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ANURBF LEC > CHEMICAL EXAMINATION > Flashcards

CHEMICAL EXAMINATION Flashcards

1
Q

determination of the presence and/or levels of the different analytes in urine associated with pathologic conditions

A

CHEMICAL EXAMINATION OF URINE

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2
Q

three methods are available:

A

(1) reagent strips (2) manual colorimetric/enzymatic (3) automated

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3
Q

Most frequently tested in urine

A

GLUCOSE

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4
Q

Intermediate products of fat metabolism

A

KETONES

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5
Q

Increased in carbohydrate deprivation and decreased utilization of carbohydrates

A

KETONES

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6
Q

Determined by the concentration of H+ ions which are secreted by the kidneys => ammonium ions, hydrogen phosphate and weak organic acids

A

pH

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7
Q

Identification of crystals and determination of unsatisfactory specimens

A

pH

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8
Q

Most indicative of RENAL DISEASE

A

PROTEIN

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9
Q

Produces white foam when shaken

A

PROTEIN

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10
Q

GLUCOSE

Renal Threshold:

A

160-180 mg/d L

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11
Q

First morning urine: pH

A

5.0 to 6.0

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12
Q

Random urine: pH

A

4.5 to 8.0

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13
Q

PROTEIN

Normal value:

A

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

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14
Q

Normal Albumin Excretion Rate (AER):

A

0-20 ug/min

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15
Q

Microalbuminuria:

A

20-200 ug/min (or 30 to 300 mg of albumin/24 hours)

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16
Q

Clinical albuminuria:

A

> 300 ug/min

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17
Q

Albumin:

A

10-150mg/L

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18
Q

Creatinine:

A

10-300mg/dL., 0.9-26.5 mmol/L

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19
Q

– presence of any sugar in urine
– presence of any reducing sugar in urine
– presence of glucose in urine

A

Mellituria
Glycosuria
Glucosuria

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20
Q

occurs after meals due to withdrawal of H+ ions for the purpose of secretion of HCl

A

Alkaline tide

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21
Q

Clinical proteinuria types

A
  1. Prerenal/overflow 2. Renal 3. Postrenal
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22
Q

INTACT RED CELLS

A

Hematuria

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23
Q

NO RED CELLS

A

Hemoglobinuria
Myoglobinuria

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24
Q

CLOUDY RED URINE

A

Hematuria

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25
Q

CLEAR RED URINE

A

Hemoglobinuria
Myoglobinuria

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26
Q

characterized by “cola drink” or “black coffee” urine

A

Myoglobinuria

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27
Q

bleeding is renal or genitourinary in origin

A

Hematuria

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28
Q

lysis of RBC produced in urinary tract particularly in dilute, alkaline urine

A

Hemoglobinuria

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29
Q

result to intravascular hemolysis

A

Hemoglobinuria

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30
Q

 Not indicative of actual renal disease

A
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31
Q

 Not detected by reagent strip

A

Pre-renal(“before”) or Overflow Proteinuria

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32
Q

 Characterized by an increase in low molecular weight proteins which are readily filtered out from the circulation by the glomerulus

A

Pre-renal(“before”) or Overflow Proteinuria

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33
Q
  • Intravascular hemolysis:
A

↑hemoglobin

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34
Q
  • Muscle injury:
A

↑myoglobin

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35
Q
  • Severe infection and inflammation:
A

↑acute phase reactants

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36
Q
  • Multiple myeloma:
A

↑Bence Jones protein

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37
Q

 Abnormal protein excreted by patients with MULTIPLE MYELOMA

A

BENCE-JONES PROTEIN

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38
Q

 NOT ALL patients with (?) will excrete detectable levels of BJP

A

Multiple myeloma

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39
Q

BENCE-JONES PROTEIN
 Precipitates at
 Dissolves at

A

40-60 ᴼC
100ᴼC

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40
Q

Indicative of True Renal Disease

A

Renal

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41
Q

 Most common type

A

GLOMERULAR PROTEINURIA

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42
Q

 Occurs in primary glomerular diseases

A

GLOMERULAR PROTEINURIA

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43
Q

 Seen in glomerulonephritis, amyloidosis, exposure to toxic substances, SLE, hypertension

