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Analysis of Urine, Other Body Fluids, and Miscellaneous Specimens > Chemistry Examination > Flashcards

Chemistry Examination Flashcards

1
Q

Unmixed Specimen (_ and _ sink at the bottom)

A

RBC & WBC

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2
Q

reagent strip timing for reaction for pH

A

immediately

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3
Q

reagent strip timing for reaction for leukocyte esterase

A

120s

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4
Q

reagent strip timing for reaction for the rest of parameters

A

60 -120s

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5
Q

reagent strip ph principle

A

Double indicator system

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6
Q

pH Reagent Strip Reaction:

Double indicator system of _ and _

A

methyl red and bromthymol blue

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7
Q

ph color changes

A

red - yellow - blue

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8
Q

pH rx

Methyl Red → Red to _ (pH _)

A

Yellow; 4-6

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9
Q

pH rx
Bromthymol Blue → Yellow to _ (pH _)

A

Blue; 6-9

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10
Q

reagent strip pH reagents:

A

Methyl Red, Bromthymol Blue

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11
Q

reagent strip pH sensitivity

A

Multistix: 5.0-8.5 in 0.5 increments
Chemstrip: 5.0-9.0 in 1.0 increments

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12
Q

chemstrip increments for pH parameters

A

1.0

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13
Q

reagent strip pH interferences

A
  • No known interfering substances
  • Run-over from adjacent pads
  • Old specimens
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14
Q

reagent strip pH correlations

A

nitrite, leukocyte, microscopic

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15
Q

causes of acidic urine

A
  • Emphysema
  • Diabetes mellitus
  • Starvation
  • Dehydration
  • Diarrhea
  • Presence of acid producing
    bacteria (Escherichia coli)
  • High-protein diet
  • Cranberry juice
  • Medications: Methenamine mandelate, Mandelamine, Fosfomycin tromethamine, Monurol
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16
Q

the inability of a person to produce an acid urine due to an impaired ammonia production

A

Renal tubular acidosis

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17
Q

Renal tubular acidosis has _ urine

A

alkaline

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18
Q

causes of alkaline urine

A
  • Hyperventilation
  • Vomiting
  • Renal tubular acidosis
  • Presence of urease producing bacteria
  • Vegetarian diet
  • Old specimen
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19
Q

reagent strip protein principle

A

Protein error of indicator

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20
Q

protein error of indicators to produce a _ reaction

A

visible colorimetric

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21
Q

reagent strip protein reaction:

the protein area of the strip contains reagent and an _ to maintain _ at a constant level

A

acid buffer; pH

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22
Q

reagent strip protein reaction:

At a pH level of _, both indicators appear _ in the absence of protein.

however, as the protein concentration increases, the color progresses through various shades of _ and finally to _

A

3; yellow

green; blue

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23
Q

protein trace value (reagent strip)

