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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
Q

reagent strip protein reporting:

A

negative, trace, 1+, 2+, 3+, and 4+; or the semiquantitative values of 30, 100, 300, or 2000 mg/dL

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26
Q

reagent strip protein sensitivity

A

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

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27
Q

reagent strip protein interferes

A

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

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28
Q

if a px is allergic to iodine as antiseptic, use _

A

chlorhexidine

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29
Q

reagent strip protein correlation

A

blood, nitire, leukocyte, microscopic

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30
Q

reagent strip glucose principle

A

Double sequential enzymatic reaction

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31
Q

reagent strip glucose reaction

A

Glucose Oxidase

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32
Q

method by impregnating the testing area with a mixture of glucose oxidase, peroxidase, chromogen, and buffer to produce a double sequential enzyme reaction

A

glucose oxidase testing

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33
Q

Glucose oxidase testing method by impregnating the testing area with a mixture _, _, _, and _ to produce a double sequential enzyme reaction

A

glucose oxidase, peroxidase, chromogen, and buffer

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34
Q

reagent strip glucose chromogens

A

Multistix: potassium iodide (green to
brown)

Chemstrip: tetramethylbenzidine
(yellow to green)

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35
Q

t/f. multistix & chemstrip glucose parameter has same reagents but different chromogens

A

true

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36
Q

reagent strip glucose color reaction (multistix)

reagent strip glucose color reaction (chemstrip)

A

green to brown

yellow to green

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37
Q

reagent strip glucose reporting

A

Negative, Trace, 1+, 2+, 3+, 4+

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38
Q

reagent strip glucose sensitivity

A
  • Multistix: 75-125 mg/dl
  • Chemstrip: 40 mg/dl
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39
Q

reagent strip glucose correlations:

A

ketones and proteins

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40
Q

reagent strip glucose interferences

A

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

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41
Q

reagent strip protein reaction (clinitest)

A

copper reduction test

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42
Q

test for reducing sugars; can detect other reducing sugars except sucrose

A

copper reduction test

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43
Q

copper reduction test can detect other reducing sugar except

A

sucrose

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44
Q

copper reduction test relies on the ability of glucose and other
substances to reduce _ to _ in the presence of alkali and heat

A

copper sulfate; cuprous oxide

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45
Q

copper reduction test color change

A

neg blue - orange/red

blue, green, yellow, orange/red

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46
Q

“PASS-THROUGH” phenomenon is observed in what test

A

copper reduction test

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47
Q

reagent strip glucose interferes(clinitest)

A

other reducing sugars (galactose, lactose, fructose, maltose, pentoses, ascorbic acid, certain drug metabolites, and antibiotics such as the cephalosporins

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48
Q

Ketones represents 3 immediate products of _

A

fat metabolism

49
Q

3 Types of Ketones in Fat Metabolism

A
  1. Acetone (2%)
  2. Acetoacetic Acid (20%)
  3. B-hydroxybutyrate (78%)
50
Q

what ketones is measured in reagent strip test?

A

acetoacetate (20%)

51
Q

what ketones are measured in reagent strip test when glycine is present?

A

acetone (2%) and acetoacetic acid (20%)

52
Q

reagent strip ketones principle

A

Nitroprusside reaction

53
Q

reagent strip ketones reaction

Acetoacetic acid in_ medium reacts with sodium nitroprusside to produce a _ color

A

alkaline; purple

54
Q

reagent strip ketones reporting

A

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
Q

reagent strip ketones reagents

A

Sodium nitroprusside
Glycine (Chemstrip)

56
Q

reagent strip ketones sensitivity

A

Multistix: 5 - 10 mg/dL acetoacetic acid
Chemstrip: 9 mg/dL acetoacetic acid; 70 mg/dL acetone

57
Q

reagent strip ketones interferences

A

False-positive:
Phthalein dyes
Highly pigmented red urine
Levodopa
Medications containing free sulfhydryl groups

False-negative:
Improperly preserved specimens

58
Q

reagent strip ketones correlation

59
Q

reagent strip blood principle

A

Pseudoperoxidase activity of hemoglobin

60
Q

reagent strip blood chromogen

A

tetramethylbenzidine

61
Q

reagent strip blood end color

A

green-blue

62
Q

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.

A

hemoglobin and myoglobin; tetramethylbenzidine

63
Q

reagent strip blood reagents

A

Multistix: Diisopropylbenzene dihydroperoxide and 3,3’,5,5’- tetramethylbenzidine

Chemstrip: dimethyldihydroperoxyhexane and tetramethylbenzidine

64
Q

reagent strip blood sensitivity

A

Multistix: 5-20 RBCs/ml | 0.015-0.062 mg/dl Hgb
Chemstrip: 5 RBCs/ml | Hgb corresponding to 10 RBCs/ml

65
Q

reagent strip blood interferences

A

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
Q

reagent strip blood correlations

A

protein and microscopic

67
Q

Pathologic: disorders of renal or genitourinary origin (trauma or damage)

68
Q

Hematuria examples:

A

Renal calculi, glomerular disease

69
Q

Hematuria non-pathologic

A

strenuous exercise, menstruation

70
Q

Result from lysis of RBC produced in the urinary tract, particularly in dilute, alkaline urine

