post lab discussion: exp 9

Question 1

functions of the kidney

Answer 1

❑ excretion of wastes in the form of urine
❑ regulation of blood volume and pressure through the production of urine
❑ regulation of concentration of major ions in the body
❑ regulation of extracellular fluid pH
❑ regulation of red blood cell synthesis through hormonal control with the hormone erythropoietin
❑ regulation of vitamin D synthesis

Question 2

what is the purpose of urinalysis

Answer 2

provides many useful information about various diseases and
conditions

• generally easily available and relatively inexpensive simple test

Question 3

why is called “a poor man’s kidney biopsy”

Answer 3

[bcs it can provide a lot of information about kidney health and other internal conditions without needing an expensive or invasive procedure like a kidney biopsy.]

because of the plethora (a lot) of
information that can be obtained about the health of the kidney or other internal diseases

Question 4

how much of urine should be collected

Answer 4

30 to 60 mL clean catch or the midstream urine collection (should be freshly collected)
- sample should be taken to the laboratory for analysis, typically within one hour of collection

Question 5

what happens if transportation to the lab could take more than one hour

Answer 5

sample may be refrigerated

Question 6

what are the different types of examinations in urinalysis

Answer 6

o Physical examination
o Chemical examination
- the urine sample is tested for the presence of certain chemical substituents
o Microscopic examination

• we are not registered to these

Question 7

substances that are not normally present in urine

Answer 7

• serum proteins
• glucose
• ketones
• bicarbonate ions
• oxalate ions

Question 8

what are the composition of urine

Answer 8

❑ mostly water with 5% dissolved substances:
* ammonia and organic compounds (urea, uric acid)
* proteins from pathogens and drugs
* ions (H, Na, K, Ca, Cl, PO4, SO4)

Question 9

physical characteristics
odor/ smell -
color -
clarity -
pH -

Answer 9

odor/ smell - odorless or can be slightly pungent
color - typically light yellow
clarity - no cloudiness
pH - usually acidic (pH 6) but can range from 4.5 to 8.0

Question 10

color of urine:
dark urine -
red urine -
orange or tea-colored -
tea-colored -

Answer 10

dark urine - dehydrated
red urine - hematuria (red blood present in urine)/ menstruation
orange or tea-colored - muscle breakdown
tea-colored - liver disease

*certain medication may also change the color of the urine

Question 11

clarity of urine:
cloudy -
very foamy -

Answer 11

cloudy - infection
very foamy - large amts of proteins in the urine (proteinuria)

Question 12

what are some substances that cause cloudiness in urine but are not considered unhealthy

Answer 12

mucus
sperm and prostatic fluid (men)
cells from the skin
normal urine crystals
contaminants like body lotions and powders

Question 13

what substances that causes cloudiness in the urine that requires attention

Answer 13

RBCs
WBCs
bacteria

Question 14

what is the role of kidneys

Answer 14

maintain acid-base balance of the body

Question 15

in the production of acids/ bases,
it is high in pH in urine -
it is low in pH in urine -

Answer 15

it is high in pH in urine - alkalosis
it is low in pH in urine - acidosis

Question 16

true or false:
ingestion of acidic/ basic foods does not directly affect urine pH

Answer 16

false - it directly affects

Question 17

what test tests for
protein -
sugar -

Answer 17

protein - biuret test
sugar - benedict’s test

Question 18

what are the reagents used for
protein -
sugar -
ketone -
bicarbonate test -
chlorine -
ammonia -

Answer 18

protein - NaOH, CuSO4

sugar - benedict’s reagent (CuSO4 in citrate and carbonate)

ketone - 1:1 mixture of glacial acetic acid and 10% sodium nitroprusside

bicarbonate test - H2SO4

chlorine - HNO3, nitric aid and AgNO3, silver nitrate

ammonia - NaOH, sodium hydroxide

Question 19

what are the standards for each tests
protein -
sugar -
ketone -
bicarbonate test -
chlorine -
ammonia -

