Urine Chemistry
When testing for the Urine pH and old Urine can cause the pH to be falsely _________
Alkaline
The Ketone body found in highest % is
Beta-hydroxybutyric acid ( 78%)
** The dipstick and Acetest only react with Acetoacetic acid and Acetone not B-Hydroxybuterate.. but ok because if any are present the others are also
This crystal is found in acidic urine and is typically normal but can be seen increased in gout
Show Pic 1
Uric Acid
The matrix of casts consist of
Tamm Horsfall / Uromodulin
The functional unit of the kidney
For Urine Dipstick testing the method used for Protein determination is __________
Protein Error of Indicators
Both the strip and tablet ( Acetest ) methods for Ketones use _____________ and a positive result turns _________
Nitroprusside , Purple
This crystal is normally found in alkaline urine and often seen in old urine
show pic 2
Ammonium biurate
Name the following cast and in what state do you usually see them?
Picture # 6
RBC Cast / acute glomerular disease
The initial glomerular filtrate has the same composition as plasma except for _________
very little protein
Highly alkaline urine will cause a false __________ test when using the SSA test for protein
False Negative *** This is the opposite of the dipstick method which would be a false positive
When plasma Hemoglobin is increased and haptoglobin is saturated you can see hemosiderin , which are iron deposits . The hemosiderin can be seen when stained with_________
Prussian Blue
This is an abnormal crystal found in liver disease
See picture 3
Tyrosine
This type of cast is seen with end stage renal disease
See picture 7
Waxy cast
patients with diabetes typically have a higher urine output. this is referred to as _______
polyuria
The method used for glucose determination on the dipstick is ______________
Glucose oxidase method
The strips for Blood use the peroxidase activity of Hgb , with this method what else can cause a positive result?
Oxidizers ( bleach , peroxide, iodine)
Myoglobin
This is an abnormal crystal seen in liver disease
Bilirubin
What is this
picture 8
yeast
The normal adult blood volume that passes through the kidneys at a rate of
1200 ml/min
The Clinitest tablets uses the Copper reduction method to test for glucose. If you get a negative dipstick glucose result and a positive Clinitest result what can you conclude?
The reducing substance present is not glucose
( could be galactose, fructose , pentose )
** also note you can get a positive dipstick and negative clinitest if glucose is >100 but <250
Bilirubin method for dipsticks uses what reagent
diazo
** so does the confirmation Ictotest - Ictotest is more sensitive
This is an abnormal crystal most likely seen in refrigerated urine and likely seen along with fatty casts
Picture 5
Cholesterol
What is this
Picture 9
trichomonas vaginalis
In a person with normally functioning kidneys , glucosuria occurs when serum glucose concentration exceeds
180 mg/dl