Ex. Intravascular hemolysis

A

Hemoglobinuria

71
Q

Clear red-brown urine (coca-cola)
Result of: muscle destruction (rhabdomyolysis)

A

Myoglobinuria

72
Q

heme-containing protein found in muscle tissue

(heme portion is toxic to renal tubules → acute renal failure)

73
Q

blood condition that has “speckled pattern” reagent strip reaction
-presence of intact rbcs

74
Q

blood conditions that have uniform color ranging from a negative yellow through green to s strongly positive green-blue appears on the pad

A

myoglobinuria and hemoglobinuria

75
Q

reagent strip bilirubin principle

A

Diazo reaction

76
Q

reagent strip bilirubin color change

A

increasing degrees of tan or pink to violet

77
Q

reagent strip bilirubin reagents

A

Multistix: 2,4-dichloroaniline diazonium salt

Chemstrip: 2,6- dichlorobenzenediazonium salt

78
Q

reagent strip bilirubin sensitivity

A

Multistix: 0.4-0.8 mg/dl

Chemstrip: 0.5 mg/dl

79
Q

reagent strip bilirubin correlations

A

urobilinogen

80
Q

reagent strip bilirubin interferences

A

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
Q

reagent strip urobilinogen principle

A

Ehrlich’s Reaction (M)
Diazo Reaction (C)

82
Q

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

A

M: Ehrlich’s aldehyde reaction
C: azo- coupling (diazo) reaction

83
Q

reagent strip urobilinogen end color

A

light to dark pink (m)
pink (c)

84
Q

reagent strip urobilinogen reagents

A

Multistix: p-dimethylaminobenzaldehyde

Chemstrip: 4-methoxybenzenediazonium Tetrafluoroborate

85
Q

reagent strip urobilinogen sensitivity

A

Multistix: 0.2 mg/dl
Chemstrip: 0.4 mg/dl

86
Q

reagent strip urobilinogen interferences

A

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
Q

reagent strip urobilinogen correlations

88
Q

reagent strip nitrite principle

A

Greiss Reaction

89
Q

Greiss reaction has _ reactions

90
Q

reagent strip nitrite reaction - urine pH

91
Q

reagent strip nitrite reagents

A

Multistix: p-arsanilic acid, Tetrahydrobenzo(h)-quinolin-3-ol

Chemstrip: Sulfanilamide, hydroxytetrahydrobenzoquinoline

92
Q

reagent strip nitrite sensitivity

A

Multistix: 0.06-0.10 mg/dl
Chemstrip: 0.05 mg/dl

93
Q

reagent strip nitrite correlation

A

protein , leukocytes, microscopic

94
Q

reagent strip nitrite interferences

A

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
Q

reagent strip leukocyte esterase principle

A

hydrolysis of ester

96
Q

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

A

acid ester; aromatic

diazonium salt

97
Q

reagent strip leukocyte esterase end color (+)

A

purple azodye

98
Q

reagent strip leukocyte esterase reporting

A

Trace, small, moderate, and large or trace, 1+, 2+, and 3+

99
Q

reagent strip leukocyte esterase reagents

A

Multistix: Derivatized pyrrole amino acid ester, Diazonium salt

Chemstrip: Indoxylcarbonic acid ester, Diazonium salt

100
Q

reagent strip leukocyte esterase correlations

A

nitrite, protein

101
Q

reagent strip leukocyte esterase interferences

A

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
Q

reagent strip specific gravity principle

A

change in pKa of polyelectrolytes

103
Q

reagent strip specific gravity color change

A

blue (1.00 alkaline) - green - yellow (1.030 acid)

104
Q

specific gravity of acid and alkaline

A

acid - high SG
alkaline - low SG

105
Q

reagent strip specific gravity reagents

A

Multistix: Poly (methyl vinyl ether/maleic anhydride) bromthymol blue
Chemstrip: Ethylene glycol diaminoethyl ether tetraacetic acid, bromthymol blue

106
Q

reagent strip specific gravity sensitivity

A

1.000 - 1.030

107
Q

reagent strip specific gravity interferences

A

False-positive: High concentrations of protein
False-negative: Highly alkaline urines (greater than 6.5)

108
Q

reagent strip ascorbic acid principle

Action of Ascorbic Acid to _ a dye in the impregnated pad

109
Q

reagent strip ascorbic acid positive result:

can detect AA concentration as low as _ and consistently detect _ of AA in 90% urine tested.

A

7.0mg/dL ; 20mg/dL

110
Q

significance of AA in reagent strip

A

can cause false negative

111
Q

High AA causes false negative on:

A

glucose, blood (>25 mg/dl), bilirubin (>25 mg/dl), nitrite, LE

112
Q

Classic test for differentiating UROBILINOGEN & PORPHOBILINOGEN

A

Watson-Schwartz Test

113
Q

Benedict’s Test principle

A

copper reduction

114
Q

Sulfosalicylic Acid Precipitation (SSA) Test principle

A

precipitation of urine by strong acid

115
Q

other urine chemical test that uses water bath

A

Benedict’s Test

116
Q

Benedict’s Test ++++

A

orange to brick red precipitate

117
Q

Benedict’s Test color change

A

blue (solution) - green - yellow - muddy orange - orange - brick red

118
Q

(urine) normal albumin in 24 hours

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

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