Upgrade to remove ads
Only $35.99/year

urinalysis 2 test review

Terms in this set (47)

describe the proper technique for performing reagent strip testing and give examples of how improper technique could adversely affect the results of the reagent strip testing.
-quickly dip strip into urine
-make sure to wipe the edge of the strip on edge of container
-mix specimen well
-dont let strip sit outside container
-dipping prevents runoff
-blot the long edge of the strip on a paper towel
-follow manufacturers guidelines
-hold horizontally next to color chart
How will failure to allow a refrigerated specimen to come to room temperature before testing affect reagent strip testing?
reactions are based on room temperature, could cause for abnormal results high or low, enzymatic reactions on strip are effected by temperature
how are reagent strips protected by deteriation caused by moisture, volatile chemicals, light, and heat?
moisture: decadent, silica
volatile chemicals: keep away from chemicals and have container closed
Light: dark bottle so light doesnt get in
Heat: do not store in cold area, keep at room temperature
list times when positive and negative controls should be ran on reagent strips
-run positive and negative controls at least once per 24 hours or on each shift
-run controls when a new lot of strips is opened, new shipment, results are questionable, or concern of integrity of strip
-do not use distilled water as a negative control
list patient factors that can produce either an acidic or alkaline urine
alkaline-hyperventilation, presence of urease, veggie diet, vomiting, renal tubular acidosis, old specimen
acidic- diabetes, starvation, dehydration, diarrhea, e. coli, high protein diet, cranberry juice, meats
explain the relationship of urine pH to the formations of crystals and renal calculi
precipitation can be ruled out based on ph of urine
what is the significance of a urine with a ph of 9
the ph should never be above an 8.5, old specimen that should be redone
pre, renal, or post for microalbuminuria
acute phase proteins
preeclampsia
multiple myeloma
orthostatic proteinuria
prostatitis
microalbuminuria-renal
acute phase proteins-pre renal
preeclampsia-renal
multiple myeloma-pre renal
orthostatic proteinuria-renal
prostatitis-post renal
describe the solubility characteristics of Bence jones protin
they coagulate at temps between 40-60 C and dissolve when reaches 100 C
explain the protein error of indicators
-certain indicators change color in the presence of protein at a constant pH
-protein, primarily albumin, accepts H+ from the indicator
-most sensitive to albumin because albumin has more amino groups to accept H+ than other proteins
what is the primary cause of a false negative test for glucose in a urine?
old specimen, bacteria are multiplying and utilizing the glucose
how does the clinitest detect oxidizing or reducing substances? what other substances is the clinitest capable of detecting?
the reducing substances pass through and glucose, fructose, lactose, oxidizing agents
describe the phenomenon known as pass through when performing a clinitest
high concentration of glucose or reducing substance present, it passes thru the orange yellow and returns to blue, add 2 drop method to correct instead of 5 drop method
what is the primary reason that labs perform clinitest?
screen for galactosemia (inborn error in metabolism) in newborns-2 years of age
state three reasons for presence of ketones in urine
starvation, malabsorption, diabetes, vomiting, strenuous exercise, pancreatic disorders
what substance on the reagent strip is sodium nitroprusside used to detect?
Ketones, specifically acetoacetic acid and acetone when glycine is present
why may yellow brown granules appear in urine sediment?
hemociterin, denatured feratin, reabsorption of hemoglobin, severe burns, transfusion reactions, hemolytic anemias, infections/malaria, strenuous exercise, brown recluse spider bites
what is the purpose of peroxide on the reagent strip pad for blood
reagent in the pseudoperoxidase activity of hemoglobin
what is the cause for a speckled reaction on the blood reagent pad?
intact RBC produce speckled pattern, lyse when come in contact with pad
what other substances would be detected by the reagent pad for blood that would not cause a speckled reaction on the reagent pad?
hemoglobin and myoglobin uniformed reaction
what conditions are associated with the substances that can cause the reagent strip pad for blood to become positive?
hematuria-renal calculi, tumors, trauma, nephritis, glomerular disease
hemoglobinuria-transfusion reactions, hemolytic anemia, severe burns, infection/malaria, brown recluse
myoglobinuria- muscular trauma, prolonged coma, convulsions,alcoholism, drug abuse, extensive exertion
which test reactions on the reagent pad are affected by high levels of ascorbic acid? which reagent pads would not be affected by high levels?
-glucose, blood, bilirubin, nitrite, leukocyte esterase (cause false negative)
-Not affected: protein, ph, ketones, urobilinogen, and specific gravity
list in order the products formed in the degradation of hemoglobin to urobilin
