Chem Properties pt 2 (Chem strip tests) Flashcards
Describe the glucose threshold
What is glucosuria
what are some causes?
160-180ml
glucosuria is glucose in urine:
following a meal
hormonal function imbalance
renal tube problems
Describe the glucosuria: Not diabetic origin
following?
FIrst morning?
when do you collect and why?
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
Describe glycosuria caused by hormonal imbalance
inc T4, epinephrine, cortisol, glucagon
glycogenolysis increases glucose
Describe renal glycosuria
glucose in the absence of hyperglycemia
renal tube unable to reabsorb
renal failure/pregnancy
Describe gestational diabetes
disapears?
what crosses the placenta/what doesnt?
higher incidence of?
disapears after pregnancy
glucose crosses the placenta, insulin doesn’t
higher incidence of diab. type 2
What test is utilized in the glucose pad?
what does the rxn look like?
glucose oxidase
double sequential enzyme
glucose and air - gluconic acid/hydro peroxidase
peroxidase - Hp/chromogen - colorchange
T/F the glucose test is non specific to glucose - has rxns with other sugars
false it is specific to glucose and doesnt have rxns with other sugars
False positives of Glucose test
p/o
False negatives
rs
V
b
H sg
false pos: contam with peroxide/oxidizing subj (detergents)
False negative: reducing substance Vit D ascorbic acid
bacteria
high specific gravity
Describe the copper reduction clintest
measures
detects
others
measures reducing substances, not specific for glucose
sensitivity 200-250
Detects: galactose
lactose
fructose
ascorbic acid/microbes
Describe the rxn inside the copper reduction clintest
colorchange?
glucose and reducing agents reduce copper sulfide to cuprous oxide/alk and heat
colorchange blue to green/yellow/orange - red
What are things to be weary of in the copper reduction clintest?
pass through effect, watch closely, dont get burned
Describe the galactose clintest
was preformed on any child less than 24mos old
Major problem, galac - 1- phos-ur transferase
galactosemia and failure to thrive
what do they use now instead of the clintest?
every child is now screened with tandem mass spectrocopy
Galactosemia/uria
Clinist results
UA stick results
clinist - pos
UA stick - neg
Glycosuria
clintist results
UA stick
clintest - pos or neg (<200)
UA stick - pos (1+-4+)
Describe Ketones
converts fats to CO2 and H2O
in diet/exercise
diabetes
vomit/starving/malabsorption
3 intermediate products of ketones
acetone
ACETOACIDIC ACID
BHBA
Describe diabetes mellitus with ketones
deficiency of insulin, need to reg dosage
(1+)
Describe accumulation of ketones
electrolyte imbalance, dehydration acidosis
Ketone strip test rxn and reagents
sodium Nitropruside
acetoacid rxn w sodium nitro to produce pink color
DOESNT MEASURE BHBA/ACETONE
False positives for ketones
false negatives
+ few/levodopa, sulf groups, red pigment
- improper preservation
Describe the Acetest
tablet with nitro/lactose, works with urine/serum/body fluids
Describe Blood
Hematuria
Hgburia
Myoglobinuria
hematuria - whole rbc in blood cloudy
Hgburia - hgb in urine due to hemolysis/clear
Myoglobinuria - due to muscle destruction/clear
Clinical significance of blood
5 rbcs can be clear in urine with trace amounts, confirm with microscope
RBC/HGB/MYO all have?
pseudoperoxidase activity
Describe the rxn in the blood test
H202 + chromogen
oxidi chromogen + h2O
False positive blood test
false negative
+ strong oxid detergent
vegetable peroxidase
bacterial peroxidase (e.coli)
- high levels of Vit C
formalin/mixed specimen
Describe hematuria
renal calculi, golm. disease, trauma, pyelonephritis
Non-path- exercise/menstration
Describe Hgburia
lysis of rbcs in urine tract
dilute urine/alk urine
Intravascular hemolysis
heme anemia
transfusion/burns
T/F normal breakdown of hgb is completed with haptoglobin and is too large to be filtered by the glomerulous
true
Describe hemosiderin
denatured ferritin
yellow brown granules
renal epithelial cells/casts
Describe myoglobinuria
heme protein found in muscle/toxic to tubes
acute renal failure
muscle destruction (rhabdomyelosis)
coma/alcoholism
Diagnosis Hxt
increased serum creatinine/lactic acid
WHat test differentiates between Hgb and Myo
Ammonium sulfate test
Describe the ammonium sulfate test
hgb binds to amonia sulfate, heavy complex
myoglobin remains in supernatent/strip test
HGB = neg
MYO = posD
Describe bilirubin
appearance in urine = indicator of liver disease
LIVER DAMAGE AND BILE OBSTRUCITON
pigmented, degraded hgb (not due to lysis)
T/F protoporhyrin ring is converted to unconjugated bilirubin and is H20 soluble, gets filtered by the kidneys
False unconjugated bilirubin is not H2O soluble and is not filterd by the kidney
Describe conjugated bilirubin
obstruction of bile duct/liver damage
determine cause of jaundice
Reagent test / rxn for bilirubin
Diazo rxn
bilirubin rxn with diazonium salt to produce azoddye
False + for bilirubin
False - for bilirubin
+ azo
indican
pigmented urine
- light exposure
ascorbic acid
How do you confirm bilirubin?
Ictotest
when bilirubin is + less sensitive to intert. substances, more sensitive
useful for early causes of liver disorders
PURPLE
Describe urobilinogen
intestine, reabsorbed into blood norm to have small amounts <1mg
increased amount damage to liver/heme disorder
T/F there is bilirubin in urine
false
Describe the ….. with bilirubin and urobilinogen
bile duct obstruction
Liver damage
Hem disease
bile duct obstruction
Urine bilirubin +++ Urinbilinogen norm
Liver damage
Urine Bili + or -
Urobilinogen ++
Hem Disease
urine bilini negative
urobiliogen +++
Absence of urobilinogen
Clinically significant
obstruction of bile duct
not detected by strip test - causes pale urine
What test is used with urobilinogen/reagent
Ehrlichs rgn not specific for urobilin - pink/red color
Urobilinogen
Tube test color
tube test: cherry pink
Hoesch screen test
screens for?
Ml?
what is inhibited?
what reacts/color change?
False +
screen for urinary prophobilinogen
6ml HCL
urobilinogen inhibited due to acidic pH
Porpho reacts turns pink
False + other compounds
Describe Nitrate
Tests results
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
Rapid screen for UTI
Nitrite
standardized
not overly sensitive
+ with culture levels
Describe Bacteriuria
bacteria bladder infection or kidney
pyelonephritis
Clinically significant combined with leuk esterase test (WBC)
False negatives in nitrite
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
Organisms that cause UTIs that do NOT reduce nitrate to nitrite
Gram positive bacteria and yeast
Will reduce nitrate to nitrite to nitrogen
enterobacteriacea
False + of nitrite
not fresh sample/color interference
Describe leukocyte esterase
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
Test rxn of leukocyte esterase
indoxl/pyrole - carbonic ester - indoxl/pyrole
+ dyaz salt = purple color
False + of LE
False - of Le
+ formalin, high pigmentation
= protein, glucose, ascorbic acid
crenated WBC (cant release esterase)
Abx gent/ceph/tretra
