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Clinical Chemistry 2 > 5-8. Urinalysis > Flashcards

5-8. Urinalysis Flashcards

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1
Q

Urine creatinine should be __x that of plasma creatinine

A

50x

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2
Q

What can be used to differentiate hemoglobin from myoglobin in terms of solubility

A

Ammonium sulfate

  • Hgb precipitates
  • Myo remains soluble
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3
Q

Method for determining glucose on dipstick

A

Glucose oxidase

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4
Q

If these casts remain in tubules long enough, they begin to look waxy

A

Granular

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5
Q

How to differentiate whether hemoglobin or myoglobin is present in urine?

A

Solubility in saturated ammonium sulfate

  • Hgb precipitates
  • Myoglobin is soluble
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6
Q

2 main differences between ischemic and toxic acute tubular necrosis (ATN)

A

Ischemic - affects tubules in random areas; disrupts basement membranes = RTEs in urine

Toxic - tubular necrosis in proximal tubules; doesn’t involve BMs = epi cells in urine

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7
Q

Isosthenuric urine (SG=1.010) occurs when..?

A

Tubules unable to concentrate urine, so SG of excreted urine is same of ultrafiltrates’

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8
Q

These casts signify nephrotic syndrome

A

Fatty casts

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9
Q

Crystal that is a feature of an old specimen

A

Ammonium biurate

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10
Q

3 mechanisms that result in ketonuria

A
  • Inability to use carbs
  • Inadequate intake of carbs
  • Loss of carbs
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11
Q

Responsible for white foam in urine

A

Albumin

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12
Q

Urine preservative when urine is for drug analysis

A

Sodium fluoride

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13
Q

Limitation of chemstrip protein pad?

A

Only detects albumin

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14
Q

What interferes with diazo rxn and how

A

Ascorbic acid; competes w/ nitrite to combine w/ diazonium salt

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15
Q

The refractometer is affected by this parameter and is a source of error

A

Temperature fluctuations

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16
Q

Most commonly requested test on a catheter specimen

A

Bacterial culture

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17
Q

Epithelial casts are mostly composed of this cell

A

RTE

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18
Q

Large colorless needles in fan or wheat sheaf formations w/ eccentric binding

A

Sulfonamide crystals

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19
Q

What does clear, red urine suggest (scientific name)?

A

Hemoglobinuria or myoglobinuria

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20
Q

Pre-hepatic jaundice urobilinogen and bilirubin in urine?

A
  • Uro INCREASED

- NO bili in urine

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21
Q

Usually found together with leucine crystals in patients with terminal cirrhosis or viral hepatitis

A

Tyrosine crystals

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22
Q

What does cloudy, red urine suggest (scientific name)?

A

Hematuria (RBCs present)

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23
Q

Refractile needles occurring in sheaves or clusters; may be colourless but appear black as the field is focused

A

Tyrosine

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24
Q

Which rxn principle? Leukocyte

A

Diazo

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25
Q

Urine preservative best for bilirubin/urobilinogen

A

Freezing

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26
Q

Normal pH of urine

A

4.0 - 8.0

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27
Q

Normal urine odour is due to?

A

Volatile acids

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28
Q

Con of refrigeration as a method of preservation?

A
  • Precipitation = adds formed elements

- Changes clairty

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29
Q

Clear red urine may be caused by?

A

Hemoglobin

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30
Q

pH on chemstrip source of error?

A

Bacterial growth

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31
Q

Nitrite is detected by this reaction

A

Greiss

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32
Q

Uric acid is soluble at _______ or with addition of ________

A

60 degC

10% NaOH

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33
Q

The only 4 physical/chemical/microscopic changes that increases rather than decrease in unpreserved urine

A
  • Odour
  • pH
  • Nitrite
  • Bacteria
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34
Q

What does significant pyuria WITHOUT bacteria suggest?

A

UTI involving viruses, yeast, chlamydia

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35
Q

4 confirmatory tests?

A
  • Ictotest (bilirubin)
  • Clinitest (glucose)
  • Acetest (ketones)
  • SSA test (protein)
36
Q

3 ingredients in SG reagent strip test pad?

A
  • Polyelectrolyte
  • Acid-base indicator
  • Buffers
37
Q

4 clinical reasons for performing a routine urinalysis

A
  1. Aid diagnosis of disease
  2. Screen population for disease
  3. Monitor progress of disease
  4. Monitor effectiveness or complications of therapy
38
Q

The presence of RBC casts is indicative of this disease

A

Glomerulonephritis

39
Q

Crystal associated with maple syrup disease

A

Leucine

40
Q

Which rxn principle? Blood

A

Peroxidase

41
Q

Which rxn principle? Ketones

A

Nitroprusside

42
Q

Characteristic yellow colour, but oxidizes to biliverdin upon standing => greenish hue

A

Bilirubin

43
Q

Red-brown urine may be caused by?

