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Urinalysis Spring > Chem Properties pt 2 (Chem strip tests) > Flashcards

Chem Properties pt 2 (Chem strip tests) Flashcards

1
Q

Describe the glucose threshold

What is glucosuria
what are some causes?

A

160-180ml

glucosuria is glucose in urine:
following a meal
hormonal function imbalance
renal tube problems

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2
Q

Describe the glucosuria: Not diabetic origin
following?

FIrst morning?
when do you collect and why?

A

following a high sugar meal
controlled intake of glucose and or fasting
First morning not always best
(glucose can remain in bladder overnight) - collect second moring

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3
Q

Describe glycosuria caused by hormonal imbalance

A

inc T4, epinephrine, cortisol, glucagon
glycogenolysis increases glucose

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4
Q

Describe renal glycosuria

A

glucose in the absence of hyperglycemia
renal tube unable to reabsorb
renal failure/pregnancy

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5
Q

Describe gestational diabetes
disapears?
what crosses the placenta/what doesnt?
higher incidence of?

A

disapears after pregnancy
glucose crosses the placenta, insulin doesn’t
higher incidence of diab. type 2

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6
Q

What test is utilized in the glucose pad?

what does the rxn look like?

A

glucose oxidase
double sequential enzyme

glucose and air - gluconic acid/hydro peroxidase

peroxidase - Hp/chromogen - colorchange

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7
Q

T/F the glucose test is non specific to glucose - has rxns with other sugars

A

false it is specific to glucose and doesnt have rxns with other sugars

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8
Q

False positives of Glucose test
p/o

False negatives
rs
V
b
H sg

A

false pos: contam with peroxide/oxidizing subj (detergents)

False negative: reducing substance Vit D ascorbic acid
bacteria
high specific gravity

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9
Q

Describe the copper reduction clintest

measures

detects

others

A

measures reducing substances, not specific for glucose
sensitivity 200-250

Detects: galactose
lactose
fructose

ascorbic acid/microbes

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10
Q

Describe the rxn inside the copper reduction clintest

colorchange?

A

glucose and reducing agents reduce copper sulfide to cuprous oxide/alk and heat

colorchange blue to green/yellow/orange - red

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11
Q

What are things to be weary of in the copper reduction clintest?

A

pass through effect, watch closely, dont get burned

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12
Q

Describe the galactose clintest

A

was preformed on any child less than 24mos old

Major problem, galac - 1- phos-ur transferase
galactosemia and failure to thrive

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13
Q

what do they use now instead of the clintest?

A

every child is now screened with tandem mass spectrocopy

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14
Q

Galactosemia/uria
Clinist results
UA stick results

A

clinist - pos
UA stick - neg

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15
Q

Glycosuria
clintist results
UA stick

A

clintest - pos or neg (<200)
UA stick - pos (1+-4+)

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16
Q

Describe Ketones

A

converts fats to CO2 and H2O

in diet/exercise
diabetes
vomit/starving/malabsorption

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17
Q

3 intermediate products of ketones

A

acetone
ACETOACIDIC ACID
BHBA

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18
Q

Describe diabetes mellitus with ketones

A

deficiency of insulin, need to reg dosage
(1+)

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19
Q

Describe accumulation of ketones

A

electrolyte imbalance, dehydration acidosis

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20
Q

Ketone strip test rxn and reagents

A

sodium Nitropruside

acetoacid rxn w sodium nitro to produce pink color

DOESNT MEASURE BHBA/ACETONE

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21
Q

False positives for ketones

false negatives

A

+ few/levodopa, sulf groups, red pigment

  • improper preservation
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22
Q

Describe the Acetest

A

tablet with nitro/lactose, works with urine/serum/body fluids

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23
Q

Describe Blood
Hematuria
Hgburia
Myoglobinuria

A

hematuria - whole rbc in blood cloudy
Hgburia - hgb in urine due to hemolysis/clear
Myoglobinuria - due to muscle destruction/clear

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24
Q

Clinical significance of blood

A

5 rbcs can be clear in urine with trace amounts, confirm with microscope

25
Q

RBC/HGB/MYO all have?

