3.8 Chemical Examination of Urine (Urobilinogen) Flashcards
Normal value for urobilinogen?
<1.0 mg/dL or <1.0 EU
Urobilinogen is never reported as negative
T or F
T
Reagent strips for urobilinogen lacks sensitivity
T or F
T
Urobilinogen is normally present in urine
T or F
T
The only chemical parameter that is never reported as negative because
- it lacks sensitivity
- Cannot distinguish between small amount or zero
- Any amount less than 1 is reported as normal
Urobilinogen
Recirculation Pathway for Bilirubin Metabolism:
1. Unconjugated form of Bilirubin (B1) is transported to the liver bound to albumin.
2. B1 will be conjugated to B2 in the presence of the enzyme UDGPT
3. B2 is secreted to the bile canaliculi
4. And finally, excreted to the intestine
5. Once in the intestine, B2 will be further metabolized by intestinal bacteria to urobilinogen
6. Once urobilinogen is produced, majority will be recirculated into the liver
7. The liver will reabsorb the urobilinogen and will be re-excreted and finally, will be oxidized to urobilin
Arrange
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Urine Bilirubin: Neg
Urine UBG: 3+
a. Hemolytic (B1)
b. Hepatic (Both)
c. Obstructive (B2)
a
Urine Bilirubin: 3+
Urine UBG: Normal RST
a. Hemolytic (B1)
b. Hepatic (Both)
c. Obstructive (B2)
c
Urine Bilirubin: +/-
Urine UBG: 2+
a. Hemolytic (B1)
b. Hepatic (Both)
c. Obstructive (B2)
b
Form of bilirubin that’s high in hemolytic jaundice
B1
Form of bilirubin that’s high in Obstructive jaundice
B2
Crigler-Najar syndrome, Physiologic jaundice of newborn Increase in What form of bilirubin?
Both B1 and B2
B1 is not excreted in urine
T or F
T
Excretion of B2 is prevented if delta bilirubin is formed or bounded to albumin
T or F
T
If B2 does not reach the intestine, there will be no urobilinogen, then, no urobilinogen will not be recirculated, then none will be excreted.
T or F
T
Why is hemolytic and hepatic high or positive in UBG?
Urine urobilinogen increases because of the hepatic uptake of the recirculated urobilinogen is impaired, not accepted by
liver.
T or F
T
Test for Urobilinogen:
A traditional test that is nonspecific
a. Ehrlich’s Tube Test
b. Schwartz-Watson Differentiation test
a
Test for Urobilinogen:
Reagent: Paradimethylaminobenzaldehyde
a. Ehrlich’s Tube Test
b. Schwartz-Watson Differentiation test
a
Test for Urobilinogen:
Involves initial extraction using chloroform and butanol prior to the addition of the reagent paradimethylaminobenzaldehyde
a. Ehrlich’s Tube Test
b. Schwartz-Watson Differentiation test
b
Test for Urobilinogen:
Positive result: Cherry red
a. Ehrlich’s Tube Test
b. Schwartz-Watson Differentiation test
a
In Schwartz-Watson Differentiation Test:
UBG: Insoluble in both chloroform and butanol
PBG: soluble in both chloroform and butanol
T or F
F
Baligtad
In Schwartz-Watson Differentiation Test:
Other Ehrlich reactive compounds: Soluble in chloroform and insoluble in butanol
T or F
F
Baligtad
In Schwartz-Watson Differentiation Test:
Tube 1: Top-urine, bottom-chloroform
Tube 2: Top-butanol, bottom-urine
T or F
T
