Term
| What is the manual confirmatory test for bilirubin? |
|
Definition
| Ictotest. It uses the diazo reaction but produces a sharper color than the reagen strip. |
|
|
Term
| What are the interferences for the Acetest? |
|
Definition
There are minimal interferences but large doses of Levodopa can cause a false-negative.
Phthalein dyes can cause color interferences.
Phenylketones can distort color. |
|
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Term
|
Definition
| A protein found in muscle tissue. Will show up on the blood reagent strip test even though it has nothing to do with blood. |
|
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Term
How do the kidneys regulate the
acid-base balance? |
|
Definition
| The secretion of hydrogen ions in the form of ammonium ions and hydrogen phosphates and by the reabsorption of bicarbonate. |
|
|
Term
| When does conjugated bilirubin appear in urine? |
|
Definition
| When the normal breakdown cycle is disrupted by an obstruction of the bile duct or when the liver is damaged. Cirrhosis and hepatitis for example. |
|
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Term
|
Definition
| The presence of protein in urine. |
|
|
Term
| What is the normal amount of ketones found in urine? |
|
Definition
| Normally ketones are not present in urine in measureable amounts. |
|
|
Term
| Urine crystals are dependent on what? |
|
Definition
| pH. Certain types of crystals are formed in acidic urines and certain types are formed in alkaline urines. |
|
|
Term
| How many stip tests can you perform at one time? |
|
Definition
|
|
Term
|
Definition
| Myoglobin in the urine. It produces clear, red urine and reacts with the blood test pad on the reagent strip eve though it has nothing to do with blood. |
|
|
Term
| What causes the speckled pattern on the blood test pad on the reagent strip? |
|
Definition
| Intact red blood cells are lysed to release hemoglobin and cause the reaction. |
|
|
Term
| What are the two major types of reagent strips? |
|
Definition
|
|
Term
| What are some causes of Hyposthenuria? |
|
Definition
| Diabetes Insipidus, Glomerluonephritis, an Pyelonephritis (tubular damage) |
|
|
Term
| How do we differentiate Hemoglobinuria from Myoglobinuria? |
|
Definition
1. Look at the patient history.
2. Look at the serum. Hemoglobinuria makes serum red or pink. Myoglobinuria has normal looking serum.
3. Precipitation test. Add ammonium sulfate to urine. Hemoglobinura will precipitate, myoglobinuria will not. |
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Term
|
Definition
| The freezing point of urine by supercooling a measured amount to approx. 27º C. |
|
|
Term
| What are the possible causes of intravascular hemolysis? |
|
Definition
| Transfusion reaction, the body can destroy its own blood cells, cells may be lysed in the urinary tract in the filtration process. This causes free hemoglobin to be floating around. |
|
|
Term
| What is glomerular membrane damage? |
|
Definition
| The membrane is damaged and selective filtration is impaired. This causes increased amounts of serum albumin and large globulin molecules are excreted in the urine. |
|
|
Term
| What is the sensitivity of the blood reagen pad? |
|
Definition
| It can detect concentrations between 5-10 RBC/μl. It is more sensitive to free hemoglobin than intact red blood cells. |
|
|
Term
| How does large amounts of hematuria appear on a phyiscal exam of urine? |
|
Definition
|
|
Term
|
Definition
| A transport protein for hemoglobin. It makes the hemoglobin too big to be filtered by the glomerulus. |
|
|
Term
| How much protein does normal urine contain? |
|
Definition
|
|
Term
| What is the manual test for ketones? |
|
Definition
|
|
Term
|
Definition
| Protein produced by the tubules and proteins from the prostatic, seminal and vaginal secretions. |
|
|
Term
| What factors can result in inaccurate reporting? |
|
Definition
| Technical carelessness, interfering substanes and color blindness. |
|
|
Term
| What routine chemical test of urine is the most indicative of renal disease? |
|
Definition
|
|
Term
| What is the pH range of the reagent strip? |
|
Definition
|
|
Term
|
Definition
| High specific gravity due to excessive water loss, congestive heart failure and adrenal insufficiency. |
|
|
Term
| Elevated concentrations of protein do what to the specific gravity readings? |
|
Definition
