Chemical Dipsticks: pH & Protein

00:00 Let's go to the pH now, another component that's important determined by diet. Remember if it's uric acid, which is what, what does that mean to you biochemically? what uric acid means? Breakdown of? Purines Good you've heard of purine salvage pathway and uric acid may then accumulate in the urine how often do cells break down? cells break down all the time Do cells contain DNA? Of course they do and what is DNA composed of? Purines and Pyrimidines You break down your purine, what are you gonna release? Uric Acid And if it ends up in your urine, what's your pH? decreased. Correct? Uric acid - decreased urine pH, keep that in mind Now, determined by diet and acid-base status of the patient I'll just give you one, for example Pure vegan, who's your patient here? In the United States, maybe perhaps more along the lines of Californians and such? Doesn't have to be, but just saying in terms of vegan communities and these individuals are doing what? Well they're not consuming any meat, there's a difference between vegetarians and vegans vegans don't even consume dairy products Now, that becomes a big deal for us pathologically, because vegans in developed countries might actually develop over a number of years, known as B12 deficiency There are certain things that you want to keep in mind But for now, pure vegan usually have what kind of pH? alkaline.

01:28 The citrate is converted into bicarbonate. What does bicarbonate mean to you? An increased pH - alkaline.

01:33 What about meat eaters, carnivores, they usually have acid pH because of organic acids in the meat.

01:39 Simple example of diet and as to how they will influence the pH of the urine what if it was alkaline? this would be ammonia perhaps? So here if you're thinking about urinary tract infection and you have an alkaline organism such as Proteus, then please understand that some of these urease is then going to take your urea and convert them to ammonia what is that going to do with your pH? It will then alkalinize it Let's move on to protein being a component of your urinalysis detects albumin, big time importance in differentiation from globulins now globulins perhaps may or may not get through, let's not focus our time on that let's focus on albumin.

02:24 let's say for example that you have diabetic nephropathy and we'll talk further about this later on and one of the first signs that you'll find with diabetic nephropathy is going to be that you find microalbuminuria and you'll use a specific dipstick so that you can find this and that to you should mean automatic glomerular damage now there's something called sulfosalicylic acid and this is going to be pay attention here, SSA, least keep in mind "salicylic acid" salicylic acid which is part of SSA test specifically for protein what kind of protein? You've heard of BJ proteins (Bence Jones proteins), have you not? as soon as your Bence Jones proteins, what are you thinking about immunoglobulins light chains What's that mean to you? kappa, lambda, right? What does that mean to you? you know, you've done immunology. if you haven't, you will and when you do you've dissected the anatomy of an immunoglobulin and immunoglobulins are made up of heavy chains and light chains you've heard of constant and variable regions Now, forget about all that, let's keep it simple pathology the light chains are kappa lambda