Biochemical Testing II Flashcards
Protein:
- principle
Protein error of indicators
Protein:
- What protein is primarily tested?
albumin
Protein:
- Proteinuria is an indicator of ______ ______ and is often the very first indicator.
renal disease
Protein:
- reference range
Varies 1-14 mg/dL (150 mg/dL) is ok, but > 30 mg/dL is considered clinical proteinuria
Protein:
- 6 general reasons for protein in the urine
- Glomerular Damage
- Increased Glomerular Pressure
- Decreased Tubular Reabsorption
- Orthostatic/Postural Proteinuria
- Overflow Proteinuria
- Benign Causes
Protein:
- Causes of Glomerular Damage (4)
- Amyloidosis
- Toxic Substances
- SLE
- Strep glomerulonephritis
Protein:
- Causes of Increased Glomerular Pressure (3)
- Exercise
- Dehydration
- Hypertension
Protein:
- Cause of Decreased Tubular Reabsorption (3)
- Toxic Substances
- Viral Infections
- Fanconi’s Syndrome (damages prox tubules)
Protein:
- Describe Orthostatic/Postural Proteinuria and best urine specimens to collect
- Standing puts pressure on renal vein which leads to protein in the urine but laying down relieves the pressure.
- Best to collect day and night time urine specimens
Protein:
- Conditions that lead to PRE-RENAL overflow proteinuria
- Septicemia
- Hemolytic episode (hemoglobinuia)
- Muscle Injury (myoglobinuria)
- Immunoglobulins (Bence-Jones Proteins)
Protein:
- Conditions that lead to POST RENAL overflow proteinuria
- Inflammations due to bacterial or fungal infections
- presence of blood
- prostatic fluid or sperm
Protein:
- Benign causes of proteinuria (4)
- exposure to the cold
- exercise
- dehydration
- fever
Protein:
- Sensitively on Chem strip
6 mg/dL albumin
Protein:
- False Negatives
Strips detect albumin, proteins other than that may not be detected
Protein:
- False Positives
- very alkaline urines (>9)
- High specific gravity
What is albumin present in the urine below the detectable limits of a routine urine strip?
microalbuminuria
Principle for detecting microalbuminuria
use sensitive dye-binding reaction that is specific for albumin
What alternate test will precipitate all proteins by cold precipitation (not just albumin?)
Sulfosalicyclic Acid (SSA)
What will excess protein present look like when shaken?
foamy when shaken
What is the most common test performed on urine and why?
Glucose! because of its importance in detection and monitoring of diabetes
Glucose:
- Principle
Double sequential enzyme reaction
Glucose:
- Renal threshold
180 mg/dL
Glucose:
- Hyperglycemic patients will present with glycosuria. What patients are these?
- dabetes and gestational diabetes
- conditions: pancreatitis, cushing’s syndrome, hyperthyroidism (oppose function of insulin leading to hyperglycemia)
Glucose:
- What causes patients with normal glucose levels to still present with glycosuria?
- damage to tubules that hinders reabsorption
- occurs in end stage real disease
- osteomalacia
- Fanconi’s syndrome
- decreased reabsorption threshold in pregnancy
Glucose:
- false positives
oxidizing agents
Glucose
- False Negatives
- Ascorbic acid
- High Ketones
- High specific gravity
- drugs
What test should be performed for patients less than 2 years old to detect reducing sugars other than glucose?
Clinitest
What is a pathological condition that can lead to severe mental retardation, liver dysfunction, and cataracts?
Galactosemia
Limitation of the Clinitest
- Not as specific or sensitive as glucose strip
2. man interfering reducing substances (ascorbic acid, drugs)
