AUBF lab bile acids, calcium, chloride, microalbumin (copy)

acids and salts

Bile is composed of

T

[T or F] Bile pigments can be extracted from blood

Bilirubin

Principle pigment of bile

Bilirubin

degradation product of hemoglobin

oxidation; derivatives

Tests for bile depends upon the __ of bile pigments by acids with the formation of a series of colored _ of bilirubin

Green

color of biliverdin

Blue

color of bilicyanine

Yellow

color of choletellin

alcoholic iodine

Reagent for smith’s test

First morning

Preferred urine speciment for smith’s

F

[T or F] freshly voided or random urine cannot be used for smiths test

emerald green ring at contact

Positive result for smiths

presence of bile pigments

Positive result of smith indicates

Fauchet’s reagent

10% barium chloride

“Harry’s FB Group”

Reagent for harrison’s spot test

FIrst morning

Preferred specimen for harrison’s spot test

F

[T or F] freshly voided or random urine cannot be used for harrisons spot test

blue to green color on filter paper

Positive result of harrison’s spot test

Ictotest

This test uses the same chemical reaction as bilirubin pad on multi reagent dipstick but in a tablet form

Purple color around the tablet

Positive result of ictotest

• True color reaction is less affected by color of urine

• More sensitive to bilirubin

Advantage of ictotest

T

[T or F] Ictotest can confirm or refute false-positive reactions on dipstick in cases where urine is deeply colored

0.1 mg/dL of bilirubin

Sensitivity of ictotest to bilirubin

Colorimetric method DMSO

Method where bilirubin reacts with diazotized sulphanilic acid (DMSO) to form a purple colored azobilirubin complex

conjugated bilirubin

What reacts with the aqueous solution in colorimetric method

unconjugated bilirubin

What reacts with the DMSO in colorimetric method

T

[T or F] the intensity of the color formed ins proportional to the bilirubin concentration in the sample

Na, Cl, K

What are the major inorganic chemicals found in urine

• Absorption in the intestinal tract

• Filtration in the glomerulus

• Passive reabsorption by the proximal convoluted tubules, with sodium

How is chloride ingested in food

Sweat and urine

Excess chloride is excreted where

24-hour/ timed urine

preferred specimen for chloride determination

F

[T or F] freshly voided or random urine cannot be used for chloride determination

Precipitation

What is the principle behind chloride determination

silver chloride; silver nitrate; nitric acid

Chloride is precipitated as ___ upon addition of ___ and ___in urine

nitric acid; silver nitrate; quantitative

• In a test, place 5 mL urine and add 3 to 4 drops of 6 N ___. Centrifuge.

• To the filtrate, add 2 to 3 drops of ___ solution.

• Record results as positive or negative.

• If positive, proceed to the ___ estimation.

Clouded precipitate

positive reaction for qualitative chloride determination

8-15 g/day

Normal chloride excreted in 24hr urine sample

Increased

“PDA”

Polydipsia

use of Diuretics

Addisons disease

Increased or decreased Chloride levels:

Polydipsia

Increased

“PDA”

Polydipsia

use of Diuretics

Addisons disease

Increased or decreased Chloride levels:

use of Diuretics

Increased

“PDA”

Polydipsia

use of Diuretics

Addisons disease

Increased or decreased Chloride levels:

Addisons disease

Increased

Increased or decreased Chloride levels:

Associated with Volume expansion and hypokalemia

Increased

Increased or decreased Chloride levels:

excess aldosterone, severe K deficiency, bartter syndrome

Decreased

“DICE”

Diabetes insipidus

Infections

Cushing’s syndrome

Excessive sweating, fasting, diarrhea, vomiting

Increased or decreased Chloride levels:

Excessive sweating, fasting, diarrhea, vomiting

Decreased

“DICE”

Diabetes insipidus

Infections

Cushing’s syndrome

Excessive sweating, fasting, diarrhea, vomiting

Increased or decreased Chloride levels:

Excessive sweating, fasting, diarrhea, vomiting

Decreased

“DICE”

