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AUBF Lecture > Lesson 3: Chemical Examination of Urine > Flashcards

Lesson 3: Chemical Examination of Urine Flashcards

1
Q

Two major types of reagent strips are manufactured

A

Multistix (Siemens Healthcare Diagnostics)
Chemistrip (Roche Diagnostics)

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2
Q

Chemical reagent strips consist of chemical-___________ attached to a plastic strip

A

chemical-impregnated absorbent pads

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2
Q

The pH of normal random specimens can range from?

A

4.5 to 8.0

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3
Q

Formed elements, such as RBCs and WBCs sink to the bottom of the specimen and will be undetected when?

A

Specimens are not mixed

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3
Q

How to avoid runover phenomenon?

A

Blot the pad

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4
Q

Allowing excess urine to remain on the strip after its removal from the specimen can produce a ________ between chemicals on adjacent pads, producing distortion of colors

A

runover

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5
Q

Reading time for: Leukocyte esterases (LE)

A

30 to 120 seconds

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5
Q

Reagent strips are to be stored in?

A

Room temperature (below 30C) and are never refrigerated

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5
Q

True or False

Reagent strips must be checked with both positive and negative controls according to the frequency established by the laboratory policy

A

True

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5
Q

Reagent strips are packaged in opaque containers with _________ to protect then from light and moisture

A

Dessicant

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6
Q

Why is distilled water not recommended as a negative control for reagent strips?

A

Because reagent strip reactions are designed to perform at ionic concentrations similar to urine

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6
Q

A more alkaline pH is found after meals which is called as an?

A

Alkaline tide

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6
Q

Identify if Acid Urine or Alkaline Urine

Medications like methenamine, mandelate, fosfomycin, tromethamine

A

Acid Urine

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7
Q

Phenazopyridine compounds could give of what color reaction in the urine?

A

Phenazopyridine = orange pigment

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7
Q

A healthy individual usually produces a slightly acidic pH in a first morning specimen, what is the pH range?

A

5.0 to 6.0

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7
Q

It is the major serum protein found in normal urine

A

Albumin

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8
Q

True or False

Maintaining a Alkaline pH discourages renal calculi formation

A

True, it is because Calcium Oxalate precipitates at acidic pH and not in alkaline pH

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8
Q

Identify if Acid Urine or Alkaline Urine

Presence of E. coli

A

Acid Urine (Acid-producing bacteria = E. coli)

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8
Q

Identify if Acid Urine or Alkaline Urine

Presence of urease-producing bacteria

A

Alkaline Urine

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8
Q

Identify if Acid Urine or Alkaline Urine

Renal Tubular Acidosis

A

Alkaline Urine

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9
Q

It is a frequent constituent of renal calculi that precipitates primarily in ACIDIC and not alkaline urine

A

Calcium oxalate

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9
Q

Does maintaining an acidic urine valuable in treating UTIs caused by urea-splitting organisms>

A

Yes, because urea-splitting bacteria do not multiply as readily in an acidic medium

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9
Q

Why do people with UTIs advised to drink cranberry juice?

A

Because cranberry juice inhibit the colonization of some urinary pathogens

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10
Q

Technical Tip: Collecting specimens in containers other than the single-use-laboratory-supplied containers can produce a pH above 8.5 if alkaline detergent remains in the container

A

Wow! Thank you! Strasinger for this wonderful information!

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10
Q

Clinical proteinuria is indicated at?

A

30 mg/dL or greater (300 mg/L)

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10
Q

Reagent strips use a double indicator system of ________ and _________

A

Methyl red and Bromothymol blue

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10
Q

Double-Indicator System color change:

Methyl Red:
Bromothymol Blue:

A

Methyl Red: Red to Yellow (4 to 6 pH range)
Bromothymol Blue: Yellow to Blue ( 6 to 9 pH range)

Note: 5 to 9 pH range (5 = orange to yellow to green to 9 = deep blue)

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11
Q

Bacterial growth by certain organisms in a specimen may cause a marked alkaline shift in the reagent strip because of the the conversion of urea to _______

A

ammonia

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11
Q

These are monoclonal immunoglobulin light chains that are markedly elevated in patients with cases of multiple myeloma (proliferative disorder of the immunoglobulin-producing plasma cells)

A

Bence-Jones Proteins

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12
Q

Of the routine chemical tests performed on urine, the most indicative of renal disease is the?

