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Biochimie > Urine (Biochimie) > Flashcards

Urine (Biochimie) Flashcards

1
Q

The average daily output of urine is:

  1. 200 ml
  2. 500 ml
  3. 1200 ml
  4. 2500 ml
A

3 - 1200 ml

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2
Q

An unidentified fluid is received in the laboratory with a request to determine whether the fluid is urine or another body fluid. Using routine laboratory tests, what tests would determine that the fluid is most probably urine:

  1. glucose and ketones
  2. urea and creatinine
  3. uric acid and amino acids
  4. protein and amino acids
A

2 - Urea and creatinine

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3
Q

The primary inorganic substance found in urine is:

  1. sodium
  2. phosphate
  3. chloride
  4. calcium
A

3 - chloride

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4
Q

A patient presenting with polyuria, nocturia, polydipsia, and a low urine specific gravity is exhibiting symptoms of:

  1. diabetes insipidus
  2. diabetes mellitus
  3. urinary tract infection
  4. uremia
A

1 - diabetes insipidus

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5
Q

A patient with oliguria might progress to having:

  1. nocturia
  2. polyuria
  3. polydipsia
  4. anuria
A

4 - Anuria

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6
Q

All of the following are characteristics of recommended urine containers except:

  1. a flat bottom
  2. a capacity of 50 ml
  3. a snap on lid
  4. are disposable
A

3 - a snap on lid

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7
Q

Labels for urine containers are:

  1. attached to the container
  2. attached to the lid
  3. placed on the container prior to collection
  4. not detachable
A

3 - placed on the containor prior to collection

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8
Q

A urine specimen may be rejected by the laboratory for all of the following reasons except the fact that the:

  1. requisition states the specimen is catheterized
  2. specimen contains toilet paper
  3. label and requisition do not match
  4. outside of the container has fecal material contamination
A

4 - outside of the container has fecal material contamination

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9
Q

A cloudy specimen received in the laboratory may have been preserved using:

  1. boric acid
  2. chloroform
  3. refrigeration
  4. formalin
A

1 - boric acid

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10
Q

For general screening the most frequently collected specimen is a:

  1. random one
  2. first morning
  3. midstream clean-catch
  4. timed
A

1 - random one

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11
Q

The primary advantage of a first morning specimen over a random specimen is that it:

  1. is less contaminated
  2. is more concentrated
  3. is less concentrated
  4. has a higher volume
A

2 - is more concentrated

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12
Q

If a patient fails to discard the first specimen when collecting a timed specimen the:

  1. specimen must be recollected
  2. results will be falsely elevated
  3. results will be falsely decreased
  4. both 1 and 2
A

4 - both 1 and 2

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13
Q

The primary cause of unsatisfactory results in an unpreserved routine specimen not tested for 8 hours is:

  1. bacterial growth
  2. glycolysis
  3. decreased pH
  4. chemical oxidation
A

1 - bacterial growth

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14
Q

Prolonged exposure of a preserved urine specimen to light will cause:

  1. decreased glucose
  2. increased cells and casts
  3. decreased bilirubin
  4. increased bacteria
A

3 - decreased bilirubin

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15
Q

Which of the following would be least affected in a specimen that has remained unpreserved at room temperature for more than 2 hours:

  1. urobilinogen
  2. ketones
  3. protein
  4. nitrite
A

3 - protein

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16
Q

Bacterial growth in an unpreserved specimen will:

  1. decrease clarity
  2. increase bilirubin
  3. decrease pH
  4. increase glucose
A

1 - decrease clarity

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17
Q

The most sterile specimen collected is a:

  1. catheterized
  2. midstream clean-catch
  3. three-glass
  4. suprapubic aspiration
A

4 - suprapubic aspiration

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18
Q

Which of the following would not be given to a patient prior to the collection of a midstream clean-catch specimen:

  1. sterile container
  2. iodine cleanser
  3. antiseptic towelette
  4. instructions
A

2 - iodine cleanser

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19
Q

Urine specimen collection for drug testing requires the collector to do all of the following except:

  1. inspect the specimen color
  2. perform reagent strip testing
  3. read the specimen temperature
  4. fill out a chain of custody form
A

2 - perform reagent strip testing

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20
Q

The concentration of a normal urine specimen can be estimated by which of the following:

  1. color
  2. clarity
  3. foam
  4. odor
A

1 - color

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21
Q

The normal yellow color of urine is produced by:

  1. bilirubin
  2. hemoglobin
  3. urobilinogen
  4. urochrome
A

4 - urochrom

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22
Q

The presence of bilirubin in a urine specimen produces a:

  1. yellow foam when shaken
  2. white foam when shaken
  3. cloudy specimen
  4. yellow-red specimen
A

1 - yellow foam when shaken

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23
Q

A urine specimen containing melanin will appear:

  1. pale pink
  2. dark yellow
  3. blue green
  4. black
A

4 - black

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24
Q

A patient with a viscous orange specimen may have been:

  1. treated for a urinary tract infection
  2. taking vitamin B pills
  3. eating fresh carrots
  4. taking antidepressants
A