A

GLOMERULAR PROTEINURIA

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44
Q

 Involves tubular reabsorption dysfunction

A

TUBULAR PROTEINURIA

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45
Q

 Seen in exposure to toxic substance or heavy metals, severe viral infections, Fanconi’s syndrome, pyelonephritis and acute tubular necrosis

A

TUBULAR PROTEINURIA

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46
Q

 Not detected by the routine reagent strip

A

MICROALBUMINURIA

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47
Q

 Associated with diabetic nephropathy and increased risk of CVD

A

MICROALBUMINURIA

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48
Q

 Proteinuria when standing due to increased pressure to renal veins.

A

POSTURAL, ORTHOSTATIC, OR CADET PROTEINURIA

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49
Q

 Found during the day but not at night

A

POSTURAL, ORTHOSTATIC, OR CADET PROTEINURIA

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50
Q

 Screening test: comparison of first morning vs second specimen

A

POSTURAL, ORTHOSTATIC, OR CADET PROTEINURIA

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51
Q

 First morning urine should be negative for protein

A

POSTURAL, ORTHOSTATIC, OR CADET PROTEINURIA

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52
Q

 Strip employing antibody-enzyme conjugate that binds albumin

A

MICRAL TEST

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53
Q

 Principle: MICRAL TEST

A

Enzyme Immunoassay

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54
Q

 Reagents: MICRAL TEST

A

Gold-labelled antibody, beta-galactosidase, chlorophenol re galactosidase

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55
Q

 Sensitivity: MICRAL TEST

A

0-10 mg/dl

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56
Q

sensitive albumin tests related to creatinine concentration to correct for patient hydration

A

IMMUNODIP

Clinitest Microalbumin Strips/MultistixPro

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57
Q

 Protein is added to urine as it passes through the lower urinary tract

A

Post-renal (“after”)

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58
Q

 May also be due to contamination during menstruation or from prostatic or vaginal secretions

A

Post-renal (“after”)

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59
Q

urine is coagulated by heat

A

HEAT AND ACETIC ACID

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60
Q

(REFERENCE METHOD)

A

HEAT AND ACETIC ACID

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61
Q

SULFOSALICYLIC ACID/SSA

 Reagent:
 MOST proteins are precipitated by:

A

3% SSA
dilute SSA

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62
Q

 Presence of albumin=
 Presence of proteins Other than albumin=

A

+ SSA; + RGT STRIP
+ SSA; - RGT STRIP

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63
Q

HEAT AND ACETIC ACID

diffuse cloudiness
granular, cloudy
distinct flocculate 4+ large flocculate, dense, something solid

A

1+
2+
3+

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64
Q

SULFOSALICYLIC ACID/SSA

No increase in turbidity
Less than 6

A

Negative

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65
Q

SULFOSALICYLIC ACID/SSA

Noticeable turbidity
6–30

A

Trace

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66
Q

SULFOSALICYLIC ACID/SSA
Distinct turbidity, no granulation
30–100

A

1+

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67
Q

SULFOSALICYLIC ACID/SSA

Turbidity, granulation, no flocculation
100–200

A

2+

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68
Q

SULFOSALICYLIC ACID/SSA

Turbidity, granulation, flocculation
200–400

A

3+

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69
Q

SULFOSALICYLIC ACID/SSA

Clumps of protein
Greater than 400

A

4+

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70
Q

SULFOSALICYLIC ACID/SSA

False positive

A

radiographic dyes, tolbutamide metabolites, cephalosporins, penicillins and sulfonamides

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71
Q

SULFOSALICYLIC ACID/SSA

False negative

A

highly alkaline urine, very dilute samples

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72
Q

 Highly pigmented yellow degradation product of hemoglobin

A

BILIRUBIN

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73
Q

Appearance in urine can provide early indication of liver disease

A

BILIRUBIN

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74
Q

Detected long before the development of jaundice

A

BILIRUBIN

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75
Q

Tea-colored/amber urine with yellow foam

A

BILIRUBIN

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76
Q

Normal value: BILIRUBIN

A

0.02 mg/dL

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77
Q

Normal value: UROBILINOGEN

A

< 1 Ehrlich unit or 0.5 to 2.5 mg/24 hours

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78
Q

Colorless and labile substance formed via the conversion of bilirubin in the intestines