Hemoglobin-protoporphryn-bilirubin- bili/albumin unconjugated-bili diglucoride conjugated-urobilinogen- stercobilinogen- urobilin
how would the reagent strip test for bilirubin and uribilinogen appear in patients with bile duct obstruction, liver damage, hemolytic disease
...
state the advantages of the ictotest over the reagent strip bilirubin test
more sensitive and specific, interfering substances get washed into the mat
what is the major cause of false negative test results for bilirubin?
photo oxidation
why is it normal to have 0.1-1.0 mg/dl of urobilinogen in urine?
because some is going to get reabsorbed into the blood through the intestines then filtered by the kidneys and excreted through urine.
how does hemolytic anemia affect urine urobilinogen? why?
would be increased, increased amount of RBC being produced because of lysis of so many RBC, which therefore increased more urobilinogen production
describe the diagnostic value of the nitrite test
rapid screening for UTI and initial screening for bladder infection cystitis, antibiotic therapy, helps screen for recurrent infections
how is it possible for a urine specimen with a very large amount of bacteria to have a negative nitrite test?
gram positive doesnt reduce nitrate to nitrite, gram negative does, must be in bladder for at least four hours, dietary nitrite has to be present for it to be reduced, could also be reduced to nitrogen gas
how is it possible to have a positive LE reaction and not see any WBC's in the microscopic exam?
it can detect lysed WBC which you wouldnt see on microscope
how do specific gravity reactions differ between reagent strips and refractometers?
reagent strips only measure ionic solutes and are better for patients on radiographic dye
what reagent strip results would you expect to be abnormal in an uncontrolled diabetic?
Glucose and ketones
confirmatory test for protein, bilirubin, galactose, and ketones? how do these results correlate with results that would be obtained from reagent strip?
protein-SSA
bilirubin- ictotest
galactose- clinitest
ketones-acutest
would be testing for the same substance but by different means and these tests are more specific
name the different types of proteins and the conditions they would be associated with
bench jones-multiple myeloma
microalbumin- diabetic necropathy and diabetes melitus
albumin- kidney disease, will let leak in from blood and pass
what are the intermediate products of fat metabolism and what reagent strip test is used to detect them?
ketones- acetone, beta hydroxybuturic acid, acetoacetic acid
what test is the nitrite test used in conjunction with as a diagnostic tool?if both nitrite and LE are positive what does this indicate?
leukocyte esterase used in conjuction
possible bacterial infection, UTI
how would the reagent strip test for bilirubin and uribilinogen appear in patients with bile duct obstruction, liver damage, hemolytic disease
bile dict obstruction-post hepatic, normal urobilinogen, increased bilirubin
liver damage- hepatic, positive urobilinogen, bili can be positive or negative
hemolytic disease-pre hepatic, bilirubin is negative, increased urobilinogen
pre renal disorders associated with protein
intravascular hemolysis
muscle injury
acute phase proteins
multiple myeloma
renal disorders associated with protein
glomerular disorder
immune complex disorder
amyloidosis
toxic agents
diabetic nephropathy
strenuous exercise
dehydration
hypertension
pre-eclampsia
orthostatic or postural proteinuria
postrenal protein disorders
lower urinary tract infections
injury
menstrual contamination
prostate fluid
vaginal secretions
ph-principle, reagent, interfering substances
double indicator
methyl red and bromthymol blue
run over from acidic protein pad and old specimens
protein-principle, reagent, interfering substances
-indicative of renal disease, protein error of indicators
-tetrabromophenol blue & tetrabromsulfonphthalein and acid buffer
-highly buffered alkaline urine, leaving reagent pad in urine too long, highly pigmented urine, false negatives for proteins other than albumin
glucose-principle, reagent, interfering substances
-double sequential enzyme reaction
-glucose oxidase
peroxidase
chromogen
potassium iodide=multistix
tetramethylbenzidine= chemstrip
-false positive: peroxide, oxidizing detergents
false negatives: enzymatic reaction, ascorbic acid, high ketones, high SG, low temp, old specimens
ketones-principle, reagent, interfering substances
-sodium nitroprusside reaction
-sodium nitroprusside
-phtalein dyes in medication, medication with sulfhydryl
false-positives from too long timing
false negative from old specimen
Blood-principle, reagent, interfering substances
-pseudoperoxidase activity of hemoglobin
-hydrogen peroxide and chromogen
-false positive: strong oxidizing agent, bacterial peroxidases menstrual contam.
false negatives: High SG/crenated cells
formalin
captopril
high concentration of nitrite
unmixed specimen
bilirubin-principle, reagent, interfering substances
-diazo reaction
-multistix: 2,4-dichloraniline diazonium salt
chemstrip: 2,6-dichlorbenzene diazonium salt
-false positive: urine pigment, pyridium, indicant, iodine
false negative: old specimen, increase ascorbic acid and nitrite
Sets with similar terms