1 - treated for a urinary tract infection

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25
Q

The presence of a pink precipitate in a refrigerated specimen is caused by:

  1. hemoglobin
  2. urobilin
  3. uroerythrin
  4. beets
A

3 - uroerythrin

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26
Q

Microscopic examination of a clear urine that produces a white precipitate after refrigeration will show:

  1. amorphous urates
  2. porphyrins
  3. amourphous phosphates
  4. yeast
A

3 - amorphous phophates

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27
Q

The color of urine containing porphyrins will be:

  1. yellow brown
  2. green
  3. orange
  4. port wine
A

4 - port wine

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28
Q

Which of the following specific gravities would be most likely to correlate with a pale yellow urine:

  1. 1.005
  2. 1.010
  3. 1.020
  4. 1.030
A

1 - 1.005

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29
Q

A urine specific gravity measured by refractometer is 1.029, and the temperature of the urine is 14oC. The specific gravity should be reported as:

  1. 1.023
  2. 1.027
  3. 1.029
  4. 1.032
A

3 - 1.029

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30
Q

The principle of refractive index is to compare:

  1. light velocity in solutions with light velocity in solids
  2. light velocity in air with light velocity in solutions
  3. light scattering by air with light scattering by solutions
  4. light scattering by particles in solution
A

2 - light velocity in air with light velocity in solutions

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31
Q

A correlation exists between a specific gravity by refractometer of 1.050 and a:

  1. 2+ glucose
  2. 2+ protein
  3. first morning specimen
  4. radiographic dye infusion
A

4 - Radiographic dye infusion

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32
Q

A cloudy urine specimen turns black upon standing and has a specific gravity of 1.012. The major concern about this specimen would be:

  1. color
  2. turbidity
  3. specific gravity
  4. all of the above
A

1 - Color

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33
Q

A specimen with a specific gravity of 1.035 would be considered:

  1. isosthenuric
  2. hyposthenuric
  3. hypersthenuric
  4. not urine
A

3 - hypersthenuric

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34
Q

A specimen with a specific gravity of 1.001 would be considered:

  1. hyposthenuric
  2. not urine
  3. hypersthenuric
  4. isothernuric
A

2 - not urine

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35
Q

A strong odor of ammonia in a urine specimen could indicate:

  1. ketones
  2. normalcy
  3. phenylketonuria
  4. an old specimen
A

4 - an old specimen

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36
Q

The microsopic of a clear red urine is reported as many WBCs and epithelial cells. What does this suggests:

  1. urinary tract infection
  2. dilute random specimen
  3. hematuria
  4. possible mixup of specimen and sediment
A

4 - possible mix up of specimen and sediment

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37
Q

Which of the following would contribute the most to a urine osmolality:

  1. one osmole of lucose
  2. one osmole of urea
  3. one osmole of sodium chloride
  4. all contribute equally
A

3 - one osmole of sodium chloride

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38
Q

Which of the following colligative properties is not stated correctly:

  1. the boiling pointing is raised by solute
  2. the freezing point is raised by solute
  3. the vapor pressure is lowered by solute
  4. the osmotic pressure is raised by solute
A

2 - the freezing point is raised by solute

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39
Q

An osmole contains:

  1. one gram molecular weight of solute dissolved in one liter of solvent
  2. one gram molecular weight of solute dissolved in one kilogram of solvent
  3. two gram molecular weights of solute dissolved in one liter of solvent
  4. two gram molecular weights of solute dissolved in one kilogram of solvent
A

2 - one gram molecular weight of solute dissolved in one kilogram of solvent

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40
Q

The unit of osmolality measured in the clinical laboratory is the:

  1. osmole
  2. miliosmole
  3. molecular weight
  4. ionic charge
A

1 - osmole

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41
Q

In the reagent strip specific gravity reaction the polyelectrolyte:

  1. combines with hydrogen ions in response to ion concentration
  2. relases hydrogen ions in response to ion concentration
  3. relases hydrogen ions in response to pH
  4. combines with sodium ions in response to pH
A

2 - relases hydrogen ions in response to ion concentration

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42
Q

Which of the following will react in the reagent strip specific gravity test:

  1. glucose
  2. radiographic dye
  3. protein
  4. chloride
A

4 - chloride

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43
Q

Pourquoi on veut un urine du matin:

A

Les cristaux, les cylindres et les cellules se conservent mieux.