A

UROBILINOGEN

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79
Q

Reabsorbed from the intestines into the blood, some are excreted by the kidneys and the remaining recirculates back to the liver

A

UROBILINOGEN

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80
Q

Rapid, indirect method for the detection of bacteria capable of reducing nitrate to nitrite

A

NITRITE

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81
Q

Detects the presence of esterase in WBCs that function as the body’s defense against microorganisms

A

LEUKOCYTE ESTERASE

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82
Q

source of interference due to its strong reducing property = FALSE NEGATIVE RESULT

A

ASCORBIC ACID

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83
Q

source of interference due to its strong reducing property = FALSE NEGATIVE RESULT

A

ASCORBIC ACID

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84
Q

GLUCOSE CLINICAL SIGNIFICANCE

A

Hyperglycemia-associated
Renal-associated

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85
Q

KETONES CLINICAL SIGNIFICANCE

A
  1. Diabetes mellitus
  2. Loss of carbohydrate from vomiting
  3. Inadequate intake of carbohydrate (starvation and malabsorption)
  4. Inborn errors of amino acid metabolism
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86
Q

pH CLINICAL SIGNIFICANCE

A
  1. Acid Urine
  2. Alkaline Urine
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87
Q

PROTEIN CLINICAL SIGNIFICANCE

A
  1. Albumin
  2. Tamm-horsfall protein
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88
Q

BILIRUBIN CLINICAL SIGNIFICANCE

A

Liver disorders:
 Hepatitis, cirrhosis
 Biliary obstruction (gallstones, carcinoma)

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89
Q

NITRITE CLINICAL SIGNIFICANCE

A
  1. Urinary tract infections (cystitis, pyelonephritis)
  2. Evaluation of antibiotic therapy
  3. Monitoring of patients at high risk for urinary tract infection
  4. Screening of urine culture specimens
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90
Q

LEUKOCYTE ESTERASE CLINICAL SIGNIFICANCE

A
  1. Bacterial and non-bacterial urinary tract infections
  2. Inflammation of the urinary tract
  3. Screening of urine culture specimens
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91
Q

↑ Blood glucose = ↑ urine glucose

A

Hyperglycemia-associated

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92
Q

Normal blood glucose = ↑ urine glucose

A

Renal-associated

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93
Q

 Diabetes

A

Hyperglycemia-associated

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94
Q

 Fanconi’s syndrome  Nephrotic syndrome  Osteomalacia  Pregnancy

A

Renal-associated

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95
Q

 Mellitus

A

Hyperglycemia-associated

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96
Q

 Cushing’s syndrome

A

Hyperglycemia-associated

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97
Q

 Pheochromoc ytoma

A

Hyperglycemia-associated

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98
Q

 Acromegaly

A

Hyperglycemia-associated

99
Q

 Hyperthyroidism

A

Hyperglycemia-associated

100
Q

Fanconi’s syndrome

A

Renal-associated

101
Q

Nephrotic syndrome

A

Renal-associated

102
Q

Osteomalacia

A

Renal-associated

103
Q

Pregnancy

A

Renal-associated

104
Q

 Metabolic and respiratory acidosis

A

Acid Urine

105
Q

 Chronic obstructive pulmonary disease

A

Acid Urine

106
Q

 Pyrexia

A

Acid Urine

107
Q

 Methanol poisoning

A

Acid Urine

108
Q

 Increased protein diet

A

Acid Urine

109
Q

 Acid-producing bacteria Cranberry juice

A

Acid Urine

110
Q

 Respiratory and metabolic alkalosis

A

Alkaline Urine

111
Q

 Renal tubular acidosis

A

Alkaline Urine

112
Q

 Urease-producing bacteria

A

Alkaline Urine

113
Q

 Vegetable and fruit diet

A

Alkaline Urine

114
Q

 Alkaline tide

A

Alkaline Urine

115
Q

Old specimens

A

Alkaline Urine

116
Q

MAJOR serum protein found in urine

A

Albumin

117
Q

produced by the renal tubules and forms MATRIX OF ALL YPES OF CASTS

A

Tamm-horsfall protein

118
Q

Most common organisms that infect the urinary tract:

