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AUBF > PART 1: routine examination of urine (week 4) > Flashcards

PART 1: routine examination of urine (week 4) Flashcards

1
Q

plastic strips that contain one or more chemically impregnated test sites on an absorbent pad. Each absorbent pads contain one or more reagents and these
reagents react with the urine, producing a distinct color. The color produced will be compared to the comparator block

A

Reagent Strips (dip stick)

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2
Q

1) Mix the urine
2) Insert reagent strip
3) Remove excess urine
4) Time according to manufacturer’s directions.
5) Compare test areas closely with corresponding color
charts.
6) Hold strip horizontally and close to the color chart.

A

Reagent Strips (dip stick) PROCEDURE

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3
Q
  • With desiccant (used to absorb moisture) in opaque (black container bottle), tightly capped containers. Most common reason for the discoloration of the strip
    is the uncapped containers
  • Room temperature (below 30°C)
  • Keep strips in their original container
A

DO STORAGE AND GENERAL PRECAUTION

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4
Q
  • Expose the strips to volatile fumes
  • Touch the test areas
  • Use if the chemical pads become discolored
  • Use past the expiration date
  • Also: Do not transfer test strips to another vial, prolong the dipping of the test (1 second is all it takes), and touch the test zones with you fingers
A

DON’T STORAGE AND GENERAL PRECAUTION

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5
Q

Sources of erros

A
  • Unmixed specimen
  • Strip in urine for extended period
  • Excess urine in the strip (run over bet chemicals)
  • Refrigerated specimen
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6
Q

If the urine specimen will not be mixed, the formed elements such as RBCs and WBCs will just settle at the bottom and will not be detected

A

Unmixed specimen

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7
Q

Leaching of reagents from the pad.
*Leaching - lalabas

A

Strip in urine
for extended
period

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8
Q

Distortion of colors

What to do to prevent run-over of chemicals?
Blot the edge of the strip and hold the strip
horizontally

A

Excess urine
in the strip
(run-over bet
chemicals)

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9
Q
  • False negative enzymatic tests. For example, glucose which has an enzyme called glucose oxidase that doesn’t react in cold temperatures.
  • To avoid this, allow the specimen to reach room temperature before dipping the strip
A

Refrigerated
specimen

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10
Q

Tested with known positive or negative controls.

A

QUALITY CONTROL

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11
Q

1) Test using different reagents or methodologies to detect the
same substances as detected by the reagent strips
2) Same or greater sensitivity or specificity
3) Tablets and liquid chemicals

A

CONFIRMATORY TEST

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12
Q
  • It reflects the ability of the kidney to maintain normal hydrogen ion concentration in plasma and extracellular
    fluid.
  • The organs that play a role in acid
    base balance are the kidneys and the lungs
A

REACTION/ pH

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13
Q

‒ To maintain acid-base balance in the body; kidneys secrete hyrogen ions and bicarbonate should be reabsorbed
‒ Blood must buffer and eliminate excess acids
‒ Buffering capacity of blood depends on bicarbonate ions (HCO3- )
‒ Secretion of hydrogen ions causes reabsorption of
bicarbonates

A

pH

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14
Q

i. Secretion of H+ in the form of NH4+, hydrogen
phosphate & weak organic acids
ii. Reabsorption of bicarbonate from the filtrate in the
PCT.

A

Maintenance of acid-base balance in the body via the kidneys is made possible through

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15
Q

Respiratory or metabolic

A

acidosis

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16
Q

Respiratory or metabolic

A

alkalosis

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17
Q

Defects in renal tubular secretion and re-absorption of acids and bases

A

Renal tubular acidosis

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18
Q

Determination of unsatisfactory specimen. An unsatisfactory pH is when the specimen reaches a

A

pH of 9 or a pH of 4

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19
Q
  • Increased protein and meat diet
  • Cranberries
  • Acid producing bacteria
  • Starvation
  • Dehydration
  • Diarrhea
  • Diabetes mellitus
A

Acid urine

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20
Q
  • Increased fruits and vegetables
  • Citrus
  • Less acidic after meal (alkaline tide)
  • Renal tubular acidosis
  • Urease producing bacteria
  • Hyperventilation
  • Old specimen
A

Alkaline urine

21
Q

methyl red changes
color from red to yellow

A

pH range of 4 to 6

22
Q

bromthymol blue changes color from yellow to blue in the

A

pH range of 6 to 9

23
Q

The pH range measured by the reagent strips

A

5 to 9

24
Q

The color changes from orange to yellow, green

A

At pH 5

25
Q

color changes to blue when the pH reaches

A

pH 9.0

26
Q

Methyl red (red to yellow)

A

pH 4-6

27
Q

Bromthymol blue (yellow to blue)

