Chemical Examination Of The Urine

Question 1

Reagent Strip: Simple, rapid means for performing medically significant chemical analysis of urine

Answer 1

• glucose
• ketones
• blood
• protein
• nitrite
• bilirubin
• specific gravity
• pH
• urobilinogen
• leukocytes

Question 2

chemical-impregnated absorbent pads attached to a plastic strip.

Answer 2

Reagent strip

Question 3

interpreted by comparing the color produced on the pad with a chart supplied by the manufacturer.

Answer 3

Reagent strip

Question 4

Care of Reagent Strips:

Answer 4

• Store with desiccant in an opaque, tightly closed container.
• Store below 30C; do not freeze.
• Do not expose to volatile fumes.
• Do not use past the expiration date.
• Do not use if chemical pads become discolored.
• Remove strips immediately prior to use.

Question 5

Quality Control of Reagent Strips:

Answer 5

• Test open bottles of reagent strips with known positive and negative controls every 24 hr.
• Resolve control results that are out of range by further testing.
• Test reagents used in backup tests with positive and negative controls.
• Perform positive and negative controls on new reagents and newly
opened bottles of reagent strips.
• Record all control results and reagent lot numbers.

Question 6

Major regulator of acid-base content of the body

Answer 6

Lung and kidney

Question 7

Reabsorbed in CT

Answer 7

HCO3

Question 8

First morning Urine (healthy individuals) pH

Answer 8

5.0-6.0 pH

Question 9

Normal Random sample pH

Answer 9

4.5-8.0 pH

Question 10

Acid urine causes:

Answer 10

• Emphysema
• Diabetes mellitus
• Starvation
• Dehydration
• Diarrhea
• Presence of acid- producing
bacteria (Escherichia coli)
• High-protein diet
• Cranberry juice
• Medications

Question 11

Alkaline Urine causes:

Answer 11

• Hyperventilation
• Vomiting
• Renal tubular acidosis
• Presence of urease-
producing bacteria
• Vegetarian diet
• Old specimens

Question 12

pH (Clinical Significance):

Answer 12

• Respiratory or metabolic acidosis/ketosis
• Renal calculi formation
• Treatment of urinary tract infections
• identification of crystals
• Determination of unsatisfactory specimens

Question 13

Reagent Strip Reaction Measures pH between:

Answer 13

5-9 pH

Question 14

Reagent Strip Reaction Measures pH between:

Answer 14

5-9 pH

Question 15

pH (Reagent Strip Reaction) principle:

Answer 15

DOUBLE-INDICATOR SYSTEM OF METHYL RED AND BROMTHYMOL BLUE.

Question 16

Methyl red pH range and color change

Answer 16

red to yellow; 4-6 pH

Question 17

Bromthymol blue pH range and color change

Answer 17

Yellow to blue; 6-9 pH

Question 18

Orange pH

Answer 18

5 pH

Question 19

Green pH

Answer 19

9 pH

Question 20

Prevent runover between pH and CHON

Answer 20

false acidic Reading

Question 21

Most indicative of renal disease

Answer 21

Protein

Question 22

early renal dse

Answer 22

Proteinuria

Question 23

NV: protein

Answer 23

<10mg/dL or 100mg/24h (usually albumin)

Question 24

Does not always signify renal disease and Presence requires additional testing

Answer 24

Proteinuria

Question 25

Clinical proteinuria: mg/dL

Answer 25

≥ 30mg/dL or 300 mg/L

Question 26

Type of proteinuria

Answer 26

◦Pre-renal proteinuria ◦Renal proteinuria ◦Post-Renal proteinuria

Question 27

Protein (Pre-renal Proteinuria) Frequently transient

Answer 27

• Hemoglobin • Myoglobin • APR due to inflammation • Not usually discovered in routine urinalysis

Question 28

Clinical Significance of Urine Protein: Pre- renal proteinuria

Answer 28

Bence Jones Protein

Question 29

Clinical Significance of Urine Protein: Protein (Renal Proteinuria)

Answer 29

GLOMERULAR PROTEINURIA TUBULAR PROTEINURIA ORTHOSTATIC (POSTURAL) PROTEINURIA MICROALBUMINURIA

Question 30

Clinical Significance of Urine Protein: Post-renal Proteinuria

Answer 30

• Bacterial and fungal infections and inflammation • Injury/trauma

Question 31

Protein (Reagent Strip) principle:

Answer 31

Protein error of indicators

Question 32

Protein (Reagent Strip) Reagent: Multistix Chemstrip

Answer 32

Multistix: Tetrabromphenol blue Chemstrip: 3’, 3’’, 5’, 5’’ tetrachlorophenol 3,4,5,6- tetrabromosulfophthalein

Question 33

Protein (Reagent Strip) sensitivity: Multistix Chemstrip

Answer 33

Multistix: 15–30 mg/dL albumin Chemstrip: 6 mg/dL albumin

Question 34

Other Albumin Qualitative test General Principle:

Answer 34

Precipitation of protein by heat and coagulation by chemical reagents

Question 35

Heat and Acetic Acid Reagent: (+) Result:

Answer 35

◦Reagent: Acetic Acid ◦(+) Result: White Cloudiness

Question 36

Sulfosalycilic Acid (SSA)/ Exton’s Test Reagent: (+) Result:

Answer 36

Reagent: Sulfosalicylic Acid or Sodium Sulfate (+) Result: White ring at zone of contact

Question 37

Heller’s Ring Test ◦ Reagent: ◦(+) Result:

Answer 37

◦ Reagent: Concentrated nitric acid ◦(+) Result: White opaque ring

Question 38

most frequent chemical analysis performed on urine

Answer 38

Glucose

Question 39

Purdy’s Test ◦ Reagent: ◦(+) Result:

Answer 39

◦ Reagent: 50% Acetic Acid ◦(+) Result: White cloudiness

Question 40

Picric Acid Test ◦Reagent: ◦(+) Result:

Answer 40

◦Reagent: Saturated solution of picric acid ◦(+) Result: precipitation

Question 41

Robert’s Ring Test ◦Reagent: ◦(+) Result:

Answer 41

◦Reagent: Magnesium sulfate or concentrated nitric acid ◦(+) Result: white ring at the zone of contact

Question 42

Potassium Ferrocyanide Test ◦Reagent: ◦(+) Result:

Answer 42

◦Reagent: Glacial acetic acid and K ferrocyanide ◦(+) Result: Cloudiness (proteases)

Question 43

Clinical Significance: glucose ◦DM = ___________ ◦ ___________ = tubular transport of glucose ceases - 180 mg/dl

Answer 43

Hyperglycemia Glycosuria

Question 44

Hyperglycemia- Associated

Answer 44

Diabetes mellitus Pancreatitis Pancreatic cancer Acromegaly Cushing syndrome Hyperthyroidism Pheochromocytoma CNS damage Stress Gestational diabetes

Question 45

Renal-Associated

Answer 45

Fanconi syndrome Advanced renal disease Osteomalacia Pregnancy

Question 46

Interference (Glucose Oxidase) false positives

Answer 46

Contamination by oxidizing agents

Question 47

Interference (Glucose Oxidase) false negative

Answer 47

• High levels of ascorbic acid • High levels of ketones • High specific gravity • Low temperatures • Improperly preserved specimens

Question 48

relies on the ability of glucose and other substances to reduce copper sulfate to cuprous oxide in the presence of alkali and heat.

Answer 48

Copper Reduction Test

Question 49

Other sugars

Answer 49

Fructose Maltose Galactose Pentose Lactose