Studied by 27 people
Looks like no one added any tags here yet for you.
Confirmatory
Benedict’s is not ___________ since not all tube methods are considered ___________
Reagent strip
Consist of chemical-impregnated absorbent pads attached to a plastic strip
A color reaction takes place when the pad comes in contact with urine
Reactions are interpreted by comparing the color pads with a chart provided by the manufacturer
Results are described as trace 1+, 2+, 3+, 4+
SEMIQUANTITATIVE
pH
Specific gravity
Glucose
Protein
4 parameter consists of what parameters? (PSGP)
pH
Specific gravity
Glucose
Ketones
Proteins
Blood
Bilirubin
Urobilinogen
Nitrite
Leukocyte esterase
10 parameter strip consists of what parameters? (PSG-KPB-BUNL)
Vitamin C
The 11th parameter?
Creatinine
The 12th parameter?
Microalbumin
The 13th parameter?
Siemens
Multistix manufacturer
Roche
Chemstrip manufacturer
Tetramethylbenzidine
Chemstrip chromogen for glucose
Urobilinogen
Only parameter we don’t report as negative
Unmixed
Formed elements, such as red and white blood cells, sink to the bottom of the specimen and will be undetected in an _________ specimen.
leaching of reagents from the pads.
Allowing the strip to remain in the urine for an extended period may cause:
Horizontally
When comparing the strip with the color chart, how is the strip held?
Reflectance photometry
Automated reagent strip reader principle?
Room temperature
Specimens that have been refrigerated must be allowed to return to what temp before reagent strip testing, as the enzymatic reactions on the strips are temperature dependent?
1. Store with desiccant in an opaque, tightly closed container.
2. Store below 30°C; do not freeze.
3. Do not expose to volatile fumes.
4. Do not use past the expiration date.
5. Do not use if chemical pads become discolored.
6. Remove strips immediately before use.
Care of reagent strips (6)
1. Test open bottles of reagent strips with known positive and negative controls every 24 hrs
2. Resolve control results that are out of range by further testing.
3. Test the reagents used in confirmatory tests with positive and negative controls.
4. Perform positive and negative controls on new reagents and newly opened bottles of reagent strips.
5. Record all control results and reagent lot numbers.
Quality control (5)
Daily
When do you perform QC in urinalysis lab?
60-120 seconds
If precise timing cannot be achieved, what is the recommended range of time that reactions are read?
Glucose and bilirubin
30 secs
Ketones
40 secs
Sp gravity
45 secs
pH
Protein
Blood
Urobilinogen
Nitrite
60 secs (PPBUN for 60 seconds)
Leukocyte esterase
Parameter read after 120 seconds
pH
Parameter that is first to be read because it is most vulnerable
60 seconds
pH cannot be read after how many secs?
Tubular secretion
pH, what tubular function?
Crystal identification
pH is the parameter that can differentiate what?
Ammonium ions and hydrogen phosphate
Hydrogens ions are excreted in the form of?
Bicarbonate
Hydrogen ions are retained in the form of?
pH 4.5-8.0
Physiologic pH
pH 5-6
pH range in first morning specimen
Alkaline tide
pH after meal turns alkaline which is termed:
pCO2
Reflects carbon dioxide dissolved in water
CHON
Cranberry
DM
Dehydration
Diarrhea
E. coli
Emphysema
Starvation
UTI medication
Causes of acidic urine (CCDDDEESU)
High fruit and vegetables
Hyperventilation
Vomiting
Renal tubular acidosis
Old specimen
Post-prandial specimen
Presence of urease producing-bacteria (Enterobacteriaceae)
Causes of alkaline pH (HHVROPP)
Bicarbonate
Fruits are rich in what that’s why it leads to alkaline urine when eaten?
Respiratory acidosis
Emphysema leads to this condition
Urine protein
Most indicative of renal disease
<10 mg/dL or <100mg/day (Henry’s: <150 mg/day)
Normal urine protein levels
Proteins from prostatic, seminal, and vaginal secretion
Albumin
Serum and tubular microglobulins
Tamm-Horsefall protein
4 proteins normally found in urine (PAST)
Albumin
Major serum protein found in urine
Tamm-Horsefall protein
A mucoprotein produced by the renal tubules
Matrix of cast formation
Uromodulin
other name for Tamm-Horsefall protein
<10 mg/dL
What is the sensitivity of urine strip for protein?
>30 mg/dL
Clinical proteinuria levels?
Prerenal proteinuria
OVERFLOW of plasma proteins with low molecular weight
True
(T/F) Prerenal proteinuria is not indicative of actual renal disease
False, prerenal proteinuria is not detected by reagent strip
(T/F) Prerenal proteinuria is detected by reagent strip
Severe infection or inflammation (↑ APRs)
Hemoglobinuria
Myoglobinuria
Multiple myeloma (BJP)
4 causes of prerenal proteinuria (SHMM)
Coagulates at 40-60 degrees Celsius, dissolves at 100 degrees Celsius
BJP coagulates at what temp and dissolves at what temp?