A

 Proteus spp  E.Coli  Klebsiella pneumoniae  Pseudomonas aeroginos

119
Q

Reagent strip

Oxidizing agent interference on reagent strip (False positive)

Non-glucose reducing substance
Possible interfering substance for reagent strip (ex: Ascorbic acid)

A

Small amount of glucose

1+
4+
Nega

120
Q

Procedure: Clinitest

(?) drops of urine + (?) drops dist. Water + (?)

A

5
10
Clinitest tablet

121
Q

Pass-through phenomenon

 Occurs when (?) sugar is present
 (?)&raquo_space;»»»> Blue or Greenbrown
 to prevent pass-through, use (?)

A

> 2g/dl
Blue > Green > Yellow > Brick red
2 drops of urine

122
Q

Results: Clinitest

Small amount of glucose

Oxidizing agent interference on reagent strip (False positive)

Non-glucose reducing substance
Possible interfering substance for reagent strip (ex: Ascorbic acid)

A

Nega
Nega
Posi

123
Q

GLUCOSE METHODS

A
  1. Reagent strip 2. Benedict’s test 3. Clinitest
124
Q

KETONES METHODS

A
  1. Reagent strip 2. Acetest
125
Q

pH METHODS

A
  1. Reagent strip 2. Litmus paper 3. Nitrazine paper 4. Liquid indicators such as methyl red
126
Q

PROTEIN METHODS

A

None

127
Q

BLOOD METHODS

A
  1. Reagent strip 2. Microscopic examination 4. Blondheim Test
128
Q

BILIRUBIN METHODS

A
  1. Reagent strip 2. Ictotest
129
Q

UROBILINOGEN METHODS

A
  1. Reagent strip 2. Ehrich Tube Test 3. Hoesch Test(Inverse Ehrlich reaction) 4. Watson- Schwartz Test
130
Q

Acetest Reagents:

A

Na nitroprusside, glycine, disodium phosphate, lactose

131
Q

Acetest Sensitivity:
acetoacetic acid
acetone

A

5 to 10 mg/dL
20 to 25 mg/dL

132
Q

Acetest

Procedure: (?) drop of urine on tablet

A

1

133
Q

Acetest

Results: Posi

A

lavender to deep purple

134
Q

DIACETIC ACID/ACTOACETIC ACID

A

 Gerhard’s test
 Rothera’s test
 Acetest

135
Q
  • Ferric chloride w/ diacetic acid => PORTWINE/ Bordeaux red color
A

 Gerhard’s test

136
Q
  • can detect about 1-5 mg/dL if diacetic acid and 10-25 mg/dL of Acetone
A

 Rothera’s test

137
Q
  • provides sodium nitroprusside, glycine, disodium phosphate, and lactose in tablet form
A

 Acetest

138
Q

ACETONE

A

 Rothera’s test
 Legal’s Test
 Frommer’s Test
 Lange’s Test
 Acetest

139
Q

BHYDROXYBUTYRIC ACID

A

 Hart’s test
Orberg

140
Q
  • INDIRECT METHOD for detection of Bhydroxybutyric acid
A

 Hart’s test
Orberg

141
Q

 Intact RBCs settle at the bottom of tube

A

Reagent strip
Hematuria

142
Q

 Red color of urine is lost

A

Reagent strip
Hematuria

143
Q

Presence of intact RBCs

A

Microscopic examination
Hematuria

144
Q

Salt precipitation test

A

Blondheim Test
Hematuria

145
Q

Urine remains red

A

Reagent strip
Hemoglobinuria, Myoglobinuria

146
Q

Absence of intact RBCs

A

Microscopic examination
Hemoglobinuria , Myoglobinuria

147
Q

Precipitate is clear

A

Microscopic examination
Myoglobinuria

Blondheim Test
Myoglobinuria

148
Q

Red supernatant is positive with reagent strip

A

Microscopic examination
Myoglobinuria

Blondheim Test
Myoglobinuria

149
Q

Pale yellow

A

Microscopic examination
Myoglobinuria

Blondheim Test
Myoglobinuria

150
Q

Testing mat and tablet:
Urine absorbs into the mat while bilirubin stays on the surface
Tablet contains p-nitrobenzne-diazoniumptoluenesulfonate, SSA, sodium carbonate, boric acid