A

pH 6-9

28
Q
  • a pH meter w/ glass electrode
  • it measures the voltage caused by the H+ ions in the urine
  • Dipped into a solution
A

pH electrode

29
Q
  • Measured by titrating an aliquot of 24 hr.
  • urine with 0.1N NaOH with pH 7.4 as an end point
A

Titrable acidity

30
Q

1) Most of the albumin is not filtered
2) Filtered albumin is reabsorbed by tubules

A

Protein

31
Q

Important test is the _____ because if it is increased, there could be problems with glomerular basement membrane or
podocytes

A

albumin

32
Q

a) Refers to protein in urine in sufficient quantities to be detected by most clinical tests
- Proteins are derived from the plasma and the urinary tract
b) Very small amount of albumin is present in urine compared to blood level
- Most of the albumin is not filtered by the glomerulus
- Much of the filtered albumin is reabsorbed by the tubules
c) Protein determination is the most indicative of renal disease among the routine chemical tests

A

Proteinuria

33
Q

Types of proteinuria

A
  • Physiologic or functional
  • Postural or thostatic
  • Accidental or false or pseudo
  • Pathologic
34
Q
  • Seen in excessive ingestion of proteins, prolonged cold baths, late pregnancy, fever, emotional stress, strenuous exercise. This type of albuminuria is_____
  • 0.5 g/day
  • Resolved with rest for 2-3 days
    Causes:
    1) Dehydration
    2) Exercise
    3) Congestive Heart Failure -less blood, less
    urine is formed
    4) Cold exposure (prolonged cold baths)
    5) Fever
    6) Late pregnancy
    7) Emotional stress
A

Physiologic or functional
- transient

35
Q

Urine protein :
i. (+) day; vertical (nakatayo)
ii. (-) night; horizontal (nakahiga) - kasi di
napepress yung renal vein

A

Postural/Orthostatic

36
Q

a) First voided urine: (-)
protein
b) 2 hrs standing or
walking : (+) protein

A

Tests for this proteinuria

37
Q

Urine is contaminated directly or indirectly with albuminous fluids, pus cells, blood, vaginal discharge (e.g. vaginitis and cystitis -inflammation of the bladder

A

Accidental
or False or
Pseudo

38
Q
  • Renal diseases and indicates increased
    permeability of the glomerular filter
  • With defect in glomerular filter (endothelial cells, glomerula filtrate barrier, and podocytes), proteins can easily pass through.
  • If we see protein in the urine, it is because of problems in
    the glomerulus
A

Pathologic

39
Q
  • Heavy proteinuria
    >4g per day
  • Moderate
    proteinuria
  • Minimal proteinuria
A

QUANTIFICATION (amount in 24 hrs)

40
Q

Nephrotic syndrome:
- ↓Serum albumin
- ↑Lipid in blood & urine
- Granular cast
- Fatty cast
- Oval fat body

A

Heavy proteinuria
>4g per day

41
Q

1 to 4 g/day

A

Moderate
proteinuria

42
Q

Minimal proteinuria

A

<1 g/day

43
Q

“large molecules can pass through
because the glomerulus has
problems”

  • > 3-4 g/day
  • (-) charge on GBM is ↓
  • Urine (+) large protein a2 macroglobulin
    B-lipoprotein
  • Glomerulonephritis

Sira ang glomerulus kaya masyadong marami ang protein

A

GLOMERULAR
PATTERN

44
Q

“problems with the
renal tubular
reabsorption”

  • 1-2 g/day
  • Urine (+) small protreins
  • a1 microglobulin
  • b2 microglobulin
  • Fanconi, cystinosis

Intact ang glomerular filtration membrane but the problem is in the tubules

A

TUBULAR
PATTERN

45
Q

” umaapaw usmobrang dami kaya nakikita sa urine”

  • This is due to the overflow of excess levels of protein in the circulation
  • It can be seen with hemoglobin, myoglobin or immunoglobulin loss into the urine
A

Overflow proteinuria

46
Q

Causes of proteinuria
- Conditions affecting the blood before it reached the kidney
- Multiple myeloma (Bence Jones Protein)
- Intravascular hemolysis (hemoglobin)
- Myoglobin
- Acute phase reactants

A

Prerenal (before)

47
Q
  • Associated with true renal disease, either because of glomerular or tubular damage
  • Glomerular disorders
  • Tubular proteinuria
  • Orthostatic proteinuria
  • Microalbuminuria
A

Renal

48
Q
  • Protein is added to the urine specimen as it passes through the lower urine tract
  • Lower UTI
  • Menstrual contamination
  • Vaginal secretions
A

Post renal

49
Q
A

AUBF (12 decks)

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