between
40oC and 60oC

Answer 23

Coagulates

Question 24

when the temperature
reaches 100oC. (dissolved when boiled)

Answer 24

Dissolves

Question 25

Unique characteristic of Bence Jones

Answer 25

Coagulates and Dissolves

Question 26

malignant disorder that results in infiltration of bone marrow by plasma cells

Answer 26

Multiple myeloma

Question 27

Predictor of clinical nephropathy in insulin dependent diabetes mellitus (diabetic nephropathy - Hypertension and cardiovascular risk - Specimen: random or first morning urine

Answer 27

MICROALBUMINURIA

Question 28

Albumin Excretion rate (AER) is______

Answer 28

20 to 200 µg/min

Question 29

Principle: IMMUNOLOGIC TEST (Enzyme Immunoassay) - Strip contains gold labeled antihuman albumin antibody - enzyme conjugate - Albumin binds w/antibody & move up the strip - React with the enzyme substrate - Sensitivity = 0-10mg/dl Dip strip into the urine for 5 seconds - Stand for 1 min - (-) white (+) pink-red

Answer 29

MICRAL TEST

Question 30

Principle:Immunologic (immunochromatography) 1) Strip in urine for 3 min - albumin in urine binds with blue latex particles coated with antihuman albumin antibody 2) Bound & unbound particle migrate up the strip unbound particles do not migrate as far as the bound particles

Answer 30

IMMUNODIP

Question 31

1) Dye binding method 2) Reported in albumin:creatinine ratio

Answer 31

CLINITEK MICROALBUMIN

Question 32

a) Estimates 24 hr microalbumin excretion b) Corrects for for overhydration or dehydration in a randspecimen c) Creatinine – produced & excreted at a constant rate

Answer 32

Albumin: Creatinine ratio

Question 33

produced & excreted at a constant rate

Answer 33

Creatinine

Question 34

Principle: Binding of albumin to sulphonaphthalein dye - Dye: diiodo-dihydroxy-dinitrophenyltetrabromosulphonaphthalein (DIDNTB) - Specific & sensitive to albumin (sensitivity: 8 and 15 mg/dL or 80 to 50 mg/dL)

Answer 34

ALBUMIN

Question 35

Principle: seudo-peroxidase activity of copper – creatinine complexes ◦ DBDH-diisopropylbenzenedihydroperoxide (acts as a peroxide ) ◦ TMB- tetramethylbenzidine (chomogen)

Answer 35

CREATININE

Question 36

DBDH (acts as a peroxide )

Answer 36

diisopropylbenzenedihydroperoxide

Question 37

TMB (chomogen)

Answer 37

tetramethylbenzidine

Question 38

Reagent strip that measures protein-high, protein-low, creatinine, specific gravity, pH, glucose, ketones, bilirubin, blood, nitrite, leukocytes

Answer 38

MULTISTIX PRO

Question 39

Albumin sensitivity in multistix pro

Answer 39

10 to 150 mg/L

Question 40

Creatinine sensitivity in multistix pro

Answer 40

10 to 300 mg/dL

Question 41

- Leukocytes - Nitrite - UROBILINOGEN - Protein - pH - Blood - Sp Gr - Ketone - Bilirubin - Glucose

Answer 41

MULTISTIX

Question 42

- Glucose - PROTEIN HIGH - PROTEIN LOW - Ketone - Sp gravity - Creatinine - pH - Blood - Nitrite - Leukocytes

Answer 42

Multistix pro