| Slightly increases the readings as the result of protein ions. |
|
|
Term
| What is the biggest variable in reagent strip interpretation. |
|
Definition
|
|
Term
| Can you perform tests on urine right out of the refrigerator? |
|
Definition
| No. It must warm to room temperature first. |
|
|
Term
| What conditions are associated with muscular destruction? |
|
Definition
| Trauma, prolonged coma, convulsions, muscle wasting disease and extensive exertion. |
|
|
Term
| Why is the Ictotest performed? |
|
Definition
| it is more sensitive than the reagent strip and less susceptible to interfering substances. |
|
|
Term
| How do you perform QC on reagent strips? |
|
Definition
| Compare with known positive and negative controls that have a very similar matrix as urine. |
|
|
Term
| What is the significance of unconjugated bilirubin? |
|
Definition
| it cannot cross the glomerular membrane. When it builds up it causes juandice. |
|
|
Term
| What is specific gravity used for? |
|
Definition
| To monitor hydration and dehydration, loss of renal tubular concentrating ability, diabetes insipidus and to determine unsatisfactory specimens. |
|
|
Term
| What must reagent strips be protected from? |
|
Definition
| Deterioration caused by moisture, volatile chemicals, heat and light. They must not be refrigerated. |
|
|
Term
| What are the major regulators of the acid-base balance of the body? |
|
Definition
| The kidneys and the lungs. |
|
|
Term
|
Definition
| Precipitation of inorganic chemicals dissolved in the urine. |
|
|
Term
| What is the color range of the Diazo reaction? |
|
Definition
| Pink to violet. Color reaction of bilirubin is the hardest to interpret because of the natural pigmen of the urine. |
|
|
Term
| For specific gravity what are reagent strip reactions based on? |
|
Definition
| The change of pKa of a polyelectrolyte in an alkaline medium. |
|
|
Term
| What are some of the non-pathological causes of hematuria? |
|
Definition
| Strenuous exercise and menstration. |
|
|
Term
| What is not measured inthe ketone test? |
|
Definition
| Beta-hydroxybutyric acid. It's only slightly sensitive to acetone. Their presense is assumed. |
|
|
Term
| Reagent strips provide a simple, rapid way of performing how many chemical tests? |
|
Definition
|
|
Term
| What is unconjugated bilirubin? |
|
Definition
| Bilirubin that is water insoluble and bound to albumin. |
|
|
Term
| What must you document when open a new bottle of reagent strips? |
|
Definition
| The date the container is opened. |
|
|
Term
| What happens to the indicator as specific gravity increases? |
|
Definition
| It changes from blue (1.000 alkaline) through shades of green to yellow (1.030 acid) |
|
|
Term
| What are some pathological causes of hematuria? |
|
Definition
| Renal calculi, glomerular disease, tumors, trauma, pyelonephritis, and exposure to toxic chemicals or drugs. |
|
|
Term
| What reaction is used in the reagent strip test for ketones? |
|
Definition
| The sodium nitroprusside reaction. Acetoacetic acid reacts with Sodium Nitroprusside to produce a purple color. |
|
|
Term
| What is the osmolality range for urine? |
|
Definition
|
|
Term
| What is the normal osmolality of serum? |
|
Definition
|
|
Term
|
Definition
| Fixed specific gravity of 1.010. This indicates severe renal damage because that is the specific gravity of the specimen before it starts the filtration process. |
|
|
Term
| What is a non-pathological condition for hemoglobinuria? |
|
Definition
|
|
Term
| What is intravascular hemolysis? |
|
Definition
| Red blood cells are being lysed inside the vessels. |
|
|
Term
| Allowing the reagent strip to remain in the urine too long can result in what? |
|
Definition
| Leaching of the reagents from the pad and causes runover between the chemicals. |
|
|
Term
| What interferes with urinary pH measurement? |
|
Definition
| No know substance interferes but be careful of runover. |
|
|
Term
| What is conjugated bilirubin? |
|
Definition
| In the liver the bilirubin is released from albumin and bound to glucuronic acid making it water soluble. |
|
|
Term
|
Definition
| Low specific gravity. 1.001-1.003. Kidneys can't concentrate. |
|
|
Term
| What is the nitroprusside reaction sometimes referred to? |
|
Definition
|
|
Term
| What does increased ketones in the blood lead to? |
|
Definition
| Electrolyte imbalance, dehydration, acidosis and diabetic coma. |
|
|
Term
