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Urinalysis (BIOL 380) > Quiz 2 > Flashcards

Quiz 2 Flashcards

0
Q

What constitutes the chemical examination?

A
  1. pH
  2. Protein
  3. Glucose
  4. Ketones
  5. Blood
  6. Bilirubin
  7. Urobilinogen
  8. Nitrite
  9. Leukocyte Esterase
  10. Specific Gravity
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1
Q

What is the purpose of quality control?

A

Ensure that the reagent strips are accurate and precise

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2
Q

What is the normal range for pH?

A

4.5-8.0

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3
Q

What regulates the acid-base balance (pH)?

A

Kidneys and lungs

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4
Q

Clinical Significance of an acid urine (below 6.0)

A

High protein diets, medications, diabetes mellitus, starvation, dehydration, diarrhea, certain renal stones

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5
Q

Clinical Significance of an Alkaline urine (above 6.5)

A

After meals, hyperventilation, vomiting, urease-producing bacteria, vegetarian diet, old specimens, certain renal stones

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6
Q

The pH reagent strip is what kind of system?

A

Double pH indicator

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7
Q

What chemical indicators are used in the pH reagent strip?

A

Methyl Red and Bromthymol Blue

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8
Q

What is the normal value for protein?

A

< 100 mg/ 24 hours

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9
Q

What clinical significance does protein show?

A

Renal disease

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10
Q

Proteins tested for are:

A

Albumin
Serum and tubular microglobulins
Tamm-Horsfall protein
Prostatic, seminal, and vaginal protein secretions

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11
Q

Proteinuria

A

Increase protein in urine ( > 30mg/dL)

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12
Q

What major pathological causes are there to indicate a protein problem?

A
  • Prerenal
  • Renal
  • Postrenal
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13
Q

Prerenal

A

condition affecting plasma prior to kidney; infection/inflammation; too much protein to reabsorb

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14
Q

Renal

A

Glomerular damage and tubular damage

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15
Q

Postrenal

A

Protein added as passes through lower urinary tract

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16
Q

What are nonpathological causes of proteinuria?

A
  • Exposure to cold
  • Strenuous exercise
  • High fever
  • Orthostatic (postural)
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17
Q

Protein Reagent Strip: Indicator

A

Tetrabromphenol blue

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18
Q

What could give you a false positive for protein?

A

*Highly buffered alkaline urines, delay in reading results, high specific gravity

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19
Q

What would give false negatives for a protein?

A

*Measures mostly albumin and may miss other proteins

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20
Q

What confirmatory tests are used for protein?

A

Sulfosalicyclic Acid Precipitation

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21
Q

What is the renal threshold for glucose?

A

160-180 mg/dL

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22
Q

Glycosuria

A

Increase of urine glucose

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23
Q

Causes of glycosuria?

A 
Diabetes mellitus 
Pancreatitis 
Advanced renal disease
Hyperthyroidism 
Emotional stress
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24
Q

What is the chemical basis for the glucose reagent strip?

A

Double sequential enzymatic reaction based on action of glucose oxidase on glucose

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25
Q

What two enzymes are used in the glucose reagent strip?

A

Glucose oxidase

Peroxidase

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26
Q

What could cause a false negative for glucose?

A

Ascorbic acids, ketones, pH, specific gravity, aspirin, low temperatures

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27
Q

What test is done to confirm a positive glucose test?

A

Clinitest

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28
Q

What principle is the clinitest based off of?

A

Uses the benedict principle

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29
Q

Why is the clinitest done on all children under the age of two years old?

A

Detects metabolic disorders like galactose

Catches inborn defects early in life

30
Q

Memorize the comparison of strip to clinitest slide on page 43

A

Page 43 of notes

31
Q

How are ketones produced?

A

Lack of carbohydrates causes increased fat metabolism for energy produces ketone

32
Q

What are the 3 intermediate products of fat metabolism?

A
  1. Acetone (2%)
  2. Acetoacetic Acid (20%)
  3. Beta-hydroxybutyric Acid (78%)
33
Q

Ketonemia

A

Ketones in the blood

34
Q

Ketonuria

A

Ketones in the urine

35
Q

Ketosis

A

Ketones in both blood and urine

36
Q

What is the clinical significance of positive ketones?

