AUBF 1 Flashcards
currently provide a simple, rapid
means for performing medically significant
chemical analysis of urine
reagent strips
parts of reagent strips
chemically impregnated absorbent pads
plastic strips
pads+urine=
color reaction
illustrate parameters
glucose
ketones
specific gravity
ph
protein
urobilinogen
leukocyte
nitrite
blood
bilirubin
additional parameters
microalbumin - for renal disease
creatinine - for muscle waste
ascorbic acid- vitamins
major interference of ascorbic acid
B- bilirubin
B- blood
L- leukocyte
N- nitrite
G- glucose
longest time of reading
leukocyte-120s
Consists of chemical-impregnated absorbent
pads attached to a plastic strip. A color-producing
chemical reaction occurs when the absorbent pad
comes in contact with urine.
reagent strip
Two major types of reagent strips are
manufactured under the trade names
multistix
chemstrip
the enzymatic reactions
on the strips are
temperature dependent
possible inaccurate results
1.Interfering substances
2.Technical carelessness
3.Color blindness
Reagent strips must be protected from ____ caused
by moisture, volatile chemicals, heat, and light.
deterioration
moisture, volatile chemicals, heat, and light.
Reagent strips are packaged in ___ to protect them from ___
opaque containers with a
desiccant
light and moisture.
Bottles should not be opened in the presence of
volatile fumes
Manufacturers recommend that reagent strips be stored at
room temperature below 30°C (but never refrigerated).
Reagent strips must be checked with both ___ a minimum of ___
positive and
negative controls
once every 24 hours.
not
recommended as a negative control
distilled water
why distilled water is not recommended as negative control
because reagent strip chemical reaction designed to perform at ionic concentration similar urine
Test using different reagents or methodologies to
detect the same substances as detected by the
reagent strips with the same or greater sensitivity
or specificity.
confirmatory testing
Parameter with longest reading time:
leukocyte esterase
11th pad in the urine reagent strip detects: _
ascorbic acid
Parameters affected by the presence of Ascorbic Acid:
BBLNG
principle of ph
double indicator system
For precipitation and identification of crystals
ph
Assessment of acid base disorders
ph
Assessment of defects in tubular specimens
ph
Determination of unsatisfactory specimens
ph
NORMAL VALUE: ph
RANDOM SAMPLES:
4.5 - 8.0
normal value: ph
FIRST MORNING:
5.0 - 6.0
acid urine
diabetes mellitus
high protein and high meat diet
starvation
diarrhea
acid producing bacteria
emphysema
cranberry juice
medication
alkaline urine
Hyperventilation
Renal tubular disorders
Renal tubular disorders
Vegetarian Diet
Old specimens
Vomiting
Urease-producing bacteria
After meals (alkaline tide)
ph Manufacturers use a double-indicator
system of
methyl red and bromthymol
blue
methyl red color and ph
red to yellow
4-6
bromthymol blue color change and ph
yellow to blue
ph 6-9
ph range 5-9 color change
ph 5 - orange to yellow
ph9- green to final deep blue
ph reagent strips sensitivity of multistix and chemstrip
multistix: 5.0 to 8.5 in 0.5 increments
chemstrip: 5.0 to 9.0 in 1.0 increments
principle of protein
protein error of indicator
reagent of protein
tetrabromphenol blue
Reagent strip for protein is more sensitive to
albumin
major protein found in urine)
albumin
mucoprotein produced by the renal tubules and forms
tamm horsfall protein and uromodulin
MATRIX of ALL TYPES OF CASTS
Serum and tubular microglobulins
Proteins from prostatic, seminal and vaginal secretions
most common indication of renal disease.
proteinuria
sink to the bottom of the specimen and will be
undetected in an unmixed specimen.
red and white blood cells
normal values of proteinuria
150mg/24 hours (henry)
<10mg/dl or 100mg/24 hr (strasinger)
minimal proteinuria
<1.0g/day or <10mg/day
MODERATE PROTEINURIA=
1.0-4.0g/day (10-40 mg/day)
HEAVY PROTEINURIA=
= >4.0 g/day (>40 mg/day)
found in patients with MM;
a monoclonal light chain that precipitates at 40-60C
and dissolve at 100C.
bence jones protein
bence jones protein precipitates at ___ and dissolves at __
40-60C
100 C
presence of increased
proteins in the urine
clinical proteinuria
clinical proteinuria value
> 30 mg/dL(300 mg/L)
-caused by conditions affecting the
plasma prior to its reaching the kidney and,
therefore, is not indicative of actual renal disease
pre renal
caused by increased levels of low-molecularweight plasma proteins such as hemoglobin
(intravascular hemolysis), myoglobin(muscle
injury, and acute phase reactants (infection and
inflammation)
pre renal
-associated with true renal disease
may be the result of either glomerular or tubular damage
RENAL PROTEINURIA-
Glomerular Proteinuria
- impaired selective filtration
- increased amount of serum protein
- RBC/WBC pass through the membrane
postural proteinuria w/c occurs in
3%- 5% of apparently healthy young adults
ORTHOSTATIC PROTEINURIA
usually transient and can be produced by
conditions such as strenuous exercise, high fever, dehydration,
and exposure to cold.
Benign proteinuria
fanconi syndrome, toxic
agents/heavy metals, pyelonephritis, acute
tubular necrosis, polycystic kidney disease,
phenacetin damage
TUBULAR PROTEINURIA
proteinuria not detected by
the routine reagent strip
MICROALBUMINURIA-
signifies onset of renal complications of DM
MICROALBUMINURIA-
METHODS for detecting Microalbuminuria
Quantitative procedures
MICRAL TEST
IMMUNODIP
ALBUMIN:CREATININE RATIO
for albumin using 24 hour
specimen
Quantitative procedures
strip employing antibody-enzyme
conjugate for human albumin
micral test
PRINCIPLE: Immunochromatographics
IMMUNODIP
PRINCIPLE: Sensitive albumin tests related to
creatinine concentration to correct for patient
hydration
ALBUMIN:CREATININE RATIO
SENSITIVITY: Albumin:
Creatinine:
10-50 mg/L
10-300 mg/dL
SIGNIFICANT if ALBUMIN:CREATININE is
> 3.4 mg/mmol
lower UTI (ureters, bladders, uethra, prostate and
vagina
Menstrual contamination
Vaginal secretions or prostatic sperms
these indicates?
post renal
