Clinical Significance of Chemical composition Flashcards
What is the normal pH range of urine?
4.5 to 8.0
What is the typical pH of 1st morning urine?
5.0 - 6.0
What is the pH of unpreserved urine?
≥ 9.0
What occurs after meals due to withdrawal of H* ions for HCL secretion?
Alkaline tide
What contains quinic acid that causes urinary excretion of hippuric acid?
Cranberry juice
What is most indicative of renal disease?
Protein
What does protein produce in shaken urine?
White foam
What is the normal urinary protein level?
<10mg/dL or <100 mg/day; 150 mg/day
What is considered mild/minimal proteinuria?
<1g/day
What is considered moderate proteinuria?
1 to 3 or 4 g/day
What is considered large/heavy proteinuria?
> 3 or 4 g/day
What does protein in normal urine consist of?
1/3 albumin and 2/3 globulin
What is the major serum protein found in urine?
Albumin
What percentage of filtered protein is reabsorbed?
95-99%
What is the most abundant protein in normal urine?
Tamm-Horsfall protein (uromodulin)
What conditions are categorized as pre-renal proteinuria?
Intravascular hemolysis, Muscle injury, Severe infection and inflammation, Multiple myeloma
What is Multiple Myeloma characterized by?
Ig-producing plasma cells
What protein is produced in Multiple Myeloma?
Bence Jones proteins (BJP)
BJP is identical to what?
Immunoglobulin light chains (identical kappa and lambda)
What tests are used for detecting BJP?
Serum electrophoresis, Immunofixation electrophoresis
Urine precipitates at ____ and dissolves at ___
40-60 deg C (cloudy); 100 deg C (clear)
Glomerular proteinuria is indicated in
Diabetic nephropathy, Orthostatic/Cadet/Postural/Cyclic proteinuria, Tubular proteinuria
Diabetic nephropathy is characterized by
Decreased glomerular filtration; microalbuminuria is present
Albumin excretion rate in ug/min or mg/24 hrs: Normal
0-20 ug/min (negative in strip)
Albumin excretion rate in ug/min or mg/24 hrs: Microalbuminuria
20-200 ug/min or 30-300 mg/24 hrs (negative protein strip)
Albumin excretion rate in ug/min or mg/24 hrs: Clinical albuminuria
> 200ug/min (positive protein reagent strip)
Orthostatic proteinuria is due to
Increased pressure to renal veins when standing
In testing cadet proteinuria, what should be done?
Patient must empty bladder before going to bed and collect specimen immediately upon waking and another one 2 hours after standing
Orthostatic proteinuria result in first morning and after 2 hrs standing
First morning - negative; 2 hrs after standing - positive
Clinical proteinuria result in first morning and 2 hrs after standing
Positive in first morning and 2 hrs standing
Nephrotic syndrome, toxic agents, dehydration, strenuous exercise, hypertension, amyloidosis, pre-eclampsia is a type of what proteinuria
Renal proteinuria
Originally discovered in workers exposed to cadmium dust (a heavy metal)
Tubular proteinuria
Causes of tubular proteinuria
Fanconi’s syndrome, toxic agents/heavy metals, viral infections
Post renal proteinuria is caused by
Lower UTI/inflammation, menstrual contamination, injury/trauma, vaginal secretions, prostatic fluid/spermatozoa
Most frequently tested in urine
Glucose
Other sugars in urine caused by fruits, honey, syrups, fructose intolerance
Fructose (levulose)
Infants with galactosemia secrete in urine
Galactose
Increased sugar during pregnancy, lactation, strict milk diet, lactose intolerance
Lactose (Glucose + Galactose)