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Urinalysis (BIOL 380) > Quiz 2 > Flashcards

Quiz 2 Flashcards

(74 cards)

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0
Q

What constitutes the chemical examination?

A
  1. pH
  2. Protein
  3. Glucose
  4. Ketones
  5. Blood
  6. Bilirubin
  7. Urobilinogen
  8. Nitrite
  9. Leukocyte Esterase
  10. Specific Gravity
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1
Q

What is the purpose of quality control?

A

Ensure that the reagent strips are accurate and precise

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2
Q

What is the normal range for pH?

A

4.5-8.0

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3
Q

What regulates the acid-base balance (pH)?

A

Kidneys and lungs

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4
Q

Clinical Significance of an acid urine (below 6.0)

A

High protein diets, medications, diabetes mellitus, starvation, dehydration, diarrhea, certain renal stones

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5
Q

Clinical Significance of an Alkaline urine (above 6.5)

A

After meals, hyperventilation, vomiting, urease-producing bacteria, vegetarian diet, old specimens, certain renal stones

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6
Q

The pH reagent strip is what kind of system?

A

Double pH indicator

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7
Q

What chemical indicators are used in the pH reagent strip?

A

Methyl Red and Bromthymol Blue

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8
Q

What is the normal value for protein?

A

< 100 mg/ 24 hours

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9
Q

What clinical significance does protein show?

A

Renal disease

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10
Q

Proteins tested for are:

A

Albumin
Serum and tubular microglobulins
Tamm-Horsfall protein
Prostatic, seminal, and vaginal protein secretions

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11
Q

Proteinuria

A

Increase protein in urine ( > 30mg/dL)

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12
Q

What major pathological causes are there to indicate a protein problem?

A
  • Prerenal
  • Renal
  • Postrenal
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13
Q

Prerenal

A

condition affecting plasma prior to kidney; infection/inflammation; too much protein to reabsorb

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14
Q

Renal

A

Glomerular damage and tubular damage

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15
Q

Postrenal

A

Protein added as passes through lower urinary tract

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16
Q

What are nonpathological causes of proteinuria?

A
  • Exposure to cold
  • Strenuous exercise
  • High fever
  • Orthostatic (postural)
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17
Q

Protein Reagent Strip: Indicator

A

Tetrabromphenol blue

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18
Q

What could give you a false positive for protein?

A

*Highly buffered alkaline urines, delay in reading results, high specific gravity

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19
Q

What would give false negatives for a protein?

A

*Measures mostly albumin and may miss other proteins

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20
Q

What confirmatory tests are used for protein?

A

Sulfosalicyclic Acid Precipitation

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21
Q

What is the renal threshold for glucose?

A

160-180 mg/dL

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22
Q

Glycosuria

A

Increase of urine glucose

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23
Q

Causes of glycosuria?

