Biochemical Testing III Flashcards
What is in highest concentration in a patent who is oxidizing fatty acids?
Beta-hydroxybutyrate
Ketones:
- principle
Acetoacetate + sodium nitroprusside -> purple color
Ketones:
- Ketonemia and ketonuria occurs when the body metabolizes _____ _____ due to inadequate amounts of _______
Fatty Acids
Carbohydrates
Ketones:
- 3 general reasons for ketonemia
- inability to use carbohydrates (type 1/gestational diabetes)
- Inadequate intake of carbs (starvation/diets)
- Loss of carbohydrates (vomiting/starvation/dieting=Atkins diet)
Ketones:
- specificity is to what?
sensitive to acetoacetate
Ketones:
- False Postives
Drugs that contain free-sulfhydryl groups
Ketones:
- False Negatives
- improper storage and handling
- improper storage of strips
- uncapped specimens
- acidosis
Urobilinogen:
- principle (2 methods)
- Multistix (Ehrlich’s Reaction)
- Chemstrip (Diazo reaction)
Urobilinogen:
- what is the increased production of bilirubin leading to increased urobilinogen produced and consequently increased urobilinogen in urine
Prehepatic mechanism
Urobilinogen:
- What conditions lead to pre hepatic urobilinogen?
hemolytic anemia, sickle cell, hereditary spherocytosis, thalassemia, pernicious anemia or transfusion reactions
Urobilinogen:
- what is it when a damaged liver is not capable of reabsorping urobilinogen from the portal circulation leading to additional urobilinogen entering the blood stream?
Hepatic Mechanism
Urobilinogen:
- Conditions that cause hepatic urobilinogen?
Hepatitis
Cirrhosis
Urobilinogen:
- What is it called when conjugated bilirubin will not be able to enter the intestine due to blockage in the bile duct leading to no urobilinogen production?
Post-hepatic Mechanism
Urobilinogen:
- False Positives
- p-aminosalicylic Acid
- sufamethoxazol
Urobilinogen:
- False Negatives
- exposure to light
- High Nitrites
Bilirubin:
- principle
uses the diazo reaction
Bilirubin:
- What test has greater sensitivity to bilirubin?
ictotest
Bilirubin:
- In what mechanism is bilirubin negative?
- Examples
Prehepatic Mechanism
- hemolytic disease like transfusion reactions or hemolytic anemia
Bilirubin:
- In what mechanism does conj bilirubin “leak” from damaged hepatocyte back into the blood, thus increasing urine bilirubin?
- examples?
Hepatic mechanism
- Hepatitis and Cirrhosis
Bilirubin:
- In what mechanism is conj bilirubin unable to pass though the bile duct and thus back up not the liver and bloodstream leading to bilirubin in the urine?
- examples?
Post-Hepatic Mechanism
- Bile duct blockage
Bilirubin and Urobilinogen:
- Which one (or both) is positive in Prehepatic (hemolytic disease)
Bili: neg
Uro: Pos
Bilirubin and Urobilinogen:
- Which one (or both) is positive in Hepatic (Liver damage)
Bili: Pos
Uro: Pos
Bilirubin and Urobilinogen:
- Which one (or both) is positive in Posthepatic (bile duct obstruction)
Bili: Pos
Uro: Neg
Bilirubin:
- False Positives
- pH > 9.0
- some meds
Bilirubin:
- False Negatives
- Ascorbic Acid
- Hight Nitrites
- Improper storage
Blood:
- What all does it detect?
hemoglobin, intact RBC’s and myoglobin
Blood:
- Principle
based off of the peroxidase-like activity of hemoglobin
Blood:
- What is hematuria
- what clarity?
- intact red cells in the urine
- cloudy (red cells seen microscopically)
Blood:
- what causes hematuria?
- trauma
- renal calculi
- advanced glomerular damage
- infection
- Neoplams
Blood:
- What is hemoglobinuria
- What clarity?
- color?
- What should you look for?
- Hemoglobin in the urine
- usually clear
- yellow to red to brown
- Hemosiderin granules
Blood:
- Hemoglobinuria is caused by what?
Associated with hemolysis
- hemolytic disease
- poisoning
- burns
- transfusion reaction
- paroxysmal nocturnal hemoglobinuria
Blood:
- What is myoglobinuria
- clarity?
- color
- myoglobin in the urine
- clear
- reddish brown
Blood:
- Myoglobinuria is caused by what?
Associated with muscle destruction
- traumatic accidents
- alcoholism or drug use
- muscle wasting disease
Blood:
- False Positives
- menstrual contamination
- microbial peroxidases
Blood:
- False Negatives
- Ascorbic Acid
- Unmixed specimens
- High specific gravity leading to crenelated RBC’s
What situation makes it impossible to interpret a reaction?
In highly colored urine from meds or pigments from certain foods
