MT 35 (LAB): URINALYSIS Chemical Examination Part 2

True or False: Ketones are volatile substances that can easily evaporate.

True

What is the main precursor of acetone and beta-hydroxybutyrate?

Acetoacetic acid

Fill in the blank: Ketones are the ________ of fat metabolism.

By-products

True or False: Type II DM patients do not require daily insulin doses.

True

True or False: Type I Diabetes is an autoimmune disease targeting beta cells.

True

What condition leads to an accumulation of ketones due to lack of insulin?

Diabetic ketoacidosis

True or False: Sodium nitroprusside reacts with beta-hydroxybutyrate.

False

Identify the medication that may cause cross-reaction with ketone reagent.

Levodopa

Fill in the blank: The reagent used for ketone detection is __________.

Sodium nitroprusside

True or False: Ketones are detected using a redox reaction.

True

Fill in the blank: In Type I DM, there are no ________ cells to produce insulin.

Beta

True or False: Acetoacetate is the only ketone routinely measured in urinalysis.

True

True or False: High levels of ketones in urine are expected in starvation.

True

Identify the volatile ketone detected by reagent strips.

Acetone

Fill in the blank: A person with no beta cells has ________ Type I diabetes.

Autoimmune

True or False: Ketones are not commonly found in normal urine.

True

What disease is characterized by elevated ketone levels due to insufficient insulin?

Diabetic ketoacidosis

True or False: High levels of glucose and ketones may appear in uncontrolled DM.

True

Fill in the blank: Ketones in urine suggest fat is being used for ________.

Energy

Identify the condition where ketones increase due to no insulin activity.

Type I Diabetes Mellitus

True or False: Hematuria refers to visible red blood cells in the urine.

True

What protein is released when red blood cells lyse?

Hemoglobin

True or False: Myoglobin can also be detected as blood in urine.

True

Fill in the blank: The presence of ________ in urine suggests muscle damage.

Myoglobin

What condition can cause hematuria due to kidney stone damage?

Renal calculi

True or False: Hematuria and myoglobinuria can give the same test strip result.

True

What substance replaces peroxidase in pseudoperoxidase activity?

Hemoglobin

True or False: Positive blood pad without visible RBCs may indicate myoglobinuria.

True

Fill in the blank: ________ foams are associated with bilirubin presence.

Yellow

True or False: Phenazopyridine can interfere with bilirubin pad results.

True

What is the final product of bilirubin reaction on reagent strips?

Azo dye

True or False: Conjugated bilirubin is water-soluble.

True

Fill in the blank: ________ bilirubin is not detected by the reagent strip.

Unconjugated

Identify the organ that conjugates bilirubin.

Liver

True or False: Stercobilin is responsible for the brown color of feces.

True

What happens to bilirubin in hepatobiliary obstruction?

Excreted in urine

Fill in the blank: Increased ________ causes gray or clay-colored feces.

Conjugated bilirubin

True or False: Urobilinogen is normally present in small amounts in urine.

True

What bilirubin derivative is elevated in pre-hepatic hemolysis?

Unconjugated bilirubin

True or False: Diazotized salt is used in the detection of bilirubin.

True

Fill in the blank: A ________ reaction couples bilirubin to form azo dye.

Diazo

True or False: Type I DM results in no insulin production due to autoimmune destruction of beta cells.

True

Identify the main source of ketones in diabetic patients.

Fat metabolism

Fill in the blank: Acetoacetate is the ________ ketone detected in routine testing.

Parent

True or False: Levodopa can cause false positives in ketone tests.

True

What compound does sodium nitroprusside primarily react with?

Acetoacetate

True or False: Beta-hydroxybutyrate is detected by the ketone reagent strip.

False

What medication can interfere with ketone test results due to its chemical structure?

Levodopa

Fill in the blank: Ketones are volatile and can easily ________ if specimen is old.

Evaporate

True or False: Ketones in urine suggest the body is using fats for energy.

True

Identify the metabolic state indicated by ketonuria.

Fat metabolism

True or False: Myoglobin and hemoglobin are small and may appear in urine.

True

What test pad detects hematuria, hemoglobinuria, and myoglobinuria?

Blood

Fill in the blank: ________ are large and visible under microscopy in hematuria.

RBCs

True or False: Myoglobinuria can yield a positive blood test without RBCs.

True

What condition causes red or brown urine but no visible RBCs on microscopy?

Myoglobinuria

True or False: Myoglobin and hemoglobin both exhibit pseudoperoxidase activity.

True

Identify the pigment responsible for pseudoperoxidase activity in blood tests.

Hemoglobin

True or False: A white foam in urine indicates the presence of protein.

True

Fill in the blank: Yellow foam in urine may be a sign of ________.

Bilirubin

True or False: Hematuria and hemoglobinuria give the same reagent pad result.

True

What type of anemia can result in increased unconjugated bilirubin?

Hemolytic anemia

Fill in the blank: The liver conjugates bilirubin using ________ acid.

Glucuronic

True or False: Unconjugated bilirubin is water-soluble.

False

What reaction forms an azo dye in bilirubin testing?

Diazo reaction

True or False: Conjugated bilirubin is the form detected on reagent strips.

True

Fill in the blank: Urobilinogen is formed in the ________.

Intestine

What color is feces with absent stercobilin?

Clay-colored or gray

True or False: Increased urine bilirubin is associated with hepatobiliary obstruction.

True

Fill in the blank: A ________ result on bilirubin pad indicates possible liver damage.

Positive

True or False: A healthy liver prevents bilirubin from entering urine.

True

What compound is measured in urine that suggests liver inability to process bilirubin?

Conjugated bilirubin

Fill in the blank: A decrease in urine urobilinogen indicates ________ obstruction.

Biliary

True or False: Urobilinogen is normally found in small amounts in urine.

True

Identify the bilirubin derivative that is absent in complete biliary obstruction.

Urobilinogen

True or False: Elevated bilirubin in urine is a late sign of liver damage.

False

Fill in the blank: ________ is responsible for the brown color of feces.

Stercobilin

True or False: Nitrite detection must be interpreted with leukocyte esterase.

True

Identify the intermediate product used in the diazo reaction.

Diazonium salt

True or False: Gram-negative bacteria reduce nitrate to nitrite.

True

Fill in the blank: A negative leukocyte esterase with pyuria suggests ________.

Lymphocytes

True or False: Leukocyte esterase detects only granulocytes.

True

What enzyme is present in neutrophils and detected on reagent strips?

Leukocyte esterase

True or False: Granulocytes lacking visible granules can cause false negatives.

True

Fill in the blank: Urine pH is measured using a ________ indicator pad.

Double

True or False: High-protein diets result in acidic urine.

True

What type of diet increases the production of uric acid?

High-protein diet

Fill in the blank: A pH above 7.5 is considered ________.

Alkaline

True or False: Detergent contamination may falsely alkalinize urine.

True

What type of urine is associated with E. coli infections?

Acidic

True or False: Proteus infection makes urine more alkaline.

True

Fill in the blank: ________ fermentation produces alkaline urine.

Urease

What color on the pH pad indicates acidic urine?

Red to yellow

True or False: Blue pH pad color means alkaline urine.

True

Identify the crystals that form in acidic urine.

Calcium oxalate

Fill in the blank: Alkaline urine promotes formation of ________ crystals.

Triple phosphate

True or False: Albumin is negatively charged and usually not filtered.

True

What structure allows small amounts of albumin to be excreted?

Tubular secretion

True or False: Multiple myeloma can lead to Bence-Jones proteinuria.

True