AUBF BOOK (Finals) Flashcards
1
Q
Reagent strips currently provide a simple, rapid means
for performing medically significant chemical analysis of
urine including
A
pH
protein
glucose
ketones
blood,
bilirubin
urobilinogen
nitrite
leukocytes
specific gravity
2
Q
Two major brands for reagent strips
A
Multistix and Chemstrip
3
Q
Reagent strips should be read between
A
60 to 120 secs
4
Q
Strips are dependent on ____
A
temperature
5
Q
Manufacturers recommend that reagent strips be stored at
room temperature below
A
30 deg C
6
Q
QC of reagent strips
Reagent strips must be checked with both positive and negative
controls a minimum of once every
A
24 hours
7
Q
can cause a highly dark yellow colored urine
A
Phenazopyridine
8
Q
CARE OF REAGENT STRIPS
A
Store with desiccant in an opaque, tightly closed container
Store below 30°C; do not freeze.
Do not expose to volatile fumes.
Do not use past the expiration date.
Do not use if chemical pads become discolored
Remove strips immediately prior to use
9
Q
A healthy individual usually produces a first morning specimen with a slightly acidic pH of
A
5.0 to 6.0
10
Q
An alkaline pH is found following
A
meals
11
Q
The pH of normal random samples can range from
A
4.5 to 8.0
12
Q
Persons with high protein and high meat pH:
A
more acidic urine
13
Q
Vegetarians urine pH
A
more alkaline
14
Q
Cranberries produces an
A
acidic urine
15
Q
Medications such as methenamine, mandelamine, or monurol are metabolites to produce
A
acidic urine
16
Q
The pH of freshly excreted urine does not reach above
A
8.5
17
Q
A pH above 8.5 is associated with an
A
improperly preserved specimen
18
Q
Amorphous urate is seen in pH
A
Acidic
19
Q
Amorphous phosphate is seen in pH
A
alkali
20
Q
Renal alkali seen in urine indicates
A
kidney stones
21
Q
The Multistix and Chemstrip brands of reagent strips measure urine pH in 0.5- or 1-unit increments between pH 5 and 9 color change
A
5 orange > yellow > 9 blue
22
Q
produces a color change from red to yellow in the pH range 4 to 6,
A
Methyl red
23
Q
Turns from yellow to blue in the range of 6 to 9
A
bromothymol blue
24
Q
Most indicative of renal disease is the —- determination
A
Protein
25
Often associated with early renal disease.
Proteinuria
26
Normal urine contains very little protein: usually, less than ___ is excreted
10 mg/dL or 100 mg per 24 hours
27
Consist of low molecular proteins that have been filtered by the ____
glomerulus
28
major serum protein found in normal urine
Albumin
29
Much of the filtered albumin is reabsorbed by the _______.
tubules
30
Produced in renal epithelial tubular cells and prostatic seminal and vaginal secretions
Tamm-Horsfall protein (uromodulin)
31
Routinely produced in the DCT (distal convoluted tubule)
Tamm-Horsfall protein (uromodulin)
32
Clinical proteinuria is indicated at
30 mg/dL or greater (300 mg/L)
33
Normal value of proteinuria
Normal – less than 10 mg/DL
34
caused by conditions affecting the plasma prior to it reaching the kidney, and therefore, is not indicative of actual renal disease
Prerenal proteinuria
35
A proliferative disorder of the immunoglobulin producing plasma cells, the serum contains markedly elevated levels of monoclonal immunoglobulin light chains
Bence Jonce Protein (Multiple Myeloma)
36
Renal proteinuria associated with true renal disease may be the result of either
glomerular or tubular damage
37
toxic substances, and the immune complexes found in lupus erythematosus and streptococcal glomerulonephritis
Amyloid material
38
Proteinuria that occurs during the latter months of pregnancy may indicate a
pre-eclamptic state
39
Indication of strenuous exercises, high fever, dehydration, exposure to cold, protein shakes with amino acids
Benign proteinuria
40
Indicates the presence of an abnormal urinary excretion of albumin, signifying endothelial dysfunction and an increased risk for cardiovascular morbidity and mortality
Microalbuminuria
41
Occurs following periods spent in a vertical posture and disappears when a horizontal position is assumed.