A

<30mg/dL

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24
Q

reagent strip protein reagents

A

Multistix: tetrabromophenol blue

Chemstrip: 3’,3”,5’,5”-tetrachlorophenol, 3,4,5,6-tetrabro- mosulfonphthalein

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25
reagent strip protein reporting:
negative, trace, 1+, 2+, 3+, and 4+; or the semiquantitative values of 30, 100, 300, or 2000 mg/dL
26
reagent strip protein sensitivity
Multistix: 15 - 30 mg/dL albumin Chemstrip: 6 mg/dL albumin
27
reagent strip protein interferes
False-positive: - Highly buffered interference alkaline urine - Pigmented specimens, phenazopyridine - Quaternary ammonium compounds (detergents) - Antiseptics, chlorhexidine - Loss of buffer from prolonged exposure of the strip to the specimen reagent - High specific gravity False-negative - Proteins other than albumin - Microalbuminuria
28
if a px is allergic to iodine as antiseptic, use _
chlorhexidine
29
reagent strip protein correlation
blood, nitire, leukocyte, microscopic
30
reagent strip glucose principle
Double sequential enzymatic reaction
31
reagent strip glucose reaction
Glucose Oxidase
32
method by impregnating the testing area with a mixture of glucose oxidase, peroxidase, chromogen, and buffer to produce a double sequential enzyme reaction
glucose oxidase testing
33
Glucose oxidase testing method by impregnating the testing area with a mixture _, _, _, and _ to produce a double sequential enzyme reaction
glucose oxidase, peroxidase, chromogen, and buffer
34
reagent strip glucose chromogens
Multistix: potassium iodide (green to brown) Chemstrip: tetramethylbenzidine (yellow to green)
35
t/f. multistix & chemstrip glucose parameter has same reagents but different chromogens
true
36
reagent strip glucose color reaction (multistix) reagent strip glucose color reaction (chemstrip)
green to brown yellow to green
37
reagent strip glucose reporting
Negative, Trace, 1+, 2+, 3+, 4+
38
reagent strip glucose sensitivity
- Multistix: 75-125 mg/dl - Chemstrip: 40 mg/dl
39
reagent strip glucose correlations:
ketones and proteins
40
reagent strip glucose interferences
False-positive Contamination by oxidizing agents and detergents False-negative High levels of ascorbic acid High levels of ketones High specific gravity Low temperatures Improperly preserved specimens
41
reagent strip protein reaction (clinitest)
copper reduction test
42
test for reducing sugars; can detect other reducing sugars except sucrose
copper reduction test
43
copper reduction test can detect other reducing sugar except
sucrose
44
copper reduction test relies on the ability of glucose and other substances to reduce _ to _ in the presence of alkali and heat
copper sulfate; cuprous oxide
45
copper reduction test color change
neg blue - orange/red blue, green, yellow, orange/red
46
“PASS-THROUGH” phenomenon is observed in what test
copper reduction test
47
reagent strip glucose interferes(clinitest)
other reducing sugars (galactose, lactose, fructose, maltose, pentoses, ascorbic acid, certain drug metabolites, and antibiotics such as the cephalosporins
48
Ketones represents 3 immediate products of _
fat metabolism
49
3 Types of Ketones in Fat Metabolism
1. Acetone (2%) 2. Acetoacetic Acid (20%) 3. B-hydroxybutyrate (78%)
50
what ketones is measured in reagent strip test?
acetoacetate (20%)
51
what ketones are measured in reagent strip test when glycine is present?
acetone (2%) and acetoacetic acid (20%)
52
reagent strip ketones principle
Nitroprusside reaction
53
reagent strip ketones reaction Acetoacetic acid in_ medium reacts with sodium nitroprusside to produce a _ color
alkaline; purple
54
reagent strip ketones reporting
negative, trace, small (1+), moderate (2+), or large (3+), or semiquanti- tatively as negative, trace (5 mg/dL), small (15 mg/dL), mod- erate (40 mg/dL), or large (80 to 160 mg/dL)
55
reagent strip ketones reagents
