Bile salts in the urine are analyzed by?

Appeared in: CGHS SSC - 2018

Explanation

Hay's test is specifically used to detect the presence of bile salts in a urine sample.
The principle is based on the property of bile salts to act as surfactants, which lower the surface tension of liquids.
When finely powdered sulfur is sprinkled on the surface of normal urine, it floats.
In the presence of bile salts, the surface tension is reduced, and the sulfur powder sinks, indicating a positive test.

Option A: Benedict's test is used to detect the presence of reducing substances, most commonly glucose, not bile salts.
Option B: Smith's test is designed to detect bile pigments (specifically bilirubin) in the urine, not bile salts.
Option C: Rothera's test is used to detect the presence of ketone bodies (acetoacetate and acetone) in the urine.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Urine analysis for the detection of bile salts as background academic context rather than a clinical decision trigger.
The presence of bile salts in urine (choluria) is a significant finding that points towards obstructive or cholestatic jaundice.
It indicates that bile is not flowing correctly from the liver to the intestine and is instead regurgitating into the bloodstream and being excreted by the kidneys.
This finding, often accompanied by dark urine (from bile pigments), pale stools, and itching (pruritus), helps differentiate obstructive jaundice from other types like hemolytic jaundice, where bile salts are absent in urine.

How to Approach the Question

This is a factual recall question that tests your knowledge of specific biochemical urine tests.
First, identify the key substance mentioned in the question stem: 'Bile salts'.
Next, systematically review the purpose of each test listed in the options.
Recall that Benedict's test is for reducing sugars (like glucose).
Remember that Rothera's test is for ketone bodies.
Differentiate between Smith's test (for bile pigments like bilirubin) and Hay's test.

Concept Tested & Keywords

QaYLr9y5UZBYINcHJ_69Yn

E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart A (pp 1-239 of 478) p. 30-32

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 3 (515-969) p. 77-79

Practise the full CGHS SSC - 2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.