Orthostatic (Postural) Proteinuria
42
Causes – exposure to toxic substances and heavy metals
Tubular proteinuria
43
The amount of protein that appears in the urine following glomerular damage ranges from slightly above normal to
4g/day
44
Bacterial and fungal infections and inflammations produce exudates containing protein from the interstitial fluid
Post Renal Proteinuria
45
tetrabromophenol blue multistix detects:
Protein
46
tetrachlorophenol acid buffer
protein
47
Cold precipitation test that reacts equally with all forms of protein.
All precipitation tests must be performed on centrifuged specimens to remove any extraneous contamination.
Sulfosalicylic Acid Precipitation Test
48
Micral-Test reagent strips contain a ______
. Strips are dipped into the urine up to a level marked on the strip and held for 5 seconds. Albumin in the urine binds to the antibody.
gold-labeled antihuman albumin antibody-enzyme conjugate
49
Color produced in testing microalbuminuria ranging from:
white to red
50
Result range for testing microalbuminuria
0-10 dL
51
REAGENT STRIP REACTIONS:
Albumin reagent strips use the dye
bis-3,4,5,6-
tetrabromosulphonphthalein (DIDNTB)
52
Color result of albumin in reagent strips:
pale green to aqua blue
53
REAGENT STRIP REACTIONS:
Creatinine in the urine combines with the copper sulfate to form
copper creatinine pseudoperoxidase
54
Result in creatinine is reported as
10, 50, 100, 200, 300 mg/dL, or 0.9, 4.4, 8.8, 17.7, or 26.5 mmol/L of creatinine
55
Falsely elevated results in creatinine can be caused by
visibly blood urine
presence of gastric acid reducing medication cimetidine
56
normal creatinine concentrations:
10 to 300 mg/dL
57
Abnormal results for the A:C ratio are
30 to 300 mg/g or 3.4 to 33.9 mg/mmol
58
Prerenal protein clinical significance:
Intravascular hemolysis
Muscle injury
Acute phase reactants
Multiple myeloma
59
Clinical significance of tubular disorders
Fanconi syndrome
Toxic agents/heavy metals
Severe viral infections
60
Renal protein clinical significance
Glomerular disorders
Immune complex
disorders
Amyloidosis
Toxic agents
Diabetic nephropathy
Strenuous exercise
Dehydration
Hypertension
Pre-eclampsia
Orthostatic or postural proteinuria
61
Post renal protein clinical significance
Lower urinary tract infections/
inflammation
Injury/trauma
Menstrual contamination
Prostatic fluid/spermatozoa
Vaginal secretions
62
Clinical Significance of
Urine Glucose: Hyperglycemia associated
Diabetes mellitus
Pancreatitis
Pancreatic cancer
Acromegaly
Cushing syndrome
Hyperthyroidism
Pheochromocytoma
Central nervous system damage
Stress
Gestational diabetes
63
Clinical Significance of
Urine Glucose:
Renal Associated
Fanconi syndrome
Advanced renal
disease
Osteomalacia
Pregnancy
64
Renal threshold for glucose is
approximately
160 to 180 mg/dL
65
For purposes of diabetes monitoring, specimens are usually
tested
2 hours after meal
66
Occurs in the absence of hyperglycemia when the
reabsorption of glucose by the renal tubules is compromised
Glycosuria
67
False positive in glucose strips
Containers contaminated with peroxide or strong oxidizing detergents
68
False negative reaction with glucose strips:
High levels of ascorbic acid
High levels of ketones
High specific gravity
Low temperatures
improperly preserved specimens
69
Copper Reduction Test (Clinitest) result for glucose
negative blue (Cus04)
through green, yellow, and orange/red (Cu20)
70
Reagents for glucose Multistix
Glucose oxidase Peroxidase
Potassium iodide
71
Reagents for glucose Chemstrip
Glucose oxidase Peroxidase
Tetramethylbenzidine
72
Sensitivity for glucose multistix
75 to 125 mg/dL
73
Sensitivity for glucose chemstrip
40 mg/dL
74
Correlations with other tests of glucose
Ketones and protein
75
Three intermediate products of fat metabolism in ketones
acetone (2%), acetoacetic acid (20%), and b-hydroxybutyrate (78%)
76
Testing for urinary ketones is most valuable in the management and monitoring of
Insulin-dependent (type 1)
diabetes mellitus.
