CHEMICAL EXAMINATION Flashcards
Reagent strips:
It includes the following:
Glucose
Bilirubin
Ketones
S.G.
Protein
pH
Blood
Urobilinogen
Nitrite
Leukocytes
Ascorbic acid
____________________currently provide a simple, rapid means for
performing medically significant chemical analysis of urine.
Reagent strips
Care of Reagent Strips
a)Store with desiccant in an ____________
container.
b)Store __________(room temperature); do not freeze.
c) Once the container is opened, ____________
d)Do not expose to _________.
e)Do not use past the ______________.
f) Do not use if _______________
g)___________ immediately prior to use.
opaque, tightly closed
below 30°C
use strips within 6 months
volatile fumes
expiration date
chemical pads become discolored.
Remove strips
AUTOMATED REAGENT STRIP
READERS
PRINCIPLE = __________________
Light reflection from the test pads decreases in
proportion to the intensity of color produced by the
concentration of the test substance.
The darker the color of the reagent pad, the lesser
the light reflection. (and vice versa)
REFLECTANCE PHOTOMETRY
A measure of the amount of dissolved substances in a solution
Density of solution compared with density of similar volume of
distilled water at a similar temp.
Influenced by number and size of particles in a solution
Specific Gravity
REFERENCE RANGES:
Random urine =____________
1st morning urine = _____________
24-hour urine =__________
IF S.G. is ____________= Not a urine (except in D.I.)
If S.G. is __________ = Radiographic dye present (if refractometer is used)
Isosthenuria = S.G. = __________
Hyposthenuria = S.G.___________
Hypersthenuria = S.G. ________
1.015 to 1.030
≥1.020
1.016-1.022
<1.003
>1.040
1.010
< 1.010
> 1.010
.URINOMETRY (URINOMETER / HYDROMETER)
Calibration temperature = ___________
Requires correction for glucose and protein:
1 g/dL Glucose = __________
1 g/dL Protein = ________
Urine volume required = ______
S.G. reading should be ___________
20ºC
-0.004
-0.003
10-15ML
1.015
REFRACTOMETRY (REFRACTOMETER, RI/TS
METER) STEPS IN USING THE REFRACTOMETER
Compensated to temperature ___________
Requires correction for glucose and protein
CALIBRATION:
Distilled/deionized H2O = 1.000
_____ NaCl = 1.015 ±0.001
_____ NaCl = 1.022 ±0.00I
____NaCl = 1.035 ±0.001
______Sucrose 1034±0.001
(15-38°C)
3%
5%
7 %
9%
- REFRACTOMETRY (REFRACTOMETER, RI/TS
METER) STEPS IN USING THE REFRACTOMETER - Put _______ of sample on the prism.
- Close the ______plate gently.
- Sample must spread all over the ______
4.______at the scale through the eyepiece
5.______scale where the boundary line
intercepts it. - ______the sample from the prism clean w/
tissue & water
1 or 2 drops
daylight
prism surface
look
read
wipe
Specimens with very high S.G. readings can be
diluted and retested
To obtain the actual S.G., multiply the decimal
portion of S.G. by the dilution factor
SPECIFIC GRAVITY DILUTION
change in pka (dissociation constant) of a polyelectrolyte
REAGENT STRIP REACTION for SPECIFIC GRAVITY
REAGENT STRIP REACTION for SPECIFIC GRAVITY (45 seconds)
Multistix = ______________
Chemstrip = _______________
FALSE(+) = ____________
FALSE(-)= ____________
Not affected by _______, ___________, __________
Poly (methyl vinyl ether/maleic anhydride) bromthymol blue
Ethylene glycol diaminoethyl ether tetraacetic acid
bromthymol blue
High concentration of protein - slightly increases S.G.
reading
Highly alkaline urines (>6.5)
glucose, protein &
radiographic dye.
Obsolete method
Based on frequency of soundwave entering a soln. changes in
proportion to the density of soln.
Ex:________________
HARMONIC OSCILLATION DENSITOMETRY (H.O.D.)
Yellow IRIS (International Remote Imaging System)
IRIS Diagnostics
Models __________ and ________ workstations
________ = required urine volume
________(of 6 mL) = for IRIS Slideless microscope
_____ (of 6 mL) = for IRIS Mass Gravity Meter (for S.G.
determination - by using H.O.D.)
300 and 500
6 mL
4 ml
2ml
Acidity refers to the “sourness” of a solution, whereas
alkalinity refers to its “bitterness”
Important in the identification of crystals and determination of
unsatisfactory specimens.
A blood pH ___________ will result in death
pH
<6.8 or >7.8
Normal urine pH:
o Random – _________
o 1st morning – ________
4.5-8.0
5.0-6.0
When pH is _________ – unpreserved urine
≥9.0
Causes of Acid Urine
Diabetes Mellitus (↑ketone bodies)
Starvation (↑ketone bodies)
High protein diet
Cranberry juice
Emphysema, dehydration, diarrhea,
acid-producing bacteria (E. coli),
medications
Causes of Alkaline Urine
Renal tubular acidosis After meal
Vegetarian diet
Vomiting
Old specimens, hyperventilation,
presence of urease-producing bacteria
REAGENT STRIP REACTION for pH (60 seconds)
PRINCIPLE
REAGENT
INTERFERENCES
Double indicator system
Methyl red, Bromthymol blue
No known interfering substances
Runover from adjacent pads, old specimen
Correlations with other tests = Nitrite, Leukocytes,
Microscopic
Most indicative of renal disease
Produces white foam in urine when shaken
PROTEIN
Protein
Normal urinary protein = <10mg/dL or <100 mg/day, <150 mg/day
Mild/minimal proteinuria = <1 g/day
Moderate proteinuria = 1 to 3 or 4 g/day
Large/heavy proteinuria = >3 or 4 g/day
Major serum protein found in the urine
__________of plasma albumin enters the ultrafiltrate
________of all filtered protein is reabsorbed
Albumin
<0.1%
95-99%
OTHER PROTEINS:
a) Serum and tubular microglobulins
b) Tamm-Horsfall protein (uromodulin)
c) Proteins derived from prostatic and vaginal secretions
