Urinalysis test for Clinical Chemistry Del-Tech Owens After Review
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| What is the amount of renal blood flow for the average sized person? | 1200 mL/min
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| What is the amount of renal plasma flow for the average sized person? | 600-700 mL/min
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| Particles below what molecular weight, in Daltons, are allowed to pass through the glomerulus? | 70,000
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| Name 3 factors that influence the filtration process? | 1. Cell structure 2. Hydrostatic and oncotic/osmotic pressure 3. RAAS
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| How much filtrate passes through the glomerular every minute? | 120 mL/min
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| What is the specific gravity of ultrafiltrate? | 1.010
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| How much is the glucose threshold? | 160-180 mg/dL
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| If there's 120 mL of filtrate passing through the glomerular every minute, how much is that per day? | 172.8 Liters or 172,800 mL
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| What is the greatest source of error while running a creatinine clearance test? | Improperly timed specimen
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| The amount of creatinine that is completely removed from the plasma in 1 minute is called the ? | glomerular filtration rate
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| How is the GFR reported? | Milliliters per minute (mL/min)
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| How do you calculate the GFR? | Milliliters in 24 hour specimen/minutes collected: If 24 hour specimen=1440 mL, then you multiply the number of hours (24) by the number of mins per hour (60) which also = 1440. So the GFR=1 because 1440/1440=1
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| Creatinine is produced as a result of muscle ? | destruction
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| The larger the person, the __ creatinine they will produce. | more
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| The average amount of creatinine produced by men is ? | 107-139 mL/min
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| the average amount of creatinine produced by women is ? | 87-107 mL/min
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| Creatinue values will be __ in the elderly. | lower
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| Serum levels of cystatin C directly reflect the ? | GFR
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| Cystatin C is a small protein produced by __ __ __ and that is filtered by the glomerulus. | all nucleated cells
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| Explain what the GFR represents. | The amount of creatinine that is removed from blood plasma every minute.
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| Freezing point osmometry is based on ? | freezing points
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| PAH is a test for renal ? | blood flow
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| PAH is an __ procedure. | exogenous
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| Cystatin C is filtered by what part of the kidney? | glomerulus
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| PAH is secreted in the __ __ __, not by glomerular filtration. | proximal convoluted tubule
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| PAH is loosely bound to __ __. | plasma proteins
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| Cystatin C is absorbed by what part of the kidney? | renal tubules
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| PAH is completely removed from the blood each time it comes in contact with functional ? | renal tissue
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| What 2 components are always present in urine? | Creatinine and urea
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| Name 3 inorganic components that are part of urine? | 1. chloride 2. sodium 3. potassium
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| How much cystatin C is secreted by the kidneys? | None
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| The average range for urine excretion is ? | 1200-1500 mL
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| Urine excretion within this range is still considered normal. (HINT: range is wider than 1200-1500 mL) | 600-2000 mL
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| Someone who excretes less than 400 mL of urine every day has ? | oliguria
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| Name 4 causes of oliguria. | 1. vomiting 2. diarrhea 3. perspiration 4. severe burns
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| No urine excretion is called ? | anuria
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| Name 2 causes of anuria. | 1. severe kidney damage 2. decreased renal flow (blockage)
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| 2-3 times the urine excretion at night than in the day is called ? | nocturia
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| Excreting more than 2.5 L/day of urine is called ? | polyuria
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| Someone with polydipsia does a lot of what? | drinking and urinating
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| Someone with increased urine excretion because they need to excrete excess glucose that has not been reabsorbed from the ultrafiltrate has ? | diabetes mellitus
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| Someone with diabetes mellitus exhibits __. | polydipsia
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| What are 2 telltale signs of diabetes mellitus that can be detected in urine? | 1. urine is dilute 2. has high specific gravity 3. glucose
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| How much urine does a person have to excrete to have oliguria? | less than 400 mL
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| Someone with decreased ADH that cause decreased reabsorption of water from ultrafiltrate has ? | diabetes insipidus
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| Someone with diabetes insipidus has dilute urine with a __ specific gravity. | low
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| Name two things that diabetics with diabetes mellitus and diabetes insipidus have in common. | 1. Urine is dilute 2. polydipsia
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| How much more urine does someone have to excrete at night than during the day to have nocturia? | 2-3 times
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| How much urine does a person have to excrete to have polyuria? | more than 2.5 Liters per day
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| Someone with increased glucose in their urine has diabetes mellitus or insipidus? | mellitus
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| Which kind of diabetes is due to a lack of insulin? | mellitus
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| Unless it has been refrigerated, urine samples need to be in the lab within __ hours of collection. | 2
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| Should you accept a urine sample that is unlabeled or if the name on the label didn't match the name on the requisition? | No
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| If a urine container is contaminated with feces or paper, can you accept it? | No
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| What 7 urine values will go down (decrease) if a sample is left out 3+ hours. | 1. clarity 2. glucose 3. ketones 4. bilirubin 5. urobilinogen 6. blood cells 7. casts
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| What 6 urine values will go up (increase) if a urine sample is left out for 3+ hours. | 1. color (darkens) 2. odor 3. nitrite 4. bacteria 5. pH 6. tubidity
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| Which kind of urine sample is ideal for urine screening? | first morning specimen
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| First morning urine specimens are more __ than random specimens. | concentrated
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| What is the first step during a 24 hour urine collection procedure? | Give patient written instructions, container, and preservative for specimen.
