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MTAP1: AUBF > CHAPTER 6: CHEMICAL EXAM OF URINE > Flashcards

CHAPTER 6: CHEMICAL EXAM OF URINE Flashcards

1
Q

Provide a simple, rapid means for performing medically significant chemical analysis of urine, including pH, protein, glucose, ketones, blood, bilirubin, urobilinogen, nitrite, leukocytes, and specific gravity

A

Reagent strips

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2
Q

This technique ensures the prevention of urine run-over while comparing it with the color chart.

A

(1) Blotting the edge of the strip on absorbent paper

(2) Holding the stirp horizontally

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3
Q

Recommended storage temperature of reagent strips according to manufacturers.

A

Room temperature below 30oC (but never refrigerated)

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4
Q

Reagent strips must be checked with both positive and negative controls a minimum of once every _______________ hours.

A

24 hours

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5
Q

True or False.

Distilled water is a recommended negative control.

A

False.

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6
Q

Defined as test using different reagents or methodologies to detect the same substances as detected by the reagent strips with the same or greater sensitivity or specificity

A

Confirmatory Tests

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7
Q

Major regulators of the acid-base content in the body

A

Lungs and Kidneys

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8
Q

Normal pH for

1) Random urine
2) 1st morning urine

A

1) Random urine - 4.5 to 8.0
2) 1st morning urine - 5.0 to 6.0 (slightly acidic)

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9
Q

pH of unpreserved urine

A

9.0

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10
Q

An aid in determining the existence of systemic acid–base disorders of metabolic or respiratory origin and in the management of urinary conditions

A

pH

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11
Q

a. acidic urine
b. alkaline urine

1) Respiratory/ metabolic acidosis not related to renal function disorders

2) Respiratory or metabolic alkalosis is present

A

1) Respiratory/ metabolic acidosis not related to renal function disorders
- Acidic urine

2) Respiratory or metabolic alkalosis is present
- Alkaline urine

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12
Q

A urinary crystal that is a frequent constituent of renal calculi that precipitates primarily in acidic and not alkaline urine

A

calcium oxalate

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13
Q

Urinary pH is controlled primarily by ___________________, although medications also
may be used.

A

Dietary regulation

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14
Q

a. acidic urine
b. alkaline urine

1) Fruits and vegetables
2) High-protein and high-meat diets

A

1) Fruits and vegetables (except cranberry juice)
- alkaline urine

2) High-protein and high-meat diets
- acidic urine

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15
Q

A pH above __________ is associated with an improperly preserved specimen and indicates that a fresh specimen should be obtained to ensure the validity of the analysis

A

8.5

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16
Q

Principle of pH

A

Double indicator system of Methyl Red and Bromthymol Blue

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17
Q

1) Methyl red produces a color change from
red to yellow in the pH range _________;

2) Bromthymol blue turns from yellow to blue in the pH range of ________.

A

1) Methyl Red (Red to Yellow) - 4 to 6
2) Bromthymol Blue (Yellow to blue) - 6 to 9

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18
Q

Most indicative of renal disease

A

Protein determination

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19
Q

Often associated with early renal disease

A

Proteinuria

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20
Q

Due to its low molecular weight, __________is the major serum protein found in normal urine

A

albumin

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21
Q

NV of protein found in urine

A

<10mg/dL or <100mg/24 hours

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22
Q

Caused by conditions affecting the plasma prior to its reaching the kidney and, therefore, is not indicative of actual renal disease.

A

Prerenal proteinuria

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23
Q

A proliferative disorder of the immunoglobulin-producing plasma cells

A

Multiple Myeloma

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24
Q

In multiple myeloma, the serum contains markedly elevated levels of monoclonal immunoglobulin light chains referred to as _____________.

A

Bence Jones Protein

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25
Q

Indication of proteinuria that occurs during the latter months of pregnancy

A

Pre-eclamptic state

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26
Q

Onset of renal complications can first be predicted by detection of ___________. Its presence is also associated with an increased risk of CVD

A

microalbuminuria

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27
Q

Occurs following periods spent in a vertical posture and disappears when a horizontal position is assumed.

Increased pressure on the renal vein when in the vertical position is believed to account for this condition.

A

Orhtostatic Proteinuria (Postural)

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28
Q

If orthostatic proteinuria is present,

1) First morning spx -
2) Second spx -

a. Positive reading
b. Negative reading

A

If orthostatic proteinuria is present,

1) First morning spx - negative
2) Second spx - positive

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29
Q

Principle of protein reagent strip testing

A

Protein (Sorensen’s) error of indicators

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30
Q

The reagent strip testing for protein is more sensitive to _________ because it contains more amino groups to accept the hydrogen ions than other proteins.

