AUBF (reagent strip) Flashcards
reading time: BILIRUBIN
multistix: 30s
chemstrip: 60s
Principle: BILIRUBIN
Diazo reaction
Multistix sensitivity: BILIRUBIN
0.4-0.8 mg/dL
Chemstrip sensitivity: BILIRUBIN
0.5 mg/dL
Multistix reagent: BILIRUBIN
2,4 - Dichloroaniline diazoniun salt
Chemstrip reagent: BILIRUBIN
2,6 - Dichlorobenzene diazoniun salt
BILIRUBIN RXN
bilirubin glucuronide + diazonium salt
—(acid)—> azodye
dichloroaniline end-color: tan
dichlorobenzene end-color: pink-violet
type of bilirubin that appears in urine
conjugated
Associated with BILIRUBINURIA
hepatitis
cirrhosis
gallstones
carcinoma
correlation to BILIRUBIN
urobilinogen
false (+) sources of BILIRUBIN
• pigmented spx
• Phenazopyridine (gives yellow-orange color)
• Lodine metabolites
• Indican (intestinal disorder)
False (–) BILIRUBIN
• Light exposure (photo oxidized to biliverdin that does not react with Diazo)
• Ascorbic acid (>25 mg/dL)
• Inc. urine concentration
• Old spx
• Bilirubin hydrolysis to diglucoronide —> free bilirubin
• Nitrite (attaches to diazonium salt)
Confirmatory test for Bilirubin
Ictotest tablets
Result (+): blue —> purple color
screening test for DM
glucose chem strip
elevated glucose level
hyperglycemia
glucose renal threshold
160-180 mg/dL
(blood level at which tubular reabsorption stops)
fluctuating blood glucose level on a NONFASTING normal person after a meal
glycosuria
fasting spx required
2nd morning specimen
hyperglycemia during pregnancy
gestational diabetes
glycosuria in absence of hyperglycemia during malfunction in reabsorption of glucose by renal tubules
renal glycosuria
GLUCOSE reading time
30s
GLUCOSE principle
Double sequential enzymatic rxn
(glucose oxidase, peroxidase)
Glucose multistix sensitivity
75-125 mg/dL
Glucose Chemstrip sensitivity
40 mg/dL
reagents for GLU multistix
end color
glu oxidase, peroxidase
POTASSIUM IODIDE (green to brown)
reagents for GLU chemstrip
end color
glu oxidase, peroxidase
TETRAMETHYLBENZIDINE (yellow to green)
other examples of chromogens for glu rxn
clinistix: O-toluidine (pink—> purple)
aminopropyl-carbazol (yellow —> orange-brown)
correlation to GLUCOSE
ketone
protein
false (+) GLUCOSE
• oxidizing agents (contaminated cont with peroxide)
• detergents
false (–) GLUCOSE
• Increased Ascorbic acid, SG, Ketones
• Decreased temp.
• Improperly preserved spx standing at RT
remedy for increased ascorbic acid causing false neg GLUCOSE
iodate
represents 3 intermediate products of fat metabolism
ketones
Ketones reading time
40s
Ketones principle
Sodium nitroprusside (nitroferricyanide) rxn
Ketones multistix sensitivity
5-10 mg/dL (acetoacetic acid)
Ketones chemstrip sensitivity
9 mg/dL (acetoacetic acid)
70 mg/dL (acetone)
Ketones multistix reagent
Sodium nitroprusside (detects acetoacetic acid)
Ketones chemstrip reagent
Sodium nitroprusside + GLYCINE (detects acetoacetic acid + acetone)
early indicator of insufficient dosage in type 1 diabetes
ketones
correlated to ketones
glucose
false (+) KETONES
• Levodopa
• Sulfhydril medications (Mercaptoethane sulfonate sodium [MESNA] and Captopril)
• Phthalein dyes
• Pigmented spx
• Improperly timed reading
False (–) KETONES
Improperly preserved spx causing volatilization of acetone and acetoacetic acid
SG reading time
45s
SG principle
pKa (dissociation constant) changes of polyelectrolyte in ALKALINE medium
SG sensitivity
1.000-1.030
color if SG is 1.000
blue (alk)
color if SG is 1.030
yellow (acid)
intermediate color if SG is betw. 1.000-1.030
shades of GREEN
SG Multistix reagent
Poly (methylvinylether/maleic anhydride)
Indicator: bromthymol blue
SG Chemstrip reagent
Ethyleneglycol diaminoethylether tetraacetic acid
Indicator: bromthymol blue
T/F
Spx with pH of 6.5 or higher have decreased readings caused by interference with bromthymol blue
T
False (+) SG
increased PROTEIN conc.