A

protein determination

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12
Q

This type of proteinuria is usually transient and caused by increased levels of low-molecular-weight plasma proteins such as hemoglobin, myoglobin, and acute-phase reactants

A

Prerenal Proteinuria

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12
Q

This is often associated with early renal disease, making the urinary protein test an important part of any physical examination

A

Proteinuria

13
Q

Normal urine usually contains a small amount of protein which is?

A

<10 mg/dL or 100 mg per 24 hours

13
Q

This is a glycoprotein produced routinely in the ascending loop of henle

A

Tamm-Horsfall protein (THP) / Uromodulin

14
Q

The development of ____________ leading to a reduced glomerular filtration and eventual renal failure is a common occurrence in people with both Type 1 and Type 2 DM

A

Diabetic nephropathy

14
Q

Conditions that present the glomerular membrane with abnormal substances like and cause proteinuria due to glomerular damage:

Amyloid material
Toxic substances
Immune complexes (Lupus Erythematosus)
Streptococcal glomerulonephritis

These are included in what type of proteinuria?

A

Renal Proteinuria

15
Q

A persistent benign proteinuria occurs frequently in young adults and is termed as?

A

orthostatic proteinuria / postural proteinuria

16
Q

Fanconi Syndrome is associated with what type of renal disorder?

A

Tubular Disorder

17
Q

Traditional reagent strip testing for protein uses this principle to produce a visible COLORIMETRIC REACTION

A

protein error of indicators

17
Q

Protein area of the the Reagent Strip contains these indicators.

Multistix:
Chemstrip:
Acid buffer:

A

Multistix: Tetrabromophenol blue

Chemstrip: 3,3,5,5, tetrachlorophenol or 3,4,5,6-tetrabromosulfonphthalein

Acid buffer: maintain pH

18
Q

This contains a “gold-labeled antihuman albumin antibody-enzyme conjugate”

A

Micral-Test reagent strip

18
Q

It is a “cold precipitation” test that reacts equally with all forms of protein

A

Sulfosalicylic acid test (SSA)

18
Q

Unbound conjugates in Micral-Test are removed in what zone?

A

Captive zone

19
Q

True or False

In the Micral-Test, the amount of color produced represents the amount of albumin present in the urine

A

Ture

19
Q

In the Micral-Test, the conjugated enzymes reacts with the substrate, producing colors ranging from ______ to ______

A

White to red

19
Q

In the ImmunoDip reagent strip, it produces two blue bands (top and bottom band), which is the bound and unbound particles

A

Top band: Bound particles (urine albumin)
Bottom band: Unbound particles

19
Q

For the Micral-Test reagent strip, the bound and unbound conjugates move up the strip by what action?

A

Wicking action

19
Q

True or False

In the Micral-Test, the color is compared with a chart on the reagent strip bottle after 1 minute

Results range: 0 to 10 mg/dL

A

True

20
Q

Results interpretation for ImmunoDip reagent strip

Darker bottom band:
Equal color:
Darker top band:

A

Darker bottom band: <1.2 mg/dL (Negative)
Equal band: 1.2 to 1.8 mg/dL (Borderline)
Darker top band: 2.0 to 8.0 mg/dL (Positive)

21
Q

The principle for the reagent strip for creatinine is based on the what?

A

Pseudoperoxidase activity of copper-creatinine complexes

21
Q

Because of its value in the detection and monitoring of DM, this test is the chemical analysis performed most frequently on urine

A

Glucose Test

22
Q

Reagent strips for Creatinine contain?