A

albumin

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31
Q

At a pH level of 3, protein indicators would appear _________ in the absence of protein and __________ as the protein conc. increases.

A

yellow; green to blue respectively

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32
Q

Protein indicators

A

Tetrabromophenol blue
Tetrachlorophenol
Tetrabromosulfonpthalein

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33
Q

A cold precipitation test that reacts equally with all forms of protein.

A

Sulfosalicylic Acid (SSA) Test

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34
Q

All precipitation tests must be performed on ____________ specimens to remove any extraneous contamination.

A

centrifuged (specimens)

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35
Q

A strip containing a gold- labeled antihuman albumin antibody-enzyme conjugate that binds albumin.

A

Reagent Strips for Micral Test

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36
Q

Principle of the reagent strip for creatinine

A

Pseudoperoxidase activity of copper-creatinine complexes

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37
Q

Because of its value in the detection and monitoring of diabetes mellitus, this test is the most frequently performed chemical analysis on urine.

A

Glucose Test

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38
Q

Plasma concentration of a substance at which tubular reabsorptio stops and there is an increased amount of glucose in urine.

A

Renal threshold (approx. 160 - 180mg/dL)

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39
Q

Hyperglycemia that occurs during pregnancy and disappears after delivery

A

Gestational diabetes

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40
Q

This hormone’s primary function is to convert glucose to glycogen for storage.

A

Insulin

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41
Q

A strong inhibitor of insulin secretion and is increased when the body is subjected to severe stress, which accounts for the glucosuria seen in conjunction with cerebrovascular trauma and myocardial infarction.

A

Epinephrine

42
Q

Reagent strips for glucose are impregnated with these mixture to produce a double sequential enzyme reaction.

A

Glucose oxidase
Peroxidase
Chromogen
Buffer

43
Q

For glucose test pads, this chemical is incorporated, oxidizing ascorbic acid, so that it cannot interfere with the oxidation of the chromogen which may produce false-negative results

A

Iodate

44
Q

Greatest source of false-negative glucose
results

A

Allowing specimens to remain unpreserved at room temperature for extended periods

45
Q

This test for glucose relies on the ability of glucose and other substances to reduce copper sulfate (CuSO4) to cuprous oxide (Cu2O) in the presence of alkali and heat.

A

Clinitest (Copper Reduction Test)

46
Q

Occurs if >2g/dL sugar is present in urine

A

Pass through phenomenon

47
Q

This reducing sugar in the urine of a newborn represents an “inborn error of metabolism”

A

Galactose

48
Q

The lack of this enzyme prevents breakdown of ingested galactose and results in failure to thrive and other complications, including death.

A

Galactose-1uridyltransferase

49
Q

This reducing sugar is frequently found in the urine of nursing mothers

A

Lactose

50
Q

(-) glucose oxidase
(+) clinitest

A

(+) nonglucose reducing substance

51
Q

1+ glucose oxidase
(-) clinitest

A

True glycosuria

52
Q

4+ glucose oxidase
(-) clinitest

A

False positive (oxidizing agent interference)

53
Q

Result from increased fat metabolism due to inability to metabolize carbohydrate.

A

Ketones

54
Q

Three intermediate products of fat metabolism represented by ketones

A

2% acetone
20% acetoacetic acid (parent ketone)
78% B-hydroxybutyrate (major ketone but not detected)

55
Q

Used for insulin dosage monitoring

A

Ketones

56
Q

Shows a deficiency in insulin, indicating the need to regulate dosage

A

ketonuria

57
Q

A nonreducing sugar that does not react with Clinitest or glucose oxidase strips

A

sucrose

58
Q

Confirmatory test for ketones

A

Acetest

59
Q

Provided by Acetest in tablet form

A

Sodium Nitroprusside
Glycine
Disodium phosphate
Lactose

60
Q

(1) Blood present in the urine in the form of intact RBC

(2) Product of RBC destruction

A

(1) Blood present in the urine in the form of intact RBC - Hematuria

(2) Product of RBC destruction - hemoglobinuria

61
Q

1) Produces a cloudy red urine
2) Clear red urine w/ reddish plasma
3) Clear red urine w/ clear plasma

A

1) Produces a cloudy red urine
- Hematuria

2) Clear red urine w/ reddish plasma
- Hemoglobinuria

3) Clear red urine w/ clear plasma
- Myoglobinuria

62
Q

Amount of blood in urine considered as clinically significant

A

> 5 cells per microliter

63
Q

Result from the lysis of red blood cells produced in the urinary tract, particularly in dilute, alkaline urine.

A

Hemoglobinuria

64
Q

(+) Hemoglobinuria
Decreased haptoglobin and hemopexin

A

Intravascular Lysis

65
Q

Reabsorption of filtered hemoglobin results in the appearance of large yellow-brown granules of denatured ferritin called ____________.

