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Urinalysis > Biochemical Testing III > Flashcards

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?

A

ictotest

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
Q

Bilirubin:

- False Negatives

A
  • Ascorbic Acid
  • Hight Nitrites
  • Improper storage
26
Q

Blood:

- What all does it detect?

A

hemoglobin, intact RBC’s and myoglobin

27
Q

Blood:

- Principle

A

based off of the peroxidase-like activity of hemoglobin

28
Q

Blood:

  • What is hematuria
  • what clarity?
A
  • intact red cells in the urine

- cloudy (red cells seen microscopically)

29
Q

Blood:

- what causes hematuria?

A
  • trauma
  • renal calculi
  • advanced glomerular damage
  • infection
  • Neoplams
30
Q

Blood:

  • What is hemoglobinuria
  • What clarity?
  • color?
  • What should you look for?
A
  • Hemoglobin in the urine
  • usually clear
  • yellow to red to brown
  • Hemosiderin granules
31
Q

Blood:

- Hemoglobinuria is caused by what?

A

Associated with hemolysis

  • hemolytic disease
  • poisoning
  • burns
  • transfusion reaction
  • paroxysmal nocturnal hemoglobinuria
32
Q

Blood:

  • What is myoglobinuria
  • clarity?
  • color
A
  • myoglobin in the urine
  • clear
  • reddish brown
33
Q

Blood:

- Myoglobinuria is caused by what?

A

Associated with muscle destruction

  • traumatic accidents
  • alcoholism or drug use
  • muscle wasting disease
34
Q

Blood:

- False Positives

A
  • menstrual contamination

- microbial peroxidases

35
Q

Blood:

- False Negatives

A
  • Ascorbic Acid
  • Unmixed specimens
  • High specific gravity leading to crenelated RBC’s
36
Q

What situation makes it impossible to interpret a reaction?

A

In highly colored urine from meds or pigments from certain foods

Urinalysis (10 decks)

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