CHEMICAL EXAMINATION Flashcards
Provide a simple, rapid means for performing medically significant chemical analysis of urine
– pH: 60 seconds
– Protein: 60 seconds
– Glucose: _____
– Ketones: _____
– Blood: 60 seconds
– Bilirubin: _____
– Urobilinogen: 60 seconds
– Nitrite: 60 seconds
– Leukocyte esterase: _____
– Specific gravity: _____
– Glucose: 30 seconds
– Ketones: 40 seconds
– Bilirubin: 30 seconds
– Leukocyte esterase: 120 seconds
– Specific gravity: 45 seconds
- Kidneys secrete hydrogen in the form of ammonium ions, hydrogen phosphate,
and weak organic acids and reabsorb bicarbonate
PH
- First morning urine pH of a healthy individual: _____
- Random urine pH: _____
5.0 to 6.0
4.5 to 8.0
give 1 Clinical significance (under ph)
- Aids in determining the existence of systemic acid-base disorders of
metabolic or respiratory origin - Management of urinary conditions that require a specific pH to be
maintained
Most indicative of renal disease
protein
- Major serum protein found in urine:
albumin
Causes of proteinuria can be grouped into three major categories:
- Pre-renal
- Renal
- Post-renal
Caused by conditions affecting the plasma prior to reaching the kidney
Pre-renal proteinuria
Pre-renal proteinuria
Caused by increased levels of ____ that exceed the normal reabsorptive capacity of the tubules
LMW plasma proteins
- Monoclonal immunoglobulin light chains excreted by patients with
multiple myeloma
Bence-jones protein
- Historical screening test for BJP
– If protein coagulates (becomes turbid) at 40℃ and 60℃ and dissolves (clears)
at _____ (other proteins remain coagulated)
100℃
May be the result of either glomerular or tubular damage
Renal proteinuria
Renal proteinuria
* May be the result of either glomerular or tubular damage
- _____
– _____
– _____
– _____
- Glomerular proteinuria
– Microalbuminuria
–Orthostatic (postural) proteinuria
–Tubular proteinuria
presence of abnormal substances in the glomerular membrane may damage the glomerular membrane
Glomerular proteinuria
Glomerular proteinuria
* presence of abnormal substances in the glomerular membrane may damage the glomerular membrane
– _____
– _____
– _____
– Amyloid material in amyloidosis (buildup can cause organ failure)
– Toxic substances
– Immune complexes (main cause)
Common in patients with early-stage diabetic nephropathy leading to reduced glomerular filtration
microalbuminuria
microalbuminuria
* urinary albumin excretion of ____ mg/day, or _____ µg/min
30-300 mg/day
20-200 µg/min
Microalbuminuria/micral testing
* Micral-Test Reagent Strips
– Strips are dipped in urine for ___ and compared with the color chart after _____
5 seconds (1)
1 minute (2)
Microalbuminuria/micral testing
* Micral-Test Reagent Strips
What are the 7 steps ???
– Contain gold-labeled antihuman albumin antibody-enzyme conjugate
– Strips are dipped in urine for 5 seconds and compared with the color chart after 1 minute
– Albumin in the urine binds to the antibody. The bound and unbound conjugates move up the strip by wicking action.
– Unbound conjugates are removed in a captive zone by combining with albumin embedded in the strip.
– The urine albumin–bound conjugates continue up the strip and reach an area containing enzyme substrate.
– The conjugated enzyme reacts with the substrate, producing colors ranging from white to red.
– The amount of color produced represents the amount of albumin present in the urine.
- Occurs following long periods spent in a vertical position and
disappears when a horizontal position is assumed - Due to increased pressure on the renal vein
Orthostatic proteinuria
____ : if specimen 1 is negative for protein and specimen 2 is positive for protein
Orthostatic proteinuria
Failure to reabsorb filtered albumin
Tubular proteinuria
cause of Tubular proteinuria
exposure to toxic substances and heavy metals,
severe viral infections, Fanconi syndrome
a defect of proximal tubule leading to malabsorption of various electrolytes and substances that are usually absorbed by the proximal tubule
Fanconi syndrome
