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95 Cards in this Set
- Front
- Back
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Which reagent strip reaction should be read at the 2 min mark |
Leukocyte Esterase |
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The principal reagent strip test for pH |
A double indicator reaction |
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A urine specimen w a pH of 9.0 indicates |
A new specimen should be collected |
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The protein section of the reagent strip is mostly sensitive to what? |
Albumin |
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The principle of the reagent test for protein is what? |
Protein "error of indicators" |
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The pseudoperoxidase reaction is the principle for the reagent strip test for what? |
Blood |
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Which of the following chemical compounds makes a test for glucose in a reagent strip, specific ? |
Glucose oxidase |
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Reagent strip reactions for blood are based on what? |
The per oxidase activity of hemoglobin |
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A false neg LE reaction may be caused by what? |
The failure to wait 2 min to read the reaction |
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Pre Renal |
H- hemoglobin A- acute phase reactants M- multiple myeloma |
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Renalp |
M- microalbumin O- orthostatic proteinuria P- preeclampsia |
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Post Renal |
V- vaginal inflammation P- prostatitis |
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Myoglobin produces a + blood reaction why? |
Bc it is a heme containing protein |
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What is the correlation between a + bilirubin and a + urobinogin Result? |
The are both associated with Liver Disease |
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In the degradation of hemoglobin (what happens)?a + |
Urobilinogen reabsorbed from the intestine circulates through the kidney |
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A + nitrite test should be accompanied by a _________ |
+ LE Test |
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What produces a + LE test? |
T- trichomonous E- eosinophils N- neutrophils
(Not lymphocytes) |
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The principle of the routine routine protein reagent strip |
Protein error of indicators |
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High levels of ascorbic acid will interfere with all of the following reactions Except? |
Glucose Nitrite Leukocyte Esterase Will all be effected
Keytones are the exceptions |
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A high alkaline pH interferes with all of the following except |
Can interfere with - Urobilinogen (Doesn't effect SG or protein ) |
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What tests form a diazo reaction? |
- Bilirubin - Nitrite - leukocyte Esterase |
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What can cause a + blood reaction? |
-Rhabdomlosis -Transfusion Reaction - Renal calculi
Overdosing on vitamins won't cause a + blood reaction |
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Strenuous exercise can cause what? |
- hemoglobinuria -hematuria - myoglobinuria |
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What can cause a false neg blood reaction? |
Unmixed specimens |
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What differentiates myoglobinuria from hemoglobinuria? |
Pale yellow plasma |
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Causes of myoglobinuria |
C- cholesterol lowering stain medications E- extensive exertion L- long term bed confinement |
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Untreated myoglobinuria can cause what? |
Renal Failure |
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A construction worker pinned under scaffolding for several hours would produce what? |
Myoglobinuria |
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2 major types of reagent strips |
Chemstrips and Multistix |
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How should reagent strips be read? |
From the bottom up |
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Non hemolyzed |
RBCs are entact |
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What temp should urine be mixed |
Room temp |
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Confirmatory Tests |
Tests used to detect the same substances as reagent strips
Protein - sulfosalycillic acid Galactose - Clinitest Keystones - Acetest Bilirubin - ictotest |
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Major regulators of acid base content |
Lungs and kidneys |
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Normal range of urine pH |
4.5- 8.0 First morning 5.0 (slightly more acidic After you eat(postrandial) = more alkaline |
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Renal calculi formation |
Formation of kidney stones |
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What should pH reagent strips measure between? |
5.0- 9.0 |
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Methyl red on a reagent strip |
4 - 6 (red/orange to yellow) |
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Bromthymol Blue on reagent strip |
6-9 green to blue |
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What is protein most indicative of? |
Renal Disease |
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Normal protein range |
< 10 mg / dL or 100 mg/24 hr |
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Tamm Horsfall |
Protein produced by renal tubular epithelial cells |
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Proteinuria range |
30 mg/dL 300 mg /24 hr |
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Prerenal |
Above kidney
Conditions affecting the plasma not the kidney |
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Renal |
Kidney
In proteinuria (glomerular proteinuria Microalbunuria Orthostatic Tubular |
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Post renal |
Below kidney |
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Veggies |
More alkaline |
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Meat |
More acidic |
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Ortho |
