Chemical Analysis of Urine Flashcards

1
Q

A urine test strip (Dipstick) is a basic diagnostic tool used to determine what?

A

Pathological changes in a patient’s urine in standard UA

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2
Q

Dipstick can be read between what times?

A

60-120 Seconds

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3
Q

Difference between a plastic strip and paper strip?

A

Plastic: Have pads impregnated with chemicals that react tot he urine
Paper: Reactants are absorbed directly onto the paper, usually have a single reaction

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4
Q

What is the Manual Method for using a reagent dipstick?

A

You dip the entire strip into the urine, withdraw it in you continuous motion, while removing excess

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5
Q

What is the Reading Method?

A

Colors change on the pad, compare the coloring to the brand specific color chart on the side of the bottle.

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6
Q

Do not expose strips to what? (5)

A

Sunlight, Heat, Cold, Volatile substances, and moisture

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7
Q

What should you do for accurate reading results? (5)

A

Only remove number of strips you need for immediate testing, Urine should be at room temperature and well mixed
Don’t use discolored dipsticks, Don’t use expired reagent strips, Don’t touch testing areas with fingers.

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8
Q

What does discoloration of pads indicate?

A

Significant loss of reactivity

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9
Q

Kidneys and lungs regulate what in the body?

A

Acid-base balance

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10
Q

The pH of the urine reflects the kidney’s ability to do what?

A

Maintain normal H+ concentration in plasma and ECF

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11
Q

What are the two main objectives of Urine pH?

A

Diagnostic- metabolic abnormalities

Therapeutic- reg of diet or meds

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12
Q

Does urine pH remain constant or fluctuates?

A

It fluctuates, does not remain constant for long periods of time

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13
Q

What diet results in urine pH higher than 6?

A

Vegetable diets

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14
Q

What results in a more acidic urine? (3)

A

Higher protein intake, more phosphates, and sulfates.

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15
Q

What are the factors resulting in persistent Acidity? (9)

A

1.Dehydration 2.Diarrhea 3.Fever 4.Diabetes ketoacidosis 5. Gout 6. Pulmonary emphysema 7. High protein diets/ cranberries 8. Renal tubular acidosis (PT, DT) metabolic acidosis 9. Acidifying drugs

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16
Q

What are the factors resulting in persistent Alkalinity? (5)

A

1.Acute/Chronic renal failure 2.UTI 3.Bacterial contamination of urine 4.Alkaline drugs 5. Diuretics

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17
Q

Small amounts of low-molecular weight proteins found in urine are from where?

A

genito-urinary tract

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18
Q

Mucoprotein Tamm-Horsfall (T-H) is secreted from where? And NOT derived from what?

A

Renal tubules (renal eithelial cells); blood plasma

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19
Q

How much T-H protein is excreted?

A
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20
Q

T-H protein is a matrix formation of what?

A

Calculi or casts

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21
Q

What is the “Protein Error of pH Indicators?”

A

The ability of protein to alter the color of some acid-base indicators without altering the pH; Testing for proteins

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22
Q

What color would the tetrabromphenol blue be if it was devoid of protein and buffered at pH of 3?

A

yellow

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23
Q

If the tetrabromphenol blue was in the presence of albumin what color would it be?

A

green then blue, depending on the concentration.

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24
Q

Urine protein is false ____ if:
Highly buffered alkaline urine (meds/ old pee), Prolonged exposure to the sample, Container cleaning compounds (quaternary ammonia), Some skin cleaners, Blood in urine

