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BF exam2
BF terms
| Question | Answer |
|---|---|
| What is Bence Jones Protein? | low-molecular-weight protein which consists with monoclonal immunoglobulin light chains. It coagulates at 40-60C, and dissolves at 100C. If this presence is suspected, the person may have multiple myeloma. |
| What does urinary pH help to detect? | 1. metabolic or repiratory acidosis or alcalosis 2.how the urine was maintained 3. kinds of crystals formed 4. person's dietary habit 5. medications the person took |
| What is often associated with early renal disease? | proteinuria |
| what is three major categories of proteinuria? | 1.prerenal 2.renal 3.postrenal |
| Which category of proteinuria is not indicative of actual renal disease? | prerenal |
| How does prerenal proteinuria occur? | Increased plasma proteins exceeds the normal absorptive capacity of renal tubules and overflow into the urine. |
| What kind of protein presence is a good example of rerenal protenuria? | Bence Jones Protein |
| What possibility does renal proteuria indicate? | it indicates Glomerular or tubular damage |
| What makes increased amount of serum protein or abnormal substances pass through to the urine? | glomerular membrane damage |
| What is another cause of renal proteinuria can occur during strenuous exercise and dehydration? | Increased pressure from the blood entering the glomerulus which override the selective filtration of the glomerulus. |
| How does tubular dysfunction cause protenuria? | Dysfunctional tubules cannot reabsorb albumin and accumulated albumin is excreted in urine |
| What will be caused by keeping vertical position? | Orthostatic (postural) proteinuria. |
| When microalbuminuria is observed, what is suspected? | Reduced glomerular filtration caused by diabetic nephropathy is suspected. |
| What is the example of tubular proteinuria? | Fanconi syndrome. |
| what kind of principle is used for traditional reagent strip testing for protein? | protein error of indicators. protein removes hydrogen ion from indicators and indicators change colors. |
| At what kind of situation, reagent strip cannot react well? | when the sample is too alkaline, too concentrated. |
| What kind of test will be performed to confirm positive protein results of reagent strip? | sulfosalicyclic acid precipitation test (SSA) |
| What kind of test will be performed for protein if the sample is too alkaline? | SSA |
| what kind of method is used to test microalbuminuria? | immunochemical assays. |
| At where almost all the glucose filtered by the glomerulus is reabsorbed? | proximal convoluted tubule |
| what is called when the blood level of glucose become elevated? | hyperglycemia |
| what is called when glucose appears in a urine? | glycosuria |
| what is called a hyperglycemia that occurs during pregnancy and disappears after delivery? | gestational diabetes |
| what is called the function of insulin to convert glucose to glycogen for storage? | glycogenesis |
| what is called the function of breakdown of glycogen to glucose? | glycogenolysis |
| when glycosuria occurs in the absence of hyperglycemia, what is suspected? | renal glycosuria which the reabsorption of glucose by the renal tubules is compromised. |
| At what stage of renal disease renal glycosuria can be seen? | end-stage renal disease such as Fanconi syndrome. |
| What are two tests to measure urinary glucose? | glucose oxidase procedure and copper reduction test |
| Which test is a specific test for glucose? | oxidase procedure |
| What substances can copper reduction test react? | any reducing substances |
| what cause false-negative results for reagent strip for glucose? | ascorbic acid which prevent oxidation of the chromogen |
| what is the greatest source of false-negtive glucose results? | technical error of allowing specimens to remain unpreserved at room temperature for extended periods. |
| What is the name of copper reduction test? | Clinitest |
| What is called the phenomenon that the color produced goes to strong positive and returns to negative color? | pass through |
| How pass through can be avoided? | using two drops of urine instead of five drops |
| why Clinitest cannot be a confirmatory test for glucose? | Clinitest detects any reducing substances such as galactose, lactose, fructose, maltose, pentoses ascorbic acid. |
| Clinitest is used for under 2-year-old child. why? | Because Clinitest can detect the presence of galactose which means the child have inborn error of metabolism. |
| When you conducted tests for glucose, you obtained negative from reagent strip and positive from Clinitest. What you will suspect? | Nonglucose reducing substance is present. It can be garactose. |
| When you conducted tests for glucose, you obtained 1+ positive from reagent strip and negative from Clinitest. What you will suspect? | small amount of glucose present. Clinitest is not as sensitive as reagent strip. |
| When you conducted tests for glucose, you obtained 4+ from reagent strip and negative from Clinitest. What you will suspect? | Possible ixidizing agent interference on reagent strip |
| what are the three intermediate products of fat metabolism represents the term ketones? | acetone, acetoacetic acid, betahydroxybutyric acid. |
| What will happen when carbohydrate in the body becomes compromised? | Body starts to use fat for energy and produce ketone bodies. |
| What is called ketones in urine? | ketonuria |
| What will kitonuria tell? | deficiency in insulin for type1 diabetes mellitus patient |
| What is the test called for severe kitosis? | Acetest |
| What is called if intact red blood cells are found in a urine? | hematuria |
| What is called if hemoglobin is found in a urine? | hemoglobinuria |
| What is the cause of the appearance of hemoglobin in a urine? | By hemolytic disorders or lysis of red blood cells, it will appear in a urine |
| There are other tests like visual observation or microscopic examination for blood. How different is each test? | Visual test can differenciate the sample between hematuria or hemoglobinuria, but it cannot detect the presence of blood. Microscopic examination can detect intact red blood cells, but not free hemoglobin. |
