Week 7 Lab: Urine Chemical Analysis Flashcards
1
Q
intermediate products of fat metabolism
A
Ketone bodies
2
Q
Ketone bodies include?
A
- acetone
- acetoacetic acid
- beta-hydroxybutyric acid
3
Q
Measurable amounts of ketones do not appear in the urine because of the complete metabolism of fats into?
A
carbon dioxide and water
4
Q
Ketone bodies appear in the urine when there is an increase in?
A
fat metabolism
5
Q
Ketone bodies can be seen in the following conditions?
A
- inability to metabolize carbohydrates, as occurs in Diabetes mellitus
- increased loss of carbohydrate from vomiting
- inadequate intake of carbohydrates associated with starvation and weight reduction
6
Q
Ketone bodies can be detected in?
A
urine
7
Q
What reaction is employed in the analysis of ketone bodies?
A
Nitroprusside reaction
8
Q
In Nitroprusside reaction, acetoacetic acid in an alkaline medium will react with sodium nitroprusside to produce?
A
a purple color
9
Q
In Nitroprusside reaction, __________ in an alkaline medium will react with _________ to produce a purple color.
A
acetoacetic acid, sodium nitroprusside
10
Q
Nitroprusside reaction does not measure?
A
beta-hydroxybutyric acid
11
Q
Nitroprusside reaction is only slightly sensitive to?
A
acetone
12
Q
The different tests employing Nitroprusside reaction are?
A
- reagent strip
- acetest
- Legal’s test
- Rothera’s test
13
Q
Acetoacetic acid is also determined using?
A
Gerhardt’s test
14
Q
Gerhardt’s test combines acetoacetic acid with ferric chloride to produce a?
A
red color
15
Q
Gerhardt’s test combines __________ with __________ to produce a red color.
A
acetoacetic acid, ferric chloride
16
Q
It is performed to detect beta-hydroxybutyric acid.
A
Hart’s test
17
Q
In Hart’s Test, the beta-hydroxybutyric acid remained after the removal of acetone and acetoacetic acid by boiling is made to react with?
A
hydrogen peroxide
18
Q
Materials used in tests for the determination of Acetone/Acetoacetic Acid that serves as positive control?
A
acetone
19
Q
Tests for the determination of Acetone/Acetoacetic Acid?
A
- Rothera’s Test
- Legal’s Test
- Acetest
20
Q
Procedure for Rothera’s Test?
A
- Saturate one(1) gm of ammonium sulfate in five(5) cc. of fresh urine
- Add 2 drops of sodium nitroprusside and mix thoroughly
- Overlay with sodium hydroxide and note the development of a purple color at the zone of contact in the presence of diacetic acid or acetone. If the color does not appear immediately stand for 10 to 15 minutes before reporting as negative
21
Q
Procedure for Legal’s Test?
A
- To 3 ml of urine in a test tube, add NaOH or KOH solution just enough to make the urine alkaline
- Add few drops of concentrated acetic acid.
- Add few drops of sodium nitroprusside solution.
- Observe for the solution to turn red to purple in the presence of acetone or acetoacetic acid.
22
Q
Procedure for Acetest?
A
- Place Acetest reagent tablet on a small piece of paper of white surface
- Put a drop of urine on tablet.
- Compare the color tablet with the color chart after 30 seconds Tablet turns purple in the presence of acetone or diacetic acid
23
Q
Diacetic acid: Trace or (+1)
A
10-20 mg%
24
Q
Diacetic acid: Moderate or (+2)
A
25-40 mg%
25
Diacetic acid: Strong or (+3)
over 50 mg%
26
Acetone: Trace or (+1)
25-50 mg%
27
Acetone: Moderate or (+2)
200-250 mg%
28
Acetone: Strong or (+3)
400-1000 mg%
29
Tests for the determination of Diacetic Acid (Acetoacetic Acid)?
1. Gerhardt's Test
2. Lindemann's Test
30
Procedure for Gerhardt's Test (Preliminary)?