A 
Metabolic problem
Diabetes mellitus
Vomiting
Starvation
Dieting
Malabsorption
37
Q

What can an increase in ketones result in?

A

Electrolyte imbalance and dehydration and acidosis and coma

38
Q

What is the chemical basis for the ketones reagent strip?

A

Acetoacetic acid and sodium nitroprusside

39
Q

What is the normal level of ketones in the urine?

40
Q

What is the confirmatory test for ketones?

41
Q

What does blood in the urine indicate?

A

Damage to kidney or urinary tract

42
Q

What is indicated by a positive reagent strip for blood?

A

The presence of red blood cells, hemoglobin, or myoglobin

43
Q

Hematuria

A

Presence of intact RBCs in urine indicating bleeding in the urinary system
**Appears as cloudy, red urine

44
Q

Hemoglobinuria

A

Presence of free hemoglobin in the urine

**Appears as red, clear urine and red plasma

45
Q

Myoglobinuria

A

Myoglobin is a heme-containing protein found in muscle tissue
**Appears red to brown and clear with normal appearing (no red) plasma

46
Q

What is the chemical basis for the blood reagent strip?

A

Peroxidase activity

47
Q

What interferes with the blood reagent strip?

A

Menstruation, ascorbic acid, medications, microbial peroxidases

48
Q

What is bilirubin?

A

A degradation product of hemoglobin and is a highly yellow pigmented compound

49
Q

What does urine bilirubin an indicator of?

A

Metabolic disorders especially with the liver

50
Q

Bilirubinuria

A

Build up of bilirubin

51
Q

What type of bilirubin cause bilirubinuria?

A

Conjugated bilirubin in blood

52
Q

What type of reaction occurs with the bilirubin reagent strip?

A

Diazo Reaction

53
Q

What is the chemical basis for the bilirubin reagent strip?

A

Bilirubin glucuronide

54
Q

What is the confirmatory test for bilirubin?

55
Q

What can interfere with the bilirubin reagent strip?

A 
Ascorbic Acid
Increased nitrites
Medications
Urine pigments
Light
56
Q

What is the normal range of urobilinogen in the urine?

A

.1-1.0 Ehrlich units/dL

57
Q

Urobilinogen (defintion)

A

Breakdown product of bilirubin

58
Q

What is the chemical basis for the urobilinogen reagent strip?

A

Ehrlich’s Aldehyde Reaction

59
Q

What does a positive nitrite always indicate?

A

Bacteriuria (UTI infection)

60
Q

What is the clinical significance of a positive nitrite?

A

Cystitis, pyelonephritis, evaluate antibiotic therapy, screen for urine cultures

61
Q

What type of reaction is the nitrite reagent strip?

A

Greiss Reaction (Diazo reaction)

62
Q

What is the basis for the nitrite reagent strip?

A

Based on bacteria’s ability to reduce nitrate to nitrite

63
Q

What interferes with the nitrite test?

A

Improperly preserved specimen, nonreductase bacteria, lack of urine nitrate, antibiotics

64
Q

What does the leukocyte esterase tests detect?

A

Intact and lysed leukocytes and presence of esterase released from granulocytes and monocytes

65
Q

What does a positive leukocyte esterase test indicate clinically?

A

UTI, UTI inflammation

66
Q

Pyuria

A

Increase WBC in urine

67
Q

What type of reaction is the leukocyte esterase reagent strip?

A

Diazo reaction

68
Q

What can interfere with a leukocyte esterase reagent strip?

A

Ascorbic acid and improper timing

69
Q

Specific Gravity (Defintion)

A

Measure of dissolved substances present in the urine or density of urine

70
Q

What is the normal specific gravity value?

A

1.010-1.030

71
Q

What is the clinical significance of specific gravity?

A

Monitor patient hydration and dehydration

Diabetes insipidus

72
Q

What is the chemical basis for the specific gravity reagent strip?

A

Based on change in pKa of a polyelectrolyte

73
Q

What is the summed up pathway of how an increased specific gravity?

A

Increased specific gravity –> Increased electrolytes –> Increased dissociation of H+ –> Increased H+ –> Decreased pH

Urinalysis (BIOL 380) (4 decks)

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