Biochemical Testing II

Question 1

Protein:

- principle

Answer 1

Protein error of indicators

Question 2

Protein:

- What protein is primarily tested?

Answer 2

albumin

Question 3

Protein:

- Proteinuria is an indicator of ______ ______ and is often the very first indicator.

Answer 3

renal disease

Question 4

Protein:

- reference range

Answer 4

Varies 1-14 mg/dL (150 mg/dL) is ok, but > 30 mg/dL is considered clinical proteinuria

Question 5

Protein:

- 6 general reasons for protein in the urine

Answer 5

1. Glomerular Damage
2. Increased Glomerular Pressure
3. Decreased Tubular Reabsorption
4. Orthostatic/Postural Proteinuria
5. Overflow Proteinuria
6. Benign Causes

Question 6

Protein:

- Causes of Glomerular Damage (4)

Answer 6

• Amyloidosis
• Toxic Substances
• SLE
• Strep glomerulonephritis

Question 7

Protein:

- Causes of Increased Glomerular Pressure (3)

Answer 7

• Exercise
• Dehydration
• Hypertension

Question 8

Protein:

- Cause of Decreased Tubular Reabsorption (3)

Answer 8

• Toxic Substances
• Viral Infections
• Fanconi’s Syndrome (damages prox tubules)

Question 9

Protein:

- Describe Orthostatic/Postural Proteinuria and best urine specimens to collect

Answer 9

• 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

Question 10

Protein:

- Conditions that lead to PRE-RENAL overflow proteinuria

Answer 10

• Septicemia
• Hemolytic episode (hemoglobinuia)
• Muscle Injury (myoglobinuria)
• Immunoglobulins (Bence-Jones Proteins)

Question 11

Protein:

- Conditions that lead to POST RENAL overflow proteinuria

Answer 11

• Inflammations due to bacterial or fungal infections
• presence of blood
• prostatic fluid or sperm

Question 12

Protein:

- Benign causes of proteinuria (4)

Answer 12

• exposure to the cold
• exercise
• dehydration
• fever

Question 13

Protein:

- Sensitively on Chem strip

Answer 13

6 mg/dL albumin

Question 14

Protein:

- False Negatives

Answer 14

Strips detect albumin, proteins other than that may not be detected

Question 15

Protein:

- False Positives

Answer 15

• very alkaline urines (>9)

- High specific gravity

Question 16

What is albumin present in the urine below the detectable limits of a routine urine strip?

Answer 16

microalbuminuria

Question 17

Principle for detecting microalbuminuria

Answer 17

use sensitive dye-binding reaction that is specific for albumin

Question 18

What alternate test will precipitate all proteins by cold precipitation (not just albumin?)

Answer 18

Sulfosalicyclic Acid (SSA)

Question 19

What will excess protein present look like when shaken?

Answer 19

foamy when shaken

Question 20

What is the most common test performed on urine and why?

Answer 20

Glucose! because of its importance in detection and monitoring of diabetes

Question 21

Glucose:

- Principle

Answer 21

Double sequential enzyme reaction

Question 22

Glucose:

- Renal threshold

Answer 22

180 mg/dL

Question 23

Glucose:

- Hyperglycemic patients will present with glycosuria. What patients are these?

Answer 23

• dabetes and gestational diabetes

- conditions: pancreatitis, cushing’s syndrome, hyperthyroidism (oppose function of insulin leading to hyperglycemia)

Question 24

Glucose:

- What causes patients with normal glucose levels to still present with glycosuria?

Answer 24

• damage to tubules that hinders reabsorption
• occurs in end stage real disease
• osteomalacia
• Fanconi’s syndrome
• decreased reabsorption threshold in pregnancy

Question 25

Glucose:

- false positives

Answer 25

oxidizing agents

Question 26

Glucose

- False Negatives

Answer 26

• Ascorbic acid
• High Ketones
• High specific gravity
• drugs

Question 27

What test should be performed for patients less than 2 years old to detect reducing sugars other than glucose?

Answer 27

Clinitest

Question 28

What is a pathological condition that can lead to severe mental retardation, liver dysfunction, and cataracts?

Answer 28

Galactosemia

Question 29

Limitation of the Clinitest

Answer 29

1. Not as specific or sensitive as glucose strip

2. man interfering reducing substances (ascorbic acid, drugs)