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| What is the 2nd step during a 24 hour urine collection procedure? | Day 1: patient voids and discards first specimen of the day, then begins to collect all urine over the next 24 hours in container.
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| What is the 3rd step during a 24 hour urine collection procedure? | Day 2. patient voids and adds his urine to previously collected specimens.
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| What is the 4th step during a 24 hour urine collection procedure? | Patient arrives at lab where the the full 24 hour collection of urine is mixed. It's volume will be measured and recorded.
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| What is the 5th and final step during a 24 hour urine collection procedure? | An aliquot of the urine specimen is saved for testing. The remaining urine is discarded.
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| Accurate __ of a 24 hour urine specimen collection procedure is critical for good results. | timing
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| A 24 hour urine collection procedure must begin and end with an __ __. | empty bladder
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| A clean catch urine sample is one where the genital area has been __ before urinating. | cleaned
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| What are the most common sources of contamination for a pediatric urine specimen? | feces and talc
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| What is the normal range of urine pH? | 4.5-8
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| A __ amount of protein in urine isn't a cause for concern. | trace
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| More than a trace amount of protein in urine is most indicative of ? | renal disease
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| Protein in the urine is a condition known as ? | proteinuria
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| You can normally find less than how much protein in the urine of a healthy person? | less than 10 mg/dL
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| What kind of protein is of primary concern when testing urine? | albumin
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| If found in the urine, Bence Jones proteins indicates what condition? | multiple myeloma
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| Prerenal proteinuria affects the __, not the kidneys. | plasma
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| Diet and metabolic factors are __ causes for proteinuria. | prerenal
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| Glomerular damage or tubular problems are causes of __ proteinuria. | renal
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| Fanconi syndrome is an example of __ proteinuria. | renal
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| Toxic substances and viral infections can cause what kind of proteinuria? | renal
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| If someone's urine proteins levels change based on what position they are in, they have __ __. | orthostatic proteinuria
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| Menstrual contamination, semen, prostatic fluids, vaginal secretions, and traumatic injuries are all potential causes of __ proteinuria. | postrenal
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| Name 3 intermediate products (ketones) of fat metabolism. | 1. acetone 2. acetoacetic acid 3. beta-hydroxybutyric acid
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| Of the 3 products of fat metabolism (ketones), which cannot be tested for? | beta-hydroxybutyric acid
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| When are ketones produced in the body? | When the body burns fat for energy
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| Ketones may appear in the urine if blood __ is too high. | glucose
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| People with ketones in their blood may have ? | diabetes or ketoacidosis
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| Without insulin, glucose in the blood can't be store and used for __. | energy
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| Clear, red urine can be caused by __. | DIC or hemolytic anemia
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| Cloudy, red urine can be caused by __. | Blood cells in the urine
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| Hematuria is? | intact RBCs in cloudy red urine
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| Hemoglobinuria is? | hemoglobin in clear, red urine
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| If you have no urobilinogen in your urine but bilirubine is high, you have ? | bile duct obstruction
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| If you have some bilirubin and medium levels of urobilinogen in your urine, you have ? | liver damage
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| If you have no bilirubin in your urine but high levels of urobilinogen, you have ? | hemolytic disease
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| Nitrites and leukocyte esterase are produced as a result of an ? | infection or UTI infection
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| Ascorbic acid can create false negatives for what tests on a reagent stick? | glucose, blood, bilirubin, nitrite, LE
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| Name the 3 primary causes of ketones being found in the urine? | 1. diabetes mellitus 2. vomiting 3. starvation/malabsorption
