Chemical properties of Urine PT 1 Flashcards
Reagent strips
chemically impregnated to measure medically sign. substances
impropeer techniques = errors
Problems with reagent strips
not ….
strip left…?
leech
t
c
not mixing samples
strip left in urine too long (rbc/wbc not detected)
reagents leeching/bleeding
timing
charts
Urine specimens
temperatures?
well…
free of..
what can interfere?
should be at RT or fridge
well mixed
free of contam
thick/mucoid can interfere
Procedure breifly of strip test
check lables
pour cup into kova
dip reagent stick
remove, tap excess
blot
wait
compare
QC briefly
2 controlls
once per shift/day
synthetic or batched
T/F distilled water is not recommended for negative controls
t
Handling/storage
protected from?
keep what in the container?
check…
dont touch
must be protected from deterioration
keep dessicant in container
remove prior to testing and tightly reseal
RT
check expirations
dont touch pad areas
pH briefly
what regs acid base balance
first morning pH
Alk tide
kidneys/lungs reg acid base balance
FM: pH 5.0-6.0 acidic
Alkaline tide: more alk throughout day/meals
Normal random pH
pH >9
NR: 4.5-8.0
> 9.0 do not test, improperly preserved
ID of crystals
pH dependent treatment forms renal calculi, UTI
Acid - diabetes
Alk - vomit
Double indicator system
methylene red Bromo blue
Red to yellow 4-6pH
Blue - Yellow to blue 6.0 -9.0 pH
Describe protein
most indicative of
normal urine?
most indicative of renal disease, early renal disease.
normal urine contains small amount <10mg
Alb
how is it filtered?
main serum protein in normal urine
not filtered by glom., most filtered is reabsorbed back to plasma
Other proteins in urine
Macroglob, vaginal sec, Tamms- Horstall (tubules/casts)
T/F proteins can accept H ions
Acid buffer pH 4.0
more sens to alb
t
f: 3.0
t
Highly alk urine
pH
overrides?
what confirmatory test
what criteria in order to preform the test?
> 7.5
overrides acid buffer: false positive
SSA TEST CONFIRMATORY
PH >7.5 AND PROTEIN +
Sources of error in SSA/Highly alk urine
false +
h
cleaning
high
buff
false -
+ : highly pigm urine
contam with cleaning solut. w ammonium
High SG
buff alk
-: proteins other than alb
Proteinuria areas of inerest
prerenal, renal, post renal
Describe prerenal
p
not indicator of…
low MW….pp/i/i/
what proteins
strip detection
plasma
not indicator of renal disease, overflow
low MW plasma proteins/infect/inflam
BENCE JONES
STRIP WILL NOT DETECT PRERENAL
Renal proteinuria
glom….(disease)
renal disease =…
glom damage = what amount per day?
tubular = low…
golm. orthostatic
renal diease = damage to golm.tube
Golm damage = 4g per day
tubular = low levels of protein
Causes of renal proteinuria
am…
ts/ic…examples?
high
inc
ex/hy
p
amyloid materias
toxic substances/immune complexes (lupus/strep)
High BP
inc alb, excersise/hypertension
preg
Golmerular damages shows what in urine
WBC/RBCS
Tubular proteinuria
increased…
what type of proteins
causes
ts
eg
af
h/m
f
inc HIB, LMW proteins due to inability to reabsorb
Causes: toxic sub, ethlyene glycol, antifungal, hgb/mygo
fanconis
Functional proteinuria
not always pathogenic
excersise, fever, dehydration, extreme cold
Orthostatic proteinuria
adolescents
vertical position: Inc protein
Horizontal: dec protein
due to inc pressure on renal arteries
post renal proteinuria
lower urinary tract (bladder/urethra)
bacterial inflamm….etc
What does ssa stand for
sulfur salysilic acid
when reagent strip is +, confirms testig
Alkaline Urine major characteristics
false
cold
rxn
centrifuge and?
false pos for protein
cold precipitation
rxn w/ all protein forms
centrifuge
report turbidity
Any substance precipitated by acid
f t
rad..
d m
anti..
false turbidity
radiopgraphic dyes
diab. mellitus
antimicrobials
Describe Microalburia
small
low levels
onset
import
small amounts of alb in urine, low levels not detected by strip test
Onset of small amounts of protein/alb = renal issues
important for diabt type 1/2
Micral-test
anti…
c
colors?
anti-human alb ab conjugate
white to red
Immuno-dip
l
I line
II lines
latex particles Ab, I line (control unbound) II lines (positive)
Dye binding assay
measures what ratio?
why?
measures ab/creatinine
ab can vary due to hydration/creatinine is constant
A:C ratio for over under
Describe limitations of immunochem assays
b
m
d
d
bloody urine
medications
dark urine
detergents
