AUBF Chapter 5 Flashcards
Ma RMT KOOOOO!!
Defined as test using different reagents/methodologies
Confirmatory testing
Using tablets and chemicals
Non-reagent strip testing
Chemical parameters for which they are used
Specific confirmatory test
Slightly acidic
First morning specimen
pH 5.0-6.0
pH of normal random samples
pH 4.5-8.0
Reagents strip must be….
Package in opaque containers w/ dessicant
Clinical significance of pH
Acid base disorders
The precipitation of inorganic chemicals dissolved in the urine forms a
Urinary crystals and renal calculi
Principles of pH
Double-indicator system
Methy red produces a color?
pH?
Red to yellow
pH 4-6
Bromthymol blue produces a color?
pH?
Yellow to Blue
pH 5-9
Reagents of pH
Methy red and bromthymol blue
Clinical significance of protein
Renal disease
Clinical proteinuria is indicated (mg/dL)
30 mg/dL or greater (300 mg/L)
Is often associated w/ early renal disease
Proteinuria
Normal urine contains
Less than 10 mg/dL or 100 mg per 24 hrs
Produce by the renal tubular epithelial cells
Uromodulin
Another name for uromodulin
Tamm-horsfall protein
Caused by conditions affecting the plasma
Prerenal proteinuria
Associated with infection and inflammation
Acute phase reactants
Associated with true renal disease
Renal proteinuria
A persistent benign proteinuria occurs in young adults
Orthostatic proteinuria
Principle of protein
Protein error of indicators
Confirmatory test in protein
SSA (sulfosalicylic acid precipitation test)
Another name for micral test
Roche diagnostics
Indianapolis, IN
A gold labeled antihuman albumin antibody enzyme (strips)
Micral test reagents strips
Another name for immunoDip
Sakisui diagnostics
Framingham, MA
Uses a immunochromographic technique
ImmunoDip reagent strip
Confirmatory test for glucose
Glucose test
Most frequently peformed chemical analysis on urine
Glucose test
Principle of glucose
Double sequential enzyme reaction
Chromogens: multistix; color
Potassium iodide
Green to brown
Chromogens: chemstrip; color
Tetramethybenzidine
Yellow to green
Reagents for glucose (M)
Glucose oxidase
Peroxidase
Potassium iodide
Reagent for glucose (C)
Glucose oxidase
Peroxidase
Tetramethylbenzidine
Confirmatory test in glucose
Clinitest (cupper reduction test)
Clinical significance of glucose
D. Mellitus
Pancreatitis
Gestational diabetes
3 intermediate products of fat metabolism and their percentage
Acetone (2%)
Acetoacetic acid (20%)
p-hydroxybutyrate (78%)
Deficiency in urine
Ketonuria
Clinical significance of ketones
Fat metabolism
D. Mellitus
Starvation
Principles of ketones
Sodium nitroprusside reaction
Color reaction of ketones
Purple
Sulfhydryl groups including…
May produce atypical color reactions
Mercaptoethane sulnate sodium (MESNa)
Captopril
Reagents for ketones (M)
Sodium nitroprusside
Reagents for ketones (C)
Sodium nitroprusside Glycine
Confirmatory test for ketones
Acetest tablets
Acetest provides..
Sodium nitroprusside, Glycine, disodium phosphate and lactose
Clinical significance of the blood
Hematuria, myoglobinuria, hemoglubinuria
Most closely related to renal disorders
Result of trauma/damage to organs of these systems
Hematuria
May result from the lysis of RBC produced in the urinary tract
Result: from intravascular hemolysis and subsequent of filtering of hemoglobin
Hemoglobinuria
A heme-containing protein found in muscles tissue.
Myoglobinuria
Principle of blood
Pseudoperoxidase activity of hemoglobin
Reagent used in blood
Tetramethylbenzidine
Color reaction of the blood
Green-blue
Higly pigmented yellow compound
A degradation product of hemoglobin
Bilirubin
Principle for bilirubin
Diazo rection
Confirmatory test for bilirubin
ICTO test
Clinical significance for bilirubin
Liver disease
Hepatitis
Cirrhosis
Color reaction of bilirubin
Tan/pink to violet
Regeant used in bilirubin (M)
Dichloroaniline diazonium salt
Reagent used in bilirubin (C)
Dichlorobenzene diazonium salt
Principle of urobilinogen (M)
Erlichs aldehyde reaction
Principle of urobilinogen (C)
Azo coupling reaction
Reagent strip for urobilinogen (M)
p-dimethylaminobenzaldehayde
Reagent strip for urobilinogen (C)
Color reaction:
Methoxybenzene-diazonium tetraflouroborate
White to pink
Principle of nitrite
Greiss reaction
An inflammatory process of the kidney and adjacent renal pelvis
Pyelonephritis
Clinical significance of nitrite
UTI
Cytitis
Valuable for detecting initial bladder infection
Nitrite test
Detection of increased urinary leukocytes
LE test
Principle of leukocyte
Granulocyte test
Color reaction of LE
Purple azodye
False (-) results may occur in the presence of protein (mg/dL)
< 500 mg/dL
False (-) results may occur in the presence of protein (mg/dL)
< 500 mg/dL
Glucose may measure in false (-)
< 3 g/dL
Reagent strip for LE (M)
Pyrrole amino acid ester
Reagent strip for LE (C)
Indoxylcarbonic acid ester
Correlations of LE
Protein
Nitrite
Microscopic
Principle of Specific gravity
Change in pKa of a polyelectrolyte
Sensitivity of the specific gravity
1.000 to 1.030
Reagent strip for SG
Bromthymol blue
SG
False (-)
False (+)
(-) higly alkaline urines
(+) high concentration of proteins
Reaction time for SG
45 secs.
Reaction time for bilirubin
30 sec
Reaction time for glucose
30 sec
Reaction time for Ketones
40 sec
Reaction time for pH, protein, blood, urobilinogen, nitrite
60 secs
Reaction time for LE
120 secs
Bilirubin
False (-)
(+)
(-) high concentration of nitrite
(+) higly pigmented urines
Glucose
False (-)
False (+)
(-)High level of ascorbic acid/ ketones
High SG
(+) Contamination by oxidizing agents and detergents
Ketones
False (-)
False (+)
(-) high pigmented red urine, phthalein dyes
(+) improperly preserved urine
pH
False (-)
False (+)
Bacterial growth and matabolism may cause marked increase
Protein
False (-)
False (+)
(-) microalbuminuria, proteins other than urine
(+) highly buffered interference urine
Blood
False (-)
False (+)
(-) higg specific gravity, formalin, captopril
(+) strong oxidizing agents, bacterial peroxidases
Uro
False (-)
False (+)
(-) old specimens, preservation in formalin
(+) highly pigmented urine
Nitrite
False (-)
False (+)
(-) non-reductase containing bacteria,
lack of urinary nitrate
(+) improperly preserved specimens
LE
False (-)
False (+)
(-) high concentration of glucose, protein, oxalic/ascorbic acid
(+) strong oxidizing agents
Formalin