To 5 cc. of urine, add 10% FeCl, until all phosphates are precipitated. Filter if necessary
and add more ferric chloride. A bordeaux red color indicates the presence of diacetic acid, aspirin, salicylates, phenol, antipyrine and sodium bicarbonate.
31
Procedure for Gerhardt's Test (Confirmatory Test)
a. To 5 ce of another fresh portion of the urine specimen, add an equal volume of water and a drop of conc HNO, and boil down to the original volume (5 cc). This will convert all the diacetic to acetone which will volatilize
b. Cool and add 10% FeCl
Note: If negative for bordeaux red color, it is positive for the presence of diacetic acid
32
Procedure for Lindemann's Test?
1. To 5 cc of urine, add 2 drops of 20% acetic acid, 3 drops of Iodine solution and 2-3 drops of chloroform
2. Shake gently. The chloroform layer will not change if diacetic acid is present and will become reddish violet if absent.
33
Bilirubin is the degradation product of ________ in the reticuloendothelial system.
hemoglobin
34
Bilirubin is the degradation product of hemoglobin in the?
reticuloendothelial system
35
The released hemoglobin is broken down into its component parts. What are those?
* iron
* protein
* protoporphyrin
36
The protoporphyrin is converted to ______ by the cells of the reticuloendothelial system.
bilirubin
37
The protoprohyrin is converted to bilirubin by the cells of the?
reticuloendothelial system
38
The bilirubin produced binds to _______ where it is transported to the liver for conjugation.
albumin
39
The bilirubin produced binds to albumin where it is transported to the liver for?
conjugation
40
The conjugated bilirubin is excreted into the ________ and then into the intestinal tract via the _________ where it is acted upon by ________ converting it to__________.
bile canaliculi, duodenum, bacteria, urobilinogen
41
The appearance of bilirubin in urine can provide an indication of?
liver damage
42
Bilirubin provides early detection of?
* hepatitis
* cirrhosis
* gallbladder disease
* cancer
43
Routine testing for urinary bilirubin can be done using reagent strips which employs?
diazo reactions and the oxidation tests
44
In the reagent strip test, what reagents could possibly react for bilirubin test?
* bilirubin combines with 2,4-dichloroaniline diazonium salt
* 2,6-dichlorobenzene diazonium combines with 2,4-dichloroaniline diazonium salt
* 2,6-dichlorobenzene diazonium-tetraflouborate in an acid medium
45
Reagent strip test for bilirubin can produce what colors?
increasing degrees of tan or pink to violet
46
Questionable results on the reagent strip for bilirubin can be confirmed using the?
Ictotest
47
Ictotest produces?
a sharply colored diazo reaction
48
Ictotest uses a test tablet which consists of?
* p-toluenesulfonate
* sulfosalicylic acid
* sodium carbonate
* boric acid
49
The reaction between the Ictotest tablet and bilirubin produces a ___________ on the surface of the test mat.
blue or purple color
50
Oxidation tests for bilirubin utilize the ability of?
ferric chloride dissolved in TCA (Fouchet's reagent) to oxidize bilirubin to biliverdin, producing a green color
51
Tests for bilirubin employing oxidation test principle?
1. Gmelin's
2. Harrison test
3. Smith's test
52
Procedure for Gmelin's Test?
1. Measure 20 cc of urine Add 10 cc of 10% BaCl2 solution
2. Mix thoroughly and stand for 4 minutes
3. Filter and discard the filtrate
4. Spread the filter paper on another piece of filter paper and add 1-2 drops of cone HNO3 on the center of filter paper Observe a play of colors from the center towards the periphery yellow, red, violet, blue
53
Procedure for Harrison's Test?
1. To 10 cc of urine, add 5 cc of 10% BaC2
2. Mix and stand for 4 miuntes
3. Filter and then spread the filter paper containing the residue on another piece of dry filter paper
4. On the center of filter paper, add 1 or 2 drops Fouchet's reagent
5. Observe a positive reaction indicated by blue to green color.
54
Procedure for Smith's Test?
