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AUBF - Lec > Chemical Examination > Flashcards

Chemical Examination Flashcards

1
Q

pH of a first-morning urine sample from a healthy individual

A

5.0 - 6.0 pH

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2
Q

Ph of a random urine sample from a healthy individual:

A

4.5 - 8.0 pH

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3
Q

Normal values for urine:

A

None. Values must be considered in conjunction with other patient info

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4
Q

Kidneys secrete hydrogen in what form?

A

Ammonium ions
Hydrogen phosphate
Weak organic acids

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5
Q

What does the kidney reabsorb to increase urine pH

A

Bicarbonate

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6
Q

High protein diet causes __________ urine

A

Acidic

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7
Q

Explain the clinical significance of pH in urine

A
  1. It aids in determining the existence of systemic acid-base disorders.
  2. Management of urinary conditions that require a specific pH to be maintained
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8
Q

What is the most common cause of kidney stones, and the pH where can be found?

A

Calcium oxalate, acidic urine

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9
Q

To avoid UTI, a person must keep a/an _____ urine pH

A

Acidic

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10
Q

What is the most indicative of a renal disease? Why?

A

Protein. There must be very low levels of protein in the urine. Those protein found in the urine are normally produced by the genitourinary tract.

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11
Q

Reagent strips are sensitive to what kind of protein?

A

Albumin

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12
Q

What is the major serum protein that is found in the urine?

A

Albumin

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13
Q

Aside from the major serum protein found in the urine, what else can be found?

A

Uromodulin
Microglobulin
Protein from prostatic, seminal, and vaginal secretions

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14
Q

Uromodulin is also known as:

A

Tamm-horsfall protein

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15
Q

What are the categories that cause proteinuria?

A

Pre-renal
Renal
Post-renal

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16
Q

Is pre-renal proteinuria an indicative of actual renal disease? Why or why not?

A

It is not an indicative of an actual renal disease because the problem is that there’s just too many protein in the body’s circulation

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17
Q

Pre-renal proteinuria is commonly caused by increased levels of

A

LMW plasma

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18
Q

Examples of LMW plasma proteins

A

Hemoglobin
Myoglobin
Acute phase reactants

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19
Q

Patients with multiple myeloma excrete monoclonal immunoglobulin light chains that are called ____

A

Bence-jones proteins

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20
Q

What is the modern test for bence-jones proteins?

A

Serum electrophoresis

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21
Q

What are the 4 renal proteinuria?

A

Glomerular proteinuria
Microalbuminuria
Orthostatic proteinuria
Tubular proteinuria

22
Q

What commonly causes the damage in gromular proteinuria?

A

Immune complexes

23
Q

What are the abnormal substances that may cause glomerular proteinuria?

A

Amyloid material
Toxic substances
Immune complexes

24
Q

Modified true or false:

Low blood pressure entering the glomerulus can cause damage that results to glomerular proteinuria

A

False. Increased blood pressure

25
Q

Normal values of urinary albumin excretion:

A

30-300 mg/day

Or

20-200 ug/min

26
Q

Low presence of albumin, but megative reagent strip for urine albumin signifies what?

A

Early kidney damage due to DM

27
Q

Poor glucose control inhibits ________ which helps in forming ________.

A

N-deacetylase

Heparan sulfate

28
Q

Importance of heparan sulfate

A

Maintains the shield of negativity to the glomerular basement membrane

29
Q

Micral test is dipped for how long? When do we compare the results?

A

5 seconds

1 minute

30
Q

Principle of micral test

A

Alb + ab -> bound conjugate -> albumin (skip) -> enzymatic substrate -> color change

Or

Alb +ab + enzyme substrate = color change

31
Q

In what zone will the unbound conjugate get trapped into?

A

Zone 2

32
Q

Other name for orthostatic proteinuria

A

Postural proteinuria

33
Q

Orthostatic proteinuria is due to what?

A

Incressed pressure on the renal vein when standing up for long periods

34
Q

How does tubular proteinuria occur?

A

Failure to reabsorb filtered albumin

35
Q

What are the causes of tubular proteinuria?

A

Exposure to toxic substances
Heavy metals
Severe viral infections
Fanconi syndrome

36
Q

Fanconi syndrome is a defect in which part of the kidney?

A

Proximal tubule

37
Q

Causes of post-renal proteinuria

A
  • Exudates containing protein from infections and inflammations
  • Blood from injury or menstrual contamination
  • Prostatic fluid and large amounts of sperm
38
Q

Modified true or false: Protein from the lower urinary tract causes renal proteinuria

A

False. Post-renal proteinuria

39
Q

Sulfosalicylic acid test is a _______ test that reacts equally with all forms of protein

A

Cold precipitation

40
Q

The most frequently performed chemical analysis in urine

A

Glucose

41
Q

What is the ideal specimen for glucose testing?

A

Fasting specimen

42
Q

What is the specimen for diabetes monitoring?

A

2-hour postprandial specimen

43
Q

Why is it important not to eat anything with sugar when testing for glucose?

A

Because there is a glucose spike after meal

44
Q

Examples of non-diabetic origin hyperglycemia

A

Cushing syndrome
Pancreatitis
Acromegaly
Hyperthyroidism
Severe stress (hormones)

45
Q

What is the test for glucose and its method?

A

Clinitest

Copper reduction method

46
Q

What is the inital color in copper sulfate method?

A

Negative blue

47
Q

True or false: reagent strip is more accurate than clinitest

A

True

48
Q

What are the 3 forms of ketones in the blood

A

Acetone
Acetoacetic acid
B-hydroxybutyrate

49
Q

What is the renal threshold for ketones in the urine?

A

70 mg/dL

50
Q

Explain why ketones appear in the body

A

When our primary source of energy, carbohydrates, are compronised, our body metabolises fats (gluconeogenesis) to supply energy throughout the body

51
Q

Explain the formation of ketones

A

The metabolosm of triglycerides will form acetyl CoA, where it then proceeds to Krebs cycle to produce, ATP, CO2, and H2O. However, when there’s too much acetyl CoA, it leades to the formation of ketone bodies.

52
Q

Ferric chloride test is also known as

A

Gehrardt’s test

AUBF - Lec (7 decks)

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