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44
Q

Délai raisonnable pour un échantillon d’urine:

A

2 heures à la température de la pièce et 24 heures au fridge

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45
Q

On ajoute souvent aux collectes d’urine de 24 heures un préservatif dans le but de:

A
  1. réduire l’action bactérienne
  2. réduire la décomposition chimique, soit d’analytes ou éléments formés
  3. solubiliser certains constituants peu solubles
  4. diminuer l’oxydation atmosphérique de composé instables
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46
Q

Les porphyrines sont conservé toujours dans:

A

Une base

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47
Q

Quels sont les préservatifs les plus communs:

A
  1. HCl
  2. acide acétique glacial
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48
Q

Sédiment rosé:

A

Urates amorphes

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49
Q

Sédiment rougeâtre:

A

Cellules rouges

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50
Q

Sédiment blanc ou gris:

A

Posphates amorphes

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51
Q

Urine visqueux filant:

A

Présence de pus ou de sang

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52
Q

Mousse blanche dans l’urine:

A

Présence d’albumine

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53
Q

Présence de mousse jaune dans l’urine:

A

Bilirubine

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54
Q

Odeur de souris:

A

fièvres très élevées

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55
Q

Odeur ammoniaque:

A

Urémie grave, infection, vieille urine

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56
Q

Odeur d’acétone:

A

acidose diabétique

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57
Q

Odeur de sirop d’érable:

A

Aminoacidurie

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58
Q

Urine incolore:

A

fortement dilué

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59
Q

Urine jaune foncé:

A

urine concentré

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60
Q

Urine blanchatre:

A

Pus

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61
Q

Urine grisatre:

A

Phosphates

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62
Q

Urine rosée

A

Urates

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63
Q

Urine laiteuse:

A

graisses

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64
Q

Urine brun, brun-noir

A
  • hématine
  • méthémoglobine
  • mélanine
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65
Q

Urine rougeatre:

A
  • sang
  • myoglobine
  • hémoglobine
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66
Q

Urine verdatre:

A
  • bleu de méthylène
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67
Q

Urine ambre ou acajou:

A

pigments biliaires

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68
Q

Valeurs normales de la gravité spécifique:

A

1.005-1.030 g/ml

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69
Q

Polyurie:

A

> 2.5 L

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70
Q

Oligurie:

A

< 400 ml par jour

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71
Q

Anurie:

A

< 50 ml par jour

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72
Q

Signification clinique d’une gravité spécifique diminuée:

A
  • ingestion de grande quantité de liquide
  • diabète insipide
  • maladie rénale
  • diurétique
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73
Q

Signification clinique d’une gravité spécifique élevée:

A
  • urine du matin
  • diabète mellitus
  • déshydratation
  • protéinurie
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74
Q

Valeur normal du pH:

A

4.5-8.0

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75
Q

Comment on mesure le pH;

A

électrode à pH ou un papier indicateur

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76
Q

Indicateurs de pH sur la bandelette:

A
  1. rouge méthyle: rouge à jaune (4.2-6.3)
  2. bleu de bromothymol: jaune à bleu (6.0-7.6)
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77
Q

Interférence du pH:

A
  1. préservatifs acide/base
  2. drogues (couleurs)
  3. vielle urine (perte de CO2)
  4. présence de bactéries (bactéries convertit l’urée à l’ammoniaque)
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78
Q

Significations cliniques d’un urine acide:

A
  1. diète haute en protéines
  2. jeûne
  3. diabète mellitus
  4. acidose
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79
Q

Significations cliniques d’un urine alcalin:

A
  1. présence de bactéries
  2. alcalose métabolique
  3. alcalose respiratoire
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80
Q

Valeur normal des protéines:

A

Aucun

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81
Q

Principe du test des protéines:

A

Ce test repose sur le principe de l’erreur des indicateurs en présence de protéines.

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82
Q

Réaction des protéines:

A

bleu tetrabromophénol + protéines —————-> bleu vert

                                  <sup>pH 3.0</sup>
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83
Q

Si on veut tester autre chose que l’albumine:

A

On fait un test de précipitation acide avec TCA ou SSA

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84
Q

Quelle est la meilleure indication d’une maladie rénale:

A

La présence de protéines dans l’urine.

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85
Q

Combien de pourcentage de protéines excrétés sont l’albumine:

A

60-90%

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86
Q

Quelle est la protéine responsable pour la formation de cylindres:

A

Tamm-Horsefall

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87
Q

Significations cliniques d’une protéinurie physiologique:

A
  1. excercice excessif
  2. protéinurie orthostatique
  3. grossesse
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88
Q

Signification clinique d’une protéinurie pathologique:

A
  1. syndrome néphrotique
  2. glomérulonéphrite
  3. myélome multiple
  4. fanconi
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89
Q

Faux positif de protéines:

A
  • urine alcaline
  • présence de trace de désinfectant utilisant l’ammoniaque quaternaire
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90
Q

Réactif utilisé pour le test de Bence-Jones:

A

Précipitation des protéines par 1ml de HCl concentré

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91
Q

Syndrome de Fanconie:

A

Tubule rénale

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92
Q

Maladie de Wilson:

A

Diminution de céruloplasmine (transporte le Cu donc augmentation de cuivre dans les tissus)

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93
Q

Maladie d’Addison:

A

Diminution ALD

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94
Q

Valeur normal du glucose dans l’urine:

A

Aucun

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95
Q

Réaction du glucose:

A

Glucose + O2 ————————-> acide gluconique + H2O2

                                          <sup>glucose oxydase</sup>

H2O2 + tétraméthylbenzidine ou KI —————————–> chromogène oxydé + H2O

<span> peroxydase</span>

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96
Q

Faux positif du glucose:

A

oxydants (javex)

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97
Q

Faux négatif du glucose:

A

antioxydants, acide ascorbique

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98
Q

Principe de réaction Bénédict (clinitest):

A

Épreuve de sucres réducteurs

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99
Q

Quels sont les réactifs dans la réaction Bénédict:

A
  1. sulfate de cuivre
  2. acide citrique
  3. NaOH
  4. bicarbonate de sodium
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100
Q

Valeur normal des corps cétoniques:

A

Aucun

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101
Q

Quel est le principe de la réaction des cétones:

A

Réaction de Rothera utilisant le nitroprussiate de sodium.