1. Four cc of urine is overlayed with 1 cc of diluted iodine solution.
2. Observe an emerald green color at the zone of contact
55
Tests for bilirubin employing diazo reaction principle?
1. Ictotest
2. Reagent strip test
56
Procedure for Ictotest?
1. Moisten the central area of a specially supplied white mat with 4 drops of the urine.
2. Place the Ictotest tablet on the middle of the moistened area
3. Flow two drops of distilled water over the tablet
4. Observe color of the mat around the tablet exactly after 30 sec A positive reaction is buish purple. The concentration of bilirubin is roughly proportional to the color intensity.
57
Procedure for Reagent Strip Test?
1. Dip the reagent strip into the urine. Remove
2. Stand for one minute and observe for a color change.
58
Blood maybe present in the urine either as?
intact red cells or as free hemoglobin
59
The presence of an abnormal number of blood cells in urine is known as?
hematuria
60
It indicates the presence of hemoglobin in urine.
hemoglobinuria
61
True or false: Hematuria is relatively common than hemoglobinuria.
True
62
Major causes of hematuria include?
* renal calculi
* glomerular diseases
* tumors
* trauma
* pyelonephritis
* exposure to toxic chemicals of drugs
63
Hematuria of non-pathologic significance is observed following?
strenous exercise and during menstrual period
64
Hemoglobinuria may occur as the result of?
* lysis of red blood cells produced in the urinary tract
* caused by intravascular hemolysis
65
Lysis of red blood cells in urine will usually show a mixture of?
hemoglobinuria and hematuria
66
No red blood cells will be seen in cases of?
intravascular hemolysis
67
Hemoglobinuria is seen in?
* transfusion reaction
* hemolytic anemia
* severe burns
* infection
* strenous exercise / RBC trauma
68
The presence of blood in the urine can be determined using the?
1. Reagent Strip test
2. Benzidine and Orthotolidine Tests
69
Reagent Strip Reaction principle for Blood?
The test is based on the liberation of oxygen from the peroxide in the reagent strip by peroxidase-like activity of heme from free hemoglobin, lysed erythrocytes, or myoglobin. Intact erythrocytes are lysed on the strip, causing the hemoglobin to react
70
The reagent area for blood is impregnated with?
buffered mixture of an organic peroxide and the chromogen tetramethylbenzidine
71
Procedure for Benzidine Test?
**A. Procedure**
1. To 2 cc of urine, add 1 cc of saturated benzidine solution. Mix (Caution: Reagent is corrosive)
2. Add 1 cc of fresh prepared 3% H2O2, Mix Observe the appearance of green to blue color within 5 minutes.
**B. Procedure**
1. To 2 cc of urine, add I cc of Orthotolidine. (Caution: Reagent is corrosive)
2. Add freshly prepared 3% H2O2, Mix, Observe the appearance of green to blue color within 5 minutes
72
Testing for blood by using benzidine has long been the standard procedure for the
detection of?
occult blood
73
True or false: Benzidine is carcinogenic and the routine use of it has been discouraged.
True
74
The dipstick procedure for blood is based on the?
peroxidaselike activity of hemoglobin and myoglobin which catalyzes the oxidation of a chromogen by an organic peroxide
75
True or false: Most dipsticks are not capable of detecting intact erythrocytes as well as free hemoglobin and myoglobin.
False
76
Intact RBCs in the urine will _________ on the test pad.
hemolyze
77
The freed hemoglobin will react with the reagent on the test pad and will result in?
green spots on a yellow or orange background
78
The presence of intact red cells will give a?
spotted green reaction
79
Free hemoglobin and myoglobin will give what color in the reagent strip?
uniform green or green to dark blue color
80
Blood is usually read at _________, and the color change is from?
60 seconds, orange to green to dark blue
81
Intact RBCs may display a ____________ in the absence of free hemoglobin.
speckle-pattern reaction
82
The results of blood regent strip test are reported as?
trace or moderate numbers of intact RBCs or trace through (large) amounts of hemoglobin
