Body Fluid Analysis Exam 2 fill in the blanks

what is the most common method for chemical testing

reagent strip

Qualitative results for reagent strip are on what

color change

what needs to be detected or eliminated in during a reagent strip test

interfering substances like ascorbic acid

store reagent strips in container at what degrees

below 30 C

products in a reagent strip test are susceptible to what

light, heat, and moisture

Normal pH varies from

4.5 to 8.0

Detects hemoglobin heme moiety, so reagent strip also detects what

myglobin

what creates false positives during reagant strip tests

highly concentrated uring or high specific gravity

Pseudoperoxidase activity of heme reduces peroxide, and chromogen is oxidized, causing what

yellow to green

Pad has what

chromogen and peroxide

Greater than 20/μL is an indication of

pathologic process

WBCs susceptible to what, so may not be seen but will release enzyme causing a positive reagent strip result

lysis

Nitrate-reducing bacteria in urine can form

nitrite

most indicative of kidney disease

protein

if protein in in urine then strip test most sensitive to

albumin

When buffers in pad hold pH constant, certain indicator dyes

release H ions due to proteins present

Hydrogen (H) ions combine with protein and cause what

a color change

Intensity of the color is proportional to

protein amount

Routine test strips unable to detect albumin in
urine that is less than

1 to 2 mg/dL

Sensitive albumin tests detect

low level albuminuria

  Urinalysis examination of urine includes:

color, clarity, specific gravity

Will appear if plasma level in urine is over
threshold level of

160 to 180 mg/d

for a reagent strip test do the strip quickly into well-mixed specimen at

room temperature

glucose oxidase in pad oxidizes glucose to form

hydrogen peroxide and gluconic acid

Peroxidase in pad catalyzes formed hydrogen
peroxide to do what

oxidize chromogen and create a color change

Reducing substances convert cupric sulfate in

cuprous oxide

color change from blue to green to orange

clinitest test

color change from orange (pH 5.0) to green
(pH 7.0) to blue (pH 9.0)

pH

ph tests should be performed on

fresh urine

what dyes does pH use

bromothymol blue and methyl red

causes color change from yellow to green

blood

what is the end result of leukocyte esterase

en azo dye

color change from beige to violet

leukocyte esterase

Color change white to pink

nitrite

Causes color change from beige to purple

ketones

In alkaline medium, acetoacetate reacts with

sodium nitroprusside in pad

Indirect bilirubin is not water soluble, so bound to

albumin in plasma

Indirect bilirubin is filtered by the

glomerulus and too large to be observed in urine

Causes urine to be dark yellow to brown

bilrubin

Bilirubin reacts with a diazonium salt in pad to form

azobilrubin, which is brown

Urobilinogen excretion is enhanced in the

slightly alkaline urine following a meal

Excess urine on the strip will cause

the spreading of reagents among the pads

Leukocyte esterase is the

endpoint at 2 minutes

Normal fresh urine should not reach

pH 9

ndicates old bacteria-contaminated urine

pH over 9

acidic pH

meat

alkaline pH

vegetables

First morning specimen normally

acidic pH

Postprandial specimen more

alkaline pH

what are the causes od proteinuria

prerenal, renal, postrenal

hemoglobin and myglobin is rarely seen on reagent strip because strip detects

only albumin

damage to glomerular membrane can impair, and allows for serum proteins to pass and into the urine

selective filtration

increased pressure on the filtration mechanism due to what

hypertension, excerice, dehydration, preclampsia

Recommended volume to centrifuge at

400 to 450 g for 5 minutes to obtain 12 mL sediment

if using the same microscope is not possible what should you do

field of view must be the same

Red blood cells (RBCs), white blood cells (WBCs), and casts should b

enumerated

Crystals and bacteria are assessed

qualitatively

Most common stain enhance visualization is

crystal-violet and safranin (sternheimer-malbin) stain

what does acetic acid do

enhance nuclear structure of WBCs and differentiates RBC from yeast

what will happen to RBCs when mixed with amino acid

hemolyze

lipid/fat stains find what

triglycerides, neutral fats, lipoproteins

no RBCs means what

positive strip test for blood; released hemoglobin

RBCs mean what

negative strip test for blood

detects myoglobin, peroxidases

false positive test for RBCs

what causes a false negative test for RBCs

Ascorbic acid interference

what are RBCs look alike

yeast and crystals

any type of WBCs from blood can be found in

urine

WBCs in healthy adults usually

less than or equal to 8 WBC/hpf

Since WBCs are motile, they can do what

enter urinary tract at any point

evidence of an upper urinary tract infection

WBCs casts

Lymphocytes do not contain

LE

what are WBC look alikes

renal tubular epithelial cells and sometimes RBCs

Inflammatory urinary tract conditions and almost al
diseases

increased WBCs, particularly neutrophils

Large numbers of some epithelial can
___________; others indicate _________

improperly collected urine; a severe pathologic process

what are the types of epithelials found in the urine

squamous, transitional (urothelial), renal tubular

Rarely significant; usually from contamination

squamous

Seen in urinary tract infection (UTI), urinary procedures, carcinoma (in sheets

transitional

Seen in acute ischemic or toxic renal tubular disease from heavy metals or drug (aminoglycosides) toxicity

renal tubular

Acid pH, increased solutes, urine stasis, and increased albumin

enhances cast formation

Concentration of urine solute, Urine pH, Slow flow of urine through tubules

factors influencing crystal formation

morphologic changes in glomerulus are

mostly immune mediated

how much renal calculi contain calcium

75%

Found primarily in renal calyces, renal pelvis, ureters, or bladder

renal calculi

what is a long term effect in diabetes mellitus

is glomerular damage and chronic renal failure

diabetes insipidus results in

polyuria

Increased porphyrins and porphyrin are

precursors in blood and urine

proximal convoluted tubule (PCT)

columnar

distal convoluted tubule (DCT)

round, oval

collecting duct

cuboidal

renal proteinuria is frequently detected on

first morning specimen

Certain indicators change color in the presence of protein at a

low pH

reagent strips are most sensitive to what

albumin

Protein accepts what from the indicator

H +

Leaving reagent pad in urine

temporarily removes buffer

SSA precipitates proteins

without heat

Placental hormones do what

reduce action of insulin

in a reagant strip test what is positive and what is negative

yellow- negative; blue/green- positive

in order to differentiate granular casts from bacteria and crystals you do what

look for cast matrix

what microscopy technique is ideal for live cells

phase contrast

here is the odor what causes it

bleach

contamination