False (–) SG
highly alkaline urine (equal or > pH 6.5)
what is recommended if the pH of urine is equal or > pH 6.5 that may cause decreased SG readings?
add 0.005 to SG
reagent for pH
Methyl red
Bromthymol blue
pH MULTISTIX sensitivity
5.0 to 8.5 in 0.5 increments
pH CHEMSTRIP sensitivity
5.0 to 9.0 in 1.0 increments
Sources of error/ interference for pH
No known interfering substances
Run-over from adjacent pads (close to
protein pad - highly acidic)
Old specimens
pH is correlated with these tests
Nitrite
Leukocytes
Microscopic
MULTISTIX reagent for protein
Tetrabromophenol blue
CHEMSTRIP reagent for protein
3’,3’’,5’,5’’-tetrachlorophenol
3,4,5,6-tetrabromosulfophthalein
Protein MULTISTIX sensitivity
15 to 30 mg/dL albumin
Protein CHEMSTRIP sensitivity
6 mg/dL albumin
False (+) protein
Highly buffered interference alkaline urine
Pigmented specimens, phenazopyridine
Quaternary ammonium compounds (detergents)
Antiseptics, chlorhexidine
Loss of buffer from prolonged exposure of the strip to the specimen reagent
High specific gravity
False (-) protein
Proteins other than albumin
Microalbuminuria
Tests correlated with protein
Nitrite
Leukocytes
Microscopic
MULTISTIX reagent for glucose
Glucose oxidase
Peroxidase
Potassium iodide
CHEMSTRIP reagent for glucose
Glucose oxidase
Peroxidase
Tetramethylbenzidine
MULTISTIX reagent for blood
Diisopropylbenzene dihydroperoxide
3,3’,5,5’- tetramethylbenzidine
CHEMSTRIP reagent for blood
Dimethyldihydroperoxy-hexane
Tetramethylbenzidine
Parameters affected by ascorbic acid causing FALSE NEG
Blood
Bilirubin
Leukocytes
Nitrite
Glucose
Tests correlated with Blood
Protein
Microscopic
MULTISTIX reagent for urobilinogen
p-dimethylaminobenzaldehyde
CHEMSTRIP reagent for urobilinogen
4-methoxybenzene-diazonium- tetrafluoroborate
Urobilinogen MULTISTIX sensitivity
0.2 mg/dL urobilinogen
Urobilinogen CHEMSTRIP sensitivity
0.4 mg/dL urobilinogen
MULTISTIX reagent for nitrite
p-arsanilic acid
Tetrahydrobenzo(h)-quinolin-3-ol
CHEMSTRIP reagent for nitrite
Sulfanilamide, hydroxytetrahydro benzoquinoline
MULTISTIX reagent for LE
Derivatized pyrrole amino acid ester
Diazonium salt
CHEMSTRIP reagent for LE
Indoxylcarbonic acid ester
Diazonium salt
reagent for Ascorbic acid
2,6-dichlorophenolindopheno
pH principle
double indicator system of methyl red and bromothymol blue
protein principle
protein (sorensen’s) error of indicator
blood principle
pseudoperoxidase activity of Hgb
urobilinogen principle
ehrlich’s rxn
nitrite principle
greiss rxn
LE principle
LE
ascorbic acid principle
reduces a dye in the pad, causing color change BLUE —> ORANGE
blood stip results
speckled blue: ?
uniform blue: ?
speckled blue: intact RBC (hematuria) - cloudy red urine
uniform blue: hgb and myoglobin (hemoglobinuria) - clear red urine