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Urinalysis 2

Urine protein and Quality Control

Define proteinuria Protein in the urine
What size protein go through the glomerular LMW-low molecular weight proteins; glomerulus prevent passage of HMW > 69,000 amu
What amount of protein is usually found in the urine None- any amount greater than trace- (small) considered significant
What happens to the protein that is in the filtrate reabsorbed from the proximal convoluted tuble to the distal convoluted tuble
What does persistent proteinuria indicate renal or kidney disease
What urine sample should be tested for protein First morning
What are the causes of transient proteinuria Physiological state- renal disease, strenuous exercise, orthostitic, dehydration, UTI, acute illness with fever
What is orthostatic proteinuria Protein excreted when upright not lying down
Urine specimens show what results in orthostatic protein uria First morning- neg; 2 hours later- positive
Nephrotic syndrome is the nutritional and clinical condition that results from what Continued massive proteinuria- two or more grams of albumin (plasma protein)/ day leaving the body
In nephrotic syndrome when the glomerulus is inflamed, which protein is found in the urine albumin 60- 90 percent of the time. Slightly larger than pores
Describe Bence Jones Proteins LMW Low molecular weight- portion of a globulin. Seen in disease called multiple myeloma
What is the colorimetric test Dipstick test
What is the principle behind the colorimetric test Protein error of indicators -citrite buffer PH3 yellow; tetrabromphenol PH4 blue
What protein is detected by the colormetric test albumin 60- 90 percent of the time because they are the smallest
What reaction does alkaline, highly buffered urine; Bence Jones or globulins cause on dipstick alkaline- false pos. visibly bloody urine, chlorhexidine skin cleaners; Bence Jones, mucoproteins.
What is CLIA '88 Clinical Laboratory Improvement Amendments developed 88- Federal Regulations. Applies to all laboratories, for accuracy and reliability of lab results
CLIA '88 includes requirements for which three areas of the laboratory Personnel, Quality Control, Proficiency Testing (PC)-outside ascessing
How long must quality control records and patient values be kept 2 years
What kind of information should the procedure manual contain Type of specimen, Refrig. or preservative, Testing procedures, Interpertations of results, possible sources of interference
How often should urinalysis controls be checked and recorded Should be done according to manufacturer- Siemens pos. neg. control whenever you open new jars- each new lot, shipment, monthly if stored more than 30 days
What should you record if a control result is out of range What corrected action was taken
Waived Certificate Not life threatening CW/COW- can only perform waived test
Non- Waived Certificate More complex, more training required- unannounced bieninnial inspections