A

pseudoperoxidase activity

26
Q

Describe the rxn in the blood test

A

H202 + chromogen
oxidi chromogen + h2O

27
Q

False positive blood test

false negative

A

+ strong oxid detergent
vegetable peroxidase
bacterial peroxidase (e.coli)

  • high levels of Vit C
    formalin/mixed specimen
28
Q

Describe hematuria

A

renal calculi, golm. disease, trauma, pyelonephritis

Non-path- exercise/menstration

29
Q

Describe Hgburia

A

lysis of rbcs in urine tract
dilute urine/alk urine

Intravascular hemolysis
heme anemia
transfusion/burns

30
Q

T/F normal breakdown of hgb is completed with haptoglobin and is too large to be filtered by the glomerulous

A

true

31
Q

Describe hemosiderin

A

denatured ferritin
yellow brown granules
renal epithelial cells/casts

32
Q

Describe myoglobinuria

A

heme protein found in muscle/toxic to tubes
acute renal failure
muscle destruction (rhabdomyelosis)
coma/alcoholism

33
Q

Diagnosis Hxt

A

increased serum creatinine/lactic acid

34
Q

WHat test differentiates between Hgb and Myo

A

Ammonium sulfate test

35
Q

Describe the ammonium sulfate test

A

hgb binds to amonia sulfate, heavy complex
myoglobin remains in supernatent/strip test

HGB = neg
MYO = posD

36
Q

Describe bilirubin

A

appearance in urine = indicator of liver disease
LIVER DAMAGE AND BILE OBSTRUCITON
pigmented, degraded hgb (not due to lysis)

37
Q

T/F protoporhyrin ring is converted to unconjugated bilirubin and is H20 soluble, gets filtered by the kidneys

A

False unconjugated bilirubin is not H2O soluble and is not filterd by the kidney

38
Q

Describe conjugated bilirubin

A

obstruction of bile duct/liver damage
determine cause of jaundice

39
Q

Reagent test / rxn for bilirubin

A

Diazo rxn
bilirubin rxn with diazonium salt to produce azoddye

40
Q

False + for bilirubin

False - for bilirubin

A

+ azo
indican
pigmented urine

  • light exposure
    ascorbic acid
41
Q

How do you confirm bilirubin?

A

Ictotest
when bilirubin is + less sensitive to intert. substances, more sensitive
useful for early causes of liver disorders
PURPLE

42
Q

Describe urobilinogen

A

intestine, reabsorbed into blood norm to have small amounts <1mg

increased amount damage to liver/heme disorder

43
Q

T/F there is bilirubin in urine

A

false

44
Q

Describe the ….. with bilirubin and urobilinogen

bile duct obstruction
Liver damage
Hem disease

A

bile duct obstruction
Urine bilirubin +++ Urinbilinogen norm

Liver damage
Urine Bili + or -
Urobilinogen ++

Hem Disease
urine bilini negative
urobiliogen +++

45
Q

Absence of urobilinogen

A

Clinically significant
obstruction of bile duct
not detected by strip test - causes pale urine

46
Q

What test is used with urobilinogen/reagent

A

Ehrlichs rgn not specific for urobilin - pink/red color

47
Q

Urobilinogen
Tube test color

A

tube test: cherry pink

48
Q

Hoesch screen test
screens for?
Ml?
what is inhibited?
what reacts/color change?

False +

A

screen for urinary prophobilinogen
6ml HCL
urobilinogen inhibited due to acidic pH
Porpho reacts turns pink

False + other compounds

49
Q

Describe Nitrate

Tests results

A

ability of bacteria to produce nitrate to nitrite (only certain bacteria do this)

test: Nitrite + aromatic amine = diazo salt
Diazo salt + indicator = azodye

Pink = pos

50
Q

Rapid screen for UTI

A

Nitrite
standardized
not overly sensitive
+ with culture levels

51
Q

Describe Bacteriuria

A

bacteria bladder infection or kidney
pyelonephritis

Clinically significant combined with leuk esterase test (WBC)

52
Q

False negatives in nitrite

A

bacteria do not have enzyme to reduce nitrate to nitrite

first morning specimen preferred

needs to be normal occuring nitrate in urine (veggies) for bacteria to make nitrite

53
Q

Organisms that cause UTIs that do NOT reduce nitrate to nitrite

A

Gram positive bacteria and yeast

54
Q

Will reduce nitrate to nitrite to nitrogen

A

enterobacteriacea

55
Q

False + of nitrite

A

not fresh sample/color interference

56
Q

Describe leukocyte esterase

A

presence of esterase in granulocytic WBC, common in UTIs

Detetcs lysed leukocytes (microscopy cannot detect this)

Compare # to bacteria
trichomonas/yeast can cause w/o infection
Inflammation

57
Q

Test rxn of leukocyte esterase

A

indoxl/pyrole - carbonic ester - indoxl/pyrole
+ dyaz salt = purple color

58
Q

False + of LE

False - of Le

A

+ formalin, high pigmentation

= protein, glucose, ascorbic acid
crenated WBC (cant release esterase)
Abx gent/ceph/tretra

Urinalysis Spring (9 decks)

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