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Analysis of Urine and Body Fluids > MIDTERM LEC: CHEMICAL EXAMINATION > Flashcards

MIDTERM LEC: CHEMICAL EXAMINATION Flashcards

1
Q
  • composed of several chemical-impregnated
  • absorbent pads attached to a plastic
  • color producing chemical reaction takes place when absorbent pad comes in contact with urine
  • reactions are interpreted by comparing the color produced on the pad with a chart supplied by the manufacturer
A

REAGENT STRIP

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2
Q

TYPES OF REAGENT STRIP

A
  1. MULTISTIX
  2. CHEMSTRIP
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3
Q

(Siemens Healthcare Diagnostics, Deerfield, IN)

A

MULTISTIX

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4
Q

(Roche Diagnostics, Indianapolis, IN)

A

CHEMSTRIP

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5
Q

PROCEDURE:

A
  1. Dip the reagent strip completely in the urine
  2. Remove excess urine from the strip by running the edge of the strip on the container when withdrawing it from the specimen
  3. Blot the strip horizontally on an absorbent medium pad
  4. Wait for the specified length of time for reactions to take place
  5. Compare the colored reactions against the
    manufacturer’s chart using a good light source
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6
Q

ERRORS CAUSED BY IMPROPER TECHNIQUE

A

✓ Formed elements such as RBC & WBC sink to the bottom of the specimen therefore it will be undetected in an unmixed specimen
✓ Allowing the strip to remain in the urine for an extended period may cause leaching of reagents from the pads
✓ Excess urine remaining on the strip after its removal from the specimen can produce over-run between chemicals on adjacent pads, producing distortion of the colors
✓ The timing of reactions should be followed; when precise timing can’t be achieved, the reactions
✓ should be read between 60 & 120 second
✓ A good light source is essential for accurate
interpretation of color reactions
✓ The strip must be held close to the color chart without actually being placed on the chart
✓ Reagent strips & color charts from different
manufacturers are not interchangeable
✓ Specimens that have been refrigerated must allow to return to room temperature prior to reagent strip testing

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7
Q

HANDLING & STORAGE OF REAGENT STRIP

A

✓ Reagent strips must be protected from deterioration caused by moisture, heat, light, & volatile chemicals
✓ Reagents are packed in opaque containers with a desiccant to protect them from light & moisture
✓ Strips are removed just prior to testing, & the bottle is tightly resealed immediately
✓ Bottle should not be open in the presence of volatile fumes
✓ Reagents should be stored at room temperature but never refrigerated
✓ All bottles are stamped with an expiration date that represents the functional life expectancy of the reagent strips therefore it must not be used past the expiration date
✓ Care must be taken not to touch the chemical pads when removing the strips
✓ A visual inspection should be done each time a strip is used to detect deterioration even though the strips may still be within the expiration date

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8
Q

QUALITY CONTROL OF REAGENTS STRIPS

A

✓ Reagent strips must be checked with both positive & negative controls a minimum of once every 24hrs, usually every start of the shift
✓ Testing is also performed when a new bottle is opened, questionable results are obtained, or when there is concern about the integrity of the reagent strip

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9
Q

AUTOMATED REAGENT STRIP READERS

A

PRINCIPLE: REFLECTANCE PHOTOMETRY

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10
Q

light reflection from the test pads decreases in
proportion to the intensity of color produced by the concentration of the test substance

A

PRINCIPLE: REFLECTANCE PHOTOMETRY

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11
Q

The most common sugar in the urine

A

GLUCOSE

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12
Q

should not be detected in normal urine

A

GLUCOSE

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13
Q

Small amounts when present are detected by any sensitive test

A

GLUCOSE

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14
Q

GLUCOSE RENAL THRESHOLD:

A

160-180 mg/dl

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15
Q

commonly used as a screening test for possible DM or to monitor control of blood glucose in diabetes

A

GLUCOSE

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16
Q

Other Sugars in Urine
* Identified by TLC:

A
  1. FRUCTOSE (Levulose)
  2. GALACTOSE
  3. LACTOSE (Glu+Gal)
  4. PENTOSE
  5. SUCROSE (NON-REDUCING SUGAR)
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17
Q

increase fruits, honey, syrup,
fructose intolerance

A

FRUCTOSE(Levulose)