A

Ictotest (BILIRUBIN)

151
Q

Sensitivity: 0.05 to 0.1 mg/dL

A

Ictotest (BILIRUBIN)

152
Q

Procedure: 10 drops urine + 1 dropH2O (60sec)

A

Ictotest (BILIRUBIN)

153
Q

Results:
Performed in case of questionable results
blue to purple

A

Ictotest (BILIRUBIN)

154
Q

Tests (BILIRUBIN)

A

ICTOTEST
FOAM-SHAKE TEST
HARRISON SPOT TEST

155
Q

 Ferric hcloride in the prsence of TCA will oxidize yellow bilirubin to

A

HARRISON SPOT TEST

156
Q

 MORE sensitive
 less subject to interference

A

ICTOTEST

157
Q

ICTOTEST

 POSITIVE:
 NEGATIVE:

A

 POSITIVE: BLUE TO PURPLE COLOR
 NEGATIVE: Other color than blue

158
Q

 Specimen: 2-hr postprandial urine
 Reagents: p-dimethylaminobenzaldehyde and sodium acetate
 Procedure: 1 part reagent + 10 parts urine
 Positive result: cherry-red color

A

Ehrich Tube Test

159
Q

Rapid screening test for urine porphobilinogen (≥2 mg/dL)

A

Hoesch Test(Inverse Ehrlich reaction)

160
Q

 Reagent: Ehrlich’s reagent in 6M HCl
 Procedure: 2 drops urine + 2ml
 Positive result: red
 Interferences: highly pigmented urine, methyldopa, indicans

A

Hoesch Test (Inverse Ehrlich reaction)

161
Q

 Classic - test to differentiate urobilinogen form porphobilinogen based on miscibility characteristics

A

Watson- Schwartz Test

162
Q

Watson- Schwartz Test

 Urobilinogen is (?) in both butanol and chloroform
 Porphobilinogen is (?) in both butanol and chloroform
 Other Ehrlich reactive compounds are (?) in butanol but not in chloroform

A

extractable
immiscible
miscible

163
Q
  1. (?) are destroyed in the spleen and liver by phagocytic cells of the RES
  2. Liberated hemoglobin is broken down into (?).
  3. The RES converts (?).
  4. Bilirubin is released into the circulation where it binds to albumin and is transported to the liver (?)
  5. In the liver, bilirubin is conjugated with glucoronic acid (?)
  6. Conjugated bilirubin is passed into the intestines. Intestinal bacteria reduce (?).
  7. A portion of urobilinogen is transported to the kidneys and excreted in urine as (?).
A

Senescent red cells
iron, protein and protoporphyrin
protoporphyrin to bilirubin
unconjugated bilirubin
conjugated bilirubin
bilirubin to urobilinogen
urobilin

164
Q

PRE-HEPATIC

A

NEGATIVE
+++

165
Q

HEPATIC

A

POSITIVE/NEGATIVE
++

166
Q

POST-HEPATIC

URINE BILIRUBIN :
URINE UROBILINOGEN :

A

+++
NORMAL

167
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

168
Q

Multistix, Chemstrip

A

REAGENT STRIPS

169
Q

Consist of a chemical-impregnated absorbent pads attached to a plastic strip

A

REAGENT STRIPS

170
Q
  1. (?) in unmixed specimens
  2. Allowing the strip to remain in the urine for an (?)
  3. Excess urine remaining on the strip after its removal from the specimen can produce a (?) between chemicals on adjacent pads
  4. Inadequate (?)
  5. The strip must be (?) to the color chart without actually being placed on the chart
  6. (?) from different manufacturers are not interchangeable
  7. Specimens that have been refrigerated must be allowed to return to room temperature prior to reagent strip testing, as the (?) on the strips are temperature dependent
A

Undetected formed elements
extended periods
runover
light source
held close
Reagent strips and color charts
enzymatic reactions

171
Q

Timing for reaction reading

Manufacturers recommend that reactions be read between (?), with the leukocyte esterase reaction read at (?)