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102
Q

Réaction de Rothera:

A

nitroprussiate de sodium + acétoacétique ————–> composé violet

Si on veut que l’acétone réagit aussi, on ajoute de la glycine au nitroprussiate

103
Q

Quels sont les pourcentages des corps cétoniques:

A
  • acétoacétique: 20%
  • acétone: 2%
  • ß-hydoxybutiryque 78%
104
Q

Faux positifs des cétones:

A

Drogues

105
Q

Réaction Gerhart:

A

FeCl3 + acétoacétique —————–> couleur rouge vin

106
Q

Acétest:

A

Détecte l’acétoacétique et l’acétone par le nitroprussiate de sodium, la glycine et lactose (meilleur différenciation de la couleur positive)

107
Q

Réaction du sang (hémoglobine)

A

H2O2 + chromogène (tetramethylbenzidine) —————–> chromogène oxydé + H2O

108
Q

Interférences du test hémoglobine:

A

Oxydant/réducteur

109
Q

Valeur normal de l’hémoglobine dans l’urine:

A

aucun

110
Q

Hémoglobinurie:

A

Seulement si haptoglobine est épuisé.

111
Q

Apparence de l’urine si hémoglobinurie:

A

Clair et rouge

112
Q

Apparence de l’urine si hématurie:

A

légèrement trouble et rouge

113
Q

Significations cliniques de l’hématurie:

A
  1. calculs
  2. glomérulonéphrite
  3. pyélonéphrite
  4. menstruations
  5. exercice épuisant
114
Q

Signification clinique d’hémoglobinurie:

A
  1. réactions transfusionnelle
  2. anémie hémolytique
  3. infection
  4. exercice épuisant
115
Q

Signification clinique de myoglobinurie:

A
  1. trauma musculaire
  2. coma
  3. convulsion
  4. maladie de la dégradation musculaire
116
Q

Comment faire la différence entre la myoglobine et l’hémoglobine:

A

L’hémoglobine dans le sang produit un sérum de coloration rouge et la myoglobine produit un sérum de couleur normale.

117
Q

Comment on fait pour dépister la présence de myoglobine:

A

On ajoute du sulfate d’ammonium à l’urine centrifugée. L’urine est filtrée et analysée pour la réaction du sang sur une bandelette. Si la réaction sur la bandelette est positive, la myoglobine est présente.

118
Q

Sang normal perdu dans les selles:

A

2.5 ml, la plupart est convertie en porphyrine par la dégradation des bactéries.

119
Q

Signification clinique du saignement gastro-intestinal:

A
  1. ulcère
  2. carcinome gastrique
  3. cancer colorectal
120
Q

Causes bénignes de saignement gastro-intestinal;

A

Sources de sang provenant du nez, bouche, hémorrhoides et menstruations.

121
Q

Selles noires:

A

Saignement de la voie gastrointestinal supérieure

122
Q

Selles rouges:

A

Saignement de la voie gastrointestinal inférieur

123
Q

Spécimen de selles:

A

Trois spécimens sur 3 jours différents ou consécutifs.

124
Q

Chromogène utilisé pour la détection des selles:

A

Gum guaiac

125
Q

Test de sang occulte utilisé pour:

A

Dépistage pour la détection du début du cancer colorectal

126
Q

Valeur normales des leucocytes dans le sang:

A

aucun

127
Q

Réaction des leucocytes:

A

Ester d’indoxyle ———-> indoxyle + sel diazonuim ————> coloration violette

estérase

128
Q

Faux positif des leucocytes:

A
  • substances pigmentés
  • formaline
  • eau de javel (oxydant)
129
Q

Faux négatifs des leucocytes:

A
  1. surconsommation d’acide ascorbique
  2. protéinurie 1g/l
  3. glucose élevé
130
Q

Valeur normal des nitrites:

A

aucun

131
Q

Réaction des nitrites:

A

p-arsailique + NO2 ——————> composé diazonium —————-> rose

132
Q

Faux positifs de nitrites:

A
  1. vieille urine
  2. substances pigmentés
133
Q

Faux négatifs des nitrites:

A
  1. acide ascorbique
  2. incubation bactérienne
134
Q

Comment longtemps ca prend pour réduction de nitrates en nitrites:

A

4 heures dans la vessie

135
Q

Bactéries plus souvent rencontrés:

A
  1. E. coli
  2. Protéus
  3. Entérobacter
  4. Klebsiella
  5. Non possible avec bactéries Gram positif et levures
136
Q

La zone réactive de la densité contient:

A

Un polyélectrolyte prétraité, un indicateur (bromothymol bleu)

137
Q

Réaction de la densité:

A

HPE (acide faible et polyélectrolyte) ——–> H + PE——–> H + ind bleu —–> vert-jaune
force ionique augmente

138
Q

Valeur normal de la bilirubine:

A

aucun

139
Q

Signification clinique de la bilirubine:

A
  1. obstruction du flux de la bile du foie à l’intestin
  2. calculs biliaires
  3. carcinome de la tête du pancréas
  4. processus inflammatoire dans le foie
140
Q

Qu’est ce qui est utile dans le diagnostique différentielle de la jaunisse:

A
  • bilirubine urinaire
  • urobilinogène urinaire
  • couleur fécale
141
Q

Réaction Diazo

A

bilirubine conjugée + sel diazonium ————–> azobilirubine (poupre)

142
Q

Faux négatifs de la bilirubine:

A

La lumière et l’air oxyde la bilirubine en biliverdine ou hydrolyse la conjugaison.

143
Q

Valeur normal de la densité:

A

1.010-1.025

144
Q

Valeur normal de l’urobilinogène:

A

3-17 umol/L

145
Q

Une augmentation de l’urobilinogène urinaire s’observe:

A
  • certaines maladies du foie
  • anémie hémolytique
146
Q

Une diminution de l’urobilinogène urinaire s’observe:

A

Obstruction des voies biliaires

147
Q

Couleur des selles durant un blocage des voies biliaires:

A

Blanc gris

148
Q

Nom de réaction pour l’urobilinogène:

A

Réaction de Ehrich

149
Q

Quel test doit on faire pour différencier porphobilinogène des urobilinogènes:

A

Test Watson-Swartz

150
Q

Réaction de l’urobilinogène:

A

p-diméthylaminobenzaldéhyde + UBG ———————-> coloration rose à rouge

151
Q

Spécimen utilisé pour l’urobilinogène:

A

Préférablement prélevé entre 2-4 pm, frais car l’urobilinogène se transforme en urobiline avec le contact de l’air.

152
Q

Formation de l’hémoglobine:

A

Glycine ⇒ PBG ⇒ URO ⇒ COPRO ⇒ PROTO ⇒ PROTO ⇒ Hème ⇒ hémoglobine

153
Q

Solubilité de l’urobilinogène:

A

L’urobilinogène est soluble dans le chloroforme et butanol

154
Q

Solubilité du prophobilinogène:

A

Il est insoluble dans le chloroforme et butanol

155
Q

Quels sont les réactifs pour les porphyrines:

A
  1. réactif Ehrlich
  2. chloroforme
  3. butanol
156
Q

Interprétation du test Watson-Schwartz:

A

Chloroforme:

  • couche rose sur le dessus ⇒ PBG
  • couche rose sur le dessous ⇒ UBG

Butanol:

  • couche rose sur le dessus ⇒UBG
  • couche rose sur le dessous ⇒ PBG
157
Q

La méthode UV détecte quoi?

A
  • Uroporphyrinogène
  • corproporphyrinogène
  • protoporphyrinogène
158
Q

Vitesse de centrifugation

A

1500-2000 rpm

159
Q

Colorant pour les lipides

A

Huile o rouge et sudan

160
Q

Quescequi peut aider a identifier les GB des GR

A

Sternheimer-malbin (cristal de violet et safranine)

161
Q

Etapes de formation des cylindres

A
  1. Agrégation de protéines tamm-horsefall dans des fibrilles de protéines
  2. attachement des fibrilles a la surface des cellules épitheliales pour les prévenirs detr emportés avec le filtrat
  3. les fibrilles s’entrelacent ensemble pour former une structure solide. Cest a ce point ou les elements peuvent etre captés par les cylindres
  4. ils sont formés plutot durant une stase renale suffisante. Sous leffet de la pression du filtrat, les cylindres se degagent et se trouvent dans lurine
162
Q

Quels sont les facteurs qui améliorent la formation des cylindres incluent :

A
  1. Ph acide
  2. augmentation de la concentration des solutés
  3. stase urinaire
  4. augmentation de la concentration des proteines dans le filtrat
163
Q

Identification des cylindres

A

Faiblr grossissement et illumination réduite

164
Q

En grand nombre, les cylindes sont associes avec:

A
  1. Glomerulonephrite
  2. pyelonephrite
  3. maladie renale chronique
  4. maladie congestive du coeur
165
Q

Quel cylindre demontre un empoisonnement a l’éthylene glycol

A

Cylindre a inclusion de cellules epitheliales tubulaires

166
Q

Les GR ont tendances a se lyser dans un urine

A

Alcaline et/ou hypotonique

167
Q

Les GR ont tendance a se creneler dans une urine

A

Hypertonique

168
Q

Pour avoir des cristaux cholesterol

A

Proteines au moins 3g/L

169
Q

Cristaux dun urine acide normal

A
  • Acide urique
  • urates amorphes
  • oxalate de calcium
170
Q

Cristaux dun urine alcalin normal

A
  • Phosphates amorphes
  • phosphates de calcium
  • triple phosphate
  • carbonate de calcium
  • urate d’ammonium
171
Q