Answer 19

protein - albumin
sugar - glucose
ketone - acetone
bicarbonate test - sodium bicarbonate
chlorine - sodium chloride
ammonia -

Question 20

what are the positive result for each tests
protein -
sugar -
ketone -
bicarbonate test -
chlorine -
ammonia -

Answer 20

protein -
copper ions in the biuret reagent forms a violet/ blue violet-colored complex with the protein’s peptide bond [complexation]

sugar -
brick red-ppt [redox]

ketone -
+ pinkish
++ red ring
+++ deep purple ring

bicarbonate test -
formation of gas bubbles

chlorine -
formation of whit ppt

ammonia - litmus paper color change (R → B)

Question 21

what is the reference table for the conc. of proteins (biuret test)

Answer 21

index cards

Question 22

which test will serve as our
- positive control
- negative control

Answer 22

• positive control
  standard
• negative control
  distilled water

Question 23

what is the normal result for protein

Answer 23

no protein or very small amt of protein in the urine (micro daw)

Question 24

elevated urine protein

Answer 24

proteinuria

Question 25

why do healthy people have temporary or persistent proteinuria

Answer 25

stress
exercise
fever
aspirin therapy
exposure to cold

Question 26

what happens if the patient repeat testing for urinalysis but shoes that there is still elevated urine protein (proteinuria)

Answer 26

it may a sign of kidney disease (small amt. of urine albumin upon onset of kidney dysfunction)
or it may be associated w many other disease or conditions - will require follow up tests

Question 27

what s the follow up test if protein is detected in the urine

Answer 27

urine albumin test
- more sensitive test for small amt of proteins
- routinely used to screen people w chronic conditions that put them at risk for kidney disease (diabetes/ hypertension)

Question 28

what is the reference table for the conc. of sugars (benedict’s test)

Answer 28

index card

Question 29

what is the normal result for sugar

Answer 29

no glycose in the urine

Question 30

presence of glucose bcs of either excessive high glucose lvl i blood or a reduction in the “renal threshold”

Answer 30

glucosuria
*reduction in the “renal threshold” - at a certain blood glucose lvl, kidneys begin to eliminate glucose into the urine to decrease blood conc.
*the threshold conc. is reduce and glucose enters the urine sooner, at a lower blood glucose conc.

[Normal situation: The kidneys filter blood and return almost all the sugar back into the body, so no sugar ends up in the urine.
When the sugar is too high: If blood sugar levels go above a certain point (the “renal threshold”), the kidneys can’t reabsorb all of it. The extra sugar spills into the urine to lower the sugar level in the blood.]

Question 31

what causes glucosuria

Answer 31

hormonal disorders
liver disease
medication
pregnancy

Question 32

true or false:
fasting blood glucose may be performed to further identify the specific cause

Answer 32

true
(for example, )

Question 33

what are the ketone bodies

Answer 33

acetoacetate
B-hydroxybutyrate
acetone

*these are intermediate products of fat metabolism
*produced when glucose is depleted as an energy source
(when u r on a low/ zero carbs diet = possible that ketone bodies can detect in the urine)

Question 34

Sodium nitroprusside (SNP) chemical formula

Answer 34

Na2[Fe(CN)5NO] * 2H2O
(strong oxidizing agent)

Question 35

the product when SNP reacts with ketone bodies

Answer 35

to form a reddish to purple ring

Question 36

what is the normal result for ketone bodies

Answer 36

no ketones in urine

Question 37

presence of high levels of ketones in urine

Answer 37

ketonuria

Question 38

what causes ketonuria

Answer 38

strenuous exercise
exposure to cold
frequent/ prolonged vomiting
several diseases in digestive system that increases fat metabolism

Question 39

for the test for ketone bodies, what is the indication when a person has diabetes

Answer 39

early indication of insufficient insulin

• With insufficient insulin, glucose cannot be properly processed and instead, fat is metabolized
• results to build-up of ketones in blood (ketosis) then progressing to ketoacidosis

Question 40

this results to build-up of ketones in blood

Answer 40

ketosis then progressing to ketoacidosis [a dangerous condition where the blood becomes too acidic, and the kidneys try to get rid of the extra ketones (and glucose) by dumping them into the urine.]