18
Q

increase in infants with galactosemia

A

GALACTOSE

19
Q

increase during pregnancy, lactation, strict milk diet, lactose intolerance

A

LACTOSE (Glu+Gal)

20
Q

– increase in benign essential pentosuria (Xylulose, Arabinose)

A

PENTOSE

21
Q

increase in intestinal disorders, sucrose intolerance

A

SUCROSE (non-reducing sugar)

22
Q

HYPERGLYCEMIA-ASSOCIATED

blood glucose:
urine glucose:

A

INCREASE; INCREASE

23
Q

RENAL-ASSOCIATED

blood glucose:
urine glucose:

A

NORMAL; INCREASE

24
Q

HYPERGLYCEMIA-ASSOCIATED CAUSES:

A
  • DM
  • PANCREATITIS
  • ACROMEGALY
  • CUSHING’S SYNDROME
  • HYPERTHYROIDISM
  • PHEOCHROMOCYTOMA
  • STRESS
  • GESTATIONAL DIABETES
25
Q

RENAL-ASSOCIATED CAUSES:

A
  • FANCONI SYNDROME
  • ADVANCED RENAL DISEASE
  • OSTEOMALACIA
  • PREGNANCY
26
Q

GLUCOSE REACTION TIME:

A

30 SECONDS

27
Q

GLUCOSE PRINCIPLE:

A

DOUBLE SEQUENTIAL ENZYME
REACTION

28
Q

REAGENTS FOR GLUCOSE
MULTISTIX:

A

Glucose oxidase and Peroxidase

29
Q

REAGENTS FOR GLUCOSE
MULTISTIX
CHROMOGEN:

A

Potassium Iodide →
(𝑏𝑙𝑢𝑒 𝑡𝑜 𝑔𝑟𝑒𝑒𝑛 𝑡𝑜 𝑏𝑟𝑜𝑤𝑛)

30
Q

REAGENTS FOR GLUCOSE
CHEMSTRIP:

A

Glucose oxidase and Peroxidase

31
Q

REAGENTS FOR GLUCOSE
CHEMSTRIP
CHROMOGEN:

A

Tetramethylbenzidine →
(𝑦𝑒𝑙𝑙𝑜𝑤 𝑡𝑜 𝑔𝑟𝑒𝑒𝑛)

32
Q

REAGENTSTRIP FOR GLUCOSE
FALSE-POSITIVE:

A

Contamination by oxidizing

33
Q

REAGENTSTRIP FOR GLUCOSE
FALSE – NEGATIVE:

A

✓ high levels of ascorbic acid
✓ high levels of ketones
✓ high specific gravity
✓ low temperatures
✓ improperly preserved specimens

34
Q

COPPERREDUCTION TEST (CLINITEST (TABLET)/BENEDICT’S TEST) PRINCIPLE:

A

Copper Reduction

35
Q

ability of the glucose and other substances to
reduce copper sulfate to cuprous oxide in the presence of alkali and heat.

A

COPPERREDUCTION TEST (CLINITEST (TABLET)/BENEDICT’S TEST)

36
Q

color change progressing from negative blue
through green, yellow, and orange/red occurs when reaction takes place

A

COPPERREDUCTION TEST (CLINITEST (TABLET)/BENEDICT’S TEST)

37
Q
  • NOTE: Observe the reaction closely , because at high glucose level “ pass through” phenomenon may occur.
A

COPPERREDUCTION TEST (CLINITEST (TABLET)/BENEDICT’S TEST)

38
Q

COPPERREDUCTION TEST (CLINITEST (TABLET)/BENEDICT’S TEST)
PREVENT PASS THROUGH :

A

use 2 gtts urine

39
Q

FALSE-POSITIVE : Reducing agents

A
  • Clinitest tablet test follow the same principle with Benedict’s Test
  • The classic Benedict’s solution was developed in 1908 and contained copper sulfate, sodium carbonate, and sodium citrate buffer
40
Q
A

Analysis of Urine and Body Fluids (4 decks)

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