A

Copper sulfate
3,3,5,5-Tetramethylbenzidine (TMB)
Diisopropyl benzene dihydroxyperoxide (DBDH)

23
Q

For creatinine in the reagent strip, the expected color for the reaction is?

A

Orange through green to Blue

23
Q

The onset of hyperglycemia ang glycosuria is normally around the __ month of pregnancy

A

6th month of pregnancy

23
Q

In mothers with gestational diabetes, since glucose can cross the placenta, the excess glucose transferred to the baby is stored as fat, resulting in a larger baby termed as?

A

Macrosomia

24
Q

Reagent Strip (Glucose Oxidase) Reaction Chromogen color

Potassium Iodide:
Tetramethylbenzidine:

A

Potassium Iodide: green to brown
Tetramethylbenzidine: yellow to green

24
Q

What do manufacturers incorporate this in test pads which oxidizes ascorbic acid so that it cannot interfere with the oxidation of the chromogen

A

Iodate

24
Q

Glycosuria in the absence of Hyperglycemia is referred to as?

A

Renal glycosuria

25
Q

The test relies on the ability of glucose and other substances to reduce copper sulfate to cuprous oxide in the presence of alkali and heat

A

Copper Reduction Test (Clinitest)

26
Q

Most clinically significant reducing sugar affecting the Clinitest for GLUCOSE

A

Galactose

26
Q

Ketonuria shows a deficiency in _______, indicating the need to regulate dosage.

A

Insulin

26
Q

Copper Reduction Test: Result

Negative:
Positive:

A

Negative: Copper Sulfate (CuSO4)(Blue)
Positive: Cuprous Oxide (Cu2O)(Orange/Red)

26
Q

Clinitest tablets are very hygroscopic and should be stored in their original, tightly closed packages.

A strong _____ color in the unused tablets suggest deterioration due to moisture accumulation, as does vigorous tablet fizzing

A

strong blue color

27
Q

Galactose in the urine of newborns suggests an inborn error of metabolism wherein there is a lack of what enzyme?

A

GALT (Galactose-1-phosphate uridyl transferase)

27
Q

Clinitest is subject to interference by reducing sugars like?

A

Galactose
Fructose
Pentose
Lactose

27
Q

Galactose in the urine of the newborn represents an?

A

Inborn error of metabolism

27
Q

It is a reducing sugar frequently found in the urine of nursing mothers

A

Lactose

28
Q

This is a non-reducing sugar which does not react with Clinitest or glucose oxidase strips. Therefore, it cannot be used as a control or in preparation of a laboratory exercise for glucose testing

A

Sucrose

28
Q

Intermediary products of “FAT” metabolism

A

Ketones

28
Q

Percentage of ketones found in the urine in descending order of concentration

A

B-hydroxybutyrate (78%)
Acetoacetic acid (20%)
Acetone (2%)

28
Q

Normally, measurable amounts of ketones do not appear in the urine because all the metabolized fat is completely broken down into _______ and _______

A

Carbon dioxide and water

28
Q

Testing for urinary ketones is most valuable in the management and monitoring of what type of diabetes?

A

Type 1 Diabetes Mellitus (Insulin-dependent)

28
Q

Both acetone and B-hydroxybutyric acid are produced from?

A

Acetoacetic acid

28
Q

Reagent strip tests use this reaction to measure KETONES

A

sodium nitroprusside (nitroferricyanide)

28
Q

Large amounts of levodopa and medications containing sulfhydryl groups, including __________ and _____, may produce atypical color reaction in Ketone Reagent Strip

A

MESNA (mercaptoethane sulfonate sodium)
Captopril

28
Q

In the sodium nitroprusside reaction, the acetoacetic acid in an alkaline medium reacts with sodium nitroprusside to produce what color?

A

Purple color

29
Q

Does sodium nitroprusside reaction for ketone measure B-hydroxybutyrate?

A

No, it does not,, but it measure acetone only when glycine is present

29
Q
A
29
Q
A

AUBF Lecture (7 decks)

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