| Hemoglobinuria can be found particularly in what kinds of urine condition? | dilute and alkaline urine |
| How does hemoglobin start to be filtered in glomerulus? | When the amount of free hemoglobin present exceeds the haptoglobin content. |
| In what situation does free hemoglobin exceeds the haptoglobin? | It occurs is hemolytic anemias, transfusion reaction, severe burn, strenous exercise. |
| what is called the large yellow-brown granules in the renal tubular epithelial cells or urine sediment which are resulted from free hemoglobin reabsorbtion? | hemosiderin |
| Where is myoglobin found? | in muscle tissue |
| When myoglobin is in urine, what color you will observe? | red-brown. cola color |
| What symptoms you will suspect from the presence of myoglobin? | rhabdomyolysis |
| What is rhabdomyolysis? | muscle disruction |
| What will high concentrations of myoglobin cause? | it is toxic for renal tubules and will cause acute renal failure |
| When you find elevated serum levels of creatinine kinase and lactic dehydrogenease, which you will suspect, hemoglobinuria or myoglobinuria? | myoglobinuria |
| when you find clear red urine in two samples and one has red plasma and another has clear plasma, what you will determine? | red plasma is showing hemoglobinuria and clear plasma is showing myoglobinuria. |
| To screen for the presence of myoglobin, what chemical will be used? | ammonium sulfate |
| What can you detect by the presence of bilirubin in a urine? | It can detect liver disease and jaundice. |
| When bilirubin appears in the urine? | it appears when the normal degradation cycle is disrupted by obstruction of the bile duct or liver is damaged. |
| What reaction is used for bilirubin by reagent strip? | diazo reaction |
| What test will be performed for questionable results from reagent strip? | Ictotest |
| What can you detect by urobilinogen in a urine? | liver disease and hemolytic disorders |
| What is unpathological cause of increased amount of urobilinogen? | constipation |
| What is the problem using Ehrlich reaction to detect urobilinogen? | Ehrlich reagent can detect other Ehrlich-reactive compounds such as porphobilinogen. |
| What test can differentiate between urobilinogen from porphobilinoge? | Watson-Schwartz differentiation test |
| In Watson-Schwartz test, what shows positive in chloroform? | Urobilinogen |
| In Watson-Schwartz test, what shows positive in butanol? | Urobilinogen ant other Ehrlich-reactive compounds other than porphobilinogen. |
| In Watson-Schwartz test, in what is porphobilinogen soluble? | It is soluble in neither chloroform nor butanol, and make red in other part of the solution. |
| If your sample contains urobilinogen, how does two tubes appear? | 1st tube shows red in lower chloroform layer and 2nd tube shows red in upper butanol layer. |
| What nitrite test can detect? | It can detect bacteriuria. |
| What is caused by bacteriuria? | Urinary track infection (UTI) |
| Why do many laboratories use the nitrite test in combination with the leukocyte esterase test? | Because there are bacteria that lack the enzyme reductase and nitrite test cannot detect them |
| What leukocyte esterase test can detect? | it detects increased urinary leukocytes showing the sign of UTO or the presence of bacteria in a urine |
| What do infections caused by Trichomonas, Chlamydia, yeast produce? | leukocyturia without bacteriuria |
| What is the predominant WBC found in the urine sediment? | neutrophil |
| Which cells are referred to as "glitter cells?" | neutrophils |
| What is associated with the presence of neutrophils? | microbial infection |
| When eosinophils will be present in the sediment? | In cases of drug-induced allergic reaction producing inflammation of the renal interstitium |
| What is the preferred stain for urinary eosinophils? | Hansel stain and Wright's stain |
| What will Prussian blue stain stains? | hemosiderin granules |
| what is called the increase in urinary WBCs? | pyuria |
| What is the clue cell? | It is the cell covered by Gardnerella vaginalis and indicative of vaginal infection. |
| What does an increase in transitional cells exhibiting abnormal morphology indicate? | malignancy or viral infection |
| What does the presence of more than two RTE cells per high-power field indicate? | tubular injury |
| What does the increased amounts of RTE cells indicate? | necrosis of the renal tubules |
| When you see single cuboidal cells in a urine, what do you suspect? | I suspect the salicylate poisoning. |
| What does RTE cells absorbed bilirubin indicate? | Liver damage |
| What does RTE cells contained hemosiderin indicate? | hemoglobinuria |
| What is hemosiderin? | It is yellow-brown granules converted from hemoglobin |
| what are oval fat bodies? | They are RTE cells absorb lipids that are present in the glomerular filtrate. |
| What stain is used to stain oval fat bodies? | Sudan III or Oil Red O fat stains. |
| What is the droplet of oval fat bodies composed of? | It is composed of tryglycerides, neutral fats, and cholesterol. |
| What do you suspect if your sample has lipiduria? | tubular necrosis, diabetes mellitus |
| If nitrite test is positive and pH is above 8, what you will do? | I determine that the specimen is unacceptable |
| What you will observe to differentiate bacteria from amorphous phosphates and urates? | observe motility |
| What is a major constituent of mucus? | Tamm-Horsfall protein. |
| In what kind if urine, the cast matrix dissolves quickly? | in dilute alkaline urine |
| What is a major constituent of cast? | Tamm-Horsfall protein |
| May Broad casts result in the case of? | extreme urine stasis |
| What therms is used for the presence of urinary casts? | cylindruria |
| What does the presence of RBC cast tell? | It shows bleeding within the nephron. |
| Of what are waxy casts representative ? | extreme urine stasis, chronic renal failure |
| What casts are often referred to renal failure casts? |
Created by:
hiroko lucky
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