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AMT MLS Exam - Urinalysis & Body Fluids > Urinalysis - Chemical Urinalysis by Reagent Strip > Flashcards

Urinalysis - Chemical Urinalysis by Reagent Strip Flashcards

1
Q

What is the normal pH of a first morning specimen?

A

5-6

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2
Q

What is the normal pH of a random urine specimen?

A

4.5-8

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3
Q

What is the principle of a pH test?

A

double indicator system

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4
Q

What is the significance of urine pH?

A

-acid-base balance
-management of urinary tract infections & renal calculi

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5
Q

pH with a protein/meat diet

A

acid

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6
Q

pH with a vegetarian diet

A

akaline

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7
Q

What is the pH of a improperly preserved urine specimen?

A

9 or above

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8
Q

What is the normal value for urine protein?

A

negative to trace

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9
Q

What is the principle of a urine protein test?

A

protein error of indicator

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10
Q

What is the significance of urine protein?

A

possible renal disease

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11
Q

In a solution that does not contain protein, tetrabromphenol blue, buffered at a pH of 3, is what color?

A

yellow

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12
Q

What protein is the urine protein test most sensitive to?

A

albumin

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13
Q

What would protein results look like in orthostatic proteinuria?

A

-protein would be negative in the first morning sample
-protein would be positive after standing

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14
Q

What is the normal range for glucose in a urine sample?

A

negative

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15
Q

What is the principle of a urine glucose test?

A

glucose oxidase/peroxidase

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16
Q

What is the significance of a positive glucose result?

A

possible diabetes mellitus

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17
Q

What is the normal renal threshold for glucose?

A

160-180 mg/dL

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18
Q

Is the glucose urine test specific for glucose?

A

yes

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19
Q

What is the normal range for urine ketones?

A

negative

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20
Q

What is the principle for the urine ketone test?

A

sodium nitroprusside reaction

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21
Q

What is the significance of ketones in urine?

A

increased fat metabolism due to uncontrolled diabetes, vomiting, starvation, low carb diet, or strenuous exercise

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22
Q

What is the ketone urine test most sensitive to?

A

acetoacetic acid

(less sensitive to acetone)

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23
Q

Does the ketone urine test react with beta-hydroxybutyric acid?

A

no

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24
Q

What is the normal range for blood in urine?

A

negative

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25
Q

What is the principle of the urine blood test?

A

pseudoperoxidase activity of hemoglobin

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26
Q

What is the significance of blood in urine?

A

-hematuria
-hemoglobinuria
-myoglobinuria

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27
Q

What does the reagent strip for blood look like if it is positive due to hemoglobin or myoglobin?

A

uniform in color

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28
Q

What does the reagent strip for blood look like if it is positive due to red blood cells?

A

speckled

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29
Q

What is the normal range for bilirubin in urine?

A

negative

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30
Q

What is the principle of the urine bilirubin test?

A

diazo reaction

31
Q

What is the significance of a positive urine bilirubin?

A

-liver disease
-biliary obstruction

32
Q

What type of bilirubin is excreted in urine?

A

ONLY conjugated bilirubin

33
Q

What is the normal range for urine urobilinogen?

A

1 Ehrlich unit or 1 mg/dL

34
Q

What is the principle of the urine urobilinogen test?

A

Ehrlich aldehyde reaction OR diazo reaction

35
Q

What is the significance of an increased urine urobilinogen result?

A

-liver disease
-hemolytic disorders

36
Q

Do urine reagent strips detect the absence of urobilinogen?

A

no, they only detect increases

37
Q

What is the normal range for urine nitrites?

A

negative

38
Q

What is the principle of the urine nitrite test?

A

Greiss reaction

39
Q

What is the significance of a positive urine nitrite?

A

UTI

40
Q

Why would a nitrite test be positive in cases of UTIs?

A

some bacteria reduce nitrates to nitrites

41
Q

Why is a first morning specimen ideal when testing for nitrites?

A

increased sensitivity when urine has been in the bladder for at least 4 hours

42
Q

What is the normal range for urine leukocyte esterase (LE)?

A

negative

43
Q

What is the principle of the leukocyte esterase test?

A

leukocyte esterase reaction

44
Q

What is the significance of a positive leukocyte esterase?

A

UTI

45
Q

What does the leukocyte esterase test detect?

A

intact and lysed granulocytes and monocytes, NOT lymphocytes

46
Q

What urine reagent strip tests can be used to screen urines for culture?

A

nitrite and leukocyte esterase tests

47
Q

What test on a urine reagent strip has the longest reaction time?

A

leukocyte esterase (2 minutes)

48
Q

What is the normal range for urine specific gravity?

A

Random specimen: 1.003-1.030

49
Q

What is the principle for a urine specific gravity test?

A

pKa change of polyelectrolyte

50
Q

What is the significance of specific gravity?

A

-indication of the kidney’s concentrating ability & state of hydration

51
Q

Why is specific gravity increased in diabetes mellitus?

A

glucose

52
Q

Why is specific gravity decreased in diabetes insipidus?

A

decreased ADH

53
Q

What is reagent strip specific gravity NOT affected by?

A

-urea
-glucose
-radiographic contrast media
-plasma expanders

54
Q

Possible effect of failure to test urine within 2 hours of collection or to preserve correctly

A

changes in chemical composition

55
Q

Possible effect of failure to bring refrigerated specimens to room temperature before testing

A

false-negative enzymatic reactions

56
Q

Possible effect of failure to mix specimen well

A

false-negative leukocyte, blood

-WBCs and RBCs settle out

57
Q

Possible effect of failure to perform quality control

A

erroneous results

58
Q

When should quality control for reagent strips be done?

A

every 24 hours and when opening a new container

59
Q

Possible effect of failure to dip all test pads in urine

A

false-negative reactions

60
Q

Possible effect of prolonged dipping of the reagent strip into urine

A

false-negative reactions

-reagents may leach from pads

61
Q

Possible effect of failure to remove excess urine from the reagent strip

A

runover of chemicals to adjacent pads, distortion of colors

62
Q

Possible effect of failure to read at recommended time

A

erroneous results

63
Q

Possible effect of highly pigmented urine

A

atypical colors, false-positive reactions

-pigment masks true reactions (should test by alternate methods)

64
Q

Possible effect of failure to store test strips properly

A

erroneous results

65
Q

How should urine reagent strips be stored?

A

in capped original container at RT

66
Q

What would cause an increased pH on a reagent strip?

A

improperly preserved specimen

67
Q

What would cause a decreased pH on a reagent strip?

A

acid runover from protein square

68
Q

What would cause a false positive protein result on a reagent strip?

A

-highly buffered alkaline urine
-prolonged dipping
-contaminated container
-increased specific gravity

69
Q

What would cause a false negative protein on a reagent strip?

A

proteins other than albumin

70
Q

What would cause a false positive glucose on a reagent strip?

A

contamination with peroxide or bleach

71
Q

What would cause a false negative glucose on a reagent strip?

A

-improperly preserved specimen
-increased ascorbic acid
-increased specific gravity
-decreased temperature

72
Q

What would cause a false positive blood result on a reagent strip?

A

-menstruation
-oxidizing agents
-bacterial peroxidase

73
Q

What would cause a false negative blood result on a reagent strip?

A

-increased ascorbic acid
-increased nitrite
-increased specific gravity (crenated RBCs)
-unmixed specimen

AMT MLS Exam - Urinalysis & Body Fluids (6 decks)

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