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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What is the result of urinary albumin for a random specimen? | show 🗑
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show | less than 10mg/dL or 100 mg per 24 hours.
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Even though albumin is present in high concentrations in the plasma, why is the content low in the urine? | show 🗑
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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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show | it's caused by conditions affecting the plasma prior to its reaching the kidney and, therefore, is not indicative of actual renal disease.
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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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How do you test for Orthostatic proteinuria and what results would indicate that patient has this? | show 🗑
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Because reagent strips detect albumin, would prerenal proteinuria usually be discovered in a routine urinalysis? | show 🗑
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What do Bence Jones protein excretion indicate? | show 🗑
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What is multiple myeloma? | show 🗑
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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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What happens when you have a damaged glomerular membrane? | show 🗑
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What are some of the causes of glomerular proteinuria? | show 🗑
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show | ranges from slightly above normal to 4g/day.
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show | because the normally filtered albumin can no longer be reabsorbed.
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What are some of the causes of tubular dysfunction? | show 🗑
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show | No
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show | Because several benign causes of renal proteinuria exist, which is usually transient and can be produced by conditions such as strenuous exercise, high fever, dehydration, and exposure to cold.
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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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What other condition can be associated with if the patient has microalbumin in their urine? | show 🗑
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What type of urine sample if required to detect microalbumin? | show 🗑
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show | Using quantitiatve procedures results are reported in mg of albumin/24 hrs or as the albumin excretion (AER) in ug/min.
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show | 30 to 300 mg of albumin is excreted in 24 hrs or the AER is 20-200 ug/min.
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What does postrenal proteinuria mean? | show 🗑
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What are some of the causes of protein in postrenal proteinuria? | show 🗑
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show | Indicators change color in the presence of protein at a constant pH. Strong buffer, in protein pad, resists any change in urine pH. Therefor if protein is present, albumin will effect the color change BUT the pH in the pad does not change.
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How are the results read for protein? | show 🗑
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How are trace values considered? | show 🗑
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show | Bacteria can increase the urinary pH,if the pH is >9, the buffer in the protein pad is OVERWHELMED. The color change that occurs is due to the pH change in the pad caused by the bacterial breakdown of urea; not b/c of presence of proteinuria.
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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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show | Sulfosalicyclic acid precipitation assay(SSA)
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Explain SSA | show 🗑
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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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show | The first morning sample does NOT always represent a fasting sample because glucose from the evening meal may remain in the bladder.
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show | Checking for diabetes mellitus, gestational diabetes, stress hormones(gluconeogenesis) Advance renal disease(glucose isn't reabsorbing back), Faconi's syndrome(overflow of glucose), and hormones that cause glycongenolysis.
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show | Enzymatic(glucose oxidase or hexokinase) and Copper reduction?
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What does glucose oxidase test for? | show 🗑
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What do the reagent strip employ(for glucose oxidase) to test for glucose? | show 🗑
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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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show | the container being contaminated with peroxide or strong oxidizing detergents.
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How do false negatives reactions occur with the glucose oxidase test? | show 🗑
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How does absorbic acid cause a false negative? | show 🗑
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What is the copper reduction test? | show 🗑
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Explain the clinitest. | show 🗑
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show | The color produced passes through the orange/red stage and returns to a green-brown color
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Compare glucose oxidase and clinitest | show 🗑
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What is the most significant discrepancy with the glucose oxidase and clinitest? | show 🗑
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What are the false positives for the copper reduction method? | show 🗑
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show | none because it's a rare finding.
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Why is galactose in urine an important finding? | show 🗑
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