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Analysis In Urinalysis And Body Fluids > CHEMICAL EXAM > Flashcards

CHEMICAL EXAM Flashcards

1
Q

Ph
Random and fasting: Normal values

A

Random 4.5-8
Fasting 5.5-6.5

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2
Q

Determine Acid base disorder

A

Ph

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3
Q

Acid Urine: Diseases

A

Emphysema
DM
Starvation
Diarrhea
Dehydration
Increase Protein

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4
Q

Alkaline Urine

A

Hyperventilation
Vomiting
Urease
Vegetables
Old Specimen

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5
Q

Principle of PH and Reading Time

A

Double Indicator System

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6
Q

Interferences

A

Run over from other pads
Old Specimen

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7
Q

Reagent

A

Methyl red ——– Brothymol Blue

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8
Q

This parameter is an indicator foe early renal disease

A

Protein

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9
Q

Normal Values of Protein

A

<10mg/dl or 100mg/24hrs

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10
Q

other urinary proteins

A

Uromodulin
Urokinase
IgA

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11
Q

Stages Of Proteinuria

A

Pre
Renal
Post

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12
Q

Stage of Proteinuria:
-Increase Plasma Protein, excess is sent to the kidneys and cannot be reabsorb
-impaired reabsorptive capacity
-intravascular hemolysis
-inflammation/ septicemia
- bence-jones protein

A

Pre renal proteinuria

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13
Q

Bence-jones protein

A

IGs proliferate = impaired reabsorptive capacity
Coagulates at 40° to 60°C & dissolves at 100°C
Methods: Electrophoresis, Immunofixation, Immunoassays

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14
Q

Stages of Proteinuria:
Renal Proteinuria

A

may be caused by glomerular or tubular damage

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15
Q

Glomerular proteinuria

A

Toxic substance, L.E, Streptococcal infection

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16
Q

Tubular proteinuria

A

Toxic substance, Viral infection, Fanconi syndrome

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17
Q

Orthostatic (postural) Proteinuria

A

vertical posture

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18
Q

Stage of Proteinuria:
Post-renal Proteinuria

A

from other parts (Ureter, bladder, urethra)

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19
Q

Causes of post renal proteinuria

A

Bacteria, spermatozoa
Lower UTI

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20
Q

Principle of Protein and Reading time

A

Protein error of indicators, 60 seconds

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21
Q

Protein:
Specific to ____ , with buffer “____”

A

Albumin, 3.0

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22
Q

Sensitivity and Reagent
Multistix
Chemstrip

A

Multistix:15-30 mg/dl Tetrabromphenol blue
Chemstrip = 6 mg/dL 3355 tetrachlorophenol 3456 Tetrabromosulfonphthalein

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23
Q

Interferences: False +

A

-highly buffered alkaline urine
-high SG
-antiseptics
-loss of buffer
-chlorhexidine
-phenazopyridine, detergents

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24
Q

Interferences of protein: False (-)

A

-prolonged contact with urine
-globulins,
-microalbumin,
-high salt concentration

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25
Q

Microalbimunuria

A

Presence of albumin in urine
above normal levels but below detectable levels

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26
Q

Microalbimunuria
Seen in type ___ & ____ DM

A

1 and 2

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27
Q

Microalbuminuria:
Albumin/24hrs _______mg is significantl

A

30-300mg

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28
Q

Micral test

A

EIA principle
Rgt: Gold-labelled anti-human albumin antibody-enzyme conjugate
Dip for 5 seconds
Wait 1 minute before reading
White to Red = Albumin
Sensitivity = 0-10mg/dL False (-)= dilute urine

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29
Q

Protein Interpretation:

A

Trace = <30mg/dL
+1 = 30mg/dL
+2 = 100mg/dL
+3 = 300mg/dL
+4=2000mg/dL

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30
Q

Correlate the Protein Chem Exam To:

A

Blood Nitrite WBC

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31
Q

Confirmatory Test for Proteins:

