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Urinalysis & Body Fluids > C5 Glucose through Ketones > Flashcards

C5 Glucose through Ketones Flashcards

1
Q

The most frequent chemical analysis performed on urine?

A

glucose

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2
Q

clinical significance of glucose:

A

major screening test for DM, renal threshold is 160-180 mg/dl, higher blood sugar

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3
Q

disease state when placental hormones block action of insulin?

A

gestational diabetes

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4
Q

hormonal disorders

A

pancreatitis, pancreatic cancer, acromegaly, Cushing’s syndrome, hyperthyroidism, pheochromocytoma

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5
Q

Hormones

A

glucagon, epinephrine, cortisol, thyroxine, growth hormone oppose glucose

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6
Q

Insulin

A

converts glucose to storage glycogen

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7
Q

hormones

A

glycogen back to glucose

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8
Q

epinephrine

A

inhibits insulin; seen with stress, cerebral trauma, and MI

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9
Q

Renal glycosuria

A

tubular reabsorption disorder, end-stage renal disease, Fanconi syndrome, cystinosis

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10
Q

Reagent strip: chromogens used:

A

potassium iodide (green to brown) & tetramethylbenzidine (yellow to green)

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11
Q

Reaction interferance: false positive

A

only peroxide, oxidizing detergents

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12
Q

Reaction interference: false negative

A

enzymatic reaction interferance ((ascorbic acid and strong reducing agents))

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13
Q

Copper Reduction Test (Clinitest)

A

reduction of copper sulfate to cuprous oxide with alkali & heat, color change- negative blue (CuSO4) through green, yellow, and orange/red (Cu2O)

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14
Q

CuSO4(cupric sulfide)+reducing substance=

A

heat

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15
Q

CuSO4(cupric sulfide)+oxidized substance+color

A

alkali

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16
Q

In a clinitest, hygroscopic tablets: strong blue color and excess fizzing=

A

deterioration

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17
Q

Interferance from reducing sugars:

A

galactose, lactose, fructose, maltose, pentoses, ascorbic acid, cephalosporins

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18
Q

What is the major use for the clinitest?

A

inborn error of metabolism, in children up to 2 yrs, not specific for glucose

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19
Q

Ketones

A

3 intermediate products of fat metabolism: acetone: 2%, acetoacetic acid: 20%, B-hydroxybutyrate: 78%

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20
Q

diabetic ketoacidosis

A

increased accumulation of ketones in the blood (electrolyte imbalance, dehydration, & diabetic coma)

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21
Q

Reagent Strip, primary reagent

A

sodium nitroprusside

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22
Q

Acetest

A

not a urine confirmatory test, tablet=sodium nitorprusside, glycine, disodium phosphate, lactose…. test for ketones

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23
Q

Hematuria

A

intact RBCs, cloudy red urine

24
Q

Hemoglobinuria

A

product of RBC destruction

25
Q

any amount of blood greater than five cells per microliter of urine is considered?

A

clinically significant

26
Q

Hemoglobinuria may result from?

A

lysis of RBCs in dilute, alkaline urine

27
Q

myoglobinuria

A

heme containing protein in muscle tissue: clear, red/brown urine

28
Q

rhabdomyolysis

A

muscle destruction

29
Q

urine bilirubin is an indicator of?

A

liver disease

30
Q

bilirubin is a normal degredation product of?

A

hemoglobin

31
Q

protophorphyrin is broken down in to?

A

bilirubin

32
Q

bilirubin is bound to?

A

albumin

33
Q

unconjugated bilirubin

A

water insoluble

34
Q

conjugated biliruin

A

water soluble

35
Q

conjugated bilirubin appears in urine with?

A

bile duct obstruction, liver disease/damage

36
Q

What is hepatitis, cirrhosis

A

conjugated bilirubin leaks back into circulation from damaged liver, some bilirubin passes into intestines

37
Q

Reagent strip reactions principle

A

diazo reaction

38
Q

Ictotest

A

confirmatory test for bilirubin, use specified mat for test, mat keeps bilirubin on surface for reaction

39
Q

Positive reactions for Ictotest is what color?

A

blue to purple

40
Q

bilirubin in intestine converted to ?

A

urobilinogen & stercobilinogen

41
Q

urobilinogen is

A

reabsorbed into circulation

42
Q

stercobilinogen is

A

not reabsorbed into circulation

43
Q

There is always a small amount of urobilinogen filtered by the kidneys & is found in the urine, what is that amount?

A

<1 mg/dl

44
Q

Negative bilirubin and strong positive urobilinogen are seen in what type of disorders?

A

hemolytic disorders

45
Q

in a urine with bile duct obstruction, how much urobilinogen is seen?

A

none

46
Q

Multistix principle?

A

Ehrlich’s aldehyde reaction- light to dark pink

47
Q

Chemstrip principle?

A

diazo (azo-coupling) reaction- white to pink

48
Q

Nitrite

A

rapid screening test for the presence of UTI, tests ability of bacteria to reduce nitrate into nitrite

49
Q

Greiss reacton:

A

nitrite reacts w/ aromatic amine to form a diazonium salt that then reacts with tetrahydrobenzoquinoline to form a pink azodye

50
Q

Leukocyte esterase (LE)

A

standardized means for the detection of leukocytes, so as to not rely on microscopic, detects presence of esterase in the granulocytes and monocytes, detects presence of lysed leukocytes, perform microscopic if +

51
Q

clinical significance of leukocyte esterase (LE)

A

UTIs, inflammation of urinary tract, also seen with trichomonas, chlamydia, yeast & interstitial nephritis

52
Q

Leukocyte esterase (LE) reaction

A

catalyzes the hydrolysis of acid esterase on pad to aromatic compound and acid; aromatic compound reacts with diazonium salt on pad for purple color

53
Q

How long is the reaction time for Leukocyte Esterase (LE)

A

2 minutes

54
Q

Specific gravity

A

bases on pka (dissociation constant) of a polyelectrolyte in alkaline medium, polyelectrolyte ionizes releasing Hydrogen in relation to concentration of urine

55
Q

Reagent strips

A

provide a simple, rapid means for performing routing chemical tests on urine

Urinalysis & Body Fluids (5 decks)

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