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AUBF > 4.1 CHEMICAL EXAMINATION > Flashcards

4.1 CHEMICAL EXAMINATION Flashcards

1
Q

What are the two major types of reagent strips used for urine chemical analysis?

A

Multistix (Siemens) and Chemstrip (Roche).

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2
Q

What is the primary advantage of using reagent strips for chemical analysis of urine?

A

They provide a simple, rapid means for performing medically significant chemical analysis.

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3
Q

What are the common chemical tests included on reagent strips?

A

pH,
protein,
glucose,
ketones,
blood,
bilirubin,
urobilinogen,
nitrite,
leukocytes, and
specific gravity.

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4
Q

What is the proper technique for using reagent strips?

A

Dip the strip briefly into a well-mixed urine specimen, remove excess urine, blot on absorbent paper, wait for the specified reaction time, and compare the color to the chart.

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5
Q

What can happen if the reagent strip remains in the urine for too long?

A

It may cause leaching of reagents from the pads.

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6
Q

Why is it important to blot the strip after dipping it into urine?

A

To prevent runover between chemicals on adjacent pads, which can distort the results.

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7
Q

How long should leukocyte esterase (LE) reactions on reagent strips be read?

A

Between 60 and 120 seconds, with 120 seconds recommended for LE reactions.

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8
Q

What must be done with refrigerated urine specimens before testing with reagent strips?

A

They must be allowed to return to room temperature because enzymatic reactions are temperature-dependent.

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9
Q

Can reagent strips and color charts from different manufacturers be used interchangeably?

A

No, reagent strips and color charts from different manufacturers are not interchangeable.

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10
Q

What are some errors caused by improper reagent strip technique?

A

Unmixed specimens can lead to undetected elements like red or white blood cells, and excess urine on the strip can cause runover between pads.

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11
Q

Why is a good light source important during reagent strip testing?

A

For accurate interpretation of color reactions.

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12
Q

They are used for chemical analysis of urine, including tests for pH, protein, glucose, ketones, blood, bilirubin, urobilinogen, nitrite, leukocytes, and specific gravity

A

reagent strips

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13
Q

How are reagent strips structured?

A

They consist of chemical-impregnated absorbent pads attached to a plastic strip.

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14
Q

What types of values are reported based on reagent strip color changes?

A

Semiquantitative values such as trace, 1+, 2+, 3+, or 4+, with estimates of the milligrams per deciliter present.

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15
Q

What must be done after dipping the reagent strip into the urine to prevent runover between pads?

A

Blot the strip on absorbent paper and hold it horizontally.

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16
Q

Why should the strip not be immersed in urine for too long?

A

Extended immersion can cause leaching of reagents from the pads.

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17
Q

What can happen if excess urine remains on the reagent strip after removal from the specimen?

A

It can cause runover between chemicals on adjacent pads, distorting the results.

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18
Q

Why is it important to properly time reagent strip reactions?

A

The reactions vary between tests and manufacturers, typically between 30 seconds and 120 seconds, with leukocyte esterase (LE) requiring up to 120 seconds.

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19
Q

What can cause inaccurate results if the urine specimen is not well mixed before testing?

A

Formed elements like red and white blood cells can sink to the bottom and go undetected.

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20
Q

Interferes with tests for blood, glucose, and nitrite.

A

Ascorbic acid

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21
Q

Presence of bacteria in urine.

A

Bacteriuria

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22
Q

Indicates liver dysfunction when found in urine.

A

Bilirubin

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23
Q

Chemical reaction used to detect bilirubin.

A

Diazo reaction

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24
Q

Reaction used for detecting urobilinogen.

A

Ehrlich reaction

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25
Q

Disorder of kidney tubules that leads to abnormal excretion of glucose, amino acids, and more.

A

Fanconi syndrome

26
Q

Protein that stores iron, detectable in urine in some conditions.

A

Ferritin

27
Q

Presence of glucose in urine.

A

Glucosuria

28
Q

Synonym for glucosuria.

A

Glycosuria

29
Q

Used to detect nitrite in urine (indicates bacteriuria).

A

Greiss reaction

30
Q

Presence of blood in urine.

A

Hematuria

31
Q

Presence of hemoglobin in urine.

A

Hemoglobinuria

32
Q

Iron-storage complex, sometimes found in urine.

A

Hemosiderin

33
Q

Condition often linked with bilirubin in the urine.

A

Jaundice

34
Q

Presence of ketones in urine.

A

Ketonuria

35
Q

Presence of white blood cells in urine.

A

Leukocyturia

36
Q

Presence of small amounts of albumin in urine, indicative of early kidney disease.

A

Microalbuminuria

37
Q

Presence of myoglobin (muscle protein) in urine.

A

Myoglobinuria

38
Q

Proteinuria occurring only when standing.

A

Orthostatic proteinuria

39
Q

Proteinuria due to urinary tract disorders.

A

Postrenal proteinuria

40
Q

Proteinuria due to systemic conditions affecting kidney function.

A

Prerenal proteinuria

41
Q

Principle used in protein testing on reagent strips.

A

Protein error of indicators

42
Q

Presence of abnormal amounts of protein in urine

A

Proteinuria

43
Q

Proteinuria caused by intrinsic kidney disease

A

Renal proteinuria

44
Q

Form of urobilinogen that appears in the intestines.

A

Stercobilinogen

45
Q

Byproduct of bilirubin breakdown, excreted in urine.

A

Urobilinogen

46
Q

Tamm-Horsfall protein, found in normal urine, produced by renal tubular cells.

A

Uromodulin

47
Q

How should reagent strips be stored to prevent deterioration?

A

Store in an opaque, tightly closed container with desiccant, below 30°C, away from volatile fumes, and do not freeze.

48
Q

What should be done immediately after removing reagent strips from the container?

A

The bottle should be tightly resealed to prevent exposure to light and moisture.

49
Q

Why is visual inspection of reagent strips important before use?

A

To detect any deterioration, such as discoloration of the chemical pads, even if the strips are within their expiration date.

50
Q

How should reagent strips be handled when opening them from their packaging?

A

Strips should be removed just before testing, and care must be taken not to touch the chemical pads.

51
Q

What is the recommended storage temperature for reagent strips?

A

Below 30°C, but they should not be refrigerated.

52
Q

When should reagent strips not be used?

A

They should not be used if past the expiration date or if the chemical pads are discolored.

53
Q

What factors can lead to errors in reagent strip testing besides reagent strip deterioration?

A

Technical carelessness, interfering substances in the urine, and color blindness can lead to errors.

54
Q

What are some examples of interfering substances in urine that can affect reagent strip testing?

A

The orange pigment from phenazopyridine compounds, which can mask color reactions.

55
Q

What should be done when questionable results are obtained with reagent strips?

A

Confirmatory tests should be performed using different reagents or methodologies to detect the same substances with greater sensitivity or specificity.

56
Q

What is the purpose of confirmatory tests in reagent strip testing?

A

To validate the results when questionable results are obtained or for highly pigmented specimens.

57
Q

What should be done with refrigerated urine specimens before reagent strip testing?

A

Allow them to warm to room temperature to ensure accurate enzymatic reactions.

58
Q

Why should distilled water not be used as a negative control in reagent strip testing?

A

Because reagent strip reactions are designed to perform at ionic concentrations similar to urine.

59
Q

What must be done if control results for reagent strips do not agree with the expected values?

A

Further testing should be performed, and the issue must be resolved through additional control testing.

60
Q

What are some newer technologies that reduce the need for routine confirmatory testing?

A

The increased specificity and sensitivity of reagent strips and automated strip readers.

AUBF (22 decks)

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