A

hemosiderin

66
Q

heme-containing protein found in muscle tissue,
not only reacts positively with the reagent strip test for blood
but also produces a clear red-brown urine

A
67
Q

A heme-containing protein found in muscle tissue that produces a clear red-brown urine

A

Myoglobin

68
Q

Myoglobinuria is associated with muscle destruction known as _________.

A

rhabdomyolysis

69
Q

1) Uniform green/blue appearance on pad
2) Speckled pattern

a. Hemoglobinuria
b. Myoglobinuria
c. Hematuria

A

1) Uniform green/blue appearance on pad
- Hgb/Mgb
2) Speckled pattern
- Hematuria

70
Q

A bacteria that causes false positive reactions in blood strip test

A

E. coli

71
Q

Provide an early indication of liver disease

A

Bilirubin

72
Q

A highly pigmented yellow compound; a degradation product of hemoglobin

A

Bilirubin

73
Q

Where RBCs are destroyed by phagocytic cells

A

spleen and liver

74
Q

Components of hemoglobin

A

Iron, Protein, Protoporphyrin

75
Q

Where bilirubin is reduced by bacteria to urobilinogen, which is then oxidized and excreted in the feces in the form of stercobilinogen and urobilin.

A

intestine

76
Q

This is the only type of bilirubin that can appear in the urine when the normal degradation cycle is disrupted by bile duct obstruction.

A

conjugated bilirubin

77
Q

Bilirubin combines with these reagents in an acid medium to produce an azodye

A

2,4 - dichloroanilinine diazonium salt
2,6 - dichlorobenzene diazonium salt

78
Q

An unstable compound that is rapidly photo-oxidized to biliverdin when exposed to light

A

Bilirubin

79
Q

True or false.

Biliverdin reacts with diazo reaction

A

False

80
Q

Confirmatory test for bilirubin

A

Ictotest

81
Q

Positive result (color) in Ictotest tablets

A

blue to purple

82
Q

Pigments responsible for characteristic brown color of feces

A

Stercobilin and Urobilin

83
Q

For early detection of liver disease

A

Urobilinogen

84
Q

1) Soluble to both chloroform and butanol
2) Insoluble to both chloroform and butanol

a. Porphobilinogen
b. Urobilinogen

A

1) Soluble to both chloroform and butanol
- Urobilinogen
2) Insoluble to both chloroform and butanol
- Porphobilinogen

85
Q

A rapid screening test for the presence of UTI designed to detect cases in which the need for culture may not be apparent (but not designed to replace culture)

A

Nitrite

86
Q

A test valuable for detecting initial bladder infection (cystitis)

A

Nitrite

87
Q

An inflammatory process of the kidney and adjacent renal pelvis, is a frequent complication of untreated cystitis

A

Pyelonephritis

88
Q

Detects nitrate in which nitrite at an acidic pH reacts with an aromatic amine to form a diazonium compound that then reacts with tetrahydrobenzoquinolin compounds to produce a pink-colroed azodye

A

Greiss Reaction

89
Q

Standardized quantitative bacterial culture criterion of organisms per milliliter for nitrite.

A

100,000 (>100,000: UTI)

90
Q

Bacteria that lack this enzyme do not possess the ability to reduce nitrate to nitrite.

A

Reductase

91
Q

Reductase is found in the gram-____________ bacteria that most frequently cause UTIs.

A

gram neg (enterobacteriaceae)

92
Q

When should nitrite be performed?

A

First morning or spx collected after urine has remained in the bladder for at least 4 hours

93
Q

Offers a more standardized means for the detection of leukocytes.

A

Leukocyte Esterase

94
Q

LE test detects the presence of esterase in the granulocytic white blood cells, except:

A

Lymphocytes

95
Q

True or False.
Esterases are also present in Trichomonas and histiocytes

A

True

96
Q

Other than lymphocytes, what else do not contain esterases?

A

erythrocytes, bacteria, renal tissue cells

97
Q

Used to catalyze the hydrolysis of an acid ester embedded on the reagent pad to produce an aromatic compound and acid

A

LE

98
Q

Crenation of leukocytes preventing release of esterases may occur in urines with a ______specific gravity.

a. low
b. high

A

b. high specific gravity

99
Q

Based on the change in pKa (dissociation constant) of a polyelectrolyte in an alkaline medium.

A

Specific Gravity

100
Q

Urine concentration = high
Hydrogen ions = increased
pH = ?

A

low pH

101
Q

Type of solute measured by specific gravity reagent strip that eliminates the interference by the large organic molecules (urea and glucose)

A

ionic solutes

MTAP1: AUBF (17 decks)

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