A

Sulfosalicylic acid Precipitation test

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32
Q

Sulfosalicylic acid Precipitation test:
Centrifuge at_____ speed

A

low

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33
Q

Sulfosalicylic acid Precipitation test
procedure:

A

3ml 3% SSA + 3ml Centrifuged urine= mix then check result

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34
Q

Sulfosalicylic acid Precipitation test
False (+):

A

Mucin
Uric Acid
Penicillin,
Tolbutamides,
Sulfonamides,
Radio contrast media,
Cephalosporins

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35
Q

Sulfosalicylic acid Precipitation test
False (-)

A

-highly buffered alkaline urine

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36
Q

Sulfosalicylic acid Precipitation test
Reporting:

A

Negative (<6 mg/dL)
Trace (6-30 mg/dL)
Positive then grading:
1+= (<30-100 mg/dL) Distinct turbidity, no granulation
2+=(100-200 mg/dL) Turbidity with granulation, no flocculation
3+=(200-400 mg/dL) with Turbidity, Granulation and Flocculation
4+= (>400 mg/dL) Clumps of protein

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37
Q

more sensitive for Microalbuminuria

A

Albumin-Creatinine Ratio:

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38
Q

Albumin-Creatinine Ratio:
Albumin cause a ________dye to change color (at constant pH)

A

sulfonephthalein

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39
Q

pseudoperoxidase activity of copper creatinine complex

A

Creatinine

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40
Q

Albumin-Creatinine Ratio:
_______ on pad is reduced and ______ is oxidized

A

-Peroxide
-Tetramethylbenzidine

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41
Q

Albumin-Creatinine Ratio:
PAD with H2O2 + TMB=

A

(+) = Red
(-) = White

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42
Q

Ketones: Types

A

Acetone (2%) = only detected if glycine is added
Acetoacetic acid (20%) = detected by RGT strip B-hydroxybutyric acid (78%)

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43
Q

Ketones: Principle and reading time

A

sodium nitrprusside, 40 seconds

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44
Q

Ketones RGT:

A

Multistix: Acetoacetate + Na* nitroprusside = Purple color
Chemstrip: (detects Acetone): Acetoacetate +Na+ nitroprusside + glycine = Purple color

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45
Q

Interferences
False (+)

A

-Phthalein dyes
-high pigmented red urine,
-Levodopa,
-Medications with Sulfhydryl drugs

46
Q

Ketones Interferences:
False (-)

A

improperly preserved specimen

47
Q

-Hygroscopic, for sever ketosis
- acetone and Acetoacetic acid
-Can be used with whole blood, plasma or serum

A

Acetest Tablets

48
Q

Ace test Tablets Components

A

Na* nitroprusside
Glycine
Disodium phosphate
Lactose (for better color)

49
Q

Ketone Test:
urine is acidified with H2SO4 and Ether and then FeCl is added to form violet-red color

A

Gerhardt’s test

50
Q

-detects DMI
-It is reabsrobed in PCT
-Has a renal threshold: 160-180 mg/dl
-needs fasting or 2hrs after meals

A

Glucose

51
Q

Principle for Glucose and reading time

A

glucose oxidase reduction and 30 seconds

52
Q

Rgt strip for glucose contains:

A

Glucose oxidase
peroxidase
Chromogen
Buffer

53
Q

Chromogen:

A

Multistix: k iodide= green to brown
Chemstrip: tetramethylbenzidine= yellow to green

54
Q

Glucose Rgt Reactions:

A
  1. glucose + O2—- glucose oxidase— gluconic acid + h20
  2. H2O2+chromogen—–Peroxidase——>Oxidized colored chromogen +h20
55
Q

Overflow Glucosuria:

A

Hyperglycemia
DM
Pancreatitis
GDM

56
Q

Renal Glycosuria- failure of tubule to reabsorb

A

Fanconi Syndrome
Renal Tubular dysfucntion
Pregnancy

57
Q

Glucose Interferences:
False (+)

A

contamination by oxidizing agents
detergents

58
Q

Interferences
False (-)

