Chemical Examination of Urine Chpt. 5 Part 2 Protein and Glucose
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| What is a early indicative of renal disease on a routine chemical test performed on urine? | show 🗑
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| What is a normal 24hr range for protein? | show 🗑
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| show | Albumin
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| show | negative
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| What is the normal amount of protein found in normal urine or first morning sample? | show 🗑
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| show | Because majority of albumin presented to the glomerulus is not filtered, and much of the filtered albumin is reabsorbed by the tubules.
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| show | small amounts of serum and tubular microglobulins, Tamm-Horsfall protein produced by the tubules, and proteins from prostatic, seminal, and vaginal secretions.
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| show | ≥30 mg/dL (300 mg/L)
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| show | prerenal, renal, and postrenal, which is based on the origin of the protein.
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| What does prerenal proteinuria mean? | show 🗑
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| show | Because it's caused by increased levels of low-molecular weight plasma proteins such as hemoglobin, myoglobin, and the acute phase reactants associated with infection and inflammation.
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| What are some of the causes of transient proteinuria? | show 🗑
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| What is Orthostatic proteinuria? | show 🗑
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| show | Obtain a first morning sample which would be negative and get a second sample after remaining in the vertical position for several hours. The second sample would be positive.
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| show | No
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| What do Bence Jones protein excretion indicate? | show 🗑
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| show | a proliferative disorder of the immunoglobulin-producing plasma cells, the serum would contain markedly elevated levels of monoclonal immunoglobulin light chains(Bence-Jones protein).
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| show | Bence J. protein coagulates at temps b/w 40°C to 60°C and dissolves when the temp reaches 100°C. Specimen that appears turbid b/w 40 t0 60°C and clear at 100°C.
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| Renal Proteinuria is associated with? | show 🗑
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| show | selective filteration is impaired, and increased amounts of serum protein and eventually rbc and wbc pass through the membrane and are excreted in the urine.
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| show | Amyloid material, toxic substances, and the immune complexes found in lupus and streptococcal glomerulonephritis.
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| What is the amount of protein that appears in urine following glomerular damage? | show 🗑
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| Why is increased albumin in the urine if it's tubular proteinuria? | show 🗑
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| What are some of the causes of tubular dysfunction? | show 🗑
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| show | No
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| Why isn't discovery of protein in a random sample not always pathologic significance? | show 🗑
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| show | Diabetic nephropathy leading to a reduced glomerular filtration and eventual renal failure.
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| What can the onset of renal complications first be detected by? | show 🗑
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| show | Cardiovascular disease
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| What type of urine sample if required to detect microalbumin? | show 🗑
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| How are the results reported if testing for microalbumin? | show 🗑
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| When is microalbumin considered significant? | show 🗑
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| show | protein added to a urine specimen as it passes through the structures of the lower urinary tract(ureters, bladder, urethra, prostate, and vagina).
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| What are some of the causes of protein in postrenal proteinuria? | show 🗑
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| What does protein error of indicators mean and why does this happen? | show 🗑
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| How are the results read for protein? | show 🗑
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| show | considered less than 30mg/dL. The specific gravity of the specimen should be considered b/c a trace protein in a dilute specimen is more significant than in a concentrated specimen.
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| How can highly buffered alkaline urine override the acid buffer system? | show 🗑
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| What can cause a false positive reading with proteinuria? | show 🗑
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| What causes false negative results with proteinuria? | show 🗑
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| What is the confirmatory test for urine protein? | show 🗑
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| show | cold precipitation test that reacts with all forms of proteins, performed on centrifuged specimens, mix equal volumes of SSA with centrifuged urine and grade for turbidity.
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| What are some of the sources of errors associated with SSA? | show 🗑
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| How would you know if you have a radiographic dye or other substances in urine for a SSA test? | show 🗑
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| Under normal conditions glucose should be: | show 🗑
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| How should urine samples be obtained for gluose monitoring? | show 🗑
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| Why is the second voided sample after fasting preferred? | show 🗑
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| What is the Clinical significance of testing for Glucose in urine? | show 🗑
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| What are the 2 different methods for glucose detection? | show 🗑
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| What does glucose oxidase test for? | show 🗑
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| show | by impregnating the testing area with a mixture of glucose oxidase, peroxidase, chromogen, and buffer to produce a double sequential enzyme reaction.
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| What are the steps that the reagent strips uses to test for glucose? | show 🗑
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| How is urine glucose results reported? | show 🗑
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| How do false positive reactions occur with the glucose oxidase test? | show 🗑
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| show | by high levels of ascorbic acid, high levels of aspirin and low specific gravity, technical error of allowing specimens to remain unpreserved.
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| How does absorbic acid cause a false negative? | show 🗑
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| show | It test for glucose and other reducing substances, such as galactose, aspirin, and vitamin C. The test relies on the ability of glucose and other substances to reduce copper sulfate to cuprous oxide in the presence of alkali and heat.
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| show | Tablet contains copper sulfate, sodium carbonate, sodium citrate, and sodium hydroxide. You add tablet to urine & dilute with water. Sensitivity is 200mg/dL.
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| Explain the "pass through" | show 🗑
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| show | 1+ reagent strip and neg. clinitest is okay because clinitest isn't as sensitive as the reagent strips but a strong positive strip and a neg clinitest test could mean contamination by strong oxidizing agents.
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| What is the most significant discrepancy with the glucose oxidase and clinitest? | show 🗑
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| show | all other reducing substances such as galactose, aspirin, ascorbic acid, an cephalosporins.
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| show | none because it's a rare finding.
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| show | galactose in urine in newborns represents "inborn error of metabolism" in which lack of the enzyme galactose-1-phosphate uridyl transferase prevents breakdown of ingested galactose causing complications and/or death.
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