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| If bilirubin is present in a urine sample, shaking it will produce what color foam? | yellow
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| If bilirubin is found in a urine sample, this suggests the patient may have ? | hepatitis virus/liver disease
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| Patient's with malignant melanoma may have what color of urine? | black
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| Direct measure of a samples specific gravity can be obtained with what tools? | urinometer, HOD
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| Name 2 indirect methods for obtaining specific gravity of urine? | refractometer, reagent strip
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| What are 3 substances that can be used to calibrate a refractometer? | 1. distilled water 2. 5% sodium chloride 3. 9% sucrose
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| If specific gravity of urine is off the scale, you can __ it to get a result that can be read. | dilute
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| A 1:2 dilution of urine with a reading of 1.030 will be recorded with a specific gravity of ? | 1.060 (2 x. 030)
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| What 3 tests are first morning specimens preferred for? | 1. routine screening (random also used) 2. pregnancy tests 3. orthostatic protein
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| A colorless urine sample could be due to ? | recent fluid consumption
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| A pale yellow urine sample could be due to ? | polyuria, diabeted mellitus, dilute random speciment
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| A dark yellow urine sample could be due to ? | concentrated specimen
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| An amber urine sample could be due to ? | dehydration (which could be induced by fever or burns)
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| An orange urine sample could be due to ? | bilirubin
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| A yellow-green or yellow-brown urine sample could be due to ? | biliverdin (oxidized form of bilirubin)
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| A green urine sample could be due to ? | *Pseudomonas* infection (remember to underline this answer for italics)
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| A blue-green urine sample could be due to several causes. Name 6 of them. | 1. Ellavil/amitriptyline (same thing) 2. methocarbamol/Robaxin (same thing) 3. clorets 4. indican 5. methylene blue 6. phenol
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| A pink/red cloudy urine sample that tests + for blood could be due to ? | RBCs in blood (hematuria)
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| A pink/red clear urine sample that tests + for blood could be due to ? | Hemoglobin (hemoglobinuria)/myoglobin
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| A sample with hemoglobin in it could be due to ? | intravascular hemolysis
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| A port-wine colored urine sample that tests negative for blood may be due to ? | porphyrins
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| If RBCs in the blood oxidize into methemoglobin, the sample could turn ? | brown-black
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| Methemoglobin is __ hemoglobin. | denatured
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| For genetic reason, some people who eat beets may excrete what color of urine? | red
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| Homogentistic acid (alkap-tonuria) can turn urine what color ? | brown-black
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| What are the 5 descriptions for urine clarity, from highest clarity to lowest clarity? | clear, hazy, cloudy, turbid, milky
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| Metronidazole (flagyl) can urine to __ upon standing. | darken/turn brown-black
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| Hemoglobinuria will be accompanied by what color of plasma? | red
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| Myoglobinuria will be accompanied by what color of plasma? | clear
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| What is the refractive index, which is used by a refractometer to measure specific gravity? | a comparison of the velocity of light in air with the velocity of light in a solution.
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| Specific gravity is a comparison of a __ __ of distilled water with another solution, like urine, that is influenced by the number and size of the particles present. | similar volume
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| Osmolarity is related to __ __, but is unaffected by the size of the particles present. | specific gravity
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| How does urine travel from the kidneys to the bladder? | ureter
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| A word for low urine excretion but for a level that's still higher than oliguria (which is excretion of less than 400 mL) is ? | dysuria
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| Urine with a "mousy" smell is probably due to ? | phenylketonuria
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| Orthostatic proteinuria manifests when the patient is __ but disappears once the patient is __ __. | standing, laying down
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| Pyuria is __ in the urine. | pus or WBCs
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