AUBF MIDTERM: CHEMICAL EXAMINATION

It composed of several chemical impregnated

Reagent strip

Types of reagent strip

multistix, chemstrip

Principle for automated reagent strip method

Reflectance photometry

It is the light reflection from the text pads

Automated reagent strip method

The most common sugar in the urine

Glucose

Renal threshold for glucose

160-180 mg/dl

Increased fruits, honey, syrup, fructose tolerance

Fructose

Increased in infants w/ galactosemia

Galactose

Increased during pregnancy, lactation, strict milk diet lactose intolerance

Lactose

Increased in benign essential pentosuria

Pentose

Increased in intestinal disorders, sucrose intolerance

Sucrose

Principles of glucose

Double sequential enzyme reaction

Time of reagent

30 s

Multistix of glucose

Blue to green to brown

Chemstrip

Yellow to green

F-P for glucose

Contamination by oxidizing

False - negative

Hight glucose of ascorbic acid

Principle for cupper reduction test

Copper reduction

It is the ability of the glucose and other substances to reduce copper sulfate

Copper reduction

Prevent pass through for cupper reduction test

2 drop of urine

It detect the water soluble

Bilirubin

pigmented yellow compound from the breakdown of hemoglobin

Bilirubin

Clinical significance of bilirubin in urine

Hepatitis, cirrhosis, other liver disease k

Time for reagent trip for bilirubin

30s

Reagent multistix for bilirubin

2-4 dichloroaniline diazonium salt

Reagent chemstrip of bilirubin

2,6 dichlorobenzene diazonium salr

False positive for bilirubin

Indican

False negative o

Ascorbic acid

More sensitive than reagent strip with less interferences positive blue to purple color

Ictotest

result from increased fat metabolisms due to inability to metabolite carbohydrates

Ketones

Fatty acids breakdown when glucose is not used as a source of energy

Ketones bodies

Clinical significance of ketones in urine

Starvation, vomiting

Second Reagent strip for ketones

49 seconds

Principle for ketones

Nitroprusside

Reagent chemstrip for ketones

Sodium nitroprusside

Reagent multistix for ketones

Detect acetoacetic acide

False positive for ketones

Levodopa

False negative for ketones

Improperly preserved specimens

Acetest it contains of what

Sodium, nitroprusside, disodium phosphate, lactose

density of the sodium, number and size of particles in a solution

Specific gravity

Clinical significance of specific gravity

Diabetes insipidus

Second for specific gravity

45 seconds

Principle for specific gravity

Change in polyelectrolytes

False positive for specific gravity

High concentration of protein

False negative for specific gravity

Highly alkaline urine

The most indicative of renal disease

Protein

Associated with renal disorder

Proteinuria

Urine contains very little protein

100 mg/ 24 hrs

Major protein found in the urine

Albumin

Normal values of albumin

< 10 mg/dl

Other sample protein and it produce by the renal tubular cells

Tamm-horsfall

Caused by conditions that affect the plasma prior to its reaching the kidney

Pre-renal proteinuria

True renal disease

Renal proteinuria

Decreased glomerular filtration

Diabetic nephrophathy

Indicator for diabetic nephrophathy

Microalbuminuria

Proteinuria when standing due to increases pressure to renal veins

Orthostatic

Test for microalbuminuria

Micral test.

Reagent for micral test

Gold-labeled antibody, b-galactosidase, chlorophenol red galactoside

Sensitivity of micral test

0-10 mg/dl

Interference for micral test

Dilute urine

Normally filtered albumin can no longer be absorbed

Tubular proteinuria

Clinical significance of tubular proteinuria

• Fanconi syndrome

• Toxic agents/heavy metals

• Several viral infections

Increased protein urine caused by inflammation that add protein in the urine after its formation

Post-renal protenuria

Clinical significance of post-renal protenuria

• lower UTI

• Injury or trauma

• Menstrual inflammation

• Vaginal secretion

Second reagent strip for post renal protenuria

60 s

Principle of post renal protenuria

Based error of indicator principle

Presence color for protein

Green

Multistix for post renal proteinuria

Tetrabromphenol blue

Chemstrip of post renal proteinuria

Tetrachlrophenol

A cold precipitation test that reacts equally with all forms of proteins

Sulfosalicylic acid

False positive for sulfos alicylic acid

Contrast media

False negative sulfos alicylic acid

Dilute urine

Regulate the acid base balance of the body

Kidney and lungs

Normal ph of range

4.8-8.0

1st morning:

5.0-6.0

Ph of 9.0

Unpreserved urine

What are two type of ph urine

Acidic urine, alkaline urine

Causes of acidic urine

• Diabetes mellitus

• Starvation

• High protein diet

• Cranberry juice

Causes of alkaline urine

• renal tubular acidosis

• Vegetarian diet

• After meal

• Vomiting

Clinical significance of ph

Respirat Of metabolic acidosis/ ketones

Second time of ph

60 seconds

Reagent for ph

Methyl red and bromthymol blue

What are the 3 types of urine blood

• hematuria

• Hemoglobinuria

• Myoglobinuria

reporting urine for hematuria

Cloudy red urine

Hematuria seen wht

Renal calculi

Reporting urine of hematuria

Cloudy red urine

reporting of hemoglobinuria

Clear red uria

Seen for hemoglobinuria

Intravascular hemolysis

Reporting urine for myoglobinuria

Clear red

Seen for myoglobinuria

Rhabdomyolysis

Second reagent for blood

60 seconds

multistix for blood

Diisoprophylbenzene

Chemstrip blood

Tetramathylbenzine

A bile pigment produced from bilirubin when bacteriamact on it in the intEstine

Urobilinogen

What color stool for urobilinogen

Brown color of stool

Normal values for urobilinogen

<1 mg/dl.

Specimen time used for bilirubin

Afternoon urine (2-4 pm)

Reagent strip second

60 seconds

Principle for urobilinogen

Ehrlichs reactions

False positive for urobilinogen

Indican