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Chemical Examination of Urine, Chpt 5

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Question
Answer
What do the urinary dip stick test for?   pH, blood, leukocyte esterase, nitrite, protein, glucose, ketones, blood, bilirubin, urobilinogen, and specific gravity.  
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How are improper results obtained on the reagent strips?   Unmixed specimen, allowing the strip to remain in urine for excess amount of time, and excess urine on pads of reagent strips.  
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When should you perform a quality control of reagent strips?   every 24 hrs for open bottles, new bottle of reagent strips, questionable results, or there is a concern about the integrity of the strips.  
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Why can't you use distilled water to test a negative control?   because the reagent strips are designed to perform at ionic concentrations similar to urine.  
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What is the orange pigment present in urine that is caused by the patient?   Phenazopyridine ompounds that are found in the urine of patients taking certain medicines.  
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What organ(s) are the major regulators of the acid-base content in the body?   Lungs and kidneys  
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How is the acid-base content maintained?   By secretion of hydrogen in the form of ammonium ions, hydrogen phosphate, and weak organic acids, and by the reabsorption of bicarbonate form the filtrate in the convoluted tubules.  
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What is the pH of the first morning specimen?   slighly acidic 5.0 to 6.0  
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Is the urine acidic or alkaline after meals.   more alkaline  
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What is the range of pH from random samples?   4.5 to 8.0  
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What is the pH influenced by, or what other patient information must be considered in conjunction with?   Diet, medication, acid-base content of blood, renal function, presence of urinary tract infection, age of specimen.  
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What is the importance of urinary pH?   Primarily as an aid in determining the existence of systemic acid-base disorders of metabolic or respiratory origin and in the management of urinary conditions that require the urine to be maintained at a specific pH.  
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Is the urine acidic or alkaline if there is a respiratory or metabolic acidosis/ketosis present but not related to renal function disorder.   acidic  
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Is the urine acidic or alkaline if there is a respiratory or metabolic alkalosis present?   alkaline  
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If the urine doesn't conform to this pattern, what does it mean?   May be used to rule out the suspected condition or may indicate a disorder resulting from the kidneys' inability to secrete or to reabsorb acid or base.  
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What do the precipitation of inorganic chemicals dissolve in the urine form and how does it relate to pH?   Urinary crystals and renal calculi; and precipitation depends on urinary pH.  
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How does controlling the urine pH help control crystals and stones?   By making it incompatible with the precipitation of the particular chemicals causing the calculi formation.  
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What is the primarily pH of a person on a high-protein and high-meat diet?   acidic  
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What is the primarily pH of a vegetarian?   alkaline  
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What does it mean if a freshly excreted urine produces a pH of 9.   A pH of 9 means that it is a improperly preserved specimen. No normal or abnormal condition would produce a 9 pH.  
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What are some of the causes of acidic urine?   Emphysema, diabetes mellitus, starvation, dehydration, diarrhea, presense of acid-producing bacteria, high-protein diet, cranberry juice and some medications.  
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What are some of the causes of alkaline urine?   Hyperventilation, vomiting, renal tubular acidosis, presence of urease-producing bacteria, vegetarian diet, and old specimens.  
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What are the clinical significance of urine pH?   Respiratory/metabolic acidosis/ketones, respiratory/metabolic alkalosis, defects in renal tubular secretion & reabsorption of acids and bases-renal tube acidosis,stone formation, treatment of uti, precipitation/id of crystals, determines bad specimens.  
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What does increased pH cause?   It causes false positive protein results.  
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How is pH measured and what is the range?   It is measured in 0.5 to 1-unit increments b/w 5 and 9.  
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What is the double-indicator system?   It is what is use to measure the wide range of pH and its measured by using methyl red and bromthymol blue.  
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What is the pH range for methyl red and what does it change to?   It produces a color change from red to yellow in the pH range of 4.4 to 6.2.  
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What is the pH range for bromthymol blue and what does it change to?   It turns to yellow to blue in the range of 6.0 to 7.6.  
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What is the combined color change for a double-indicator system, explain?   In the pH range 5 to 9 measured by reagent strips, one sees colors progressing from orange at pH 5 through yellow and green to a final deep blue at pH 9. Methyl red + H^+ --> Bromthymol blue - H^+(Red-Orange-->Yellow) (Green-->Blue)  
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Even though there are no known substances that interfere with urinary pH measurements, what could happen to cause a alkaline urine to falsely read acidic?   Runover from a highly acidic protein pad.  
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