A

Increase Ascorbic acid, SG and ketones
low temp
improper preservation

59
Q

Copper reduction:

A

glucose + copper sulphate-Alkali & heat –> cuprous oxide

60
Q

follows benedict’s principle, used on babies to detect galactose

A

Clinitest Tablets

61
Q

Components of tablet:

A

-Copper sulfate = main reacting agent -NaOH= Heat production
-Na Citrate = Heat production
-Na carbonate = remove air interference
+Water (10 drops) + Urine (5 drops) = Heat then shake (Blue to orange red)

62
Q

Reminders Clinitest:

A

-Wait 15 minutes before boiling
-observed to prevent “pass through” (>2g/dL sugar)
- avoid pass through use 2 drops urine

63
Q

Strongly (+) Rgt Strip, (-) Clinitest

A

Possible contamination

64
Q

(-) Rgt Strip, (+) Clinitest

A

Other reducing sugar

65
Q

Glucose Interpretations:

A

Negative
Trace = 100 mg/dL
1+= 250 mg/dL
2+= 500 mg/dL
3+= 1000 mg/dL
4+=>2000 mg/dL

66
Q

rapid test for uti
initial bladder infection

A

Nitrite

67
Q

Nitrite Principle and Reading Time

A

Greiss reaction, 60 seconds

68
Q

Ketones Aromatic amines

A

Multistix: p-arsanilic acid
Chemstrip: Sulfanilamide

69
Q

Ketones Aromatic Compound

A

Multistix and Chemstrip: Hydroxytetrahydrobenzoquinolinol

70
Q

Reactions

A
  1. Aromatic amine + NO2-acid—-> diazonium salt
  2. Diazonium salt + Aromatic compound-acid->

PINK azodye

71
Q

Sensitivity

A

Multistix: 0.06-0.1mg/dL nitrite ion
Chemstrip: 0.05mg/dL nitrite ion

72
Q

Correlated Parameters

A

Protein
WBC
Microscopic findings (bacteria)

73
Q

Interferences:
False +

A

Improperly stored urine
Highly pigmented urine (produce color)(phenazopyridine, beets)

74
Q

Interferences:
False -

A

-non-reductase containing bacteria
-insufficient contact time for bacteria
-Lack of Nitrate
-high SG
-increase bacteria= Nitrite →Nitrogen
-Antibiotics
-INCREASE ASCORBIC ACID (>25mg/dL)

75
Q

-degradation product of hemoglobin
-Detects liver disease

A

Bilirubin

76
Q

Bilirubin Principle and Reading Time:

A

Diazo Reaction, 30 seconds

77
Q

Sensitivity

A

Chemstrip = 0.5 mg/dL
Multistix = 0.4-0.8 mg/dL

78
Q

Bilirubin test Reactions:

A
  1. Bilirubin + Multistix: 2, 4 dichloroaniline diazonium salt (Chemstrip: 2, 6 dichlorobenzene diazonium tetrafluoroborate)
  2. Bilirubin glucuronide + diazonium salt-Acid-> Azobilirubin (azodye = TAN/PINK to VIOLET)
79
Q

Interferences

A

False (+)
-Phenazopyridine and its metabolites (Pyridium),
-chlorpromazine,
-Indicans

False (-)
-Not fresh specimen (bilirubin is unstable),
-Increase Nitrite and ASCORBIC ACID (they combine with diazonium salt, >25 mg/dL)

80
Q

-for double check
-hygroscopic
-protected from moisture or high humidity

A

ICTOTEST TABLETS

81
Q

Ictotest Tablets Sensitivity

A

(0.05-0.10mg/dL sensitivity)

82
Q

Ictotest Tablets Components

A

-p-nitrobenzene-diazonium p-toluene sulfonate
-SSA
-Na* Carbonate
-Boric acid

83
Q

Ictotest Procedure and reactions/result

A

10 drops of urine on the Mat + drop of H2O + Tablet
= (+) Blue to purple

84
Q

Other Test for Bilirubin

A

*Foam/Shake test: (+)=yellow foam persist
*Oxidation tests: (Gmelin’s, Fauchet’s)
*Smith Emerald green (+)
*Harrison’s spot = Blue-green
*Schlesinger = for urobilin (greenish-fluorescence)

85
Q

Measure renal concentrating ability

A

Specific Gravity

86
Q

Isosthenuria tells you?

