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urinalysis 1 > strip tests > Flashcards

strip tests Flashcards

1
Q

describe non-diabetic origin of glycosuria

A
  • normal diet
  • hormonal function (increase circulating blood glucose)
  • renal tubule damge
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2
Q

describe renal glycosuria

A

glucose in the absence of hyperglycemia
- normal glucose in blood but still in urine

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3
Q

what causes renal glycosuria

A

renal tubule unable to reabsorb glucose (renal disorders)

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4
Q

describe the glucose strip test reaction steps

A

1) glucose -glucose oxidase + air -> gluconic acid and hydrogen peroxide
2) hydrogen peroxide -peroxidase + chromogen -> oxidized color compound

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5
Q

true or false:
glucose oxidase strip test is specific for only glucose

A

true

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6
Q

list false positive glucose reactions on a strip tests

A

contamination with: peroxide or oxidizing substances

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7
Q

list false negatives of glucose strip tests

A
  • reducing substance (vitamin C)
  • high specific gravity
  • bacteria (from alone 2 hours)
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8
Q

why is first morning specimen not best for glucose UA

A

glucose can remain in bladder over night -> collect 2nd specimen

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9
Q

principle of clinitest

A

measures reducing substances and is not specific for glucose
- galactose, lactose, fructose and pentose

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10
Q

on what age of perosn was clinitest historically done

A

under 24 month old children to test for galactoemia

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11
Q

describe galactosemia

A

lack of galactoe-1-phosphate uridyl transferase enzyme causing lack of galactose -> glucose

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12
Q

why isn’t clinitest used anymore

A
  • galactosemia is now part of new born screening tests using tandem mass spec
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13
Q

name the disorder:
clinitest pos
UA glucose dipstick neg

A

galactosemia

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14
Q

name the disorder
clinitest pos/neg (<200mg)
UA glucose dipstick pos

A

glycosuria

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15
Q

why are ketones monitored

A
  • diabetes mellitus (deficiency of insulin)
  • accumulation of ketones (acidosis, dehydration)
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16
Q

what intermediate ketone product is measured

A

acetoacetic acid

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17
Q

what does acetoacetic acid break down into

A

acetone and BHBA (other main intermediate products)

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18
Q

how are ketones measured on a strip test

A

sodium nitroprusside in alkaline medium

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19
Q

how does acetest differ from dipstick

A

tablet test with sodium nitroprusside and lactose for increased color differentiation

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20
Q

define hematuria and characteristic appearence

A

intact RBC in urine
red and cloudy

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21
Q

define hemoglobinuria and characteristic appearance

A

hemoglobin in urine due to RBC destruction
red and clear

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22
Q

define myoglobinuria and characteristic appearance

A

myoglobin in urine due to muscle destruction
red and clear

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23
Q

what is the clinically significant amount of red blood cells in urine

A

5 RBC/uL

24
Q

what does the blood strip detect

A
  • RBC
  • hemoglobin
  • myoglobin
25
Q

how does the blood strip test detect RBCs, hgb and myoglobnin

A

all have pseudoperoxidase activity

26
Q

define blood reaction on strip test

A
  • peroxide and chromogen -(hgb peroxidase)-> oxidized chromogen
27
Q

list causes of false pos blood strip

A
  • strong ox reagents
  • vegetable peroxidase
  • bacterial peroxidase (e. coli)
28
Q

list causes for false neg blood strip

A
  • high levels of vitamin C
  • reducing agents
29
Q

list cuases of hematuria

A
  • kidney stones
  • glomerular disease
  • tumor
    -trauma
  • pyelonephritis (kidney infection)
  • toxic substances
30
Q

what causes RBCs to lyse in urinary tract

A

in dilute or alkaline urine
still hemoglobinuria

31
Q

how is hemoglobin kept out of urine normally

A

hgb complexed with haptoglobin = too large to filter

32
Q

how does hemosiderin form

A

reabsorption of filtered hemoglobin

33
Q

where does hemosiderin normally accumulate

A

renal tubuluar epithelial cells (RTE) -> causes damage

34
Q

how is myoglobin a probelm

A

breakdown product of skeletal muscle
toxic to renal tubule cells
can cause acute renal failure

35
Q

describe the ammonium sulfate test

A
  • differentiates myoglobin from hemoglobin
  • ammonium sulfate binds hgb and forms sediment when spun
  • myoglobin remains in supernatant when spun
  • supernatent is then tested for blood
36
Q

hemoglobinuria or myoglobinuria:
ammonium sulfate test was preformed and a new strip test was used on the supernatant
strip test pos for blood

A

myoglobinuria

37
Q

what does the presence of bilirubin indicate

A

liver disease
- liver damage or bile duct obstruction

38
Q

list steps in bilirubin breakdown

A
  • RBC
  • hgb
  • protoporphyrin
  • unconjugated bilirubin
  • conjugated bilirubin (liver)
  • urobilinogen (intestine)
  • urobilin (feces)
39
Q

what form of bilirubin is sent back to the liver and kidney

A

urobilinogen

40
Q

what form of bilirubin in urine is indicative of bile duct obstruction

A

conjugated bilirubin
- liver is leaking conjugated material

41
Q

descirbe the bilirubin strip test reaction

A
  • diazo reaction
  • bilirubin and diazonium salt in acid form azodye
42
Q

what form of bilirubin in urine is indicative of liver disease or hemolytic disorders

A

urobilinogen

43
Q

true or false:
absence of urobilinogen from urine and feces is clinically significant

A

true
- a small amount of urobilinogen should be in urine

44
Q

what is ehrlichs reagent

A

part of urobilinogen detection
- p methylaminobenzaldehyde

45
Q

what else will be pos in a ehrlichs reagent tube test

A
  • urobilinogen tube test
  • pos if porphobilinogen is present, indicans and antibiotics
  • not urobilinogen specific
46
Q

describe hoesch reagent

A

ehrlichs reagent in 6M HCl

47
Q

when is hoesch screening test used

A

rapid screening test for urinary porphobilinogen
- red if porpho pos
- urobilinogen inhibited from acidic pH

48
Q

why is nitrite tested

A

bacterial ability to breakdown nitrite to nitrate is significant

49
Q

what test result is combined with nitrite to determine clinical significance

A

leukocyte esterase test
- bacteria and WBC response

50
Q

what specimen is preferred for nitrite testing

A

first morning

51
Q

list false negatives for nitrite test

A
  • bacteria missing reducing enzyme
  • GP and yeast present (no enzyme)
  • ascorbic acid
52
Q

list false pos for nitrite test

A

bacterial over growth from being left out (not fresh sample), color interference

53
Q

describe what leukocyte esterase measures

A

presence of esterase in granulocytic white blood cells
- lysed cells

54
Q

false pos for leukocyte esterase

A

pigmented urine, formalin

55
Q

false negatives of leukocyte esterase test

A

ascorbic acid (binds dizonium)
crenated WBC
antibiotics

urinalysis 1 (13 decks)

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