77
Reagent strip tests for ketones use the
sodium nitroprusside
(nitroferricyanide)
78
Falsely decreased values of ketones
improperly preserved specimens
79
False-positive for ketones
Phthalein dyes
Highly pigmented red urine
Levodopa
Medications containing free
sulfhydryl groups
80
provides sodium nitroprusside, glycine, disodium phosphate, and lactose in tablet form
Acetest Tablets
81
produces a cloudy
red urine
hematuria
82
appears as a clear red
specimen.
hemoglobinuria
83
Result of reagent strip in RBCs:
pseudo-peroxidase activity of hemoglobin to catalyze a reaction between the heme component of both
hemoglobin and myoglobin and the chromogen tetramethylbenzidine to produce an oxidized chromogen
green-blue color
84
REAGENT STRIP REACTIONS of bilirubin
Diazo reaction
85
Diazo reaction for bilirubin uses
Multistix: 2,4-dichloroaniline diazonium salt
Chemstrip: 2,6-dichlorobenzenediazonium salt
86
Reaction color for bilirubin in reagent strips
tan or pink to violet
87
False positive result of Bilirubin
Highly pigmented urines,
phenazopyridine
Indican (intestinal disorders)
Metabolites of Lodine
88
False negative result of bilirubin
Specimen exposure to light
Ascorbic acid greater than 25 mg/dL
High concentrations of nitrite
89
A confirmatory test for bilirubin
ICTOTEST TABLETS
90
Ictotest tablets contains:
p-nitrobenzenediazonium- p-toluenesulfonate
SSA
sodium carbonate
boric acid
91
Ictotest result in the presence of bilirubin
Blue to purple
92
Urobilinogen reagent in multistix
p-dimethylaminobenzaldehyde (Erlich's reagent)
93
Ehrlich's aldehyde reaction is used in
Urobilinogen
94
Urobilinogen produces colors ranging from
light to dark pink
95
False-negative results of urobilinogen
improperly preserved
formalin is used as a preservative
96
Greiss reaction is seen in
Nitrite
97
Color result of nitrite
Pink color
98
False-negative nitrite
Nonreductase-containing bacteria
Insufficient contact time between
bacteria and urinary nitrate
Lack of urinary nitrate
Large quantities of bacteria convert-
ing nitrite to nitrogen
Presence of antibiotics
High concentrations of ascorbic acid
High specific gravity
99
Fase positive of nitrite
Improperly preserved specimens
Highly pigmented urine
100
Reaction of Leukocyte esterase in reagent strip
purple
101
Reading time for Leukocyte esterase
2 mins
102
Reagents for Leukocyte esterase
Multistix: Derivatized pyrrole amino acid ester, Diazonium salt
Chemstrip: Indoxylcarbonic acid ester, Diazonium salt
103
False positive reaction of Leukocyte esterase
Strong oxidizing agents, formalin, highly pigmented urine, nitrofurantoin
104
False negative reaction of Leukocyte esterase
High concentrations of protein, glucose, oxalic acid, ascorbic acid, gentamicin, cephalosporins, tetracyclines, inaccurate timing
105
Principle of Specific gravity
pKa Change in Polyelectrolyte
106
Reagents for SG
Multistix: Poly (methyl vinyl ether/maleic anhydride) bromthymol blue
Chemstrip: Ethylene glycol diaminoethyl ether tetraacetic acid, bromthymol blue
107
False positive result in specific gravity
High concentrations of protein
108
Fase negative result of specific gravity
Highly alkaline urine (>6.5)
109
Correlations of pH
Nitrite, Leukocytes
110
Correlatioin of glucose
Ketones, Proteins
111
Correlation of protein
Blood, Nitrite, Leukocytes
112
correlation of ketones
glucose
113
Correlation of Blood
Proteins
114
Correlation of Bilirubin
Urobilinogen
115
Correlation of Urobilinogen
Bilirubin
116
Nitrite correlation
Protein, Leukocytes
117
Correlation of leukocyte esterase
Protein, Nitrite