A

Myoglobin (rhabdomyolysis)

44
Q

2 indicators in pH reagent pad

A

Methyl red, bromothymol blue

45
Q

Post-hepatic jaundice urobilinogen and bilirubin in urine?

A
  • NO uro

- INCREASED bili in urine

46
Q

When do you +0.005 to SG readings on manual chemstrips?

A

When pH >= 7.0

47
Q

Appearance of “thorny apples”

A

Ammonium biurate

48
Q

Crystal that is a pink precipitate

A

Amorphous URATES

49
Q

Gives urine its characteristic yellow colour

A

Urochrome

50
Q

Colourless, long, thin prisms or needles with on pointed end

Often arranged in rosettes or stars

A

Calcium phosphate

51
Q

Hepatic jaundice urobilinogen and bilirubin in urine?

A
  • Uro VARIABLE

- INCREASED bili in urine

52
Q

Normal temperature of urine

A

32.5-37.5 degC

53
Q

Normal specific gravity of urine

A

1.002 - 1.035

54
Q

Outline ketone reagent pad reaction

A

Acetone + sodium nitroprusside (+glycine) → purple colour

55
Q

3 ketone bodies in urine, and which can’t be detected on dipstick and acetest

A
  • Acetone
  • Acetoacetate
  • B-hydroxybutryic acid

B-hydroxybutryic acid not detected

56
Q

Condition under which glucosuria will occur?

A

Blood glucose >10 mmol/L

57
Q

This crystal has monohydrate and a dihydrate form

A

Calcium oxalate

58
Q

Appear as long narrow crystals with points at EITHER end

Soluble in acetic acid

A

Hippuric acid

59
Q

Principle behind automated chemstrip reader

A

Reflectance photometry

60
Q

3 crystals found in acid pH

A
  • Uric acids
  • Calcium oxalates
  • Amorphous urates
61
Q

Urine preservative that acts as a reducing agent (interferes with glucose, blood, leukocyte esterase)

A

Formalin

62
Q

2 types of timed specimen

A

Pre-determined length of time (hormones, creatinine clearance)

At specific time of day (glucose, urobilinogen)

63
Q

2 crystals soluble at 60C or addition of dilute NaOH

A

Uric acid

Amorphous URATES

64
Q

2 other urine proteins that may be present in lower concentrations

A
  • Urokinase

- secretory IgA

65
Q

Abnormal crystal associated with ethylene glycol poisoning

A

Hippuric acid

66
Q

Urine preservative that may interfere with drug and hormone analysis

A

Acidification

67
Q

Environment that may cause RBCs to appear as ‘ghost cells’

A

Alkaline pH

68
Q

Red-purple urine may be due to..

A

Porphyrins

69
Q

Hgb oxidation to methehemoglobin in urine is enhanced at this pH range

A

Alkaline

70
Q

Whcih rxn principle? Glucose

A

Peroxidase

71
Q

Cloudy red urine may be caused by?

A

RBCs, menstrual contamination

72
Q

Which rxn principle? Urobilinogen

A

Ehrlich reaction

73
Q

Casts are mainly composed of this glycoprotein

A

Tamm-Horsfall

74
Q

Difference between glomerular and tubular proteinuria?

A

Glomerular - due to increased gloumerular permeability

Tublar - due to defective tubular reabsorption

75
Q

Responsible for orange-brown pigment in urine

A

Urobilin

76
Q

Principle of Greiss reaction in nitrite detection

A

Nitrite, in acidic pH, reacts with aromatic amine = diazo compound

Diazo reacts w/ quinolone compound = pink azodye

77
Q

These cells exude the Tamm-Horsfall mucoprotein

A

Renal tubular epithelial cells (RTEs)

78
Q

Bacterial decomposition and UTI may give urine this odour

A

Ammonia odour

79
Q

Potential cause of false positive protein dipstick

A

Highly alkaline urine

80
Q

Clinitest is based on what reaction and principle?

A

Cupric sulfate -> cuprous oxide

(colour change blue to green to orange)

via reducing substances (sugars)

81
Q

Colourless, retractile hexagonal plate

A

Cysteine

82
Q

Acetest

_______ + ______________ -> purple colour

A

Acetone + sodium nitroprusside

83
Q

Mousy urine odour may be due to what disease?

A

PKU

84
Q

What is ‘alkaline tide’?

A

When urine is less acidic after a meal due to stomach secreting acid to aid in digestion

85
Q

On urine chemstrip - this ingredient dissociates and releases H+ in response to pH

A

Polyelectrolyte

86
Q

Pink pigment most evident when it deposits on urate crystals, producing a precipitate

A

Uroerythrin

87
Q

__________ does not show up in a chemical test for blood on the SUPERNATANT of a spun urine

A

Myoglobin

Clinical Chemistry 2 (15 decks)

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