Reaction de bilirubine

A

Protoporphyrine ⇒ biliverdine——–> bilirubine

Oxydation. Reduction

172
Q

Combien de urobilinogene formé est réabsorbé dans la circulation sanguine

A

20%

173
Q

Combien d’urobilinogene est amené au reins

A

2-5%

174
Q

Quels sont les 3 types de jaunisse

A
  1. Préhaptique
  2. hépatique
  3. post hépatique
175
Q

Maladies prehepatique

A

Defaut dans les GR, production ou destruction

176
Q

Maladies hepatique

A
  • Defaut dans le transport de bilirubine dans les cellules hepatiques: maladie Gilbert
177
Q

Defaut de conjugaison

A
  • Jaunisse neonatale
  • syndrome crigler-najjar
178
Q

Perturbation dans le transport de la bilirubine des cellules hepatiques a la vesicule biliaire

A

Maladie dubin-johnson et syndrome rotor

179
Q

Posthepatique

A

Obstruction mecanique du flux de bili conj dans l’intestin (carcinome, calcul)

180
Q

P. 5 tableau

A

:D

181
Q

Association substance-test:

A
  • pH
    • Bandelettes: rouge méthyle et bleu de bromothymol
  • Protéines (albumine)
    • Bandelettes: bleu tetrabromophénol
  • Autres protéines
    • Précipitation acide: TCA ou SSA
    • Bence-Jones: HCl
  • Glucose
    • Trinder: tétraméthylbenzidine ou KI
    • Clinitest (réaction Bénédict): Sulfate de cuivre, NaOH
  • Corps cétoniques (acétoacétique)
    • bandelettes (réaction Rothera): nitroprussiate de sodium
    • réaction Gerhart: FeCl3
  • Corps cétoniques (acétoacétique et acétone)
    • bandelettes: nitroprussiate de sodium et glycine
    • Acétest: nitroprussiate de sodium, glycine et lactose
  • Sang (hémoglobine)
    • Bandelette: tetramethylbenzidine
  • Sang (myoglobine)
    • Bandelette: sulfate d’ammonium
  • Sang occulte
    • Gum guaiac
  • Leucocytes
    • Bandelettes: indoxyle, sel diazonium
  • Nitrites
    • réaction Greiss: p-arsanilique et composé diazonium
  • Densité
    • bandelette: polyélectrolyte et bromothymol bleu
  • Bilirubine
    • réaction Diazo: sel diazonium
  • Urobilinogène
    • réaction Ehrlich: p-diméthylaminobenzaldéhyde
  • Porphyrines
    • Watson-Schwartz: réactif Ehrlich, chloroforme, butanol
    • détection UV
      *
182
Q

Leaving excess urine on the reagent strip after removing it form the specimen will:

  1. cause run-over between reagent pads
  2. alter the color of the specimen
  3. cause reagents to leach from the pads
  4. not affect the chemical reactions
A

1 - Cause run over between reagent pads

183
Q

Failure to mix a specimen before inserting the reagent strip will primarily affect the:

  1. glucose reading
  2. blood reading
  3. leukocyte reading
  4. both B and C
A

4 - both B and C

184
Q

Testing a refrigerated specimen that has not warmed to room temperature will adversely affect:

  1. enzymatic reactions
  2. dye-binding reactions
  3. the sodium nitroprusside reaction
  4. diazo reactions
A

1 - enzymatic reactions

185
Q

The reagent strip reaction that requires the longest reaction time is the:

  1. bilirubin
  2. pH
  3. leukocyte esterase
  4. glucose
A

3 - leukocyte esterase

186
Q

Quality control of reagent strips is performed:

  1. using positive and negative controls
  2. when results are questionable
  3. at least once every 24 hours
  4. all of the above
A

4 - all of the above

187
Q

All of the following are important to protect the integrity of reagent strips except:

  1. removing the desiccant from the bottle
  2. storing in an opaque bottle
  3. storing at room temperature
  4. resealing the bottle after removing the strip
A

1 - removing the desiccant from the bottle

188
Q

The principle of the reagent strip for pH is the:

  1. protein error of indicators
  2. greiss reaction
  3. dissociation of a polyelectrolyte
  4. double indicator reaction
A

4 - double indicator reaction

189
Q

A urine specimen with a pH of 9.0

  1. indicates metabolic acidosis
  2. should be recollected
  3. may contain calcium oxalate crystals
  4. is seen after drinking cranberry juice
A

2 - should be recollected

190
Q

In the laboratory, a primary consideration associated with pH is:

  1. identifying urinary crystals
  2. monitoring vegetarian diets
  3. determining specimen acceptability
  4. both 1 and 3
A

4 - both 1 and 3

191
Q

Source of Microalbuminuria:

A

Renal

192
Q

Source of acute phase reactants:

A

Prerenal

193
Q

Source for pre-eclampsia:

A

Renal

194
Q

Source for vaginal inflammation:

A

Post renal

195
Q

Source for multiple myeloma:

A

Prerenal

196
Q

Source for orthostatic proteinuria:

A

Renal

197
Q

Source for prostatitis:

A

Postrenal

198
Q

The principle of the protein error of indicators reaction is that:

  1. protein keeps the pH of the urine constant
  2. albumin accepts hydrogen ions from the indicator
  3. the indicator accepts hydrogen ions from albumin
  4. albumin changes the pH of the urine
A

2 - albumin accepts hydrogen ions from the indicator

199
Q

All of the following will cause false-positives protein reagent strip values except:

  1. microalbuminuria
  2. highly buffered alkaline urines
  3. delay in removing the reagent strip from the specimen
  4. contamination by quaternary ammonium compounds
A

1 - microalbuminuria

200
Q

A patient with a 2+ protein reading in the afternoon is asked to submit a first morning specimen. The second specimen has a negative protein reading. This patient is:

  1. positive for orthostatic protenuria
  2. negative for orthostatic proteinuria
  3. positive for Benje Jones protein
  4. negative for clinical proteinuria
A

1 - positive for orthostatic proteinuria

201
Q

Testing for microalbuminuria is valuable for early detection of kidney disease and monitoring patients with:

  1. hypertension
  2. diabetes mellitus
  3. cardiovascular disease risk
  4. all of the above
A

4 - all of the above

202
Q

The primary chemical on the reagent strip in the Micral-test for microalbumin binds to:

  1. protein
  2. antihuman albumin antibody
  3. conjugated enzyme
  4. galactoside
A

2 - antihuman albumin antibody

203
Q

All of the following are true for the ImmunoDip test for microalbumin except:

  1. unbound antibody migrates farther than bound antibody
  2. blue latex particles are coated with antihuman albumin antibody
  3. bound antibody migrates further than unbound antibody
  4. it utilizes an immunochromographic principle
A

1 - unbound antibody migrates farther than bound antibody

204
Q

The principle of the protein-high pad on the Multistix Pro reagent strip is the:

  1. diazo reaction
  2. enzymatic dye-binding reaction
  3. protein error of indicators
  4. microalbumin-micral-test
A

3 - Protein error of indicators

205
Q

Which of the following is not tested on the Multistix pro reagent strip:

  1. urobilinogen
  2. specific gravity
  3. creatinine
  4. protein-high
A

1 - urobilinogen

206
Q

The principle of the protein-low reagent pad on the multistix pro is the:

  1. binding of albumin to sulphonphthalein dye
  2. immunologic binding of albumin to antibody
  3. reverse protein error of indicators reaction
  4. enzymatic reaction between albumin and dye
A

1 - binding of albumin to sulphonphtalein dye

207
Q

The principle of the creatinine reagent pad on microalbumin reagent strip is the:

  1. double indicator reaction
  2. diazo reaction
  3. pseudoperoxidase reaction
  4. reduction of a chromogen
A

3 - pseudoperoxidase reaction

208
Q

The purpose of performing an albumin : creatinine ratio is to:

  1. estimate the glomerular filtration rate
  2. correct for hydration in random specimens
  3. avoid interference for alkaline urines
  4. correct for abnormally colored urines
A

1 - estimate the glomerular filtration rate

209
Q

A patient with a normal blood glucose and a positive urine glucose should be further checked for:

  1. diabetes mellitus
  2. renal disease
  3. gestational diabetes
  4. pancreatitis
A

2 - renal disease

210
Q

The principle of the reagent strip tests for glucose is the:

  1. peroxidase activity of glucose
  2. glucose oxidase reaction
  3. double sequential enzyme reaction
  4. dye-binding of glucose and chromogen
A

3 - double sequential enzyme reaction

211
Q

All of the following may produce false-negative glucose reactions except:

  1. detergent contamination
  2. ascorbic acid
  3. unpreserved specimens
  4. low urine temperature
A

1 - detergent contamination

212
Q

The primary reason for performing a Clinitest is to:

  1. check for high ascorbic acid levels
  2. confirm a positive reagent strip glucose
  3. check for newborn galactosuria
  4. confirm a negative glucose reading
A

3 - check for newborn galactosuria

213
Q

The three intermediate products of fat metabolism include all of the following except:

  1. acetoacetic acid
  2. ketoacetic acid
  3. b-hydroxybutyric acid
  4. acetone
A

2 - ketoacetic acid

214
Q

the most significant reagent strip test that is associated with a positive ketone result is:

  1. glucose
  2. protein
  3. pH
  4. specific gravity
A

1 - glucose

215
Q

The primary reagent in the reagent strip test for ketones is:

  1. glycine
  2. lactose
  3. sodium hydroxide
  4. sodium nitroprusside
A

4 - sodium nitroprusside

216
Q

Ketonuria may be caused by all of the following except:

  1. bacterial infections
  2. diabetic acidosis
  3. starvation
  4. vomiting
A

1 - bacterial infections

217
Q

Urinalysis on a patient with severe back and abdominal pain is frequently performed to check for:

  1. glucosuria
  2. proteinuria
  3. hematuria
  4. hemoglobinuria
A

3 - hematuria

218
Q

What is associated with transfusion reactions:

A

Hemoglobinuria

219
Q

What is associated with clear red urine and pale yellow plasma:

A

`Myoglobinuria

220
Q

What is associated with clear red urine and red plasma:

A

hemoglobinuria

221
Q

What is associated with rhabdomyolysis:

A

Myoglobinuria

222
Q

What produces hemosiderin granules in urinary sediments:

A

Hemoglobinuria

223
Q

What is associated with acute renal failure:

A

Myoglobinuria

224
Q

The principle of the reagent strip test for blood is based on the:

  1. binding of heme and a chromogenic dye
  2. peroxidase activity of heme
  3. reaction of peroxide and chromogen
  4. diazo activity of heme
A

2 - peroxidase activty of heme

225
Q

A speckled pattern on the blood pad of the reagent strip indicates:

  1. hematuria
  2. hemoglobinuria
  3. myoglobinuria
  4. all of the above
A

1 - Hematuria

226
Q

The principle of the reagent strip test for bilirubin is the:

  1. diazo reaction
  2. ehrlich reaction
  3. greiss reaction
  4. peroxidase reaction
A

1 - Diazo reaction

227
Q

An elevated urine bilirubin with a normal urobilinogen is indicative of:

  1. cirrhosis of the liver
  2. hemolytic disease
  3. hepatitis
  4. biliary obstruction
A

4 - biliary obstruction

228
Q

The primary cause of a false-negative bilirubin reaction is:

  1. highly pigmented urine
  2. specimen contamination
  3. specimen exposure to light
  4. excess conjugated bilirubin
A

3 - specimen exposure to light

229
Q

The purpose of the special mat supplied with the Ictotest tablets is that:

  1. bilirubin remains on the surface of the mat
  2. it contains the dye needed to produce color
  3. it removes interfering substances
  4. bilirubin is absorbed into the mat
A

1 - bilirubin remains on the surface of the mat

230
Q

The reagent in the Multistix reaction for urobilinogen is:

  1. a diazonium salt
  2. tetramethylbenzidine
  3. p-dimethylaminobenzaldehyde
  4. hoesch reagent
A

3 - p-dimethylaminobenzaldehyde

231
Q

The primary problem with urobilinogen tests using Ehrlich reagent is:

  1. positive reactions with porphobilinogen
  2. lack of specificity
  3. positive reactions with Ehrlich’s reactive substances
  4. all of the above
A

1 - Positive reactions with porphobilinogen

232
Q

The reagent strip test for nitrite uses the:

  1. greiss reaction
  2. ehrlich reaction
  3. peroxidase reaction
  4. pseudoperoxidase reaction
A

2 - Ehrlich reaction

233
Q

All of the following can cause a negative nitrate reading except:

  1. gram positive bacteria
  2. gram negative bacteria
  3. random urine specimen
  4. heavy bacterial infections
A

2 - gram negative bacteria

234
Q

A positive nitrite test and a negative leukocyte esterase test is an indication of a:

  1. dilute random specimen
  2. speciman with lysed leukocytes
  3. vaginal yeast infection
  4. specimen older than 2 hours
A

4 - specimen older than 2 hours

235
Q

All of the following can be detected by the leukocyte esterase reaction except:

  1. neutrophils
  2. eosinophils
  3. lymphocytes
  4. basophils
A

3 - lymphocytes

236
Q

pH

A

Bandelettes - rouge méthyle et bleu bromophénol

237
Q
A
238
Q

Protéines (albumine)

A

Bandelettes: bleu tetrabromophénol

239
Q

Autres protéines

A

Précipitation acide: TCA ou SSA

240
Q

Bence-Jones

A

HCl

241
Q

Glucose

A
  • Trinder: tétraméthylbenzidine ou KI
  • Clinitest (réaction Bénédict): Sulfate de cuivre, NaOH
242
Q

Corps cétoniques (acétoacétique)

A
  • bandelettes (réaction Rothera): nitroprussiate de sodium
  • réaction Gerhart: FeCl3
243
Q

Corps cétoniques (acétoactéique et acétone)

A
  • bandelettes: nitroprussiate de sodium et glycine
  • Acétest: nitroprussiate de sodium, glycine et lactose
244
Q

Sang (hémoglobine)

A

Bandelette: tetramethylbenzidine

245
Q

Sang (myoglobine)

A

Bandelette: sulfate d’ammonium

246
Q

Sang occulte

A

Gum guaiac

247
Q

Leucocytes

A

Bandelettes: indoxyle, sel diazonium

248
Q

Nitrites

A

réaction Greiss: p-arsanilique et composé diazonium

249
Q

Densité

A

bandelette: polyélectrolyte et bromothymol bleu

250
Q

Bilirubine

A

réaction Diazo: sel diazonium

251
Q

Urobilinogène

A

réaction Ehrlich: p-diméthylaminobenzaldéhyde

252
Q

Porphyrines

A
  • Watson-Schwartz: réactif Ehrlich, chloroforme, butanol
  • détection UV
253
Q
A

Biochimie (21 decks)

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