Urinalysis final review

Match the confirmatory tests with their urine strip

bilirubin - ictotest

glucose - clinitest

ketones- acetest

specific gravity- refractometer

protein - SSA

What is the normal range for specific gravity?

1.005-1.030

classify the following as prerenal, renal, tubular or postrenal:

muscle injury

UTI

Fanconi syndrome

preeclampsia

muscle injury- prerenal

UTI- postrenal

fanconi syndrome- tubular disorder

preeclampsia - renal

Name the scenarios where you should run QC on strips?

at the start of a shift, when a new bottle is opened, when the UA results are questionable, when you have concern over strip integrity 

Name the three ketone bodies

acetone, acetoacetic acid, BOH

Which two ketone bodies are detected by the urine strip?

acetone and acetoacetic acid 

Match the strip tests to their principals

Protein, pH, blood, leukocyte, SG, nitrites, glucose, urobilinogen, ketones, bilirubin 

Daizo reaction, double indicator system reaction, protein error of indicators, sodium nitroprusside reaction, ehlrichs aldehyde reaction, pseudoperoxidase activity of hemoglobin, pka change, greiss reaction, enzymatic hydrolysis of an acid esterase, glucose oxidase double sequential enzyme reaction

If someone were to starve themselves for a week what would you likely see in their urine?

Ketones

Positive glucose is most associated with what disease?

Diabetes mellitus

Urinalysis is preformed on a 2 week old, the glucose is negative. a copper reduction test should be preformed next, what substance is it looking for?

Galactose 

a urine sample is analyzed for glucose by both the glucose strip and a copper reduction test, if both are positive what does that mean? (based on a chart)

Glucose and reducing substances are present 

What does it mean if a urine sample has a pH of 9.5?

The specimen is old

What can cause a negative nitrite reading?

gram positive bacteria 

failure to blot the edge of the reagent strip can result in errors in color interpretation caused by what?

Chemical runover

What is a positive leukocyte esterase most helpful in diagnosing?

UTI

Myoglobinuria can be caused by what disorders?

rhabdomyolysis, muscle wasting, crushing injury

What should not be positive in the urine of a healthy patient?

nitrite, bilirubin, ketones

list some preanalytical errors for urine strips

not mixing properly, not using the manufactures chart, improper patient ID

reagent strip testing can be incorrect if:

the sample is tested right after refridgeration

what component can cause false negatives in glucose, ketones, blood, and bilirubin

Ascorbic acid (vitamin C)

the presence of abnormal intact RBCs in urine is called what?

hematuria

the presence of lysed RBCs in urine is called what?

hemoglobinuria

How should reagent strips be stored?

at room temp in a dry place

Draw the urobilinogen and bilirubin chart from unit 2

insert pic

Which two foods can produce acidic urine?

Cranberry juice and high protein content foods

Which two ways can you tell the difference between hemoglobinuria and hematuria?

with microscopic examination and with urine clarity 

Which urine strip test would be most impacted by a urine sample exposed to too much light?

bilirubin

What type of bacteria is detected by the nitrite strip?

GNR

During a clinitest you see the color is changing rapidly from blue to orange back to blue what should you do?

repeat the testing using fewer drops to check for passthrough

Which urine strip test is essential for diagnosing preeclampsia?

protein

Which reagent strip test is useful in identifying crystals and acid base disorders?

pH

The absence of all urobilinogen on a urine strip can indicate what?

Bile duct obstruction. Absence of urobilinogen is NOT normal. 

What three strips can be effected by highly pigmented urine?

Protein, ketones, bilirubin

Which test preformed in chemistry is essential for diagnosing early renal complications in diabetic patients?

Microalbumin