A

CGN, renal failure

87
Q

SG Principle and and Reading time

A

pka CHANGE OF POLYELECTROLYTES, 45 seconds

88
Q

Reagents Of SG

A

Multistix: Polymethyl Vinyl ether/maleic anhydride
Chemstrip: Ethylene glycol diamino ethyl ether tetra-acetic acid

89
Q

SG:
More H+?

A

Yellow-Green (Acid pH) = High Specific gravity

90
Q

SG:
Less H*?

A

Blue-Green (Alkaline pH) = Low Specific gravity

91
Q

SG Interferences:

A

False (+) = increase protein;
False (-) = Alkaline urine (>6.5)

92
Q

SG Interpretation:
1.001-1.009
1.010-1.015
1.016-1.035

A

Dilute
Average
Concentrated

93
Q

Hypersthenuria:

A

Dehydration
Diabetes mellitus
Proteinuria
Lipiduria

94
Q

Hyposthenuria

A

Diabetes Insipidus

95
Q

Is <1mg/dl urobilinogen is normal in urine?

A

Yes

96
Q

Conversion:
Urobilinogen (1.0mg/dL) to Ehrlich Unit

A

1 Ehrlich Unit

97
Q

Urobilinogen Principle And Reding time

A

EHRLICH REACTION , 60 seconds

98
Q

Reagents Reactions:

A

Multistix:
Urobilinogen + pdimethylaminobenzaldehyde-acid->RED color (light to dark pink) in Ehrlich units

99
Q

Interferences Urobilinogen:

A

False (+)
Porphobilinogen
p-aminosalycyclic acid
indican
sulphonamides
methyldopa
procaine
chlorpromazine
highly pigmented urine

False (-)
Old specimen
Formalin preservation

100
Q

Chemstrip Rgt Urobilinogen

A

4-methyloxybenzene-diazonium-tetrafluoroborate-acid

Resulting to: White to pink

101
Q

Ehrlich reagent + Urine + Na* acetate = Cherry red color

A

Ehrlich tube test

102
Q

Detectable for Ehrlich tube test?

A

Porphobilinogen
Ehrlich reactive substance

103
Q

It is a Rapid test for Porphobilinogen

A

Hoesch Screening test

104
Q

Hoesch Screening test:
Procedure and Result

A

2 gtts urine + 2ml hoesch rgt= + red (porphibilinogen)

105
Q

Hoesch Screening test:
Can detect as low as ______concentration of PBG

A

2mg/dL

106
Q

Detection Of this test Represents Hematuria and Hemoglobinuria

A

Blood

107
Q

Blood Parameters should correlated with?

A

Protein
Microscopic Findings

108
Q

Principle Of Blood and Reading Time

A

Pseudoperoxidase activity of hemoglobin, 60 seconds

109
Q

Reagents Of Bilirubin:

A

Multistix: Diisopropylbenzene dehydroperoxide Tetramethyl-Benzidine (TMB)

Chemstrip: 2, 5 dimethyl 2, 5 dihydroperoxyhexane TMB

110
Q

Interferences Blood:

A

False (+) = Strong Oxidizing agents, Bacterial peroxidase, Menstruation

False (-)= high SG (crenated RBC), Formalin, Captopril, high Nitrite, ASCORBIC ACID (>9 mg/dL), UNMIXED specimen

111
Q

Ammonium Sulfate Method:
precipitated (red precipitate) by Ammonium sulfate → supernatant read by reagent strip is (-) blood

A

Hemoglobinuria

112
Q

Ammonium Sulfate Method:

A

Red supernatant read by
Rgt strip (+) blood

Analysis In Urinalysis And Body Fluids (1 decks)

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