Straight |
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Glomelular Proteinuria |
-damage to glomerular membrane - built up of amyloids and other toxins in tissue |
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Bence Jones proteins |
Associated w multiple myeloma - immunoglobulin light chains - |
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Microalbuminuria |
Bad in diabetic patients |
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Orthostatic (postural) proteinuria |
Increases pressure on renal vein when I'm vertical position |
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Tubular proteinuria (also renal) |
Tubular damage affecting reabsorption ability |
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Amount of protein in glomerular disorders |
Glomerular 4 g a day Tubular- much lower levels |
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Trace Values |
< 30 mg /dL |
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Sulfosalycillic Acid precipitation (SSA) |
Confirmatory tear for protein * the cloudier, the higher amount of protein |
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2 Primary Tests used |
Micral Test and immunodip Test |
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DIDNTB |
Sensitive to albumin and nothing else Sensitivity 8-15 mg ( 80- 150 mg/ L |
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Creatinine Reagent Strip |
Color changes from Orange to green to blue
Elevated results - bloody urine and abnormal ursine color
*a lack of creatinine in urine is abnormal |
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Glucose |
Major screening test for diabetes mellitus
- renal threshold =160 to 180 mg/ dL |
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Glycosuria |
Higher blood sugar |
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Ascorbic Acid |
Naturally occurring organic compounds w antioxidant properties (vitamin C) |
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Non diabetic Glycosuria |
Hormonal Disorders: pancreatitis, pancreatic cancer, acromegaly, Cushing's syndrome , hyperthyroidism |
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Renal Glycosuria (Tubular reabsorption disorder) |
End Stage- kidney can't work day to day as needed |
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Cystinosis |
Build up of cystine |
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Fanconis syndrome |
Disorder of kidney tubules (CAnt reabsorb cystine) |
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Cooper reduction Test (Clinitest) |
Clinitest tablets : copper sulfate, sodium carbonate, sodium citrate , sodium hydroxide
Reduction of copper sulfate to cuprous oxide w alkali and heat |
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Reducing Substance (Clinitest) |
Anything that can reduce copper is a reducing substance - not a confirmatory test for glucose but used for galactose
*wont find out if there is galactose in the urine |
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Major use of Clinitest/reducing substance |
Used as a quick screen for " inborn error of metabolism" in children up to 4 yrs old |
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Keystones |
Appear in time when body stores far must be metabolized to supply energy
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3 intermediate products of fat metabolism (associated w keytones) |
Acetone- 2% Acetoacetic- 20% B hydroxbuturate- 78%
*if one keytone is measured on a reagent strip, they are all there |
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Increased fat metabolism = |
Inability to metabolize Carbohydrates |
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Primary causes of keytones |
-diabetes mellitus -vomiting -starvation , malabsorption , dieting -keytonuria |
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Keytonuria |
Shows insulin deficiency (Monitoring diabetes)
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Diabetic ketoacidosis knon |
Increased accumulation of keytones in the blood
Symptoms: Electrolyte imbalance Dehydration Diabetic coma |
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Non diabetic keytonuria |
-inadequate intake of carbs - vomiting -weight loss -eating disorder -frequent strenuous exercise |
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Primary reagent for keytones |
Sodium nitroprusside Acetoacetic acid + reaction = purple |
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Qualitatively |
1+ 2+ 3 + Yes/No |
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Semiquantitative |
5 mg (trace) 15mg 40 mg 80-160 mg (large)
How much?
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Levodopa |
Medication for parkence |
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False + |
Improperly times readings |
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Falsely decreased values |
Improperly preserves specimens |
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Acetest (Can use serum) |
Not a urine confirmatory test -tablet |
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Hematuria |
Intact Rbcs Causes cloudy red urine |
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Hemoglobinuria |
Product of RBC destruction (lised) Causes clear red urune |
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Hematuria symptoms |
Renal calculi Glomerular disease Tumors Trauma Exposure to chemicals |
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Hemoglobinuria symptoms |
Transfusion reactions Hemolytic Anemias Burns Infections Malaria spider bites |
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Hemosideein |
Yellow brown granules in sediment * caused by clumping together of iron molecules |
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Myoglobinuria |
Heme containing protein in muscle tissue (Clear, red/brown urine) |
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False positives w blood in urine |
Menstral contamination Bacterial perixidase |
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False negs of blood urine |
Ascorbic acid > mg High SG Cremated cells Captopril (BP medicine) High nitrite Unmixed specimens |
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Bilirubin |
Early indicator of liver disease |
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Unconjugated billirubin |
Water insoluble instead conjugated w glucoronic acid |
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Conjugated B |
Water soluble From liver to intestines |