A

60 and 120 seconds
120 seconds

172
Q

Principle

Double sequential enzyme reaction

A
  1. GLUCOSE
173
Q

Principle

Na nitroprusside Reaction (Legal’s Test)

A
  1. KETONES
174
Q

Principle

Change in acid dissociation constant

A
  1. SPECIFIC GRAVITY
175
Q

Principle

Double Indicator System

A
  1. PH
176
Q

Principle

(Sorensen’s) error of indicators

A
  1. PROTEINS
177
Q

Reagents

Multistix: Glucose oxidase, Peroxidase, Potassium iodide (blue to green to brown)

Chemstrip: Glucose oxidase, Peroxidase, Tetramethylbenzidine (yellow to green)

A
  1. GLUCOSE
178
Q

Reagents

Sodium nitroprusside / Sodium nitroferricyanide, Glycine

A
  1. KETONES
179
Q

Reagents

Bromthymol blue

A
  1. SPECIFIC GRAVITY
180
Q

Reagents

Methyl red, Bromthymol blue

A
  1. pH
181
Q

Reagents

Multistix: Tetrabromphenol blue

Chemstrip: Tetrachlorophenol tertrabromsulfonphthalein

A
  1. PROTEINS
182
Q

Reaction

KETONES

A
183
Q

Reaction

SPECIFIC GRAVITY

A
184
Q

Reaction

pH

A
185
Q

Reaction

PROTEINS

A
186
Q

Reaction

BLOOD

A
187
Q

Reaction

BILIRUBIN

A
188
Q

Reaction

LEUKOCYTE ESTERASE

A
189
Q

Reaction

GLUCOSE

A
190
Q

Reaction

UROBILINOGEN

A
191
Q

Reaction

NITRITE

A
192
Q

Principle

A
193
Q

Principle

Pseudoperoxidase activity of hemoglobin

A
  1. BLOOD
194
Q

Principle

Diazo Reaction

A
  1. BILIRUBIN
195
Q

Principle

Ehrlich Reaction

A
  1. UROBILINOGEN
196
Q

Principle

Greiss Reaction

A
  1. NITRITE
197
Q

Reagents

Multistix: Diisopropylbenzene dehydroperoxide tetramethylbenzidine

Chemstrip: Dimethyldihydroperoxyhexane tertamethylbenzidine

A
  1. BLOOD
198
Q

Reagents

Multistix: 2,4-dichloroaniline diazonium salt

Chemstrip: 2,6-dichlorobenzene diazonium salt

A
  1. BILIRUBIN
199
Q

Reagents

Multistix: pdimethylaminobenzaldehyde (PDAB or Ehrlich reagent)

Chemstrip: 4-methyloxybenzenediazoniumtetrafluoroborate

A
  1. UROBILINOGEN
200
Q

Reagents

Multistix: p-arsinilic acid, tetrahydrobenzo(h)-quinolin-3-ol

Chemstrip: Sulfanilamide, hydroxytetrahydro benzoquinoline

A
  1. NITRITE
201
Q

False Positive

strong oxidizing agent, formalin, highly pigmented urine, nitrofurantoin

A
  1. LEUKOCYTE ESTERASE
202
Q

False Positive

Oxidizing agents, detergents

A
  1. GLUCOSE
203
Q

False Positive

Phthalein dyes, highly pigmented red urine, levodopa, medications with sulfhydryl groups

A
  1. KETONES
204
Q

False Positive

High concentrations of protein

A
  1. SPECIFIC GRAVITY
205
Q

False Positive

No known interfering substance; runover from adjacent pads, old specimens

A
  1. pH
206
Q

False Positive

Highly buffered alkaline urine, pigmented specimen, Phenazopyidine, Detergents, Antiseptics, prolonged exposure of strip to specimen, high SG

