Chemical Examination of Urine Chpt. 5 Part 2 Protein and Glucose
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| show | protein
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| What is a normal 24hr range for protein? | show 🗑
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| What is the major serum protein found in normal urine and it's what the reagent strip is testing for? | show 🗑
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| show | negative
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| show | less than 10mg/dL or 100 mg per 24 hours.
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| Even though albumin is present in high concentrations in the plasma, why is the content low in the urine? | show 🗑
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| What are some of the other proteins? | show 🗑
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| show | ≥30 mg/dL (300 mg/L)
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| show | prerenal, renal, and postrenal, which is based on the origin of the protein.
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| show | it's caused by conditions affecting the plasma prior to its reaching the kidney and, therefore, is not indicative of actual renal disease.
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| show | Because it's caused by increased levels of low-molecular weight plasma proteins such as hemoglobin, myoglobin, and the acute phase reactants associated with infection and inflammation.
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| show | Exercise, dehyration, fever, an Orthostatic Proteinuria.
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| show | It's a persistant benign proteinuria that occurs frequently in young adults from periods of vertical posture which puts pressure on the renal vein.
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| show | Obtain a first morning sample which would be negative and get a second sample after remaining in the vertical position for several hours. The second sample would be positive.
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| show | No
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| show | Multiple Myeloma
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| What is multiple myeloma? | show 🗑
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| show | Bence J. protein coagulates at temps b/w 40°C to 60°C and dissolves when the temp reaches 100°C. Specimen that appears turbid b/w 40 t0 60°C and clear at 100°C.
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| show | True renal disease caused by either glomerular or tubular damage.
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| show | selective filteration is impaired, and increased amounts of serum protein and eventually rbc and wbc pass through the membrane and are excreted in the urine.
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| What are some of the causes of glomerular proteinuria? | show 🗑
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| show | ranges from slightly above normal to 4g/day.
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| Why is increased albumin in the urine if it's tubular proteinuria? | show 🗑
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| show | exposure to toxic substances and heavy metals, severe viral infections and Fanconi syndrome.
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| Are markedly elevated protein levels seldom seen in tubular disorders? | show 🗑
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| Why isn't discovery of protein in a random sample not always pathologic significance? | show 🗑
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| What can Type 1 and type 2 diabetes mellitus cause? | show 🗑
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| show | Microalbuminuria
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| What other condition can be associated with if the patient has microalbumin in their urine? | show 🗑
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| What type of urine sample if required to detect microalbumin? | show 🗑
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| show | Using quantitiatve procedures results are reported in mg of albumin/24 hrs or as the albumin excretion (AER) in ug/min.
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| When is microalbumin considered significant? | show 🗑
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| show | protein added to a urine specimen as it passes through the structures of the lower urinary tract(ureters, bladder, urethra, prostate, and vagina).
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| What are some of the causes of protein in postrenal proteinuria? | show 🗑
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| show | Indicators change color in the presence of protein at a constant pH. Strong buffer, in protein pad, resists any change in urine pH. Therefor if protein is present, albumin will effect the color change BUT the pH in the pad does not change.
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| show | negative, trace, 1+, 2+, 3+, and 4+; or semiquantitative values of 30, 100, 300, or 2000 mg/dL.
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| How are trace values considered? | show 🗑
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| How can highly buffered alkaline urine override the acid buffer system? | show 🗑
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| show | presence of bacteria which cause HIGH pH. reaction doesn't take place under acidic conditions, highly pigmented urine and contamination of the container with quaternary ammonium compounds, detergents, and antiseptics.
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| What causes false negative results with proteinuria? | show 🗑
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| What is the confirmatory test for urine protein? | show 🗑
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| Explain SSA | show 🗑
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| What are some of the sources of errors associated with SSA? | show 🗑
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| show | Radiographic material is suspected if their is a markedly elevated specific gravity and the turbidity also increases on standing due to the precipitation of crystals rather than protein.
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| show | Negative in urine, almost all the glucose filtered by the glomerulus is reabsorbed in the proximal convolute tubule by active transport, Renal threshold is 160-180mg/dL.
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| show | fasting sample, 2-hr post pranial and second sample preferred.
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| show | The first morning sample does NOT always represent a fasting sample because glucose from the evening meal may remain in the bladder.
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| show | Checking for diabetes mellitus, gestational diabetes, stress hormones(gluconeogenesis) Advance renal disease(glucose isn't reabsorbing back), Faconi's syndrome(overflow of glucose), and hormones that cause glycongenolysis.
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| What are the 2 different methods for glucose detection? | show 🗑
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| show | specific for glucose
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| show | by impregnating the testing area with a mixture of glucose oxidase, peroxidase, chromogen, and buffer to produce a double sequential enzyme reaction.
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| show | Step one glucose oxidase catalyses the reaction b/w glucose and room air to produce glouconic acid and peroxide. The second step, peroxidase catalyzes the reaction b/w peroxide an chromogen to form an oxidized colored compound that represents glucose.
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| How is urine glucose results reported? | show 🗑
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| show | the container being contaminated with peroxide or strong oxidizing detergents.
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| show | by high levels of ascorbic acid, high levels of aspirin and low specific gravity, technical error of allowing specimens to remain unpreserved.
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| How does absorbic acid cause a false negative? | show 🗑
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| show | It test for glucose and other reducing substances, such as galactose, aspirin, and vitamin C. The test relies on the ability of glucose and other substances to reduce copper sulfate to cuprous oxide in the presence of alkali and heat.
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| Explain the clinitest. | show 🗑
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| show | The color produced passes through the orange/red stage and returns to a green-brown color
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| Compare glucose oxidase and clinitest | show 🗑
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| show | A negative reagent strip but a positve clinitest test. This could mean interference of other substances but usually means other sugars are present.
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| What are the false positives for the copper reduction method? | show 🗑
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| show | none because it's a rare finding.
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| show | galactose in urine in newborns represents "inborn error of metabolism" in which lack of the enzyme galactose-1-phosphate uridyl transferase prevents breakdown of ingested galactose causing complications and/or death.
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