Biochemical Testing III Flashcards

1
Q

What is in highest concentration in a patent who is oxidizing fatty acids?

A

Beta-hydroxybutyrate

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2
Q

Ketones:

- principle

A

Acetoacetate + sodium nitroprusside -> purple color

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3
Q

Ketones:

- Ketonemia and ketonuria occurs when the body metabolizes _____ _____ due to inadequate amounts of _______

A

Fatty Acids

Carbohydrates

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4
Q

Ketones:

- 3 general reasons for ketonemia

A
  1. inability to use carbohydrates (type 1/gestational diabetes)
  2. Inadequate intake of carbs (starvation/diets)
  3. Loss of carbohydrates (vomiting/starvation/dieting=Atkins diet)
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5
Q

Ketones:

- specificity is to what?

A

sensitive to acetoacetate

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6
Q

Ketones:

- False Postives

A

Drugs that contain free-sulfhydryl groups

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7
Q

Ketones:

- False Negatives

A
  • improper storage and handling
  • improper storage of strips
  • uncapped specimens
  • acidosis
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8
Q

Urobilinogen:

- principle (2 methods)

A
  • Multistix (Ehrlich’s Reaction)

- Chemstrip (Diazo reaction)

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9
Q

Urobilinogen:
- what is the increased production of bilirubin leading to increased urobilinogen produced and consequently increased urobilinogen in urine

A

Prehepatic mechanism

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10
Q

Urobilinogen:

- What conditions lead to pre hepatic urobilinogen?

A

hemolytic anemia, sickle cell, hereditary spherocytosis, thalassemia, pernicious anemia or transfusion reactions

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11
Q

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?

A

Hepatic Mechanism

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12
Q

Urobilinogen:

- Conditions that cause hepatic urobilinogen?

A

Hepatitis

Cirrhosis

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13
Q

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?

A

Post-hepatic Mechanism

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14
Q

Urobilinogen:

- False Positives

A
  • p-aminosalicylic Acid

- sufamethoxazol

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15
Q

Urobilinogen:

- False Negatives

A
  • exposure to light

- High Nitrites

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16
Q

Bilirubin:

- principle

A

uses the diazo reaction

17
Q

Bilirubin:

- What test has greater sensitivity to bilirubin?

18
Q

Bilirubin:

  • In what mechanism is bilirubin negative?
  • Examples
A

Prehepatic Mechanism

- hemolytic disease like transfusion reactions or hemolytic anemia

19
Q

Bilirubin:

  • In what mechanism does conj bilirubin “leak” from damaged hepatocyte back into the blood, thus increasing urine bilirubin?
  • examples?
A

Hepatic mechanism

- Hepatitis and Cirrhosis

20
Q

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?
A

Post-Hepatic Mechanism

- Bile duct blockage

21
Q

Bilirubin and Urobilinogen:

- Which one (or both) is positive in Prehepatic (hemolytic disease)

A

Bili: neg
Uro: Pos

22
Q

Bilirubin and Urobilinogen:

- Which one (or both) is positive in Hepatic (Liver damage)

A

Bili: Pos
Uro: Pos

23
Q

Bilirubin and Urobilinogen:

- Which one (or both) is positive in Posthepatic (bile duct obstruction)

A

Bili: Pos
Uro: Neg

24
Q

Bilirubin:

- False Positives

A
  • pH > 9.0

- some meds

25
Bilirubin: | - False Negatives
- Ascorbic Acid - Hight Nitrites - Improper storage
26
Blood: | - What all does it detect?
hemoglobin, intact RBC's and myoglobin
27
Blood: | - Principle
based off of the peroxidase-like activity of hemoglobin
28
Blood: - What is hematuria - what clarity?
- intact red cells in the urine | - cloudy (red cells seen microscopically)
29
Blood: | - what causes hematuria?
- trauma - renal calculi - advanced glomerular damage - infection - Neoplams
30
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
31
Blood: | - Hemoglobinuria is caused by what?
Associated with hemolysis - hemolytic disease - poisoning - burns - transfusion reaction - paroxysmal nocturnal hemoglobinuria
32
Blood: - What is myoglobinuria - clarity? - color
- myoglobin in the urine - clear - reddish brown
33
Blood: | - Myoglobinuria is caused by what?
Associated with muscle destruction - traumatic accidents - alcoholism or drug use - muscle wasting disease
34
Blood: | - False Positives
- menstrual contamination | - microbial peroxidases
35
Blood: | - False Negatives
- Ascorbic Acid - Unmixed specimens - High specific gravity leading to crenelated RBC's
36
What situation makes it impossible to interpret a reaction?
In highly colored urine from meds or pigments from certain foods