Chemistry 17 (Body Fluids) Flashcards
“renal threshold” for glucose
180
enzymes used by glucose dipstick test
glucose oxidase
peroxidase
normal urine protein
150mg/d
unique solubility properties of Bence-Jones proteins
when heating: precipitate at 40 and redissolve at 100
when cooling: precipitate at 60 and redissolve at 40
ketone dipstick sensitive to
acetoacetic acid only
clues to myoglobinuria over hemoglobinuria
increased CK, increased aldolase, normal haptoglobin
urinary bilirubin
conjugated only
urobilinogen in urine seen when
liver dz prevents re-excretion or increased bilirubin leads to increased urobilinogen formation
Nitrate neg organisms that may cause UTI
enterococci
N. gonorrhea
MTB
false + leukocyte esterase with
trichomonads
eosinophils
Isosthenuria
urinary specific gravity fixed at 1.010
renal medullary dysfunction (seen in SS)
urine pH in RTA
inappropriately alkaline relative to blood, and unable to acidify below 6.5
ascorbic acid interferes with what urine dipstick tests
glucose, hgb, bilirubin, nitrate, leukocyte esterase
majority of renal stones are
calcium oxalate
oxaluria is found in
Crphn, small bowel bypass, increased oxalate ingestion
alkalotic urine promotes
Calcium phosphate stones
Dent dz
(x-linked nephrolithiasis)
chloride channel 5 (CLCN5)
causes hypercalciuria and stones
what drug increases Ca absorption
thiazides
stones promoted by acidotic urine pH
urate
stones adds with markedly alkalotic urine
struvite
urate stones commonly seen in
UC, Crohn, colectomy
stones inhibited by urine alkalinization
urate, cystine
rarest stones
2,8-dihydroxyadenine
AR deficiency of adenosine phosphoribosyl transferase
“coffin-lid” cystals
struvite (triple phosphate, magnesium ammonium phosphate)
hexagonal crystals
cysteine
“sheave of wheat” cystals
tyrosine
Red cell casts
glomerulonephritis
white cell casts
tubulointerstitial nephritis/pyelonephritis
tubular casts
ATN
broad casts
ESRD
fatty casts
nephrotic syndrome
normal CSF protein
15-45mg/dL
normally to quantitate CSF protein, must first
be precipitated with TCA or SSA
normal CSF/serum albumin ratio
<1:230
____ is suggestive for CSF when seen in a fluid
asialated transferrin
____ is sensitive marker in CSF for cerebral adrenoleukodystrophy
increased intrathecal IgA
CSF glutamine is increased in
hepatic encephalopathy
Latex agglutination tests are available for these bugs
H. influenza, S. pneumoniae, N. meningitides, Group B strep
Dressler syndrome
pleural effusion with MI
Meigs syndrome
pleural effusion with ovarian fibromas
Light’s criteria
pleural:serum protein >0.5
pleural:serum LDH >0.6
pleural LDH >200
pleural fluid in RA
pH 700
glucose <30
low pH alone in pleural fluid suggestive of
esophageal perforation
low pH with low glucose in pleural fluid suggestive of
empyema, malignancy, RA
lymphocytes in pleural fluid without mesothelial cells
TB or RA
for peritoneal fluid, use ____ to tell cirrhosis related
serum-ascites albumin gradient
in portal HTN >1.1
+ diagnostic peritoneal lavage
> 15mL blood
RBCs > 100,000
WBC >500
bacteria on gram stain
synovial lactate increased in
septic arthritis
synovial complement decreased in
RA, SLE
crystals in pseudogout =
calcium pyrophosphate
hydroxyapatite crystals can only be seen with
Alizone red S stain