Sodium nitroprusside Glycine (Chemstrip)
56
reagent strip ketones sensitivity
Multistix: 5 - 10 mg/dL acetoacetic acid Chemstrip: 9 mg/dL acetoacetic acid; 70 mg/dL acetone
57
reagent strip ketones interferences
False-positive: Phthalein dyes Highly pigmented red urine Levodopa Medications containing free sulfhydryl groups False-negative: Improperly preserved specimens
58
reagent strip ketones correlation
glucose
59
reagent strip blood principle
Pseudoperoxidase activity of hemoglobin
60
reagent strip blood chromogen
tetramethylbenzidine
61
reagent strip blood end color
green-blue
62
reagent strip blood reaction Pseudoperoxidase activity of hemoglobin to catalyze a reaction between the heme component of both _ and _ and the chromogen _ to produce an oxidized chromogen, which has a green-blue color.
hemoglobin and myoglobin; tetramethylbenzidine
63
reagent strip blood reagents
Multistix: Diisopropylbenzene dihydroperoxide and 3,3’,5,5’- tetramethylbenzidine Chemstrip: dimethyldihydroperoxyhexane and tetramethylbenzidine
64
reagent strip blood sensitivity
Multistix: 5-20 RBCs/ml | 0.015-0.062 mg/dl Hgb Chemstrip: 5 RBCs/ml | Hgb corresponding to 10 RBCs/ml
65
reagent strip blood interferences
False-positive: Strong oxidizing agents Bacterial peroxidases Menstrual contamination False-negative: High specific gravity/crenated cells Formalin Captopril High concentrations of nitrite Ascorbic acid greater than 25 mg/dL Unmixed specimens
66
reagent strip blood correlations
protein and microscopic
67
Pathologic: disorders of renal or genitourinary origin (trauma or damage)
Hematuria
68
Hematuria examples:
Renal calculi, glomerular disease
69
Hematuria non-pathologic
strenuous exercise, menstruation
70
Result from lysis of RBC produced in the urinary tract, particularly in dilute, alkaline urine Ex. Intravascular hemolysis
Hemoglobinuria
71
Clear red-brown urine (coca-cola) Result of: muscle destruction (rhabdomyolysis)
Myoglobinuria
72
heme-containing protein found in muscle tissue (heme portion is toxic to renal tubules → acute renal failure)
Myoglobin
73
blood condition that has “speckled pattern” reagent strip reaction -presence of intact rbcs
hematuria
74
blood conditions that have uniform color ranging from a negative yellow through green to s strongly positive green-blue appears on the pad
myoglobinuria and hemoglobinuria
75
reagent strip bilirubin principle
Diazo reaction
76
reagent strip bilirubin color change
increasing degrees of tan or pink to violet
77
reagent strip bilirubin reagents
Multistix: 2,4-dichloroaniline diazonium salt Chemstrip: 2,6- dichlorobenzenediazonium salt
78
reagent strip bilirubin sensitivity
Multistix: 0.4-0.8 mg/dl Chemstrip: 0.5 mg/dl
79
reagent strip bilirubin correlations
urobilinogen
80
reagent strip bilirubin interferences
False-positive: Highly pigmented urines, phenazopyridine Indican (intestinal disorders) Metabolites of Lodine False-negative: Specimen exposure to light Ascorbic acid greater than 25 mg/dL High concentrations of nitrite
81
reagent strip urobilinogen principle
Ehrlich’s Reaction (M) Diazo Reaction (C)
82
reagent strip urobilinogen reaction Multistix: uses _, in which urobilinogen reacts with p-dimethylaminobenzaldehyde (Ehrlich reagent) to produce colors ranging from light to dark pink Chemstrip: incorporates an _ using 4-methoxybenzenediazonium- tetrafluoroborate to react with urobilinogen, producing colors ranging from white to pink
M: Ehrlich’s aldehyde reaction C: azo- coupling (diazo) reaction
83
reagent strip urobilinogen end color
light to dark pink (m) pink (c)
84
reagent strip urobilinogen reagents
Multistix: p-dimethylaminobenzaldehyde Chemstrip: 4-methoxybenzenediazonium Tetrafluoroborate
85
reagent strip urobilinogen sensitivity
Multistix: 0.2 mg/dl Chemstrip: 0.4 mg/dl
86
reagent strip urobilinogen interferences