A
  1. PROTEINS
207
Q

False Positive

Strong oxidizing agents, bacterial peroxidases, menstrual contamination

A
  1. BLOOD
208
Q

False Positive

Highly pigmented urines, phenazopyridine, indican, metabolites of Lodine

A
  1. BILIRUBIN
209
Q

False Positive

Ehrlich reactive compounds, highly pigmented urine

A
  1. UROBILINOGEN
210
Q

False Positive
improperly preserved urine, highly pigmented urine

A
  1. NITRITE
211
Q

False Negative
high specific gravity, protein (>500mg/dL), glucose (>3g/dL), oxalic acid, ascorbic acid, gentamicin, cephalin, cephalothin, tetracycline

A
  1. LEUKOCYTE ESTERASE
212
Q

False Negative
non-nitrate reducing bacteria and yeast, improperly collected specimen, lack of dietary NO3, antibiotics, ascorbic acid, high specific gravity, medications

A
  1. GLUCOSE
213
Q

False Negative
old specimens, formalin and increased nitrite

A
  1. UROBILINOGEN
214
Q

False Negative
improperly stored urine, increase in nitrites and ascorbic acid

A
  1. BILIRUBIN
215
Q

False Negative
No known interfering substance; runover from adjacent pads, old specimens

A
  1. pH
216
Q

False Negative
Proteins other than albumin

A
  1. PROTEINS
217
Q

False Negative

  1. BLOOD

Uniform green / blue color =

Speckled/Spotted =

A

High SG, crenated cells, formalin, captopril, high concentrations of nitrite, ascorbic acid (>25mg/dl), unmixed specimen

Uniform green / blue color = Hemoglobin/Myoglobin

Speckled/Spotted = Hematuria (Intact RBCs)

218
Q

False Negative
improperly stored urine, increase in nitrites and ascorbic acid

A
  1. BILIRUBIN
219
Q

False Negative
old specimens, formalin and increased nitrite

A
  1. UROBILINOGEN
220
Q

False Negative
non-nitrate reducing bacteria and yeast, improperly collected specimen, lack of dietary NO3, antibiotics, ascorbic acid, high specific gravity, medications

A
  1. NITRITE
221
Q

Sensitivity/ Calibration

A
222
Q

Sensitivity/ Calibration

A
223
Q

Sensitivity/ Calibration
Clinistix: 100 mg/dL
Multistix: 75 to 125 mg/dL
Chemstrip: 40 mg/dL

A
  1. GLUCOSE
224
Q

Sensitivity/ Calibration
Add 0.005 to reading when phH>6.5 due to interference of bromthymol blue indicator

A
  1. SPECIFIC GRAVITY
225
Q

Sensitivity/ Calibration
Indicator is sensitive to albumin

A
  1. PROTEINS
226
Q

Correlations

Glucose

A

Ketones, Proteins

227
Q

Correlations

A
228
Q

Correlations

pH

A

Nitrite, Leukocyte, Microscopic examination

229
Q

Correlations

PROTEINS

A

Blood, Nitrite, Leukocytes, Microscopic examination

230
Q

Correlations

BLOOD

A

Protein, microscopic examination

231
Q

Correlations

BILIRUBIN

A

Urobilinogen

232
Q

Correlations

UROBILINOGEN

A

Bilirubin

233
Q

Correlations

NITRITE

A

Protein, Leukocytes, Microscopic examination

234
Q

ASCORBIC ACID – 11th reagent pad

Causes false negative reactions on:

A

 Blood  Bilirubin  leukocyte esterase  Nitrite  Glucose

235
Q

Purple

A

KETONES

236
Q

Red to yellow

Yellow to Blue

A

pH

237
Q

Blue-green

A

PROTEINS

238
Q

Yellow

Green to Blue

A

BLOOD

239
Q

Azodye

A

BILIRUBIN

240
Q

Red

A

UROBILINOGEN

241
Q

Red azodye

A

UROBILINOGEN

242
Q

Diazonium salt

Uniform pink

A

NITRITE

243
Q

Purple azodye

A

LEUKOCYTE ESTERASE

244
Q

blue to green to brown

yellow to green

A

GLUCOSE

ANURBF LEC (9 decks)

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