A 
Diabetes mellitus 
Pancreatitis 
Advanced renal disease
Hyperthyroidism 
Emotional stress
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24
What is the chemical basis for the glucose reagent strip?
Double sequential enzymatic reaction based on action of glucose oxidase on glucose
25
What two enzymes are used in the glucose reagent strip?
Glucose oxidase | Peroxidase
26
What could cause a false negative for glucose?
Ascorbic acids, ketones, pH, specific gravity, aspirin, low temperatures
27
What test is done to confirm a positive glucose test?
Clinitest
28
What principle is the clinitest based off of?
Uses the benedict principle
29
Why is the clinitest done on all children under the age of two years old?
Detects metabolic disorders like galactose | Catches inborn defects early in life
30
Memorize the comparison of strip to clinitest slide on page 43
Page 43 of notes
31
How are ketones produced?
Lack of carbohydrates causes increased fat metabolism for energy produces ketone
32
What are the 3 intermediate products of fat metabolism?
1. Acetone (2%) 2. Acetoacetic Acid (20%) 3. Beta-hydroxybutyric Acid (78%)
33
Ketonemia
Ketones in the blood
34
Ketonuria
Ketones in the urine
35
Ketosis
Ketones in both blood and urine
36
What is the clinical significance of positive ketones?
``` Metabolic problem Diabetes mellitus Vomiting Starvation Dieting Malabsorption ```
37
What can an increase in ketones result in?
Electrolyte imbalance and dehydration and acidosis and coma
38
What is the chemical basis for the ketones reagent strip?
Acetoacetic acid and sodium nitroprusside
39
What is the normal level of ketones in the urine?
Negative
40
What is the confirmatory test for ketones?
Acetest
41
What does blood in the urine indicate?
Damage to kidney or urinary tract
42
What is indicated by a positive reagent strip for blood?
The presence of red blood cells, hemoglobin, or myoglobin
43
Hematuria
Presence of intact RBCs in urine indicating bleeding in the urinary system **Appears as cloudy, red urine
44
Hemoglobinuria
Presence of free hemoglobin in the urine | **Appears as red, clear urine and red plasma
45
Myoglobinuria
Myoglobin is a heme-containing protein found in muscle tissue **Appears red to brown and clear with normal appearing (no red) plasma
46
What is the chemical basis for the blood reagent strip?
Peroxidase activity
47
What interferes with the blood reagent strip?
Menstruation, ascorbic acid, medications, microbial peroxidases
48
What is bilirubin?
A degradation product of hemoglobin and is a highly yellow pigmented compound
49
What does urine bilirubin an indicator of?
Metabolic disorders especially with the liver
50
Bilirubinuria
Build up of bilirubin
51
What type of bilirubin cause bilirubinuria?
Conjugated bilirubin in blood
52
What type of reaction occurs with the bilirubin reagent strip?
Diazo Reaction
53
What is the chemical basis for the bilirubin reagent strip?
Bilirubin glucuronide
54
What is the confirmatory test for bilirubin?
Icotest
55
What can interfere with the bilirubin reagent strip?
``` Ascorbic Acid Increased nitrites Medications Urine pigments Light ```
56
What is the normal range of urobilinogen in the urine?
.1-1.0 Ehrlich units/dL
57
Urobilinogen (defintion)
Breakdown product of bilirubin
58
What is the chemical basis for the urobilinogen reagent strip?
Ehrlich's Aldehyde Reaction
59
What does a positive nitrite always indicate?
Bacteriuria (UTI infection)
60
What is the clinical significance of a positive nitrite?
Cystitis, pyelonephritis, evaluate antibiotic therapy, screen for urine cultures
61
What type of reaction is the nitrite reagent strip?
Greiss Reaction (Diazo reaction)
62
What is the basis for the nitrite reagent strip?
Based on bacteria's ability to reduce nitrate to nitrite
63
What interferes with the nitrite test?
Improperly preserved specimen, nonreductase bacteria, lack of urine nitrate, antibiotics
64
What does the leukocyte esterase tests detect?
Intact and lysed leukocytes and presence of esterase released from granulocytes and monocytes
65
What does a positive leukocyte esterase test indicate clinically?
UTI, UTI inflammation
66
Pyuria
Increase WBC in urine
67
What type of reaction is the leukocyte esterase reagent strip?
Diazo reaction
68
What can interfere with a leukocyte esterase reagent strip?
Ascorbic acid and improper timing
69
Specific Gravity (Defintion)
Measure of dissolved substances present in the urine or density of urine
70
What is the normal specific gravity value?
1.010-1.030
71
What is the clinical significance of specific gravity?
Monitor patient hydration and dehydration | Diabetes insipidus
72
What is the chemical basis for the specific gravity reagent strip?
Based on change in pKa of a polyelectrolyte
73
What is the summed up pathway of how an increased specific gravity?
Increased specific gravity --> Increased electrolytes --> Increased dissociation of H+ --> Increased H+ --> Decreased pH

Urinalysis (BIOL 380) (4 decks)

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