Urine protein and Quality Control
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| Define proteinuria | Protein in the urine
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| What size protein go through the glomerular | LMW-low molecular weight proteins; glomerulus prevent passage of HMW > 69,000 amu
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| What amount of protein is usually found in the urine | None- any amount greater than trace- (small) considered significant
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| What happens to the protein that is in the filtrate | reabsorbed from the proximal convoluted tuble to the distal convoluted tuble
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| What does persistent proteinuria indicate | renal or kidney disease
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| What urine sample should be tested for protein | First morning
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| What are the causes of transient proteinuria | Physiological state- renal disease, strenuous exercise, orthostitic, dehydration, UTI, acute illness with fever
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| What is orthostatic proteinuria | Protein excreted when upright not lying down
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| Urine specimens show what results in orthostatic protein uria | First morning- neg; 2 hours later- positive
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| 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
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| 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
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| Describe Bence Jones Proteins | LMW Low molecular weight- portion of a globulin. Seen in disease called multiple myeloma
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| What is the colorimetric test | Dipstick test
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| What is the principle behind the colorimetric test | Protein error of indicators -citrite buffer PH3 yellow; tetrabromphenol PH4 blue
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| What protein is detected by the colormetric test | albumin 60- 90 percent of the time because they are the smallest
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| 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.
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| What is CLIA '88 | Clinical Laboratory Improvement Amendments developed 88- Federal Regulations. Applies to all laboratories, for accuracy and reliability of lab results
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| CLIA '88 includes requirements for which three areas of the laboratory | Personnel, Quality Control, Proficiency Testing (PC)-outside ascessing
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| How long must quality control records and patient values be kept | 2 years
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| What kind of information should the procedure manual contain | Type of specimen, Refrig. or preservative, Testing procedures, Interpertations of results, possible sources of interference
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| 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
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| What should you record if a control result is out of range | What corrected action was taken
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| Waived Certificate | Not life threatening CW/COW- can only perform waived test
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| Non- Waived Certificate | More complex, more training required- unannounced bieninnial inspections
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