Multistix: False-positive: Porphobilinogen Indican p-aminosalicylic acid Sulfonamides Methyldopa Procaine Chlorpromazine Highly pigmented urine False-negative: Old specimens Preservation in formalin Chemstrip: False-positive: Highly pigmented urine False-negative: Old specimens Preservation in formalin High concentrations of nitrite
87
reagent strip urobilinogen correlations
bilirubin
88
reagent strip nitrite principle
Greiss Reaction
89
Greiss reaction has _ reactions
two (2)
90
reagent strip nitrite reaction - urine pH
acidic
91
reagent strip nitrite reagents
Multistix: p-arsanilic acid, Tetrahydrobenzo(h)-quinolin-3-ol Chemstrip: Sulfanilamide, hydroxytetrahydrobenzoquinoline
92
reagent strip nitrite sensitivity
Multistix: 0.06-0.10 mg/dl Chemstrip: 0.05 mg/dl
93
reagent strip nitrite correlation
protein , leukocytes, microscopic
94
reagent strip nitrite interferences
False-negative: Nonreductase-containing bacteria Insufficient contact time between bacteria and urinary nitrate Lack of urinary nitrate Large quantities of bacteria converting nitrite to nitrogen Presence of antibiotics High concentrations of ascorbic acid High specific gravity False-positive: Improperly preserved specimens Highly pigmented urine
95
reagent strip leukocyte esterase principle
hydrolysis of ester
96
reagent strip leukocyte esterase reaction Uses the action of LE (leukocyte esterase) to catalyze the hydrolysis of an _ embedded on the reagent pad to produce an_ compound and acid The aromatic compound then combines with a _ present on the pad to produce a purple azodye
acid ester; aromatic diazonium salt
97
reagent strip leukocyte esterase end color (+)
purple azodye
98
reagent strip leukocyte esterase reporting
Trace, small, moderate, and large or trace, 1+, 2+, and 3+
99
reagent strip leukocyte esterase reagents
Multistix: Derivatized pyrrole amino acid ester, Diazonium salt Chemstrip: Indoxylcarbonic acid ester, Diazonium salt
100
reagent strip leukocyte esterase correlations
nitrite, protein
101
reagent strip leukocyte esterase interferences
False-positive: Strong oxidizing agents Formalin Highly pigmented urine, nitrofurantoin False-negative: High concentrations of protein, glucose, oxalic acid, ascorbic acid, gentamicin, cephalosporins, tetracyclines; inaccurate timing
102
reagent strip specific gravity principle
change in pKa of polyelectrolytes
103
reagent strip specific gravity color change
blue (1.00 alkaline) - green - yellow (1.030 acid)
104
specific gravity of acid and alkaline
acid - high SG alkaline - low SG
105
reagent strip specific gravity reagents
Multistix: Poly (methyl vinyl ether/maleic anhydride) bromthymol blue Chemstrip: Ethylene glycol diaminoethyl ether tetraacetic acid, bromthymol blue
106
reagent strip specific gravity sensitivity
1.000 - 1.030
107
reagent strip specific gravity interferences
False-positive: High concentrations of protein False-negative: Highly alkaline urines (greater than 6.5)
108
reagent strip ascorbic acid principle Action of Ascorbic Acid to _ a dye in the impregnated pad
reduce
109
reagent strip ascorbic acid positive result: can detect AA concentration as low as _ and consistently detect _ of AA in 90% urine tested.
7.0mg/dL ; 20mg/dL
110
significance of AA in reagent strip
can cause false negative
111
High AA causes false negative on:
glucose, blood (>25 mg/dl), bilirubin (>25 mg/dl), nitrite, LE
112
Classic test for differentiating UROBILINOGEN & PORPHOBILINOGEN
Watson-Schwartz Test
113
Benedict’s Test principle
copper reduction
114
Sulfosalicylic Acid Precipitation (SSA) Test principle
precipitation of urine by strong acid
115
other urine chemical test that uses water bath
Benedict’s Test
116
Benedict’s Test ++++
orange to brick red precipitate
117
Benedict’s Test color change
blue (solution) - green - yellow - muddy orange - orange - brick red
118
(urine) normal albumin in 24 hours
10mg/dL

Analysis of Urine, Other Body Fluids, and Miscellaneous Specimens (8 decks)

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