Diabetes insipidus

Infections

Cushing’s syndrome

Excessive sweating, fasting, diarrhea, vomiting

Increased or decreased Chloride levels:

Diabetes insipidus

Decreased

“DICE”

Diabetes insipidus

Infections

Cushing’s syndrome

Excessive sweating, fasting, diarrhea, vomiting

Increased or decreased Chloride levels:

Infections

Decreased

“DICE”

Diabetes insipidus

Infections

Cushing’s syndrome

Excessive sweating, fasting, diarrhea, vomiting

Increased or decreased Chloride levels:

Cushing’s syndrome

decreased (<10 mEq/L)

Increased or decreased Chloride levels:

Associated with volume depletion

decreased (<10 mEq/L)

Increased or decreased Chloride levels:

Respond to saline infusion

Bartter syndrome

• An inborn autosomal recessive defect in Na-K-2Cl cotransporter at the thick ascending loop of henle.

• increased renal prostaglandin E2 production

Microalbuminuria

Increase in urinary albumin below the detectable range of standard protein reagent strips tests.

Microalbuminuria

Occurs long before clinical proteinuria becomes evident.

Microalbuminuria

Standard test for screening, monitoring, and detection of deteriorating renal function in diabetic patients

Microalbuminuria

Also used to monitor compliance of blood pressure control, glucose control, and protein restriction

>200 mg/L

Albuminuria is the term used when albumin levels reach _ in the urine

20-200 mg/L.

Microalbuminuria is the term used when albumin levels in the urine are _

• <30 mg/24 hours (<30 mg/day)

• <20 mg/L (10-hour collection)

Reference value of microalbuminuria (in 24hr collection and 10hr collection)

Increased

Increased or Decreased microalbumin:

Diabetes with early diabetic nephropathy

Increased

Increased or Decreased microalbumin:

Hypertension

Increased

Increased or Decreased microalbumin:

Generalized vascular disease (increased risk of cardiovascular disease)

Increased

Increased or Decreased microalbumin:

Preeclampsia

• Strenuous exercise

• Hematuria

• High-protein diet or high salt levels

Interfering factors in microalbumin testing resulting in false positive result

Micral test principle

contains a gold-labeled antihuman albumin antibody-enzyme conjugate that binds to albumin present in urine

Immunochemical

MIcral test is a __ assay

white to red

urine albumin-bound conjugates move up the strip to an area containing the enzyme substrate (Detection pad) to produce colors ranging from ___

T

[T or F] The amount of color produced in micral test is proportional to the albumin concentration in the urine.

0 to 10 mg/dL

MIcral test results range from _.

Immunodip

Albumin in urine is bound by blue latex particles coated with antihuman albumin antibody. The albumin- latex complex migrate through capillary action and form a second blue band (first blue band is for unconjugated particles).

Immunochromatographic

Immunodip uses a __ technique

Band 1

Which band on the Immunodip

Blue conjugate that has not reacted with albumin in the urine sample will bind to the HSA immobilized in this Band

Band 2

Which band on the Immunodip

A capture antibody binds any blue conjugate that does not bind in Band 1

3 min

Immunodip should be read within how many minutes

<1.2mg/dL [NEGATIVE]

Interpret microalbumin readings:

Darker bottom band (first band)

1.2 to 1.8 mg/dL [BORDERLINE]

Interpret microalbumin readings:

Equal band colors

2.0 to 8.0 mg/dL [POSITIVE]

Interpret microalbumin readings:

Darker top band (2nd band)

INVALID

Interpret microalbumin readings:

99% ; 1%

Cation that is mostly seen in the bones (___%) with the remaining __ in blood and in extracellular fluid (ECF)

serum

Most common specimen for calcium determination

• calcium chloride

• calcium sulfate

• calcium phosphate

Calcium in urine is seem as these compounds

12-hour or 24-hour timed specimen

Preferred specimen for calcium analysis

Sulkowitch’s test

Test for calcium

buffered oxalate solution

Reagent for sulkowitch test

turbidity

positive result for sulkowitch test

T

[T or F] turbidity in sulkowitch is equivalent to calcium concentration