Renal proteinuria
Proteinuria associated with true renal disease
Glomerular proteinuria
Tubular proteinuria
Microalbuminuria
3 causes of renal proteinuria
Glomerular proteinuria
Most common and most clinically significant cause renal proteinuria
Orthostatic proteinuria
Orthostatic proteinuria
Glomerular proteinuria is associated with what condition?
Tubular proteinuria
A cause of renal proteinuria that occurs when normal tubular reabsorptive function is impaired
Fanconi’s syndrome
Tubular proteinuria is associated with what syndrome?
Microalbuminuria
Proteinuria not detected by the routine reagent strip
Diabetic nephropathy
Microalbuminuria is associated with what condition?
Post renal proteinuria
Proteinuria caused by proteins produced by the urinary tract
Contamination by proteins during excretion
Lower UTI
Vaginal secretions
Menstrual contamination
Semen
Hemorrhoidal blood
5 causes of post renal proteinuria (LVMSH)
Microalbuminuria
Signifies onset of renal complications due to DM
Associated with increased risk of CVD
Protein excretion of 30-300 mg/24 hours
AER of 20-200 micrograms/min
>3.4 mg/mmol
Albumin:Creatinine ratio indicating microalbuminuria?
Micral test
Enzyme immunoassay for microalbuminuria
Read after 60 seconds
White (negative) to red (represents amount of protein in specimen)
Color range for Micral test?
Immunodip test
Immunochromographic technique for microalbuminuria testing
3 minutes
Immunodip strips are placed in specimen for how long?
<1.2 mg/dL (negative)
Immunodip: darker bottom band, interpretation?
1.2-1.8 mg/dL (borderline)
Immunodip: equally dark bands, interpretation?
2-8 mg/dL (positive)
Immunodip: darker top band, interpretation?
Heat and acetic acid test
Sulfosalicylic acid test
What are the 2 tests for urine albumin?
Heat and acetic acid test
What is the reference method in testing for albumin in the urine?
5-10% acetic acid
Concentration of acetic acid used in heat and acetic acid test?
Diffuse cloud
HAc test: 1+
Granular cloud
HAc test: 2+
Distinct floccule
HAc test: 3+
Large floccule, dense, something solid
HAc test: 4+
Sulfosalicyclic acid test
Urine supernatant + SSA
Incubate at room temperature for 10 minutes
Most proteins are precipitated by dilute (3%) SSA
<6 mg/dL
SSA
Grade: NEG
Description: No increase in turbidity
What is the protein range?
<6-30 mg/dL
SSA
Grade: TRACE
Description: Noticeable turbidity
What is the protein range?
30-100 mg/dL
SSA
Grade: 1+
Description: Distinct turbidity with no granulation
What is the protein range?
100-200 mg/dL
SSA
Grade: 2+
Description: Turbidity with granulation, no flocculation
What is the protein range?
200-400 mg/dL
SSA
Grade: 3+
Description: Turbidity with granulation and flocculation
What is the protein range?
>400 mg/dL
SSA
Grade: 4+
Description: Clumps of protein
What is the protein range?
Radiographic contrast media
Drugs
Salicylates
Causes false (+) in SSA (RDS)
Highly alkaline urine
QUATS
Causes false (-) in SSA (HQ)
5-10 mg/dL to any protein
What is the sensitivity of SSA?
Albumin
SSA: (+)
Reagent strip: (+)
What proteins are present in the urine?
Proteins other than albumin
SSA: (+)
Reagent strip: (-)
What proteins are present in the urine?
Glucose
What is the most frequent chemical test performed on urine?
<15 mg/dL
What is the normal urine glucose level?
Diabetes mellitus
Urine glucose test is used to diagnose what disease?
DM
Pheochromocytoma
Hyperthyroidism
Acromegaly
Cushing’s syndrome
5 conditions associated with hyperglycemia? (DPHAC - da fak?)
Increased plasma glucose, exceeding renal threshold
Acromegaly
high growth hormones
Cushing’s syndrome
high cortisol
Hyperthyroidism
High thyroxine
Pheochromocytoma
High catecholamines
Pregnancy
Osteomalacia
Nephrotic syndrome
Fanconi’s syndrome
Advanced renal disease
5 Renal-associated conditions in glucose test (PONFA)
Normal plasma glucose, but glucose still appears in the urine
Benedict’s test
General test for glucose and other reducing sugars, NOT SPECIFIC TO GLUCOSE
Principle is based on the ability of glucose and other reducing substances to reduce copper sulfate to cuprous oxide in the presence of alkali
Note 
Flashcard (112)