| Specimens with a pH of 6.5 or higher does what to Specific Gravity readings? |
|
Definition
| Decreases readings so you have to add 0.005 to the measurement. |
|
|
Term
| What is the Diazo reaction? |
|
Definition
| Bilirubin combines with 2,4 -dichloroalinine diazonium salt or 2,6 dichlorobenzenene-tetrafluroborate in an acid medium to produce a color change. |
|
|
Term
| How is blood in urine viewed in a microscopic exam? |
|
Definition
| Intact red blood cells can be seen but lysed cells cannot. |
|
|
Term
| Because of its low molecular weight what is the major serum protein found in normal urine? |
|
Definition
|
|
Term
| What is the significance of bilirubin in the urine? |
|
Definition
Early indicator of liver disease
Hepatitis
Cirrhosis
Gallbladder disease
Cancer |
|
|
Term
| Solute dissolved in solvent causes what changes in colligative properties? |
|
Definition
| Lower freezing point, higher boiling point, increased osmotic pressure and lower vapar pressure. |
|
|
Term
| What is the specific gravity for water and an average urine? |
|
Definition
Water is 1.000
The Average urine is 1.015-1.025 |
|
|
Term
| What is the sensitivity for the specific gravity test? |
|
Definition
|
|
Term
| What does bilirubin oxidize to? |
|
Definition
| biliverdin which does not react with the test method. |
|
|
Term
| How do you calibrate a refractometer? |
|
Definition
| With deionized water. Check with 5% sodium chloride and 9% sucrose. |
|
|
Term
| What factors influence osmolarity? |
|
Definition
| lipemic serum, lactic acid, volatile substances such as ethanol. |
|
|
Term
| What does the refractometer measure? |
|
Definition
| Refractive index. Compares the velocity of the light in air to the velocity of light in urine. |
|
|
Term
| What are the normal values for pH in urine? |
|
Definition
| There are no normal values because it can range from 4.5-8.0 |
|
|
Term
| How do large amounts of hemoglobinuria appear in a physical exam of urine? |
|
Definition
|
|
Term
| How do you obtain more information on the degree of ketosis? |
|
Definition
|
|
Term
|
Definition
| Indicator of a deficiency in insulin - Dosage needs to be adjusted. |
|
|
Term
| When do you perform QC of reagent strips? |
|
Definition
| When a new bottle is opened and at least once per shift. |
|
|
Term
| What is the double indicator system used to measure pH? |
|
Definition
Methyl red an bromthymol blue.
Methyl red range is 4.4-6.2
Bromthymol blue range is 6.0-7.6 |
|
|
Term
| What two forms of blood is found in urine? |
|
Definition
Hematuria - intact red blood cells.
Hemoglobinuria - free hemoglobin because of blood cell destruction. |
|
|
Term
| What is the reactant for the reagent strip test for blood? |
|
Definition
| Blood or hemoglobin comes in contact with the pad and it reacts with peroxide. Oxygen is released and reacts with tetramethylbenzidine resultin in a color change (blue) |
|
|
Term
| What does the Ictotest tablet contain? |
|
Definition
P-nitrobenzene-diazonium-P-toluenesulfonate,
sulfosalicylic acid, sodium carbonate and boric acid. |
|
|
Term
| What are some pathological conditions for hemoglobinuria? |
|
Definition
Hemolytic anemia
Transfusion reactions
severe burns
infections
|
|
|
Term
What is the significance of urine pH?
|
|
Definition
| Aides in the determination of the existance of systemic acid-base disorders of a metabolic or respiratory origin. |
|
|
Term
| How do the lungs regulate the acid-base balance? |
|
Definition
|
|
Term
| What is the maximum time to read the reagent strip? |
|
Definition
|
|
Term
| The amount of light transmitted through a specimen is called what? |
|
Definition
|
|
Term
| What is the indicator for specific gravity? |
|
Definition
|
|
Term
| How much bilirubin and urobilinogen is in normal urine? |
|
Definition
| None that is detectable by routine testing. |
|
|
Term
| What specimen is used for an Acetest? |
|
Definition
| Urine or serum. It's better than the dip strip because of the enhancers. |
|
|
Term
|
Definition
| Conjugated bilirubin is secreted through the bile duct into the small intestines and converted to urobilinogen. 20% is reabsorbed into the blood. |
|
|
Term
| What is the clinical significance of osmolality? |
|
Definition
Evaluates renal concentrating ability,
Monitoring the course of renal disease,
Monitoring fluid & electrolyte therapy,
Establishing diagnosis of hypernatremia and hyponatremia. |
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