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urinalysis 1 > strip tests > Flashcards

strip tests Flashcards

1
Q

describe non-diabetic origin of glycosuria

A
  • normal diet
  • hormonal function (increase circulating blood glucose)
  • renal tubule damge
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2
Q

describe renal glycosuria

A

glucose in the absence of hyperglycemia
- normal glucose in blood but still in urine

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3
Q

what causes renal glycosuria

A

renal tubule unable to reabsorb glucose (renal disorders)

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4
Q

describe the glucose strip test reaction steps

A

1) glucose -glucose oxidase + air -> gluconic acid and hydrogen peroxide
2) hydrogen peroxide -peroxidase + chromogen -> oxidized color compound

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5
Q

true or false:
glucose oxidase strip test is specific for only glucose

A

true

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6
Q

list false positive glucose reactions on a strip tests

A

contamination with: peroxide or oxidizing substances

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7
Q

list false negatives of glucose strip tests

A
  • reducing substance (vitamin C)
  • high specific gravity
  • bacteria (from alone 2 hours)
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8
Q

why is first morning specimen not best for glucose UA

A

glucose can remain in bladder over night -> collect 2nd specimen

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9
Q

principle of clinitest

A

measures reducing substances and is not specific for glucose
- galactose, lactose, fructose and pentose

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10
Q

on what age of perosn was clinitest historically done

A

under 24 month old children to test for galactoemia

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11
Q

describe galactosemia

A

lack of galactoe-1-phosphate uridyl transferase enzyme causing lack of galactose -> glucose

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12
Q

why isn’t clinitest used anymore

A
  • galactosemia is now part of new born screening tests using tandem mass spec
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13
Q

name the disorder:
clinitest pos
UA glucose dipstick neg

A

galactosemia

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14
Q

name the disorder
clinitest pos/neg (<200mg)
UA glucose dipstick pos

A

glycosuria

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15
Q

why are ketones monitored

A
  • diabetes mellitus (deficiency of insulin)
  • accumulation of ketones (acidosis, dehydration)
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16
Q

what intermediate ketone product is measured

A

acetoacetic acid

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17
Q

what does acetoacetic acid break down into

A

acetone and BHBA (other main intermediate products)

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18
Q

how are ketones measured on a strip test

A

sodium nitroprusside in alkaline medium

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19
Q

how does acetest differ from dipstick

A

tablet test with sodium nitroprusside and lactose for increased color differentiation

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20
Q

define hematuria and characteristic appearence

A

intact RBC in urine
red and cloudy

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21
Q

define hemoglobinuria and characteristic appearance

A

hemoglobin in urine due to RBC destruction
red and clear

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22
Q

define myoglobinuria and characteristic appearance

A

myoglobin in urine due to muscle destruction
red and clear

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23
Q

what is the clinically significant amount of red blood cells in urine

24
Q

what does the blood strip detect

A
  • RBC
  • hemoglobin
  • myoglobin
25
how does the blood strip test detect RBCs, hgb and myoglobnin
all have pseudoperoxidase activity
26
define blood reaction on strip test
- peroxide and chromogen -(hgb peroxidase)-> oxidized chromogen
27
list causes of false pos blood strip
- strong ox reagents - vegetable peroxidase - bacterial peroxidase (e. coli)
28
list causes for false neg blood strip
- high levels of vitamin C - reducing agents
29
list cuases of hematuria
- kidney stones - glomerular disease - tumor -trauma - pyelonephritis (kidney infection) - toxic substances
30
what causes RBCs to lyse in urinary tract
in dilute or alkaline urine still hemoglobinuria
31
how is hemoglobin kept out of urine normally
hgb complexed with haptoglobin = too large to filter
32
how does hemosiderin form
reabsorption of filtered hemoglobin
33
where does hemosiderin normally accumulate
renal tubuluar epithelial cells (RTE) -> causes damage
34
how is myoglobin a probelm
breakdown product of skeletal muscle toxic to renal tubule cells can cause acute renal failure
35
describe the ammonium sulfate test
- differentiates myoglobin from hemoglobin - ammonium sulfate binds hgb and forms sediment when spun - myoglobin remains in supernatant when spun - supernatent is then tested for blood
36
hemoglobinuria or myoglobinuria: ammonium sulfate test was preformed and a new strip test was used on the supernatant strip test pos for blood
myoglobinuria
37
what does the presence of bilirubin indicate
liver disease - liver damage or bile duct obstruction
38
list steps in bilirubin breakdown
- RBC - hgb - protoporphyrin - unconjugated bilirubin - conjugated bilirubin (liver) - urobilinogen (intestine) - urobilin (feces)
39
what form of bilirubin is sent back to the liver and kidney
urobilinogen
40
what form of bilirubin in urine is indicative of bile duct obstruction
conjugated bilirubin - liver is leaking conjugated material
41
descirbe the bilirubin strip test reaction
- diazo reaction - bilirubin and diazonium salt in acid form azodye
42
what form of bilirubin in urine is indicative of liver disease or hemolytic disorders
urobilinogen
43
true or false: absence of urobilinogen from urine and feces is clinically significant
true - a small amount of urobilinogen should be in urine
44
what is ehrlichs reagent
part of urobilinogen detection - p methylaminobenzaldehyde
45
what else will be pos in a ehrlichs reagent tube test
- urobilinogen tube test - pos if porphobilinogen is present, indicans and antibiotics - not urobilinogen specific
46
describe hoesch reagent
ehrlichs reagent in 6M HCl
47
when is hoesch screening test used
rapid screening test for urinary porphobilinogen - red if porpho pos - urobilinogen inhibited from acidic pH
48
why is nitrite tested
bacterial ability to breakdown nitrite to nitrate is significant
49
what test result is combined with nitrite to determine clinical significance
leukocyte esterase test - bacteria and WBC response
50
what specimen is preferred for nitrite testing
first morning
51
list false negatives for nitrite test
- bacteria missing reducing enzyme - GP and yeast present (no enzyme) - ascorbic acid
52
list false pos for nitrite test
bacterial over growth from being left out (not fresh sample), color interference
53
describe what leukocyte esterase measures
presence of esterase in granulocytic white blood cells - lysed cells
54
false pos for leukocyte esterase
pigmented urine, formalin
55
false negatives of leukocyte esterase test
ascorbic acid (binds dizonium) crenated WBC antibiotics

urinalysis 1 (13 decks)

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