Chapter 5 - Chemical Examination of Urine

Amyloid material

________, toxic substances, and immune complexes found in lupus erythematosus and streptococcal glomerulonephritis damage the glomerolus.

Reagent strip tests

________ use the sodium nitroprusside (nitroferricyanide) reaction to measure ketones.

Cranberry juice

________, which produces an acidic urine, has traditionally been used as a home remedy for minor bladder infections.

Reagent strip bottles

________ are removed just prior to testing and tightly resealed immediately.

Post renal proteinuria

________ is caused when urine passes through the structures of the lower urinary tract (ureters, bladder, urethra, prostate, and vagina)

Ehrlich reaction

The sensitivity of the ________ increases with temperature, and testing should be performed at room temperature.

False negative results

________ occur most frequently when specimens are improperly preserved, allowing urobilinogen to be photo- oxidized to urobilin.

Multistix

________ uses Ehrlichs aldehyde reaction, in which urobilinogen reacts with p- dimethylaminobenzaldehyde (Ehrlich reagent) to produce colors ranging from light to dark pink.

Chemstrip

________ incorporates an azo- coupling (diazo) reaction using 4- methoxybenzene- diazonium- tetrafluoroborate to react with urobilinogen, producing colors ranging from white to pink.

Frequent strenuous exercise

________ can cause overuse of available carbohydrates.Acetest Tablets.

Incorporation

________ of the indicator bromthymol blue on the reagent pad measures the change in pH.

precipitation of crystals

The ________ and minerals depend on the pH, aiding in microscopic examination.

mg dL

Decreased reactivity may be seen when formalin is used as a preservative or when the hypertension medication, captopril, or high concentrations of nitrite (greater than 10 ________) are present.

Tubes

________ should be placed in a rack and not held in the hand because the reaction heat could cause a burn.

Trichomonas

Infections caused by ________, Chlamydia, yeast, and inflammation of renal tissues (i.e., interstitial nephritis) produce leukocyturia without bacteriuria.

pre eclampsia

Exercise, dehydration, hypertension and ________ can increase blood pressure.

Reaction interferences

________ include increased protein and pH.

Jaundice

________ due to increased destruction of red blood cells does not produce bilirubinuria.

Bence Jones

________ protein coagulates at temperatures between 40°C and 60°C and dissolves when the temperature reaches 100°C, so it makes the specimen turbid before becoming clear.

Qualitative results

________ are reported as negative, small, moderate, or large, or as negative, 1+, 2+, or 3+.

Tablets

________ and liquid chemicals can be alternatives if questionable results are obtained or highly pigmented specimens are encountered, though they are less specific and sensitive.pH.

Bilirubin

________ is an unstable compound that is rapidly photo- oxidized to biliverdin when exposed to light.

careful comparison

Readings can be made in 0.005 intervals by ________ with the color chart.

special properties

Ten drops of urine are added to the mat, which has ________ that cause bilirubin to remain on the surface as the urine is absorbed.

Albumin

________ is the main protein detected because it has more amino acid groups to accept hydrogen ions from the indicator.

glomerolus

If the ________ is damaged, filtration is impaired and increased amounts of serum protein, RBCs and WBCs pass trough the urine.

atypical color

Highly pigmented urines produce ________ reactions.Leukocyte Esterase.

recurrent infections

The nitrite test also can be used to evaluate the success of antibiotic therapy and to periodically screen persons with ________, patients with diabetes, and pregnant women, all of whom are considered to be at high risk for UTI.

differentiation

The addition of lactose gives better color ________.

reagent strip reaction

The ________ is based on the change in pKa (dissociation constant) of a polyelectrolyte in an alkaline medium.

reagent strips

Clinitek Microalbumin ________ and Multistix Pro ________ provide simultaneous measurement of albumin /protein and creatinine that permits an estimation of the 24- hr microalbumin excretion.

Biliverdin

________ does not react with diazo tests.

resistance

During pregnancy, hormones secreted by the placenta block the action of insulin, resulting in insulin ________ and hyperglycemia.

color change

Highly buffered alkaline urine overrides the acid buffer system, producing a rise in pH and a(n) ________ unrelated to protein concentration.

Radiographic dye

________ increases the specific gravity and turbidity due to the precipitation of crystals.

normal person

A(n) ________ may have glycosuria or glucose in the urine following a meal with a high glucose content.

40°C

Interference due to other proteins can be removed by filtering the specimen at 100°C and observing the specimen for turbidity as it cools to between ________ and 60°C.

Contaminant bacteria

________ produces measurable amounts of nitrite on specimens left to stand unpreserved, giving a false positive result.

Diabetic

________ nephropathy impairs filtration and eventually causes failure due to increased glucose that go beyond the renal threshold.

porphobilinogen

Neither ________ nor other Ehrlich- reactive compounds are soluble in chloroform.

Orthostatic proteinuria

________ is caused by increased pressure on the renal vein that overrides the filtration capacity of the glomerolus from assuming a vertical position.

heptapropylene glycol

Using paper treated with bis- (________) carbonate prevents interference from highly buffered alkaline urine.

normal degradation

Conjugated bilirubin appears in the urine when the ________ cycle is disrupted by obstruction of the bile duct (e.g., gallstones or cancer) or when the integrity of the liver is damaged, allowing leakage of conjugated bilirubin into the circulation.Ictotest Tablets.

urinary leukocytes

Increased ________ are indicators of UTI.

Neutrophils

________ are the leukocytes most frequently associated with bacterial infections.

Greiss

Nitrite is detected by the ________ reaction, in which nitrite at an acidic pH reacts with an aromatic amine (para- arsanilic acid or sulfanilamide) to form a diazonium compound that then reacts with tetrahydrobenzoquinolin compounds to produce a pinkcolored azodye.

sodium nitroprusside

It provides ________, glycine, disodium phosphate, and lactose in tablet form.

acetone

Both ________ and beta- hydroxybutyric acid are produced from acetoacetic acidClinical Significance.

Bacterial

________ and fungal infections and inflammations produce exudates containing protein from the interstitial fluid.

genitourinary tract

They comprise of proteins with low molecular weights and proteins produced in the ________.