Question 41

excess ketones and glucose dumped into the urine by the kidneys to eliminate from the body

Answer 41

Diabetic ketoacidosis (DKA)
– usually seen in persons with uncontrolled Type 1 diabetes

Question 42

equation of carbonate and bicarbonate formation

Answer 42

carbonate:
CO3^2- + 2H+ —> CO2 +H2O

bicarbonate:
HCO3- + H+ —> CO2 + H2O

Question 43

what can you tell if the bicarbonate levels are higher/lower than normal

Answer 43

it is suggestive of the body’s trouble in maintaining its acid-base balance

Question 44

what can you infer when
o Highly alkaline blood or tissues =
o Acidic blood or tissues =

Answer 44

o Highly alkaline blood or tissues = significant presence of bicarbonate in urine (alkaline urine)
o Acidic blood or tissues = bicarbonate in the blood = absence of bicarbonate in urine (acidic urine)

Question 45

what happens of you have
high bicarbonate levels:
low bicarbonate levels:

Answer 45

high bicarbonate levels:
body is having trouble removing carbon dioxide (CO2), either because of problems with the lungs or kidneys.

low bicarbonate levels:
kidney problems, respiratory issues, or conditions where the body is losing too much bicarbonate (like chronic diarrhea or diabetic ketoacidosis)

Question 46

Common causes of low bicarbonate

Answer 46

Addison’s disease (a problem with the adrenal glands)
Chronic diarrhea
Diabetic ketoacidosis (DKA)
Metabolic acidosis (when the body produces too much acid)
Respiratory alkalosis (too much CO2 is removed, often from hyperventilation)
Shock
Kidney disease
Methanol poisoning
Aspirin overdose

Question 47

what is the white ppt in the test for chlorine

Answer 47

white ppt is the silver chloride

Question 48

what are the functions of chloride

Answer 48

o helps keep the balance of amount of fluid inside and outside of the cells
o helps maintain proper blood volume, blood pressure, and pH of the body fluids

*one of the most important electrolytes

Question 49

true or false;
chloride in urine is not normal

Answer 49

false - it is normal

Question 50

it is from the salt in the diet

Answer 50

chloride
* it is absorbed by the intestines and excess chloride leaves the body through the urine

Question 51

why is the chloride test done

Answer 51

The test is often done if you have symptoms like:
Muscle twitching or spasms
Breathing problems
Weakness or confusion

Question 52

what can the chloride test show

Answer 52

1. Kidney or adrenal gland problems: Chloride levels can indicate if there are issues with these organs.
2. High blood pH (metabolic alkalosis): If your blood is too alkaline (basic), it might be due to:
   - Electrolyte loss from prolonged vomiting or diarrhea
   - Excessive loss of sodium or consuming too much baking soda (which contains sodium bicarbonate)

Question 53

what are the test for ammonia

Answer 53

1. Checking liver function: The liver normally helps get rid of ammonia, so if the liver isn’t working well, ammonia levels can rise. This test is done when there are symptoms like:
   - Confusion
   - Excessive sleepiness
   - Coma
   - Hand tremors
2. Monitoring liver disease: It’s used to check how well treatments are working for severe liver disease like cirrhosis.
3. Diagnosing Reye’s syndrome: In children, high ammonia levels can help diagnose Reye’s syndrome, a rare condition that can damage the liver and brain.
4. Predicting outcomes in liver failure: The test helps doctors understand the prognosis (outlook) for people with acute liver failure.

Monitoring nutrition: It can also be used to check ammonia levels in people who are receiving high-calorie IV nutrition.

Question 54

how to prepare the test for ammonia

Answer 54

o Do not eat, drink anything other than water, or smoke for 8 hours before having ammonia blood test
o Avoid strenuous exercise just prior to having the test