A

False POSITIVE

25
Urine protein is False___ if: | Diluted urine, elevated amounts of proteins other than albumin
False NEGATIVE
26
What factors could cause temporary proteinuria? (7)
1.Strenuous exercise 2.Postural proteinuria 3.Dehydration 4.Exposure to heat or cold 5.Fever 6.Emotional stress 7.Pregnancy
27
What diseases cause persistent proteinuria? (3)
Glomerulonephritis, Pyelonephritis, Malignant hypertension
28
When is Urine glucose present?
When threshold exceeds 160-180mg/dl; usually reabsorbed in the proximal tubules
29
Urine glucose is fale ___ if: After using oxidizing agents for urine containers (peroxide/hypochloride), Take levodopa (Parkinson's), High levels of ketones
False POSITIVE
30
Urine glucose is false ___ if: Cool urine, High specific gravity due to uricorsuria, Alkaline urine from bacterial contamination of old pee, Ascorbic acid in high doses can inhibit enzymatic rxn
False NEGATIVE
31
What is transient glucosuria
Glucose concentrations caries in different individuals and can be present in urine 2 hours after sweet food
32
What does Glucosuria depend on? (3)
Blood glucose levels, Glomerular filtration rate, Tubular resorption
33
What is glucosuria seen in?
Diabetes mellitus, congenital glucosuria
34
Persistent glucosuria develops in what pathologies (6)?
Diabetes mellitus, CNS problems, Kidney problems, Endocrine problems, Liver disorders, Pharmaceudical agents
35
What is Clintest (Benedict's Test) predominately used for?
Dx of Galactosemia bc dipstick tests doesn't work
36
Clinitest is False ___ if: | Ascorbic acid, Cephalosporins, Probenecids (treat gout/hyperuricemia), Urinary preservitives
False POSITIVE
37
Clinitest is False ___ if: | Technique error
False NEGATIVE
38
What is the Urine reducing sugar test for?
Screens for dx of genetic disorders of carb metabolism
39
Urine reducing sugar test if predominately used for?
Early detection of Galactosemia
40
When are ketones used for energy, resulting in increase production and detectible in blood and urine
Body cannot get enough glucose for energy
41
What are the ketone bodies commonly seen in urine when fats are burned for energy? (3)
Acetoacetic acid(20%), B-Hydroxybutryic acid (78%), Acetone (2%, lost in air if left standing)
42
Dipstick tests can detect all of the common ketone bodies except?
B-Hydroxybutyric acid
43
Urine ketones are False ___ if: | Highly pigmented urine, Combo of high specific gravity and low pH, Dehydration, Phenylketones, Some meds, Ascorbic acid,
False POSITIVE; Atypical color
44
Urine ketones are False ___ if: | Delay in testing, Loss of reagent reactivity
False NEGATIVE
45
Ketone bodies can be determines in what? (9)
Diabetes mallitus, Malabsorption syndrome (the shits), Exposure to cold, Fasting, Fever, Insufficient carb intake, Malnutrition, Strenuous exercise, Vomiting
46
A positive urine blood dipstick indicates what? (3)
Hematuria, Hemoglobinuria, Myoglobinuria
47
What is hematuria? Hemoglobinuria? Myoglobinuria?
1. Blood in the urine released from any organ of genitourinary tract (intact/lysis RBCs) 2. Intravascular distraction of RBC (Glomerular filtrate) 3. Muscle damage (Glom filtrate)
48
Hemouria/Hemogolbin is False ___ if: | Cleanser Oxidizing contaminant, Bacterial peroxidase, Menstrual blood
False POSITIVE
49
Hemouria/hemoglobin is False ___ if: Technique errors inadequater mixing of urine sample, Formalin perservation, High concentrations of ascorbic acid, High specific gravity, Nitrites, Proteins
False NEGATIVE
50
Hematuria is the presence of ___ or ___ __ in urine. Urine that is highly ___ or has very low _____ can cause the red blood cells to ___ this releasing thier ___ into the urine.
Blood; Intact RBCs Alkaline; Specific gravity (1.007) Lyse; Hemogoblin
51
If RBCs have lysed, examination may show an empty blood cell membrane AKA ___
Ghost cell
52
Urine gets ___ in color the greater the amount of ___ in it
redder; blood
53
What does Transient hematuria result from? (2)
Strenuous exercise, Menstrual contamination
54
Persistent hematuria can develop from what renal diseases? (5)
Glomerular, Tubular, Interstitial, Vascular, Trauma to kidneys
55
Persistent hematuria can also be present in patients with? (3)
Urolithesis, UTI, UT tumors
56
Persistent hematuria can develop in what? (4)
Bleeding disorders related to anticoagulant therapy, Prostatic cancer, Gynecological disorders, Viral infections (EBOLA)
57
Hemoglobinuria: Intravascular hemolysis can be found where? (5)
Incompatible blood transfusions, Hemolytic anemia, Immunihemolytic anemias, Burns, Electrical shock
58
Myoglobinuria: Damage to cardiac or SM due to what? (6)
Rhabdomyolysis (car crash, muscle injury), Electrical shock, Myocardial infarction, Heroin abuse, Alcoholism, Strenuous physical activity
59
What is the difference between Hemoglobin/Hematuria and myoglobin?
Microscopic: Red plasma and red urin means Hemoglobin; Clear plasma and red urine means Myogobin Chemical: If thier is ammonium sulfate precipitation it means myoglobin